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June 30, 2008

Under The Knife

50 (Per)Cent

by Will Carroll

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Carlos Zambrano (15 DXL)
Zambrano appears to be ready to come off of the DL at the minimum. After a side session before Sunday's game after some flat-ground work on Saturday, he'll still have to make it through his side session on Tuesday without any problems. Zambrano is eligible to come off the DL on Friday, and that appears to be the goal, putting him back in the rotation in time to face the Cardinals. Even with the quick return, look for Zambrano to be monitored carefully and kept to a reasonable pitch count. The Cubs will be watching his arm angle closely, and the slightest hint of drop will lead to a quick hook. Zambrano might not like the attention or the limits on his pitches and innings, but when he got the big extension from the team, his long-term health became more important to them than his short-term frustrations. Despite Piniella's barking at Sean Gallagher, it looks like it will be Sean Marshall who will be bumped from the rotation with Big Z's return.

Andruw Jones (45 DXL)
Rafael Furcal (45 DXL)
Brad Penny (15 DXL)

If you add in Jason Schmidt and Nomar Garciaparra to these three names, it's no wonder why the Dodgers lead the league in dollars lost to time on the DL so far this season. Even so, it shouldn't be considered a surprise, since almost all of these players are injury-prone. Now, with five players in some stage of rehab and recovery (and we really should come up with terms that don't sound like these guys are coming out of Betty Ford), the Dodgers are in an interesting position. Do they treat this as if they're getting a gaggle of mid-season acquisitions, or does this instead free up some talent to make that kind of deal? Penny should be the first one of the bunch back in action. The rest he's gotten should help his shoulder in both the short and long term, but Penny has shown that even at less than 100 percent he can pitch pretty well. Furcal is a tougher read; his back injury has lingered far beyond the initial expectation, and back injuries tend to both linger and recur. Even given the Dodgers' medical advantages, there's really no way to tell how this will go-or when, though Furcal looks close to a rehab assignment and I wouldn't expect it to be a long one if he's playing without pain and if he's hitting. Jones is more straightforward, since he's coming back from a relatively minor knee surgery. The unknown here is how Jones' time off may have cleared his head, or whether being healthy just means he'll have one less excuse for his poor performance. The Dodgers have some tough challenges ahead, but they may have fewer excuses heading into the All-Star break.

Hideki Matsui (5 DXL)
When a player is healthy for a long time and then suffers anything other than a freak injury, get out of the way. This sort of wearing down seldom turns around, and it seems to be the case for Matsui. The former "iron man" is now rusting. Matsui has had his troublesome left knee swell up several times over the past few weeks, necessitating fluid drainage. That's led to talk of the surgery, though the team is still calling that a "last resort." Surgery is almost always the last option, so don't think that this is anything unusual or that the Yankees won't send Matsui to a surgeon because of any turn of phrase. Matsui's knee is stable, it's just swelling repeatedly, so the damage isn't likely to be significant and the surgery, if necessary, will likely be a 'scope. In all but the worst-case scenarios, Matsui would miss six to eight weeks, just in time for the final push-or the first meaningless September in the Bronx in quite a while, a factor which could 'slow' his return. Right now, my sources are telling me that they don't see how Matsui will avoid surgery, and that the delay confuses them. Until the Yankees do push him to the DL, Matsui will miss days here and there, so his DXL stays artificially low.

Felix Hernandez (10 DXL)
When King Felix sprained his ankle on that play at the plate, many thought it was worse than it was based on how it appeared. Sometimes it takes a closer look at the mechanism of and injury to truly tell how bad or, in this case, not so bad something is. What you can't do is judge anything based off of a player's reaction. Yes, there's some to be learned by whether a player grabs at something or can or can't put weight on it, but don't try to gauge anything by a player's display of pain. I've seen football players scream and cry at minor injuries, while I've seen a girl on a soccer field limp a bit, only to find out that she'd broken her tibia. What we know is that Felix Hernandez had a forcible eversion sprain, the most common kind, and that there was initial pain but limited swelling. The medical staff worked to remove some weight-bearing, but didn't have to stabilize it. The Mariners are backing off of the idea of Hernandez getting back quickly, because they're worried that any tenderness might cause him to change his already tenuous mechanics. They could use a retroactive move at this stage, but behind the scenes, the team sounds like they'd like to avoid doing it, fearing that might cost him an All-Star bid that he's expecting.

Jason Isringhausen (2 DXL)
Pitching is a tough thing to do in the first place, but doing it while wearing a knee brace? That's tougher still. Isringhausen felt something pop in his knee during stretching, and it appears that he hyperextended his knee, damaging a ligament and the capsule. Instead of heading to the DL, the Cardinals are going to try letting him pitch in a brace to protect what most believe is a sprained PCL. The ligament shouldn't sprain further, though most writers have said that the "sprain isn't likely to tear" when they mean to say that the already-sprained ligament isn't likely to rupture. The biggest question is whether or not Isringhausen can keep his mechanics clean enough with the brace on to not cause any sort of cascade injury or any sort of exacerbation of his sprained knee.

Dan Uggla (7 DXL)
By now, you've seen the video of the complex sprain that Dan Uggla suffered on the basepaths. The unusual mechanism-one that a colleague called a "double-tap sprain"-makes this one tough to judge. So far the Marlins are just letting it play itself out, watching the swelling and pain. Uggla is valuable enough and there's a big enough value gap between him and any replacement that the Marlins almost have to do it this way, letting Uggla go until next weekend before making any decision as far the DL, and holding onto the possibility of a retro move. Weekly-move leagues have a pretty easy decision to make, but the Marlins don't. Thus far, all we really know is that the ankle isn't broken, but that's not much to go on. His response to treatment and rest will determine the rest of this, but Uggla has been pretty healthy while in baseball, so there's nothing to go on there either. My guess is that we'll know by mid-week and that if he is pushed to the DL, he could be out longer than the minimum. It's odd, I know, to say he might be back in a week's time or in three weeks, but while I think he'll be back this week, sometimes it's good to know both sides of the story.

Travis Hafner (60 DXL)
Half as strong? That's never good, and shows just how far Hafner's right shoulder had gone, that it is only half as strong as the left after weeks of treatment and therapy. Dick Martin Award-winning trainer Lonnie Soloff was quoted as saying he's convinced that Hafner will be back this season, but he wouldn't venture a comment as to when. The slow pace of the effort to strengthen the shoulder aside, it'll trend upwards after it hits some trigger level, but there's no clear evidence that Hafner is making that kind of progress. If it's at 50 percent, there's little chance that Hafner could be effective, but no one seems sure at what level he could be. One of the doctors who advises me said that's all on Hafner: "It's what point he has to be at to get the bat through, what adjustments he can make, and so much more that's completely dependent on [Hafner]." An interesting point is that Hafner has dealt with shoulder problems for years, but this injury is an acute one, making any adjustment tougher. While I'll trust Soloff's prediction that Hafner will be back, I'm still not sure what version of Hafner we'll see when he does.

Scott Kazmir (0 DXL)
The flip side of pitch counts is pitch inefficiency. Pitchers bound by the prudent use of a cap on their daily workload often end up coming out of games well before they should when their command-or a nibbling nature-works against their stated goal of staying in deep into the game and getting the win. Different pitchers adjust to this differently, such as Roy Halladay's changing his style to pitch more to contact, while others focus more on getting in a solid-as-possible six or seven innings. I'm left wondering why Kazmir is both stuck on his pitch count and why he hasn't yet been able to adjust. His recent inefficiencies are nothing new, but as the Rays begin to look towards their first meaningful September, getting Kazmir to pitch into the seventh is one thing that could improve the team that much more. Trainer Jim Hickey's done well, but this could be his biggest challenge in the second half.

Quick Cuts: I hope to see you all tonight (Monday) at Foley's in New York City, and I hope to see others of you at the next Tampa Event, which looks like that will be on August 29th, which could be the night the Rays lock up a winning season for the first time. I'll have more details about that event soon. ... I was in a taxi coming out of The Country Girl when I saw a big ticker say Magglio Ordonez hit the DL with an oblique strain. Honestly, that's about all you need to know at this stage. ... Michael Cuddyer also hits the DL with a strained finger. I'm working on the particulars. ... Ryan Braun is still dealing with some pain in his hand, but it's nothing major according to sources. ... Josh Johnson may be activated by the Marlins if his next rehab start goes well. His Sunday start did not go so well, but he's still expected to be called back later this week. Anibal Sanchez will be the next Marlins pitcher they'll be focused on. ... Chone Figgins played Sunday, but he's still fighting that infection in his knee, and he will need some offdays, and will have to deal with diminished speed and range. ... Lastings Milledge hits the DL for 15 days (and probably more) with a groin strain. ... Fausto Carmona won't try throwing another bullpen session until next weekend, pushing his return further back. ... A lot of people are curious if Dontrelle Willis will have significantly changed mechanics when he makes his first appearance for High-A Lakeland, scheduled for Sunday. Three walks in two innings and reports that he looked the same means you shouldn't expect a quick fix. ... Don't expect J.J. Putz back before August.

Related Content:  Back,  Sprain,  This Time It Counts

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