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April 20, 2009

Under The Knife

Monday Meds

by Will Carroll

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Brian McCann (NA)
One of the least understood advances being made in baseball involves fine-tuning a player's eyesight by opting for laser eye surgery. In its various forms, the vision correction has been credited with great feats, but the data set is so incomplete as to make it difficult to even guess about the actual effects. If there's one thing we could say about the surgeries, it was that it couldn't hurt. There had never been a negative consequence that was made public, but now we might have the first. McCann had the surgery last year, and has had trouble with dry eyes from time to time since then. It's become significantly worse over the past few weeks, and he's going to head to a specialist to have his eyes checked. There's a chance that he may need a redo or some smaller procedure. Since we don't have any in-season examples, we really have only anecdotal evidence to go on. McCann may need to go on the DL if the problem can't be corrected with eye drops, and this has the potential to go much further if more surgery is needed. This one will need to be watched very closely, though the team expects to make a DL decision on Monday. I don't have enough information to put a DXL on this.

Alex Gordon (60 DXL)
Gordon had his hip scoped on Friday, and according to reports, everything went as planned. The labral tear was repaired, and he'll head directly into rehab. Like Alex Rodriguez, Gordon was on a stationary bike within 48 hours of the surgery. It's always hard to tell how an individual will react to a major injury; it's a combination of pain tolerance, drive, conditioning, and genetics. It appears, though, that Alex Gordon is on much the same track as A-Rod, and while I'm going to leave the DXL at the long end of current estimates, there's no reason to expect (yet) that he can't come back on much the same schedule. It's almost funny to think back to the early reports on Chase Utley, when we were talking about his missing six months.

Cristian Guzman (15 DXL)
The Nationals-or is it Natinals now?-spent much of the weekend reconfiguring a team full of holes. One of those holes is at shortstop, where they made the move to push Guzman to the DL. This was a little surprising, since Guzman not only insisted that he was fine, but also demonstrated it with some agility drills. There might be some conservatism at work on a team under fire and with an all-new medical staff. His hamstring is worrisome, given the two "pops" that he described, as well as his past problems there. Still, all indications are that he'll return by the minimum and jump right back in where he left off, making Nate Silver look like a genius. Again.

Jay Bruce (3 DXL)
There may not be a more wired press corps than what they have in Cincinnati. All of the major beat reporters not only blog, they also use Twitter to get information out. That kind of quick data flies in the face of the idea that injuries can still be hidden. (Let's see if NFL beat writers figure this out.) We'll leave the concept that there's some competitive advantage to hiding injuries alone for now, and get back to Bruce, who was first thought to be out with a hand injury. He'd been hit on the hand by a pitch, so that was a reasonable assumption, though reports that it might be his wrist percolated on Sunday. Word is that X-rays were negative on both locations, and that Bruce will be back early this week. Look out for any signs of lingering problems in both his bat control and power.

Trevor Hoffman (20 DXL)
"Hell's Bells" in Nashville? That might not seem like the best fit, but Hoffman is headed to Triple-A. Given that most rehab outings for closers are set up with them "starting," it would probably seem a little strange to hear his trademark entrance music playing in the first inning. Hoffman has had no issues with his oblique during recent throwing sessions, and he's expected to have a few outings in Nashville to make sure he's ready. (Tuesday and Thursday are the plan, if you're looking to go.) He should be back in the Brewers' bullpen by the weekend. While I don't expect any problems, I also don't expect miracles. The differential between his fastball and changeup will remain the best predictor of his success. Don't discount the stellar performance of Heath Bell as a motivator for the competitive Hoffman.

Brandon Webb (15 DXL)
Webb is passing all of the tests the Diamondbacks are putting in front of him. He'll progress from flat ground to the mound on Tuesday, and sources tell me that they don't anticipate any problems, since he has been "living in rehab," going above and beyond. One compared Webb's reaction to that of Ivan Rodriguez a few years ago, when he first had back problems. He became fanatical about his stretching and other treatments designed to keep his back from becoming a problem again, and to this day, it hasn't been. That kind of a wake up call would be great for Webb and for his future. If he can make it back and stick, getting anything close to his Cy Young-caliber results, he'll be set up for a huge free-agent payday, insured or not. While he won't make it back at the minimum, he won't be far behind.

Chien-Ming Wang (0 DXL)
It's difficult to put a guy who says he isn't hurt into UTK. Wang and the Yankees insist that there's no physical problem in his arm or in the foot that cost him much of last season. The trouble is that they don't have a better explanation for his struggles. I've watched video on him from his first few starts this year, and from last season, but I don't see any differences that are jumping out at me. Failing an explanation, Wang and the Yanks have to figure out why he's suddenly not just hittable, but crushable. I think we'll find out that there's something out of whack, but this is going to be a major challenge for Dave Eiland, who up to this point has been rather invisible, as has most of Joe Girardi's staff.

Mike Pelfrey (9 DXL)
As expected, the Mets skipped Pelfrey's turn on Sunday, filling the slot by juggling and re-juggling their roster. None of those machinations have much to do with his forearm issue, but it could tell us that the team doesn't believe that this is a long-term problem. With a few DFA's to fill Christina's in-box, the Mets haven't DL-ed Pelfrey, and they seem to have him on track for his next start this Saturday. Better, sources tell me that the anti-inflammatories that he was placed on last week appear to have helped. He threw on the side this weekend and experienced no pain in the arm, and he'll have a bullpen session early this week that will be telling. I'm still very concerned about Pelfrey in the longer-term due to his workload, so while things may look better now, don't get too comfortable with a guy this deep into the Verducci Effect zone.

Adam Jones (2 DXL)
I never trust an athlete's self-diagnosis but all indications are that Jones is quite accurate. He has a mild hamstring strain that's functioning as more of a cramp than an actual strain. The worry is that if it tightens up, it could result in more tearing, so he'll take a day or two off and be back in the lineup. With some depth available, the team can afford to be conservative, but the O's don't tend to play things like this that way. Jones' injury concerns remain one of the few knocks against his game, and any leg problems are going to fire up the rumors of his hip condition. This is nothing more and nothing less than a simple hamstring strain, like a million others we'll see this season.

B.J. Upton (1 DXL)
Whenever a player goes out mid-game, fans become worried and fantasy owners whip into a frenzy. In this Twitter-speed world, the news that someone with a thick injury history just off of the DL had been pulled out amped up the noise even further. The thing is, he was lifted as a precautionary move by a conservative medical staff, a smart maneuver given his past leg problems. It was nothing to worry about, but it often seems that worry is what baseball fans do best. Upton is not expected to miss any time, though he's unlikely to run quite as much in the near-term. It does help to know a medical staff's tendencies, assuming that you want to reduce your stress levels. Then again, a lot of people seem to enjoy that feeling.

Quick Cuts: Alex Rodriguez remains ahead of schedule, but it does sound as if the Yankees aren't going to let him back off of the timetable, so he should still be back May 1. ... The Angels seem ready to send out both John Lackey and Ervin Santana for rehab starts. Both will likely stay close to home in the Cal League, and should only need two starts before being ready. ... Julio Lugo could be back as early as the end of the week. ... Brandon Backe will head out to one of the Astros' affiliates "within driving distance" for a rehab start later this week. ... Breathe, Baltimore. Matt Wieters has a very mild hamstring strain. He'll miss a couple of days, but expect the O's to be very, very cautious with Wieters. You'll probably hear people mentioning "tall catchers," and yes, there's something to it. ... If you like cigars, you have to try the new Cruzados. Just wow. ... Evan Longoria has a mild foot sprain and could be limited to DH duty for a few days. The Trop's turf did come into play in the decision and the injury itself. ... The Twins finally admitted that May 1 is the target date for Joe Mauer to return. He'll be playing a few games before that in Ft. Myers. ... Joel Zumaya went two scoreless innings on Saturday for Toledo. He was in the mid-90s, but "not dominating," according to observers. He'll be in the Tigers' pen by the end of the week. ... The D'backs were missing the entire left side of their infield on Sunday. Both Mark Reynolds and Stephen Drew had minor leg strains.

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