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August 9, 2006

Under The Knife

Liriano

by Will Carroll

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The intro is often the last thing I write when I'm putting together UTK. Today, I had no question on what it would be. Despite being a football piece, this is one of the best written sports medicine pieces I've ever seen. If you're not amazed and moved at the end of it, you just don't get sports. Kudos to Curtis Eichelberger for a great piece of work.

Powered by Storm Large, on to the injuries:

  • I'll start with a reminder before getting into Francisco Liriano. When you don't see me comment on someone--as I didn't with Liriano--the reason is normally that I don't have additional information beyond what you can already find elsewhere. The issues were pretty well covered in various outlets and, combined with a near-lockdown by the Twins, I had nothing to add. Given a full day to work the phones, I've been able to get more information.

    Liriano was clearly having trouble with his forearm during his start. Several readers pointed out that Liriano was extending his hand after throwing his slider, a move that would take pressure off the flexor tendon. Given his previous problems with the forearm and radiating pain into the elbow, the most likely condition is flexor tendonitis or some degree of tendon strain. This is the same injury that we've seen in several pitchers, most notably Victor Zambrano, Brandon Webb, and John Patterson. You'll note that with two of these, the initial diagnosis was not what the doctors ended up with--Zambrano needed Tommy John surgery while Patterson needed exploratory surgery that showed neuritis as well as tendonitis. It's important to note that Liriano has not yet had an MRI. The team is waiting until they return to Minnesota, giving the elbow time to rest, reducing inflammation that could confuse the imaging. There is not yet enough information to see if this is more like Webb's situation or more like Zambrano's, though. The result could mean a lot to the franchise, not just in this year's Wild Card chase, but also in the next couple seasons where many expected Liriano and Johan Santana to be co-aces.

  • "Is Rich Harden made of sugar?" one loyal reader asked. The news came out today that Harden is not only dealing with an elbow sprain, but he also managed to somehow sprain his ankle during his rehab. Susan Slusser discussed the problem yesterday on Charley Steiner's XM show, mentioning that the A's are often less than forthcoming about injuries. Harden's ankle sprain is interesting since multiple reports note that Harden will be cleared to begin throwing once his ankle has healed, echoing Kerry Wood at the start of the season. (Wood's injury was to his knee, but the reasoning of not allowing the injured pitcher to have activity that might change his mechanics to compensate for the secondary injury is still there.) All indications are that Harden is still having trouble with the elbow. As delays mount, the chances of Harden's return get smaller.

  • Every time someone tries to bury the Braves, they do something that somehow keeps them alive. It wouldn't surprise me if they continued to stay alive in the Wild Card race, even after losing Horacio Ramirez for the season. Ramirez left his last start with a torn ligament in the middle finger of his pitching hand. This is a similar injury to the one that shelved Adam Eaton for the first half of the season. Ramirez won't need surgery and should be ready for next season. Some are still holding out hope that Ramirez will be able to return, but since all pitches exit the hand off the middle finger, Ramirez would have little or no ability to get a snap or impart any spin on his pitches, reducing velocity, movement, and command. I don't know of any pitcher who can survive with that handicap.

  • I won't get into the politics, mechanics, or gossip of the Gary Majewski drama. John Fay did a great job explaining the entire situation in a pair of articles. Hiding injuries is nothing new, though it's certainly an interesting situation that Majewski sounds complicit in the hiding of the condition with his new team. Majewski's injury--tendonitis and impingement in his pitching shoulder--is significant enough to send him to the DL, but it's not serious. He should be back at or near the minimum, though his response to treatment will determine just how long he's out. The most interesting thing to medheads should be just how little is done on the medical front prior to a trade.

  • Not all of the pitching news is bad. Ben Sheets may not even miss a start after he left his last outing early. Cramping in his pectoral muscle near his shoulder was certainly scary, but not something that should keep him out. Once again, the problem is more related to how Sheets feels with his adjusted musculature than it does with an actual, chronic physical problem. The Devil Rays also got some good news with Scott Kazmir. Their ace came out of a side session with no problems and will face the A's on Friday.

  • Yes, position players get a bit of attention in today's UTK. Casey Blake looked to be an MVP contender earlier this season--if you squinted and didn't look real hard--and will put up career highs in OBP, SLG, and VORP. Injuries have derailed his season, though; his latest, a Grade 2+ ankle sprain, may end his season altogether. At best, he'll make it back in mid-September, though there are examples of players who have crushed the normal timetable. Blake hasn't shown the ability to return quicker than expected in the past and the Indians are out of contention, so I'm not sure what the value would be in his return. It's a tough break--though there is no fracture--for Blake and the Indians.

  • Quick Cuts: Great article comparing Bartolo Colon and Pedro Martinez Is Joe Girardi doing the groundwork to move on? There's no out clause, but many think Girardi would be the perfect man for the Cubs job once Dusty moves west Mike Sweeney was back in the lineup for the Royals. It was his first start in 88 games. I wonder if he had Chris Mihlfeld's assistance in getting back, like Albert Pujols did after his oblique strain No one's paying as much attention to Logan Kensing as they are Francisco Liriano. Kensing also has a flexor tendon strain and is headed to the DL. Kensing's expected back in the minimum.
Related Content:  Sprain

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Doctoring The Numbers:... (08/08)
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Prospectus Hit List: W... (08/09)

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