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June 13, 2008

UTK Wrap

Sound and Fury... and Progress?

by Will Carroll

Even if it wasn't Friday the 13th right now, some teams would be feeling like it is. It's been a horror show of injuries this year, with the DL packed with more than 150 players. Some are the injuries we count but that really don't matter in the normal scheme. For example, Thomas Diamond is rehabbing from Tommy John surgery, but the Rangers weren't expecting him to be a big part of their '08 plans in the way that they were counting on Jason Jennings or Brandon McCarthy, but a day is a day. Even dollars can be a bit skewed; Philip Hughes makes the minimum, but his value to the Yankees is far higher than that. So as we watch player after player and star after star headed to the DL, we have to ask ourselves two questions: Are things actually worse? And why can't we prevent this or at the very least reduce their number and impact?

The first is easy to answer. On June 10 of last year, there were just over 170 players on the DL, so while 150 sounds like a lot and gets plenty of attention with the injuries to big-name players like Albert Pujols, Alfonso Soriano, and Curt Schilling, the context makes it clear that numbers alone don't tell the story well. An answer to the second question is more complicated. The Cubs medical staff couldn't have stopped the pitch from coming inside and breaking Alfonso Soriano's hand, but should they have their players wearing padded gloves, or plastic inserts? I'd like to think so, but I can't fault a team for not doing something that every other team is failing to do. Do we blame this year's Indians staff or next year's for the days that Jake Westbrook will miss, despite the fact that no one, myself included, thought that Westbrook was anything other than durable? I don't think we can ever eliminate injuries from the game, but I also believe that the industry has done less in this area than any other. I'm not sure why, but the results should encourage it to start taking a look. Powered by Illusione, on to the injuries:

Victor Martinez (30 DXL/$2.5 million)
At least we have something of an explanation now. Martinez has been playing on a sore hamstring, but now it turns out that he's also been playing through a elbow issue caused by bone chips. Those chips can be easily removed, allowing for a quick, pain-free comeback. A couple of seasons back, Rich Aurilia came back from this kind of thing in the 15-day minimum, but Martinez has the complicating factor of being a catcher. I'd expect that this will take more like a month for his return, but that time off should also help his legs heal up and rest. Once back, it will be interesting to see just how much of the power outage can be blamed on the elbow, or whether this is a Hafner-esque slide.

J.J. Putz (5 DXL/$0.3 million)
Things aren't going well for the Mariners. Ten pitches into his last outing, J.J. Putz called for the trainer and left with a sore elbow. There's not much more known other than there was some pain and swelling and that he was examined by team physicians on Thursday. Putz's elbow has had similar problems before and he's always come back well (as he did in 2007) but on Thursday, the team said that Putz had hyperextended his elbow and suffered some ulnar neuritis. That's something with a very wide range of possibilities, but the team did not place Putz on the DL, saying that they would instead wait through the weekend to see how the arm responds to treatment and a couple of days of rest. Based on the current information, it's impossible to say what will happen, but sources tell me that this is much more of an acute event, one that we might look back on if Putz is eventually injured instead of as a problem in and of itself. Complicating things is the suggestion that the Mariners might be conservative in their handling of him, given their record, but they're also trying to fight their way out of the slump and keep attendance up. The Mariners are likely to use Brandon Morrow-who's had some injury problems of his own-if Putz is out for any period of time rather than the committee they used earlier this season. My estimate of 5 DXL is very low and the best-case scenario here, but like the Mariners, I'm going to be watching and waiting.

Brandon Morrow (3 DXL/$0.1 million)
Before we talk about using Morrow as closer despite his garden-variety sore shoulder, let's think about reliever usage and review how little we know about its impact in terms of health. We know that a high workload is 80 max-effort innings over a couple of years, with names like Eric Gagne, Octavio Dotel, Danny Graves, Scott Sullivan, and Keith Foulke littering a landscape where only Braden Looper and Salomon Torres have escaped. (I'm not sure what to think about Scot Shields, the last of the eight men to accomplish the [80 IP x 3] milestone.) This means nothing for Morrow, who's come up sore due to some tendonitis in his shoulder, but I'm taking it as a reminder of how little we know about reliever usage and how individuated the results of pitching are.

Albert Pujols (20 DXL/$3.2 million)
Things are a bit clearer for how long the Cards will be without their star slugger. With the knowledge that what he's dealing with is a Grade I-plus strain of his calf, he's likely to miss somewhere between three and six weeks. While we know that Pujols plays well through injury, we don't know much about his healing tendencies. I'm re-setting the DXL to 20 days on the idea that he'll heal at the low end of the range and that he'll push his way back into the lineup without a rehab assignment. More interesting was the suggestion from several UTK advisors that this injury could be connected to his foot problems. I tried to find out if Pujols had custom shoes or orthotics, but was not able to find out before deadline, but it's possible that what we're seeing here is something of a cascade, an adjustment made to compensate for his painful feet leading to a biomechanical problem in his calves. If so, this could become recurrent or worse, cascade up the leg or into his back. If this goes on longer than initially expected, here's a simple rule for you on injury cost: one week equals a million bucks lost in value for Pujols.

John Smoltz (120 DXL/$10.1 million)
Smoltz had his shoulder surgery on Tuesday, and we know more, but not enough to get a clear picture as to what is in his future. The team said his labrum was repaired, but despite Bobby Cox saying the damage was extensive, we don't know whether there was further damage. I was listening for any rotator cuff involvement or discussion of how the surgery was performed, but it sounds as if it was a 'scope. That's a positive sign and could mean that the damage wasn't as extensive outside the labrum. It's also possible that Jim Andrews went in with a plan to fix as much as he could with as minimal a surgery as possible, giving Smoltz the full knowledge of the damage while maintaining some chance of a comeback. Smoltz showed he could pitch effectively through this injury, he just couldn't recover between outings. All we know now is that the final chapter hasn't been written yet. As Smoltz himself might say, it's a comma, not a period.

Phil Hughes (90 DXL/$3.5 million)
Kyle Farnsworth (5 DXL/$0.1 million)
While Yankees fans focus on Joba Chamberlain's presence in the rotation and absence from the pen, those two areas are seeing some other changes. Hughes is making some progress with his rib fracture and could begin throwing in the next few weeks. Since this isn't an arm problem, once he clears the bone scan, the issue will be stamina and touch rather than making sure he's healthy. That should make his return a quick one, especially if the Yankees use Hughes in something similar to the way that they transitioned Chamberlain. Rather than "wasting" starts in the minors, why couldn't Hughes make shorter outings in the Bronx? Unfortunately, the Yanks don't appear to see it that way, and say it will be "weeks" before Hughes is back. Chamberlain's exit from the pen has pushed Joe Girardi's use of the remaining effective pieces at his disposal, but Farnsworth's arm hasn't responded, and he's out with some biceps tendonitis. It's easy to blame usage, but the pattern hasn't really changed, he's just doing it in different situations. Still, this just looks like one of those sore-arm situations that the team is hoping a spot of rest will clear up.

Jeremy Bonderman (90 DXL/$5.8 million)
We've seen this before, and if you're paying attention, the news is positive... in the long term. Bonderman had surgery on Saturday on a near-emergent basis to clear a clot formed as the result of Thoracic Outlet Syndrome. The angioplasty cleared the clot from his shoulder, but the root cause is still in question. Doctors will determine if his first rib is impinging the blood vessels, and could elect to remove it if this is the case. This is the same type of condition that Kenny Rogers and Hank Blalock had and came back from. Bonderman's shoulder had been feeling weak, so some of his poor results have to be chalked up to this condition. If there's any good news here, it's that Bonderman will be fine and should pitch again. If the rib is removed, he'll miss roughly a year, though recent work in the field might bring the total time lost down some. He'll have Rogers on hand to help him understand the process, and his heavily-worked young arm will get the benefit of some rest. The Tigers are going to need Dontrelle Willis to slot back in and try to salvage the rotation right now; the Tigers aren't panicking yet. I'll set the DXL at 90, leaving open the chance that he might come back late this season, though this is admittedly unlikely.

Jake Westbrook (110 DXL/$4.5 million)
Frankly, I never saw this coming, and looking back through my data Westbrook comes up green on every measure. It proves just how much I don't know about pitcher health and how much more emphasis teams should be putting on objective testing, especially biomechanical analysis. Westbrook will need Tommy John surgery and will miss the rest of the season. There's some question as to whether this was the normal insidious injury--wearing down over time--or whether this was a "snap," perhaps the result of altered mechanics due to Westbrook's core injuries. Either way, the Indians will miss a year of the deal Westbrook signed last year, though he should be able to come back around the All-Star break in 2009.

Troy Tulowitzki (45 DXL/$4.1 million)
Tulowitzki is starting his rehab assignment well ahead of schedule, and it's expected to be a short one. The Rockies are saying that they'd like to have him back on June 20, but if he hits well early, I'd be very surprised if he's not back before that. Either the quad strain either wasn't as bad as advertised or Tulowitzki is a quick healer, though he'll sit very deep in the recurrence zone for at least the first month after his return. In his first game back with High-A Modesto, he went 0-for-2 and left the game early, though afterwards, he told the Rocky Mountain News that he felt "no pain," and he has had no problems since. He should be back early next week.

Quick Cuts: Several BP regulars and a few special guests will be at Foley's NY on June 30th at 8 p.m. Come by and talk some baseball (and celebrate my birthday). ... Some sites are suggesting that Mark Prior's detached shoulder capsule happened in the collision between Prior and Marcus Giles. It's a nice theory, but wrong, since the capsule was in place during Prior's 2007 surgery. ... Billy Wagner is blowing saves and losing velocity, making Mets fans as worried as the Mets. Keep your eye on him to see if a couple of days' rest brings the heat back. ... Travis Hafner and Rafael Carmona are making progress while on the DL. Both could start rehab assignments by the next time Wrap comes out. ... Jake Westbrook had his elbow repaired by Dr. Lewis Yocum on Thursday; he should be back in a year. ... The Yankees bullpen won't be getting Jonathon Albaledejo back, as his sore elbow turned out to be a stress fracture that will need fixation.

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