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April 28, 2009

Under The Knife

Close Calls and Closers

by Will Carroll

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Hanley Ramirez (5 DXL)
Take the force of five ounces of horsehide and yarn traveling at 94 mph, and put one MVP-caliber hand in its way. I don't have the math skills to put that into an equation, but they add up to what could have been a devastating injury. John Maine's heater cracked Ramirez on the right hand, causing Marlins fans and fantasy owners to gasp in unison. X-rays came back negative, but you could see Ramirez's hand swelling before he could even get out of the batter's circle. This is a painful injury at the very least, and it will cost him a couple of games/days as it calms down. There's also concern that there might be further damage, such as smaller fractures that could have been missed. So far, all signs point to this being nothing more than a nasty bruise in a bad location, but the Marlins have seen a similar situation with Jorge Cantu going through some ups and downs as he worked to get back into the lineup; this looks very similar. Also, may I take this opportunity to once again suggest that players wear some kind of protection on their hands?

Brad Lidge (3 DXL)
Lidge hasn't been Brad Lidge! yet this season, that fire-throwing closer that was perfect through all of 2008. That could be sample size, or one of a million other things that the modern closer deals with. It could also be that his knee is acting up again. Yes, it's the same right (push) knee that he's had surgery on twice before, and remember, anytime a menisectomy happens, the cushioning cartilage that is scraped away is no longer there to provide a cushion. The value of the present short-term function is balanced against the possible long-term damage. Lidge doesn't have any structural issues, but he is seeing swelling and pain, which could be an indication of bone-on-bone grinding, among other things. The Phillies aren't pushing him to the DL yet, and surgery doesn't appear to be an option, but both remain on the table as they try to figure out how to get Lidge back to full function.

Joakim Soria (10 DXL)
Lidge is hardly the only closer who is having issues. It's also been very difficult getting a read on Soria. He came up sore late last week, but sources tell me that he's been dealing with that since spring training. (Cue the theme to "Blame the WBC!") All of the symptoms and tests seem to point to a simple soreness, but some worry that we're seeing the beginnings of an impingement syndrome. The Royals are being very conservative, resting him and only letting him do light throwing on Sunday, with a more vigorous session scheduled for Tuesday or Wednesday. The team will make a decision on whether or not to DL him at that point, but there are no leanings either way at this stage. At the very least, Soria's risk factor just soared, while Royals fans felt that familiar sinking feeling in their chest. I hope I'm wrong, but I don't feel good about this one. He's unlikely to be back before the weekend, even in the best-case scenario.

Jose Valverde (5 DXL)
Josh Katzowitz has already reported on the way that Valverde demonstrated how bad his leg injury is; it's a must-read for the first two paragraphs. The swelling, more than the pain, is the real issue now, but trying to pitch through it didn't help him, and the rest prior to his Sunday outing didn't appear to be enough. That outing takes away the retro option, and leaves Houston with a hurting closer. Sources tell me that the Astros still don't think that the injury is severe enough to need a full fifteen days to heal, and that they're willing to go with a short pen, in large part because Roy Oswalt will pitch twice this week. That confidence that he can "cover" for the pen is one of those variables we don't often make note of on the outside, but it can play a huge part in how DL moves are made, or in this case, not made. The Astros will make a decision on the DL by the end of the week.

Brad Hawpe (N/A)
Hawpe was hit with a pitch, but not in the usual way. He was diving into second base when the pickoff throw from the catcher went awry, hitting him on the neck. He was clearly unconscious, and he was removed from the game on a stretcher, a reminder that this is a dangerous game. This is the second play of this kind in the past week, with Ryan Freel being hit in virtually the same spot by a throw from the pitcher. Hawpe was held for evaluation overnight, and while it appears that he'll be OK in the long term, concussions are difficult to read, so there's no DXL yet. While it's "only" happened twice this week, I think it's time for baseball to take a look at two small equipment changes. First, they need better-fitting helmets that will stay on a player when he's running or diving. A lot of that blame goes to the players, who purposely select more comfortable, loose helmets. Secondly, the flaps should be on both sides, and there needs to be more surface area that will protect against this type of situation while not impairing the player's vision. NASCAR has developed very light, very open helmets for their pit crews, which could serve as a starting point for the design of similar gear for baseball.

Chris Dickerson (3 DXL)
Miguel Tejada (0 DXL)

My hockey duties kept me from getting to Cincinnati last night, but I'm not sorry to have missed a nasty basepath collision between Dickerson and Tejada. It was an odd play, very awkward looking, and perhaps not as bad as it could have been because of it. Dickerson was decelerating as he slid, and hitting Tejada's head rather than his knee provided some respite. A knee is harder, more pointed, and doesn't give way as much as a head would. (How does a head "give" without causing major problems? Watch the play again: See Tejada's neck snap back? That's how.) Dickerson was concussed, and gave a great line to reporters, saying that "everything went from HD to regular"; he'll be watched closely over the next few days. Tejada stayed in the game and reported no problems with his head or neck. With that collision though, there may be some delayed effects, so I'm sure the Astros' staff will be watching him as well.

Brian McCann (20 DXL)
Tom Glavine (45 DXL)

Remember that eye infection that McCann had? Well, he's back to contacts, confusing the storyline even further. Reports out of Atlanta have him trying various types of contact lenses to try and clear his fuzzy vision. While there are no details on how this went, the whispers followed yesterday's column, as I was trying to fill in the data. One plausible story that came out yesterday is that McCann had an infection in his eye that led to the change in his visual acuity. My optometry adviser says that it is a possible explanation for the time line, though it's rare that an infection isn't caught early enough to prevent it from changing the actual shape of the eye. I don't think we have the details necessary to really understand this yet, but I'll continue to follow it. At the very least, there's reason to be encouraged that his return won't be delayed; the Braves announced that he'll will head out for a few rehab games as a test. The Braves also got some good news on Glavine, who started throwing again after being shut down for two weeks. Glavine has said that he'll retire before doing another extended rehab, so it will be within the next ten days that we'll know if he'll be back, or if we've seen the end of a Hall of Fame career.

Quick Cuts: After visiting Dr. Andrews, Jesse Litsch was told to rest. See, I told you it's not always gloom and doom. ... Josh Hamilton was held out of the Rangers' lineup again, due to continued soreness after bouncing off of the wall late last week. ... The Pirates won't make a decision on Nate McLouth until the end of the week. The patience shows that they think they'll get him back without having to use the DL. ... Kyle Lohse will pitch today, despite a mild knee sprain. ... Of all the things that could have hurt Carlos Delgado's hip, it was a triple on Sunday. Hold up at second next time, big guy. The hip will cause him to miss a couple of games, but isn't believed to be serious.

Related Content:  Brad Hawpe,  The Who

17 comments have been left for this article. (Click to hide comments)

BP Comment Quick Links

Alex Schwartz

I hate to beat a dead horse (I brought this up in Christina's column), but any thoughts on the drop in Joba's velocity and the increase in Verlander's?

How does Soria's injury change the likelihood of the Royals showing some willingness to transition him into the rotation?

Apr 28, 2009 12:08 PM
rating: -1
 
wonkothesane1

Verlander said that they fixed his arm slot. He said he was throwing much higher last year and he moved the arm slot back down to what he called his "natural" arm slot.

Apr 28, 2009 13:43 PM
rating: 0
 
harderj

who gets the saves in KC?

Apr 28, 2009 13:02 PM
rating: -3
 
KerryFam4

As a Braves' fan, I follow the Brian McCann situation pretty closely. I can't find the source now but I think I read a story or a post that seemed to indicate that the Braves had to select from a list of available DL conditions and 'infection' sounded better than 'strain', 'sore', 'broken', etc.. Almost as if there's a drop down menu when you fill in the DL template and you have choose from one of the options (and body parts) listed. I'm sure you have access to better sources than what I'm reading but I haven't heard anyone from the Braves or McCann himself quoted using the term 'infection' to describe his condition.

Apr 28, 2009 13:11 PM
rating: 0
 
HankScorpio

From Will in the comments from yesterday's UTK:

"It's not like it's a pulldown menu AND it's not like they're required to publicize what the doctor wrote. I'm not giving them a pass on this but I am saying "there's more to this we don't know." I'm digging ..."

Apr 28, 2009 14:33 PM
rating: -1
 
Nathan

Does this make it more or less likely that the Royals will eventually move Soria to the rotation? Also, as a separate question, does it tell us anything about whether they should've left him a starter to begin with?

Apr 28, 2009 13:14 PM
rating: -1
 
wonkothesane1

Hawpe is a LH batter and the right side of his body was toward the catcher when the throw came in. So the ear flap was on the impacted side. What it looked like was almost a hit to the neck as it hit him with an upward angle underneath the edge of the helmet behind the ear flap. I'm guessing that it hit the bottom of the skull there and rattled things enough to cause a concussion. It was certainly an odd impact location to suffer a concussion from. I was worried that it hit his neck and had damaged an artery/vein or something.

Apr 28, 2009 13:41 PM
rating: 0
 
dianagram

Scary indeed .... but Will, I don't believe he lost consciousness. He was NOT removed on a stretcher. They placed his neck in a brace, stood him up, escorted him to a motorized cart, sat him down, and drove him off while one of the EMTs held his neck steady.

(I saw the game live on Extra Innings)

Apr 28, 2009 13:57 PM
rating: 0
 
BP staff member Will Carroll
BP staff

I stand corrected. Saw the cart, saw him on it, poor wording on my part.

Apr 28, 2009 15:16 PM
 
tfierst

If bone on bone isn't a structural issue, what is?

Apr 28, 2009 13:55 PM
rating: 1
 
BP staff member Will Carroll
BP staff

"Structural" has come to mean the supporting structures (ligaments and tendons) and it's vague enough that teams like it. If you think of the meniscus as a shock absorber, it's possible for the car to drive fine, ie the structure is intact. It's just gonna be bumpy.

Apr 28, 2009 15:22 PM
 
antoine6

Carlos Ruiz was scratched from his rehab start last night with "Discomfort". Anything on how much longer he'll be out?

Apr 28, 2009 14:09 PM
rating: 0
 
NealPhD

I noticed that Mike Lowell seemed to have some sort of hand protection on his batting glove.

Apr 28, 2009 14:33 PM
rating: 0
 
BP staff member Will Carroll
BP staff

Yep - he wears a plastic insert of some sort.

Apr 28, 2009 15:19 PM
 
Evan
(47)

Concussions are brain injuries.

Brain injuries are bad.

People need to learn this.

Now, that said, the Dickerson/Tejada collision is just one of those things that happens (like the Jackson/Damon collision in 2003, or the big Cameron/Beltran collision). But baserunners and catchers need to wear better helmets.

I would like to see baseball have some rules about manadatory missed time on concussions like professional rugby leagues do. When the Red Sox left Damian Jackson in the game after he lay unconscious on the field for 2 minutes in 2003, they were gambling with his life.

Apr 28, 2009 14:36 PM
rating: 0
 
BP staff member Will Carroll
BP staff

Downside there is we'd have what Rugby Union has, which is deliberate misreporting. Instead of concussion, we'd have "whiplash" or something. I looked at this last year in regards to the NFL. It's not so much a problem in MLB since it's not a part of every play, but an anomaly.

Apr 28, 2009 15:18 PM
 
eighteen

Any word on Kuroda or Meche's back stiffness? Thanks, Will.

Apr 29, 2009 08:44 AM
rating: 0
 
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