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August 23, 2006

Under The Knife

Gossip and Expectations

by Will Carroll

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Okay, enough rumors--I'm used to reporting on them, not being in them. Over the past few months, I've been in discussion with ESPN about several projects, some of which you'll see very soon. My football injuries column moves from Football Outsiders to ESPN.com, a move I'm excited to make. I'm very appreciative to Aaron Schatz and the rest of his Outsider crew for giving me the shot to expand into another sport, but I also want to be very clear: Under The Knife is staying here. UTK and BP are at the very core of what I do. I'm sure you'll keep on me to make sure that the quality and quantity of information that I give you remains at the level that you expect. I also hope that you'll head over to the worldwide leader and check out what I'm doing there as well.

Powered by a non-stop flight to Bristol, on to the injuries:

  • Medhead Rule #6: Fractures are better than sprains. It's a pretty solid rule, with very few exceptions. It probably doesn't make Aaron Rowand any happier that his ankle was in fact broken, despite initial reports that he had a Grade II/II+ sprain. If you think back to last year's situation with Torii Hunter, you can appreciate the downside risk. Hunter's ankle healed, but never returned to level, causing him problems that have been exacerbated by the turf in Minnesota. Hunter also had some ligament involvement, something that has definitely affected his comeback. Given the initial diagnosis, it's fair to think that Rowand would also have ligament involvements. For a player that relies on quickness, this is a bad injury. Reports that he could come back at the 4-6 week mark seem chalk, not taking into account his health history or his style of play. While it's possible that he could return near the end of the season, it's unclear at what level he would be at by that stage. If the Phillies fall out of contention, Rowand would be shut down.

  • Any lead helps, but any pitching injury hurts. The Yankees' new lead in the AL East gives them enough of a cushion to skip Mike Mussina in his next turn. Mussina left his last start with a mild groin strain, but this skipped start is simply a precaution. It's a cliché to say that Mussina would start if this were a must-win game, but in this case, it's true. He's unlikely to need more than the one missed start, and could even slot back in differently if Ron Guidry wants to line up the rotation differently down the stretch. Like the Mets and Tigers, the Yankees now have enough of a cushion to give their players some rest, and the lead, assuming it holds for a few more weeks, will allow the Yanks to work in Hideki Matsui if and when he's able to return. Matsui has been stuck for a couple weeks, but was cleared to take batting practice. He's still on track for a September return, though when in September will be determined by how his wrist deals with the return to activity.

  • How is Brandon Backe like Octavio Dotel? Dotel was once an Astro, but beyond that I can't come up with much they have in common. However, one thing they might have in common soon is what doctors call a "pre-complete procedure." Backe's elbow ligament is not completely torn, but it's very near the point where it has little structural integrity left. The original idea was to overlay the grafted ligament replacement on top of the damaged existing ligament, repairing the structure without the associated trauma of a complete or near-complete rupture. These procedures are purported to have better recovery time and less effect on proprioception, the hardest thing to recover during TJ rehab for pitchers. The sample size in terms of case histories is small, so we don't know whether these procedures really do have an advantage, though new techniques in surgery and rehab have shortened the gaps in recovery. Still, Dotel had more than his share of setbacks in his return. Backe will discuss his options with several doctors, but right now, the pre-complete TJ remains an option.

  • Francisco Liriano is throwing again. It's just catch, but this is an important first step. The team's medical staff is monitoring his shoulder strength, and taking measurements to try and figure out how much improvement it has made while setting baselines to help gauge his risk for the rest of the season. I'm sympathetic--it's a problem that I've spent the past few seasons working on. There's no good way to gauge fatigue without bulky, specialized equipment or without invasive needles and electrodes. The Twins are in something of a medhead no-man's land--they need to be conservative with their irreplaceable young pitcher, but they're also still in the playoff hunt. Ron Gardenhire has talked about the commitment of Brad Radke, because he's pitching through a torn labrum. It will be hard for the team to ask less of its young aces, making Liriano's return a scary inflection point for Twins fans.

  • An MRI on a groin is a delicate matter. Without being crass or descriptive, it's just not… comfortable. Huston Street had one of these uncomfortable procedures, but at least he got a good result. Street's groin has no major tear, and is being classified as "mild" by most sources. As expected, he'll miss the minimum. Rich Harden continues to play catch, but there's some indication that he'll move to the mound sometime in the next week. There's still no real indication of what Harden will be able to do or when he'll be able to do it, but hope's a commodity with value.

  • Derrek Lee didn't just take batting practice on Monday, he was hitting the ball out of the park. He wasn't just taking cuts, he was taking some hacks, as if to prove to someone--maybe even the guy with the toothpick--that questioning his health was the wrong idea. Lee had no problems, describing the difference between this comeback and the last one as "night and day." He had no problems before, during, or after the session, and he was reporting no pain on Tuesday. Given continued progress, Lee should be back when rosters expand or sooner; he'd like sooner. The Cubs are also talking about an opinion they received about Mark Prior's shoulder. Two words have them wondering about Prior next season: Kerry Wood. A source tells me that the Cubs were told that Prior's shoulder injury in 2006 is virtually identical to the one that Wood had at the end of 2005, we all know how that story ends.

  • Quick Cuts: Marcus Giles won't return to the Braves lineup until the weekend. The Braves are expected to deal him in the offseason … Eric Gagne is running and doing his rehab with the Dodgers medical staff. Expect him to sign an incentive-laden one-year deal with options early in the off-season to stay with the Dodgers … Watch for the Mariners to skip starts for Felix Hernandez down the stretch. His first season may not make people forget Dwight Gooden, but the real goal is to have him last longer … Ryan O'Malley came out of nowhere to pitch great for the Cubs in an emergency debut. When the Cubs gave him a chance to do it again, he may have blown out his elbow. It's been that sort of year in Wrigleyville ... Alex Gonzalez heads to the DL while Dustin Pedroia gets a chance to showcase himself for next year.

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