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June 25, 2007

Under The Knife

The Testosterone Culture

by Will Carroll

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I often write about the testosterone culture in clubhouses, where "sucking it up" and playing hurt are to be admired. There's a fine line between playing hurt and hurting your team. It's the job of the manager and medical staff to learn each player's limits. After that, they have to weigh the risk of exacerbation or re-injury, and gauge whether 80% of the starter is better than 100% of the backup. Also in play are how the day's matchup affects individuals, and how the long-term management strategy for the team factors in.

The simmering war of words between John Smoltz and Chipper Jones features two players with unquestioned talent and grit, but you'd think that two veterans would have a bit more insight into injuries than they're showing. While a winning streak would make this blow over quickly, it shows the tension that the testosterone culture can create. It's not Smoltz's job or Jones' job to set medical policy any more than it is Joe Chandler's job to grab a liner headed for a gap or throwing fastballs. The Braves have never had this problem in the John Schuerholz/Bobby Cox era. It's a chance to see if we have a defining moment that propels the team, or not.

Powered by Flight of the Conchords, on to the injuries:

  • A reader sent in an e-mail that fired me up regarding my assessment of Miguel Tejada. He called me out for asking the question "What do you mean the question is whether Tejada's injury will have any medium-term or long-term consequences for his value? Isn't that you ducking the issue?" If you call giving as much information as I have at that point "ducking," then yes. When I guess, I do it only when there's enough information to do so in an analytical manner. I didn't have enough public information or enough time to lock things down by deadline.

    With two days to work, I now know a lot more. Tejada's "broken wrist" is in fact not a wrist at all. The fracture is at the distal end of the radius, in almost the same place we saw last season with Derrek Lee. Lee's recovery is a poor comparison because of the rushed comeback and off-field issues that derailed Lee's 2006. The two-month mark is the best target, though a fluid one based on some factors we won't know, including Tejada's healing response and use of new pharmaceutical and bone stimulating techniques. Tejada figures to go through the same types of initial problems as he would with a wrist injury, but because this is not in fact a wrist injury, it does not appear that it will linger quite as long. In other words, Tejada is likely to be out well into August and his value for the rest of the '07 season is in question.

  • Coughing up blood is never good. Last season's AL MVP had one of the more brutal collisions I've seen at the plate for a runner. Miguel Olivo had time to set himself and actually delivered a blow directly to Morneau's sternum, or so it appeared in the near-infinite replays we saw. My initial thought upon seeing the play is that Morneau had either broken a rib or worse, his sternum. A bruised lung is the diagnosis. Essentially, the team will just have to wait for Morneau to feel right. That he stayed behind as the Twins left town tells us that he's not quite as best-case as some want to think, but this shouldn't be a long-term injury. There's some question about lingering pain and its affect on his swing and power, but there's really no evidence to go by here. Given the Twins' status and the way they managed Joe Mauer and his quad, I think this could take the better portion of the week, leaving a retro DL move possible. Once we're a week past his comeback, all the signs we'll have will be available and that if he looks like he's normal and swinging well, we can move past this incident.
  • While most of the media is watching to see if the suddenly-plummeting White Sox are ready to send Mark Buehrle packing, I'm more focused on the injuries that are a big part of the reason the team is sliding. Jermaine Dye is headed to the DL as a result of the quad strain that has been affecting him for a while. The injury is simply not healing quickly enough to get him into games before the 15 days are up, despite the best efforts of the medical staff to keep him available. By resting him now, the team hopes that they can heal it up and keep it from being problematic all season. With the All-Star Break coming up, the rest not only works medically, but gets him back in time to see what his trade value will be.
  • The White Sox essentially swapped Darin Erstad for Scott Podsednik after Erstad re-injured his problematic ankle. Podsednik appeared to have no trouble with his groin, even with a damp field. With the possibility of player movement in Chicago, the Sox outfield situation is very jumbled and the team's health situation will certainly affect the deals that it makes.
  • One of the great unknowns this season is exactly how the Red Sox are monitoring Jonathan Papelbon. There are vague references to continual strength testing of his problematic shoulder, but no one seems to know if this is done manually, as in one of the trainers having Papelbon push against him and comparing it, or if it is done mechanically, with a machine like a Cybex. With Curt Schilling exhibiting similar symptomology to Papelbon, and with the same vague references to strength testing, we have to once again try and understand what might be measured. With both pitchers, the team is using strength "at point"--baseline, prior to activity, and then at points during and after activity--to measure for fatigue. It's a smart idea and done at some level by all teams, though the Red Sox are taking this to new levels. We may not know the results of the tests, but the tests are what the team is hoping will keep both pitchers on the mound putting up results we can see.
  • The Phillies once had "too much" pitching, but when the market for Jon Lieber wasn't there, the trade not made ended up working out as it would had Pat Gillick taken the offered low returns. Unfortunately, the injuries keep piling up for the Phillies, and Lieber is the latest victim. His injury went quickly from being a suspected sprained ankle to a ruptured tendon in the foot. I don't mean to suggest this was a misdiagnosis; it was very difficult to see due to swelling before the MRI was done. Lieber is done for the season, leaving the Phillies scrambling and putting more of a focus on Brett Myers. The Phillies continue to insist that he'll be back in the bullpen, but he continues to rehab on the same program as a starter.
  • Cardinals fans have waited a while to see Chris Carpenter throwing to Yadier Molina. It's not quite what they wanted, but seeing Molina squatting in the pen while Carpenter threw a side session was a nice preview of what will be coming soon. For the first time since his surgery, Carpenter threw some breaking balls and, assuming he has no problems with recovery, Carpenter should begin throwing to hitters later this week. The All-Star break doesn't affect the minor leagues too much, so seeing Carpenter on a rehab assignment at that point shouldn't be surprising.
  • Molina is closer, with his hitting lagging a bit behind his defense. He is expected to take batting practice soon and depending on results there, could be sent out on a short rehab assignment by this time next week. That puts him on track to return right around the All-Star break, though the team's record could make them either aggressive or conservative with his timetable, depending on how they play between now and then.
  • Eric Karabell pointed out to me that Josh Johnson has been awful since returning, and wondered if the rule about "elbow = control" was in place for ulnar neuritis. The answer I gave when asked on Sunday morning's ESPN Fantasy Focus is "yes," but I did some more research today. The more complete answer is the same, but the sample size isn't enough to be definitive. Johnson has had two miserable starts with severe control issues, but he didn't show much of this in his rehab starts. If the control problem was directly related, we'd have expected to see some evidence there. This problem is especially important to check due to the similar injury to Huston Street. Control problems are certainly more problematic for a closer, and if Street is to make it back late in the season with the A's still in the playoff chase, the control issues could push Street out of the closer role. I guess we'll see, though my sources tell me that Street's prognosis is far more positive since visiting Toronto.
  • Let's start with the good news. First, I understand that the D.C. Ballpark Feed was quite a success. We thank the Nats for allowing BP to come in. Second, Nick Johnson is finally making more progress towards a comeback, adding both activity and intensity to his rehab in the past two weeks. There's still no timetable, but it's looking more possible that he'll contribute something this season.

    Now for the bad news. Shawn Hill is headed to Birmingham for a check of his elbow problem. Draining the fluid didn't relieve the pain and inflammation, shutting Hill down again. Coming off Tommy John surgery, the recurrence of elbow problems is especially concerning.

  • The Nats are also wondering not only when they'll see John Patterson on the mound, but if they'll see him there at RFK. He's expected to not just see a specialist, but to fly around seeing several in hopes that one of them will figure out what is causing the severe pain that he's getting in the recovery period. Once again, the Nats have no real timetable, leaving Manny Acta and his team to figure out how to fill in the innings.
  • As the Cubs came away with a sweep of the Sox, they also left with a bit of a bullpen problem. Ryan Dempster has been fighting through a mild oblique strain, something that seemed to affect him more in recovery than anything, leaving Lou Piniella worried about his availability more than his effectiveness. After the muscle had another episode, the medical staff shut Dempster down for the weekend to make sure that he didn't exacerbate the condition. That left Bobby Howry as the late-inning option with which Piniella was most comfortable. Howry performed well enough in the role that some think he might stick. That's unlikely in the short term. Dempster is expected to be available again by mid-week, but as with any oblique problem, they have a tendency towards re-injury and lingering, so Howry isn't a bad gamble if you're desperately seeking saves.

Quick Cuts: Brad Penny was pushed back, not because of injury, but due to their matchup with the D'backs, something my source in L.A. called a "statement series" ... Derek Jeter has a mild hip flexor strain. Not a worry yet, but this is a muscle that often starts as a low level injury and either lingers or gets worse ... Philip Hughes is out of the boot and will begin a throwing program that should put him back around August 1 ... If you're in the Indianapolis area, I hope you caught me on Sunrise, the morning news show on WTHR Channel 13. Looks like we'll be doing more of that in the future ... Ryan Freel will start a rehab stint this week at Triple-A Louisville. It could be as short as two games if he shows no post-concussive syndrome. Still no word on Farney ... Looks like Vicente Padilla is headed back to the DL. after his elbow got inflamed again ... Erik Bedard will make his next start on Wednesday, as will Jered Weaver.

Related Content:  Broken Wrist,  The Call-up,  Quad-a

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