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April 29, 2009

Under The Knife

Same Old Stories

by Will Carroll

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Alex Rodriguez (25 DXL)
Really? I'm not sure where we might have heard that before. Yes, I shouldn't crow about this too loudly, because Karma will jump up and give me a big ol' cause for regret, but it's the process here, not the right or wrong. As we assessed information, from the beginning of A-Rod's injury to the current state of affairs, it has led us to believe that he'd be ahead of schedule and that the Yankees' caution with their star slugger would perhaps be the only thing reining him back. I didn't think it would hold, though the Yankees have shown some institutional fortitude at times. Rodriguez has simply been the perfect model of conditioning and baseball skill getting the benefit of the best medical technology. Most of the errors made by people assessing this injury were caused by their using normal physical therapy protocols, which are almost exclusively based on people more like your grandmother than like an All-Star. Rodriguez has given no sign during his rehab that he won't step into the lineup and play at his former level.

Cole Hamels (0 DXL)
Some argue that Hamels is this year's Yovani Gallardo, in the sense that injuries disrupted their seasons, and perhaps that gives a little too much credit to the Verducci Effect where people shouldn't be jumping to refer to it. Gallardo's freakish knee injury last season had as much to do with fatigue as Hamels' long season contributed to getting pegged by a Prince Fielder liner, right? Well, again, not so fast; remember that we're not dealing with arm injuries here, but fatigue. For pitchers, arm injuries are often how fatigue will present itself, but not always. Was Gallardo a half-step slow in getting over? Was Hamels a bit slow on his follow-through? It doesn't look like it, but fatigue as a factor is both general and unpredictable. Hamels had another injury in his latest outing, despite getting back out there in turn after being hit by the comebacker. This time, he was pitching well again (a good sign that wasn't noted last time out) when he sprained his ankle fielding a grounder. Hamels said that he thinks he'll make his next start, which will be in six days due to an offday on the schedule, but the injury was serious enough that they sent him for X-rays. We'll have to see if he makes his throw day before we'll know if there's any need to assign a DXL figure.

Brad Lidge (10 DXL)
The Phillies are also waiting on Lidge and his knee, and waiting is really all they can do. He's undergoing treatment, but it's only rest and a few days' worth of time before they'll know whether or not it's working. That's frustrating to the team and to Lidge, especially since the closer is acknowledging that it's not getting any better, and he's not really sure that it will. As we noted yesterday, the injury is right in the area where he's had previous surgeries, and Lidge let slip that he's been taking anti-inflammatories since that procedure. If there's a grinding or some other chronic problem, it might take yet another surgery to fix it, which could cost him six to eight weeks. The hope is that rest and increased anti-inflammatories will help, but his quotes about "grind" and "knocking out the problem" have me worried that he's going to want to get aggressive quickly.

Josh Hamilton (15 DXL)
There was a bizarre note tossed into some reports on Hamilton, and honestly, I can't figure out where it came from: several stories said that he was in extreme pain and would probably end up on the disabled list, and that he thought that rest, not surgery, would help him heal. Up until that last part, I'm down with it. Hamilton ran into the wall and was sore, but it became progressively worse over the weekend, leaving him likely to hit the DL. The "extreme pain" is a direct quote from Hamilton, and the worst sign here. It's the surgery comment that loses me, since there's no possible surgical fix. I can't find the genesis of that one, but it seems to be a red herring. The team has some outfield depth, but none of the alternatives have Hamilton's power. The likely replacement is Greg Golson, a speed guy who's hitting well in Triple-A. The long-term prognosis for Hamilton is a bit unclear; the team isn't saying if this is a fracture, a strain of some sort, or if it's just one of those painful traumas that needs some time to heal, though the symptoms and the cause point to a bone bruise, which can come with this kind of extreme pain. If that's the case, he should get better with rest, but not quickly.

Carlos Delgado (5 DXL)
The Mets' first baseman had an MRI and a cortisone injection in his hip yesterday. Or maybe he had a cortisone injection and then the MRI. The order of these things usually doesn't matter, but in trying to assess how serious his hip situation is, this time it does matter. If the injection came first, then it's likely that the swelling was significant enough that doctors were worried about their ability to visualize the hip. If it came after, then they probably saw something on the images that they thought would be relatively simple to clear up. So you see how the difference in sequence can be important. With Delgado expected to return on Friday, it sounds as if the swelling in his hip is under control, but it bears watching closely. For the risk-averse, a hot streak would be the right time to swap Delgado out for something less risky. The Mets don't really have that option.

Geovany Soto (2 DXL)
See if you know this melody: the Cubs insist nothing's wrong with Soto, despite a terrible April, a prior shoulder issue, and Lou Piniella giving Soto a couple of days rest. It's clear that something's going on with the shoulder, but even if it's not a physical problem, it seems to have gotten into his head or changed his swing at the very least. There's simply no other explanation for him going into such a hard-core sophomore slump. The upside is that Soto hasn't forgotten how to play, and since the shoulder is the usual suspect here, it's fixable in some shape or form. It bears watching to see what the underlying issue is and how quick the fix will be, depending on your panic level; for most Cub fans, they dial it up to 11 pretty quickly.

Edwin Encarnacion (20 DXL)
Encarnacion had been dealing with some wrist soreness since spring training, but it got significantly worse after Monday's game. Tests showed a chip fracture in his wrist, possibly signaling a stress fracture as the cause of the previous soreness. These are extremely difficult to diagnose, even with imaging, so it's hard to blame the Reds; it does at least explain why Encarnacion was struggling at the plate. This type of fracture heals quickly and tends to not be quite as bad as most wrist problems in after-effects, so there's that as a positive. The talented but frustrating third baseman shouldn't miss much time beyond the minimum, with Jerry Hairston Jr. seeing most of the time at the hot corner in his absence.

Mark Ellis (15 DXL)
Nomar Garciaparra (20 DXL)
Santiago Casilla (3 DXL)

Three players lost in one game? The A's hit a nasty trifecta, having to lift three players in one game due to their suffering the same injury; that's something that we don't have records for, but it obviously occurs infrequently. Already shorthanded due to Eric Chavez's injuries, the A's lost Ellis to a strained left calf, Nomar to a strained right calf, and then Casilla came out with a strained right calf. Worse, starter Brett Anderson also had to leave the game, but his problem was a blister and not his legs. Both A's infielders are headed for the DL, but the pitchers aren't. We'll see how the A's juggle things, but once again, the team is suffering from a lot of injuries. Again.

Quick Cuts: The Cubs expected Aramis Ramirez to be back already, but he tested the calf and failed; he'll be re-evaluated on Thursday, and it sounds like he's headed to the DL. ... Despite an 0-for-3, Brian McCann was encouraged by the results in rehab playing with his new contacts. ... Jose Valverde went to the DL with his calf strain. ... Barry Bonds had 32 walks in April 2002; it's not quite the same thing, not yet, for Albert Pujols, but it's not that far off either. ... Chris Getz will try to play through a fingertip fracture; several players have been able to play through these, including Alfonso Soriano. ... Kyle Lohse showed no problems with his knee during his Tuesday start and continued to be Dave Duncan's latest reclamation success story. ... Jim Thome will be back for the White Sox's weekend series. He's being held out because of a heel bruise.

18 comments have been left for this article.

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