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June 6, 2008

UTK Wrap

Red Sox Wrist Shots and Meltdowns

by Will Carroll

The hamate bone. The glenoid ligament. The extensor carpii ulnaris. These are terms that we're adding to the baseball lexicon. I like to think we're expanding the knowledge base to the point where you'll someday say, "How 'bout them Mets" to a guy on the street and he'll say "Sure, but Jones' swing still needs to come back after he had the hook of his hamate removed if we're going to have a shot at the pennant." That's a ways off, but we're getting the chance to use these terms far too frequently. Still, as the names get ticked off the middle rounds of the draft today, remember that bonuses through about the tenth round are still about equivalent to one more athletic trainer or, better, a raise for the current staff. It's one thing to draft a Dan Schlereth, but I'll bet you that no matter how good Schlereth turns out to be, Ken Crenshaw will be more important to the D'backs' success over the next five years. Tim Beckham may be as good as the scouts say, but Ron Porterfield is already producing in the bigs. A lot of teams are talking a good medhead game, but very few are rewarding the guys on the front line. One of the great things about my job is being able to champion these men and women, telling their tales of success as part of the overall story of winning baseball. I can only hope some GMs and owners will realize what a resource they have. Powered by the upcoming Pizza Feed on June 30th in Manhattan, plus upcoming feeds in Tampa and Pittsburgh, on to the injuries:

John Smoltz (120 DXL/$10.1 million)
What we know about Smoltz is that he's come back before. All the information we have builds off of that. We saw him, in diminished physical capacity, throwing-or rather slinging-the ball at 95 and snapping off a slider. Yes, he was hurt, but that's nevertheless impressive. There were kids drafted yesterday who can't do healthy what Smoltz did broken. What it comes down to now is whether the damage in his rotator cuff is significant enough to cost him the 12-18 months that it can. In that case, while he could still come back, the tipping point for a willingness to try might be reached, and perhaps Smoltz is more likely to focus on golf and the ministry. It's important to note that while his career may be ending with an injury, most of his career wouldn't have happened without modern sports medicine. Smoltz might end up the first pitcher in the Hall of Fame after Tommy John surgery, but it's hardly the only thing that doctors have allowed him to do on a baseball field. He's a pioneer. Smoltz is scheduled for surgery early next week and once he's open, we'll know a lot more. If you're wondering, the days and dollars lost on this injury alone are going to knock the Braves way down in the rankings, which is hardly fair to their medical staff, because they kept him in action this long.

Jacoby Ellsbury (7 DXL/$0.4 million)
Another day, another wrist injury for the Sox; it just seems that way right now. Ellsbury injured his wrist diving for a ball on a play that looked eerily reminiscent of the one that injured Vernon Wells. The team is calling the injury a "strain," but Ellsbury is likely to miss some time. The team called up Brandon Moss to handle outfield duties with both Ellsbury and Manny Ramirez hurting, though after the game, Terry Francona said that the hope is that Ellsbury is merely day to day. We'll know more on today once we see how swollen the area is and how Ellsbury responds to treatment. With most reports positive and with Ellsbury's power not among his primary skills, it seems as if this will go about a week. However, the Sox are very sensitive about wrists right now, something that could make them a bit conservative.

David Ortiz (30 DXL/$2.9 million)
The news on Ortiz isn't "news," it's just the information starting to leak out about the specifics. As more of these can be confirmed-and it's not the entire picture, to be sure-the early story is actually somewhat positive. Ortiz says that the pain is the problem, a "clicking" every time he moves his wrist in any plane. That pain will be removed or at least reduced by two to three weeks of enforced rest. Of course, it's very hard to completely rest, and we'll surely see second-by-second updates coming out of Boston, something like "Papi Cheers Garnett's Dunk-Doesn't Flinch!" or "Ortiz High Fives, Reinjures Wrist." In the meantime, we'll have to just wait and see how this works out. As with Nick Johnson, it wouldn't surprise me to see this extend out past the expressed deadlines but still find a positive outcome. The Sox will shift Manny Ramirez over to DH as expected, which should help with his legs as well.

Chris Young (30 DXL/$1.3 million)
Jake Peavy (15 DXL/$1.7 million)
The Pads' pitchers are making slow progress. Young continues to rest to make sure that small fractures in his nasal cavity don't become displaced more. There's a bit of fluid movement between the areas, raising the possibility of significant infection. He's on antibiotics to stave that off; once stable, he should be able to quickly return to pitching, though there's no way of knowing exactly when that will be. If the fractures don't stabilize, Young will need some surgery; given the nature and location, it's a complex procedure that could cost him significant time. Things look good right now-"80 percent healed," according to recent reports-and he's even playing catch. The news is a bit better or at least more predictable for Peavy. After making it through a 30-pitch bullpen session, Peavy will throw another simulated game on Friday that will involve more effort and all of his pitches. Assuming that his stamina is solid and he recovers normally, Peavy would slot back into the rotation early next week. That would put him just past the fifteen-day minimum, even with the retro move that was made. (Yes, the Injury Cost is right, and telling-Peavy's injury is half as long, yet much more costly.)

Jake Westbrook (15 DXL/$0.6 million)
We have to assume that this injury is a cascade. Just a week after coming off of the DL, Jake Westbrook is back on it with some elbow inflammation. After I analyzed him closely and saw Westbrook as someone who should be durable, he now has three DL stints since, but an arm injury is even more worrisome than a problem with his core. Westbrook has been sent back to Cleveland for tests, and with inflammation in the elbow remaining days after his start, this doesn't look minor. I've taken another look at Westbrook's last start, but I don't see any significant changes in his mechanics, though watching on TV is admittedly not the ideal way to analyze mechanics. The Indians are left scrambling for a replacement, as many of their options are either injured (notably Adam Miller, who's likely done for the season) or out of sequence. The images should give a clearer picture of where Westbrook's season is headed, so I'll be watching that closely for updates. The DXL is based on current information, but is very fluid. He'll see Dr. Lewis Yocum at Kerlan-Jobe today, so we should know where this is going by the weekend. It's an object lesson that sometimes even the guys who the data says will be the healthiest won't be.

Fernando Rodney (90 DXL/$1.8 million)
Joel Zumaya (90 DXL/$2.3 million)
The Tigers are trying to rebuild themselves on the fly, shifting their various parts around in hopes of maximizing the available talent. While Jim Leyland hasn't found the magic combination on the field yet, the returns of Rodney and Zumaya are on the horizon, potentially making the bullpen a source of strength, assuming that these two power relievers can resemble what they were over the past couple of seasons. Given their injuries, though, that's no easy assumption. Returning from his freakish shoulder injury, Zumaya faced the bigger initial questions, since no pitchers in recent memory have had a similar situation. I'd expected this to be a "binary injury"-he'd recover fully, or he wouldn't at all-and things look positive so far. Zumaya has been throwing in the mid-90s, down from his peak, but useful and not in game situations, so there's some expectation that he's got some room to improve. He'll begin a rehab assignment on Tuesday, putting him on track to be back at the end of the month. Rodney's return is a more tenuous proposition, since the damage inside his shoulder is more chronic in nature. He's shown good progress since almost heading under the knife back in March and will start his rehab in Triple-A, though he also should be back near the end of the month. Rodney should be more prone to recovery problems initially, but the Tigers have to be pleased with their medical and rehab staff's work here. After tabbing Ryan Perry in the first round of yesterday's draft, the Tigers could have one of the hardest-throwing pens ever, since Perry works at 98 mph.

Curt Schilling (90 DXL/$3.4 million)
It was just twenty-five pitches from a bullpen mound, but some good news is better than none as Schilling made his first throws from a mound this season, and things went very well. Terry Francona was excited, Schilling was excited; it seems everyone was excited. It's a small step in his recovery, but a meaningful one. The slow progression should start to accelerate, with more mound sessions coming over the next few weeks, leading to the start of a rehab assignment at the end of the month. While the slow pace might keep him out until just after the All Star break, the Sox have more than held together with "Plan B," thriving in the standings while not overworking any of the young arms. The next milestone for Schilling should be throwing to live batters, probably within the next two weeks.

Mark Prior (180 DXL/$3.25 million)
As the vultures circle Mark Prior, picking off what's left of his career and reminding you that he was never "perfect" and that they knew he'd fail, I'll remind you that Prior might be the last of his kind. No, not the last injured pitching phenom-we're not that lucky yet. Instead, he's perhaps the last of that lost generation of pitchers that came of age in between the full conversion of all teams to five-man rotations, the expansion and exposure of additional pitchers on those new teams' staffs, heavier reliever usage, and no focus on pitch counts or mechanics. As Prior came up, there were no blogs touting or taunting him; his draft day wasn't even aired on radio, let alone ESPN. The pitchers we're seeing today have come of age fully in the "pitch count era," from high school on. Many saw high pitch counts, but there was notice and concern. We saw pitchers fail, breaking down due to usage not just in the pros, but from years before. Dr. Glenn Fleisig's analogy of pitching arm damage to smoking is apt, because not all smokers get lung cancer, but we don't really know why or why not. It's the same with pitching and pitcher injuries, but as with smoking, the warning labels have helped improve matters. The focus on health may just be the beginning an era where we get more and more healthy young pitchers. The next Mark Prior might avoid a second surgery, let alone one as odd as a glenohumeral avulsion, a likely career-ender despite his hopes of trying again, and if it took sacrificing Prior on that altar, well, I hope it was worth it.

Quick Cuts: Albert Pujols got some time off to rest his calf, but still had a pinch-hit homer in yesterday's doubleheader. He's expected to play this weekend. ... I'm told that Daisuke Matsuzaka is doing very well and will come off the DL as scheduled next week. ... Matt Holliday will start his rehab assignment tonight. It was held back when the field conditions in Colorado Springs were wet. ... Tadahito Iguchi heads to the DL after separating his shoulder on, of all things, a play where he was knocked down by a groundball. ... Vernon Wells will start a short rehab assignment in High-A Dunedin. He should be back with the Jays in about a week, well ahead of schedule. ... Manny Ramirez was removed for precautionary reasons after he felt his hamstring tighten. Look for him to get some DH time with Ortiz out.

Related Content:  Back,  The Who,  Jake Westbrook

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