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July 9, 2008

Under The Knife

Knowable Risks

by Will Carroll

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Rich Harden (0 DXL)
There's one constant meme within the discussion of the Harden-to-Cubs deal. That is that the A's, understanding Harden's medical situation better than anyone, knew his true value-what Joe Sheehan called "a free Rich Harden"-and saw it as the return they got. I'll leave the trade analysis to Joe and Christina, but I'd like to look at this concept: do the A's really have a better handle? I agree with the way they've dealt with him and with the conclusions they've come to, but even with the changes made coming into the season, they don't have a great track record on injuries. Bobby Crosby has been the most vocal about his injury situation, but he's not the only player that's been unhappy. It's a new staff, and relative to expectations in 2008, the A's have had a reasonable return. With guys like Harden, Eric Chavez, Crosby, and others on this roster, they were never going to have a low DL day total.

For Harden, the focus has to be on the fact that for a couple of years now, the A's haven't been able to keep him healthy. On his own program this offseason, and making some mechanical changes, it appears that his results have been better than what the A's could provide. Is it a fluke? Who knows at this stage, but that's data. The Cubs, clearly in a win-now mode, got an upgrade with some downside. The Cubs were willing to take on that risk after a sign-off from their own doctors and the word of Lewis Yocum, though there's one outside factor that I'm still following up on. While Harden is always going to be an injury waiting to happen, I think that the risk, and the team's relative assessments of that risk, are going to be the deciding factor in the perception of who "won" this deal. Given his last start, Cubs fans ought to be watching Harden's velocity closely.

Adam Wainwright (45 DXL)
Chris Carpenter (130 DXL)
The Cardinals would like to remind the NL Central that they're still in this thing despite having Christy Brown and Ray Price as their fourth and fifth starters at times this season. While the Brewers and Cubs are making big deals, the Cards are just looking to get their co-aces back on the mound for the second half. Wainwright has been cleared to start throwing again, though it's going to be the start of August before he's back in the rotation. Chris Carpenter is said by sources to be even further away, though he is throwing simulated games and could be on a rehab assignment before the end of the month. Stamina is the real question here, though a recurrence of the neuritis is something the staff is watching closely. The Cards will continue with their stopgaps, held together by duct tape and Dave Duncan voodoo, with Mark Mulder making his first start of the season on Wednesday.

Bobby Jenks (15 DXL)
The White Sox have decided to go conservative with Jenks and his back strain. While sources insist that he hasn't had a setback and that the team seriously considered not DL'ing him, the final decision was that with the retro move in place and the All-Star break coming up quickly, it was better to just go ahead and make the move. "It was to get things clear," the source told me, "so that Bobby could come in and know, rather than saying he thought he could pitch." The back injury is definitely an issue, but given the track record of both Herm Schneider and Don Cooper, there's not a much better situation for someone like Jenks to have this problem. While Jenks' physical conditioning (or lack thereof) is definitely a concern, some think this could be the kind of wake-up call that Jenks seems to need now and again. He'll be back just after the break and will slot in as closer without challenge.

David Ortiz (45 DXL)
Ortiz is hitting again, and hitting hard. Reports of his batting practice work gave bold-print notice of his six home runs, all pull shots. This is key, since the abduction of his wrist is where the tendon and tendon sheath would be under the most stress. Of course, Ortiz isn't much of an opposite-field hitter anyway, but the scouting reports are going to write themselves: down and away, down and away. Ortiz still has some recurrence risk, but it appears the bigger challenge is going to be whether he can make the adjustments at the plate needed to avoid being pitched around. One interesting note is that Ortiz is hitting without any sort of brace or even tape. That's a good sign for the strength in the wrist and how the medical staff feels about it. We won't see Big Papi in the Home Run Derby, but we should see him shortly after the All-Star break.

Jeff Suppan (20 DXL)
Some moves are just convenient. That's not to say that Suppan or anyone in a similar situation isn't actually hurt, but Suppan, who's had a bad couple of weeks, was likely pitching through the elbow soreness, and probably could have continued to if the Brewers were willing to accept the poor results. Now that CC Sabathia is on board, the Brewers can give Suppan some time off to heal up, and to figure out how their rotation will sort out once he returns. He's likely to be the guy who helps keep Manny Parra fresh as Parra tests his career highs in innings and nears Verducci Effect territory. Suppan will likely be back around August 1, though that date will depend on several factors, including how well Parra and Seth McClung pitch in the interim.

Elijah Dukes (50 DXL)
Dukes heads home to Tampa to have his knee scoped by Rays' team doc Koco Eaton, and will miss about six weeks. That's at the back end of the range that the Nats are posting, but given their record I think they'll be happy just to get Dukes back out on the field a bit to be sure he's healthy. They've seen enough from him to know that he was certainly worth trading for, and that has to be a feather in the caps of Manny Acta and Jim Bowden. Dukes will have his meniscus and patellar tendon repaired, something that can be done by arthroscopy. It's not a minor procedure by any nature, but there's little doubt that Dukes can return and be effective. The bigger question is if he can ever stay healthy. The Nats like what they have, but many are questioning if Dukes can ever stay on the field long enough to be more than a fourth outfielder. Combined with the rest of the Nats' injury-prone players, the value of Dukes is shifted downward.

Ryan Church (15 DXL)
The Mets put Church back on the DL with post-concussion syndrome after further tests showed that his symptoms weren't the result of chronic migraines, but rather the effects of Church's previous brain injury. Of course, this comes a day after reports that specialists had cleared Church to play again, so the story is both confusing and a source of concern. It's easy to criticize the Mets for their handling on this, but the confusion makes it difficult to say just how much they've been acting on need and purpose, and how much on medical advice that doesn't line up with Church's symptomology. As long as Church is experiencing symptoms like nausea and dizziness, and as long as he has concerns about his fitness to play, he shouldn't be playing. The Mets are in business to win, but there is a point where they have to step back and realize that the long-term view as well as the compassionate view actually might end up being the better play. I'm putting Church's expectation at 15 days, but there's really no way to tell.

Brian Bruney (90 DXL)
Bruney might not seem like a big part of the Yankees' chances, but he is a kind of symbol. Bruney is making some appearances at High-A Tampa and could be back in the Bronx soon. That will help with the bullpen's depth, but where Yankees fans should be taking notice is in the success and speed with which the Yankees' medical staff brought Bruney back from his Lisfranc injury. Yes, that's the same injury that put Chien-Ming Wang on the DL, and it gives us an interesting basis for comparison. While Wang and Bruney's injuries are not identical, because any two individuals will have differences, there's enough commonality here to make some reasonable inferences. If Bruney is back at or near the 90-day expectation, that would put Wang on track for a return in mid-September. As before, Wang's return will depend on the Yankees record at that point, but if the team can get back in the race, they may get a late-season boost from their ace.

R.J. Swindle (0 DXL)
For sheer joy, go now to see how R.J. Swindle's 55 mph curves looked on the new 3D Gameday. Without sounding too much like a commercial, compare what you see here to what it looks like on video. You'll be stunned! It's not an "eephus" or some trick pitch, it's just one of the damnedest things you'll see coming out of a pitcher's hand. As expected, good major league hitters like David Wright will be able to tee off on it, but for guys without that kind of eye and quick hands, it's going to make some people look mighty stupid. Swindle makes for a fun counterpoint the next time someone argues about velocity. I'd kill to see the advance scouting report the next few teams facing the Phillies get.

Quick Cuts: Fausto Carmona will throw a simulated game on Thursday and could be back just after the All-Star break if all goes according to plan. ... Paul Konerko was activated by the White Sox and goes right into the starting lineup. ... Ian Snell is saying he has his velocity back. The bigger question in his next start will be if he has his breaking stuff back. ... Todd Helton is having more problems with his back, with pain radiating into his legs. This is a bad sign, and Helton could be out much longer if epidural injections don't have the desired effect. ... Hank Blalock is headed out on a rehab assignment and he's expected back after the All-Star break. No one seems sure what his role, if any, will be. ... Jim Edmonds had imaging done on his injured thumb. No word yet on how much time he'll miss. ... The D'backs reportedly have considered Barry Bonds, Kenny Lofton, and Jay Gibbons to help fill the gap with Eric Byrnes out. That's like considering whether to date the two in the middle or the two on the ends. ... Quick request: Would the reader who talked with me and Joe about data at the NYC Feed please email me to discuss further? ... Ryan Spilborghs is heading to the DL with an oblique strain. With Willy Taveras still dealing with the quad strain, Scott Podsednik goes from being almost out of a job to the starter. ... Not only is Vicente Padilla not throwing, now Kevin Millwood might need to push his start back due to a sore groin. Good thing the Rangers have options. ... Dustin McGowan is heading for an MRI on his pitching shoulder. I should have more on this tomorrow.

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