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May 28, 2009

Under The Knife

Star Search

by Will Carroll

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Grady Sizemore (0 DXL)
A "hot" elbow? Hmm, I'll spare you all the easy Sizemore jokes, but what exactly is a hot elbow? It's... well, it's sore, and perhaps a little swollen, but that doesn't tell us much. One theory is that "hot" refers to a spot often seen on MRIs in areas of the joint where the scanner's uptake is a bit more or less than it is elsewhere because not everything "takes" the magnetic waves in the same way, revealing a defect; that would be bad. The much more likely scenario, and one that two sources agree is the most likely, is that Sizemore has bursitis, and perhaps a burst bursa in that elbow. One of the symptoms of a burst bursa is that the skin near it becomes very tender and, yes, hot to the touch. The downside here is that at that stage it often involves an infection. People from Cleveland will twitch a little when they hear 'infection,' but this seems simpler right now. Sizemore wouldn't be allowed to play through an infection. Instead they're just protecting him by keeping him from throwing and hoping that this will calm down with some treatment and time.

Melky Cabrera (7 DXL)
After suffering a dislocated shoulder, hearing "you'll miss a week" is a win. Of course, that's just the preliminary diagnosis for Cabrera. It's good that there is little or no internal damage, but his reaction to it and the strength of the shoulder are going to be the real factors in how much time he misses. Cabrera is headed back to New York to begin a strengthening program and to see the team physician. This one's teetering on the edge of a DL stint, but the team will wait until the weekend before making a decision. In large part, it will be how much strength deficit there is in the shoulder (if any), and whether he'd be putting the shoulder at more risk by playing. As a clarification, Cabrera's shoulder injury is by definition a dislocation because it did not self-reduce, or pop back into place by itself. It was clear that Gene Monahan, the Yankees' ATC, was reducing it on the field, though the distance it was out was not great. Because of that, several outlets have described this as a separation, which isn't wrong, but it isn't "most correct."

Hanley Ramirez (5 DXL)
The Marlins are still in wait-and-see mode with Ramirez's groin. (Wait, that doesn't sound right, does it?) They held him out of the lineup on Wednesday in order to pair it up with Thursday's scheduled offday, giving him two full days of rest and treatment. They'll take another look at him on Friday, though sources tell me that while they don't think he'll need to go on the DL, they're also not sure if he'll be ready by Friday or even by this weekend. The team is going to be cautious with him, both because of his value and as the team assesses its depth to evaluate possible trades. In the meantime, with Chris Coghlan and Emilio Bonifacio able to move all over the field (not to mention Alfredo Amezaga), the Fish have some flexibility. Look for Ramirez to avoid the DL, but to miss a few more games.

Edwin Encarnacion (30 DXL)
Edinson Volquez (15 DXL)

The Reds have been coasting along in the middle of the NL Central's standings despite some key injuries. It speaks to their depth, but it also shows there's not a lot of drop-off from starter to backup. The team is looking forward to getting Encarnacion back, though he seems to frustrate everyone in the organization from Dusty Baker to Marty Brennaman. Encarnacion's rehab has been TRIP (for "Textbook Rehab In Progress"), and he'll make his next step this weekend when he takes live batting practice. If his wrist doesn't react to this, he'll head out to a rehab assignment, likely with Triple-A Louisville, and should be back shortly. As with any wrist injury, there should be some loss of power and bat control in the near term. There's also good news on the pitching side for the Reds, as Volquez threw nearly 100 pitches in a bullpen session. That performance showed enough stuff and stamina to convince the team that he's ready. He'll slot back into the rotation on Monday, though he's yet to say that his back is 100 percent, so watch for any sign that he's not bending normally as a clue of any recurrence-related issues.

Brett Myers (5 DXL)
Myers left Wednesday's game with hip pain described as inflammation, something that he says he's been dealing with for about a month. You know how I feel about injuries that are "suddenly chronic," but let's use the information as given, since there's no evidence to disprove it. Early reports had it as a simple hip flexor problem, though his velocity was fine. Looking at the Pitch-f/x data, there was almost no change in his velocity from what's normal for him, or even from the start of the game. A look back through this year's numbers shows the same thing, where one would expect to see some dip, even if it's a consistent baseline drop. The worry then, and one confirmed by the team sending Myers for imaging, is that there's a bone spur or some kind of hip labrum problem. The Phillies have a nice comparison available in Chase Utley, but we haven't seen that kind of injury in a pitcher yet. The most likely scenario is a quick cortisone injection in hopes of having him ready and more comfortable by his next start. An MRI scheduled for Thursday will go a long way in determining how the Phillies will handle this from an injury standpoint, and if Myers does have to go on the DL, there will be some real rotation issues.

Matt Harrison (9 DXL)
After some tweaks made to his delivery suggested by pitching coach Mike Maddux, Harrison looked like a world-beater for a couple of starts. Over his last few, though, he's just been beaten, and it looks as if it could be a physical issue. Harrison will miss his next start with what's being described as "mild shoulder inflammation." The team will skip his Saturday turn, replacing him with Friend of UTK Tommy Hunter or Kris Benson. Harrison has been placed on anti-inflammatories and will be spending a lot of time with Jamey Reed over the next week, but the team hopes he won't need to miss more than the one start. It's important to note here that the change in delivery that helped Harrison may also be taxing some areas that he hasn't had taxed before, so this is an all-too-common scenario. The question now is, can Maddux find a way for Harrison to be both effective and healthy?

Oliver Perez (45 DXL)
Perez had a rehab outing, and it looked like a normal Oliver Perez start; I'm not sure if that's a good or bad thing. He showed good velocity and had no problem making it to 88 pitches, but he had little command, throwing only 48 strikes. He had some trouble fielding, looking very uncomfortable with his knee and with his mechanics just after the play, according to an observer. That's interesting, in that there have been a lot of questions as to how serious the knee injury was. My observer said that Perez reacted spontaneously and seemed a little confused the next few pitches, trying to find a comfortable landing point. Perez is making progress, but the Mets will probably use nearly the entire 30 days of a rehab assignment to try and get Perez back to being useful.

Scott Kazmir (30 DXL)
There's a pair of rumors regarding Kazmir. In one, Kazmir's quad strain is very mild, giving the team just enough to plausibly place him on the DL while getting him away from the team for a while. In the other, Kazmir and the Rays are just not that into each other any more, and are looking for a trade. The downside is that while those two fit together in some ways, an injured player is more difficult to trade. There are a lot of attending rumors on the why and the where of this situation, but sources tell me that, while both are very true, there's also no movement yet in dealing him. Currently rehabbing at home, Kazmir's going to be heading out for some rehab starts soon, and at that point we'll know more, like how much the quad is really affecting him, whether he's been working on something mechanical, and if teams begin to scout him more heavily. It could be the team that he pitched against in last year's World Series taking the longest look, though the Rangers and the Mets are also possible destinations, were he to be dealt.

Kyle Lohse (9 DXL)
Lohse won't make his next start, all because of a HBP, but it was his being hit and not hitting someone else. Lohse was hit on his pitching arm, and he's having what he describes as a "burning cramp" in his forearm. The symptoms best describe a deep bruise, though it's possible that it's one of several other conditions. None are particularly serious, though the fact that he's having symptoms for this long and with this much discomfort speaks for itself. The team will wait to see if they'll need to replace him, but with a long stretch of games without an offday, the Cards' pitching staff is going to be taxed anyway.

Quick Cuts: John Mozeliak might have a "gut feeling," but the word is that Troy Glaus is done for the season, and will possibly call it a career. ... Corey Brock says that Jake Peavy is dealing with a minor ankle issue. ... Joakim Soria is expected to head out on a rehab assignment early next week. ... Travis Hafner could be back by the weekend. The setback he had during his rehab was very minor. ... As further proof that seeing Dr. Andrews isn't always bad, Brian Bruney was told that he could rehab his elbow as directed. ... Hiroki Kuroda will make a rehab start in A-ball, and if all goes well he should be back in Dodger blue next trip out. ... Koji Uehara went on the DL due to a strained hamstring after the Orioles decided that they couldn't wait for Matt Wieters to arrive on Friday to do a laying-on of hands. ... Tom Glavine makes another rehab start in Gwinnett, this time with a 75-pitch ceiling. Our pal Scott McCauley will be on hand, and I'm sure he will fill us in. ... Ryan Freel heads to the DL due to his chronic hamstring issues. ... Nomar Garciaparra adds to the A's injury woes, returning to the DL due to that calf strain that has been lingering for much of May. ... Anthony Reyes is headed for elbow surgery. He'll have ulnar nerve transposition and is done for the year.

Related Content:  Will Myers,  Back,  Year Of The Injury,  Matt Harrison,  Quad-a

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