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July 24, 2006

Under The Knife

Weekends--Your Source for Pain Proliferation?

by Will Carroll

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Weekends are always interesting. There are always a couple of days' worth of injuries, and the flood of Sunday notes columns that help shake out things from the baseball bushes. My columns end up longer, I watch more baseball, and at the same time, try to step away as much as possible. My Sidekick (II, not III - damned T Mobile) keeps me 'in the game' whether I like it or not. Add in the trading deadline's approach and this wasn't exactly a normal weekend, though it occasionally seemed like the calm before a storm. I'll be on the road all week, checking in from the road. Let's hear it for in-room high-speed and cell phones.

Powered by Delta Airlines in hopes that they don't lose my bag, on to the injuries:

  • Broken bones heal. That's one of the medhead tenets that helps make injury analysis a bit more than an educated guess. In almost every case, you'd rather have a broken bone than a torn ligament or tendon. Bones heal and have the advantage of things like casts and splints, Forteo and electric stimulators, and other advanced techniques. Ligaments have Jim Andrews and Neil ElAttrache's imagination. What makes this complex is that the body isn't discreet; bones don't often break without the involvement of some other structure. A broken wrist will often involve ligaments, tendons, or nerves. That is what the Cubs are dealing with now: Derrek Lee made it back from his broken wrist on a normal schedule, and was actually a bit behind where I was expecting based on the available information. The injury is clearly still bothering Lee at the plate, enough to keep him out of the lineup three out of five days last week. Given that he played every day before that since his return, that implies that there's a complication that occurred and is problematic now that wasn't when he initially came back from the DL. Looking at Lee's lack of power and increased strikeouts, the best match for his symptomology is some tendonitis in the wrist. This is fixable and not that serious, but the Cubs' seeming inability to control it is the most worrisome aspect of this situation. Combined with the other Cub medical woes, one has to wonder if the medical staff is to blame. Luck only goes so far. One reader asked this weekend if he thought Lee's benching was Dusty Baker's way of saying that his team still wasn't healthy. I think Kerry Wood, Mark Prior, and now Sean Marshall playing injured does that far better than faking something with Lee. Lee's still injured, and more and more, he's the best symbol of the Cubs season--broken.

  • Getting someone back is often said to be as good as a deadline deal, but not always. The Rangers and Brewers would have much rather had Adam Eaton and Ben Sheets all season long, rather than saving them for the stretch run. Often, a mid-level #3 starter will be more valuable over the course of a season, making all his starts, than a short-term ace will be. Something is better than nothing, of course, so both teams are glad to see their big guys back. Sheets is more clearly the rotation's top gun in Milwaukee, and his ability to come out strong after missing most of the last year with a shoulder injury will determine the Brewers' course at the deadline. Eaton isn't the staff ace in Texas, but is the 'make or break' pitcher in the Rangers' quest for the AL West. Both return this Tuesday, and fans of each team will just have to hold their breath until then.

  • The Padres have a more interesting situation. At the start of the year, I was shocked to see Jake Peavy on the cover of BP. Sure, everyone loved him, but not many people realized how serious the shoulder injury Peavy had was going to be. I tried to explain that he was suffering from a similar injury to the one that had sidelined Ben Sheets and Bartolo Colon. Peavy's toughness and lower natural arm slot helped him pitch, but his results so far show that he's been missing the mark more than hitting it. Less control, less velocity, and less motion is the nightmare trifecta for any pitcher, let alone one expected to contend for a Cy Young. At 26, Peavy's health has him at something of a crossroads career-wise. Shoulder injuries don't portend long, effective careers without summoning up visions of Frank Tanana. At least there's better news for Padres fans when it comes to Chris Young: in addition to no dead arm, Young made it through a test of his injured push foot. He'll start as scheduled on Monday.

  • It was good news that Pedro Martinez made it through his planned 80-pitch simulated game without a problem. It was better that he came back on Sunday without anything more than normal soreness. That's the best indicator that his arm, at least, is ready. Unfortunately, there's no such indicator on how well his injured hip is going to hold up. Even after a month's rest, my best Mets sources still aren't sure how Martinez will handle things. They acknowledge that he'll be handled even more carefully, slipped out of games when possible, and have starts skipped or delayed to buy him extra rest. They'll need to do the same with Paul Lo Duca. His notorious fade is often accompanied by injury and sure enough, LoDuca's hidden a hand injury since before the All-Star break. LoDuca is hinting that he'll need surgery in the off-season, so this is no small matter. He'll test the Mets medical staff as well as the field staff as they try to keep him effective down the stretch.

  • The Braves' surge has gone uninterrupted by injury. Chipper Jones is out again, resting up this week to make sure that his oblique doesn't become a bigger problem, but he'll be lying in wait for the Mets over the weekend. The Braves did get Marcus Giles back. His thumb is still a problem, and will require constant treatment and monitoring. The Braves have shown a great deal of confidence in Wilson Betemit, and with Bobby Cox, having confidence means a lot. Remember, this guy kept Rafael Belliard around for years just because he was one of 'his guys.' Expect Giles to lose some at-bats as Betemit gets four or five starts so that Jones and Giles get as many rest days through August as he can buy them.

  • The Blue Jays hope to have less drama in their clubhouse next week than they did last week. They'll have Alexis Rios back around August 1, a big help assuming he doesn't lose too much function after nearly a month off with a tough staph infection. They'll also have to adjust the roster, using Troy Glaus at DH a bit more to help protect his bum knee. The patellar tendonitis that he's dealing with isn't bad, and would get better with rest, but there's no way to rest the slugger and stay in contention, so DHing is the next best thing.

  • People hang on to the idea that old players get hurt more often. This is true to some extent, but above the age of 35, there's a survivor effect. On the whole, old players don't get hurt more than young players, but they do take longer to heal. All that said, age has little to do with why the Giants shouldn't have been expecting to stay healthy this season. Forget age--having Moises Alou, Ray Durham>, and Barry Bonds on your roster augured problems with chronic injuries. Alou has had the worst of the bunch, with a hamstring with a lingering strain that never quite gets back to full strength before Alou convinces everyone that he's ready to go. Given the slim margin that the Giants have, keeping Alou on the field is a balancing act between effectiveness and attendance. Bonds is dealing with the normal inflammation and pain that goes with degenerating knees. At this stage, standing and running are far more traumatic for him than even getting hit by a pitch on his leg--trauma heals.

  • Most Americans know hyperbaric chambers as that weird thing that Michael Jackson was said to sleep it back at Neverland. They have a valid place in sports medicine despite the odd introduction to popular consciousness. The Dodgers used one to try and keep J.D. Drew's various hurts from swelling. While there's not much previous mention of its use in baseball, the Rockies were known to use it a couple years back in hopes of helping players acclimate themselves before road trips, and Casey Kotchman was using hyperbaric treatments earlier this year in association with his mononucleosis. I won't pretend to understand the therapy, but Drew was back out on the field Sunday, so let's tip our cap to the chamber.

  • The Twins pitchers seem to have an odd skill: they pitch better when hurt. This begs the question--could Johan Santana and Francisco Liriano benefit from a small injury, and then, is it even possible for that pair to be any better than they already are? More seriously, Carlos Silva pitched well throughout 2005 with a minor knee problem, and now Brad Radke is carrying on the tradition, pitching very well despite a shoulder injury that is alternately described as a torn rotator cuff and a torn labrum. The symptomology is much more in line with the latter, being only occasionally problematic, depending on the internal inflammation.

  • Mark Mulder is throwing again and that's a positive. What he's saying--that he's dealing with a torn rotator cuff--isn't. Quotes this week are a bit cryptic, with someone saying that Mulder needs to have his mechanics rebuilt. I think that's a bit twisted by context and that the someone who said it--either Mulder or pitching coach Dave Duncan--is trying to say that Mulder needs to get back to his normal arm slot rather than adjusting due to the pain and impingement in his pitching shoulder. Rotator cuffs remain a major problem--check this week's BP Radio for a better explanation from one of baseball's top docs--and having his hurt makes Mulder's foray into free agency particularly dicey. Teams that really understand the situations of former aces like Mulder and Kerry Wood will enjoy a big advantage in Orlando at the winter meetings.

  • Quick Cuts: Expect Hideki Matsui to take BP late this week. Gary Sheffield is about five weeks behind him… Lance Berkman left Sunday's game with a mild groin strain. He's not expected to miss any time, though he'll play first base rather than the outfield… Andruw Jones missed Sunday's game with back spasms. It's not considered serious… Placido Polanco is glad that Esteban Loaiza's only throwing a mid-80's fastball these days after taking a fastball off the jaw on Saturday. Happily for him and the Tigers, the jaw is not broken… Paul Wilson is done for the season after his latest rehab outing. The question now is if he's just plain done… Kent Mercker hits the DL with an inflamed elbow. That alone makes the Majewski-Bray deal seem slightly better. Only slightly, though… Kelvim Escobar is "real sore" after his start. Sell.

    Thanks to all the readers that asked why the most recent BP Radio was not posted on Saturday. We had some technical problems but we hope to have it up on the site sometime Monday. I apologize and hope that you'll check out what Scott Merkin (MLB.com's White Sox reporter), Gene Carney, and Dr. Neil ElAttrache had to say.

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