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June 17, 2008

Under The Knife

Stacked

by Will Carroll

Chien-Ming Wang (90 DXL)
No one knows feet like Dr. Philip Kwong of Kerlan-Jobe, so I'll just let him tell you about Wang: "It is unusual to have both a Lisfranc ligament sprain and partial tear peroneal longus together, and longer time will be needed for recovery (8-12 weeks if no significant instability occurs at the Lisfranc joints). The combined injuries represent greater rotational stress than would be experienced for each injury alone. Prognosis and time line for recovery will depend on the exact amount of ligament/tendon tear sustained and on the amount of tissue remaining to provide stability. Healing is the formation of scar tissue and not regrowth of the normal ligament or tendon tissue; consequently, future problems such as arthritis can occur at Lisfranc's joints or reinjury of the peroneal longus tendon." So as I'd expected, the additional damage beyond the Lisfranc is likely to add to the time Wang is out. It leaves very little wiggle time for him to come back and throw meaningful innings, not unless the Yankees are right and Wang comes back at the extreme low end of expectations. I think the Yankees' record is going to dictate how this is eventually handled.

David Ortiz (35 DXL)
The cast is off, but Ortiz went right into a splint. What's the difference? It's pretty significant, actually. Ortiz can now do more in the way of treatments, especially the ones that will work on his range of motion. In essence, he's cleared the portion of his rehab focused on rest and made it into the more active portion, leading back to baseball activities. The most important takeaway from the cast's removal is that there was a clear milestone for it: he's free of any pain. Ortiz is nevertheless still a couple of weeks away at best from swinging a bat, and remains in jeopardy of setbacks. We'll be watching for that next milestone and for signs that the wrist has lost strength, as it's a big factor in Ortiz's power and bat control. At this point, it still looks like Ortiz should be back around the All-Star break.

Brad Penny (7 DXL)
It could have been much worse; Penny had an MRI and it provided the club with best-case news—he's dealing with bursitis and tendonitis. It's the perfect combination of the acute and chronic to explain Penny's issues. The bursitis is the most problematic, causing the pain and "catching" that Penny described after he came out of his last start. The Dodgers medical staff will work to get the inflammation down. Whether Penny makes his next start depends on his response to treatment, something that we won't know until his throw day or even after. At this stage, the Dodgers say that he could make his start, but they'll have a Plan B at close hand (and you should as well). I'm not sure that he won't make the start, but I am sure that if you have any other option, you should use it.

Yadier Molina (3 DXL)
The power of instinct is amazing. Molina was born to be a catcher, but seeing him hold the ball on that play at the plate reminded me just how deeply the instinct to hold the ball is. Molina was clearly concussed, though reports say that he never lost consciousness, which is a positive sign. The Cards' doctor was out there quickly, managing the process, and Molina was quickly under observation. As with any concussion, it's tough to say what's next, but it seems like the team is doing everything right. Molina is going to miss some time, depending on his recovery, but it's not clear yet how the team will deal with that. The hope is that he can avoid the DL, but it does put the Cards in a tough position over the next couple games. I'd guess based on current information that Molina will be back towards the end of the week.

Todd Wellemeyer (5 DXL)
Wellemeyer made his start, but things certainly didn't seem normal for yet another injured Cardinal. He was reportedly so swollen after his last start that he couldn't fully extend his elbow. His throw day is scheduled for today, but it seems that his making it is in question. If Wellemeyer can't go, the Cards are almost out of options or at least healthy pitchers who will give the team a chance to win. I've talked about the "death spiral" before, but this goes beyond that; this looks to be a combination of factors, including a number of risky players all rolling snake eyes at once, as well as an overtaxed medical staff struggling to keep up with the load. Wellemeyer's a symptom of the larger problem and how they deal with his symptoms will be telling. I'd be surprised if he makes his start and if he does, I hope you have more pitching options than the Cards do right now.