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June 9, 2009

Under The Knife

TRIPin?

by Will Carroll

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Josh Hamilton (30 DXL)
Brandon McCarthy (110 DXL)

It was no surprise when the Rangers announced that Hamilton would have to undergo surgery to correct his sports hernia, but the news that McCarthy has one of the most unusual pitching injuries possible was surprising: McCarthy has a stress fracture in his shoulder that will likely end his season. It's the same injury and even the same location where he had this happen to him in 2007, not only making him one of very few to have this injury (Jarrod Washburn is the best-known example) but now the only player to have it recur. There's obviously something mechanical going on, but the recurrence speaks to something genetic, or at the very least anatomically anomalous. Since this is so unique, there's almost no way of saying how he'll come back from it. While he did come back last time, this is McCarthy's third "lost year," and the frustration level for everyone involved is high. As for Hamilton, the procedure is straightforward enough, and the comeback path is normal and understood. Given his conditioning and some other factors, I think Hamilton will be back on the low side of the four-to-six-week timeframe. His return to the lineup depends a lot on how the Rangers are doing as well.

Edwin Encarnacion (60 DXL)
There have been whispers going back a couple of weeks now, but the rumors regarding Encarnacion began morphing into reports on Sunday. Finally, I found someone with the info, and he told me that Encarnacion has had a "major setback" with his wrist. The Reds are sending him for an MRI, and fear that he may now need the surgery that he was trying to avoid in the first place. The chip fracture may have weakened the bone, and during some hitting drills Encarnacion seems to have put too much stress on it. Of course, Dusty Baker says it's just one of those things, telling John Fay that "he may have overhit, but how do you know until you overhit?" The answer is, you err on the side of caution in order to avoid this type of situation in the first place. The Reds seem a little too positive about the state of affairs, but we'll know more after the imaging. He certainly won't begin a rehab assignment this weekend, as had been planned.

Jeremy Bonderman (0 DXL)
Bonderman finally returned to the Tigers' rotation and... well, it wasn't all he hoped for. He started out very rough, as he needed 31 pitches to get through the first frame, and he ended up allowing three homers while throwing 81 total pitches. In ways, it was successful; he made some of his pitches, and he came out of the game healthy. On the other hand, he's not the instant partner for Justin Verlander that Tigers fans were hoping for. It was, however, medically a success as he continues a comeback from a complex series of injuries and conditions. Bonderman's next test is just making it to his next start, thereby proving that recovery from the first one will not block him from regular rotation work. At least early, things look good on that front, but we'll see by his throw day.

Jorge Cantu (1 DXL)
Cantu doesn't have a concussion, doesn't seem stressed, and looks nothing like Nick Esasky. Still, when a player comes up dizzy and disoriented, as Cantu did on Saturday, it's great that teams now take it seriously. It appears that this was minor, perhaps a simple case of dehydration, but as these types of things can come and go, especially in the early stages, it's hard to say that he's clear of the issue. Worse, since there's no clear cause, it's hard to say "don't do that" or "we've taken care of that" when there is no "that" to speak of. Since Cantu is repeatedly coming up in trade rumors, keeping him healthy and productive is going to be big for the Marlins.

Jacoby Ellsbury (7 DXL)
Jed Lowrie (45 DXL)

First, a correction: yesterday, I spoke about Lowrie's return from his wrist problem, and forgot my own reporting. Lowrie's wrist injury is not the typical wrist injury that is likely to cause bat control problems, but I saw "wrist" and went back to a few natural assumptions. Instead of explaining again, I'll just point you back to what I wrote in April when Lowrie had surgery. Aside from that oversight, everything else from yesterday as far as his return holds true. Ellsbury didn't have any significant structural damage in his shoulder that was visible in his images, which is a very good sign, but he does still have the AC sprain that he was originally diagnosed with. The Red Sox aren't sure how much time he'll miss, though it seems that he'll avoid the DL as long as his primary backup, Rocco Baldelli, is able to handle the workload this week without assistance. It's safe to say that he'll miss at least the bulk of this week.

Ryan Sweeney (15 DXL)
Aaron Cunningham (5 DXL)

The A's can be rather inscrutable, which is one reason I always wonder what's going one when something like Sweeney's situation comes up. At this rate, they're going to get comparisons to the Patriots after saying one thing (Bob Geren said Sunday that he expected Sweeney back on Monday) and then DLing the player before 24 hours had passed; that said, it's not really a fair comparison. Things just don't work the same way with injuries in the NFL and MLB, because the daily-play nature of baseball means that injury situations are much more fluid. Were the A's lying? No. Mistaken? Probably not. So what happened? Circumstances changed. The A's roster hasn't been stable all year, and a decision was made to make a retroactive move and bring Daric Barton up. Then circumstances changed again after Aaron Cunningham took a pitch off of his helmet last night; he has a mild concussion and should avoid the DL, but the A's might have to send Barton down to get another real outfielder on the roster. The team was forced to use Adam Kennedy out there last night, and that's not the most tenable solution. Things change, especially for a team that continues to be plagued by injuries.

Justin Upton (3 DXL)
After injuring his shoulder on a swing, recalling the injuries sustained by both his brother and Richie Sexson, Justin Upton missed last night's game and will have to be re-evaluated. Reports have the shoulder as "sore," but sources tell me that this is minor and serving more as a sign than anything. One doctor I spoke with about the situation agrees that this is genetic: "It's difficult to understand that a shoulder can be both loose and strong. Upton is no doubt a very strong young man, but unless you're down there with your hands on his shoulders, it's difficult to say how the structure is." He also explained that even with some notable laxity, there's not likely to be much a medical staff can do unless there's a problem. "Everyone's different, and if he's asymptomatic, why change anything, especially on a man who's so young and successful?" The D'backs will closely monitor Upton in both the short and long term. I'm sure D'backs' ATC Ken Crenshaw is talking with his old partner Ron Porterfield about the situation.

Quick Cuts: I'll be talking draft over on Twitter today, but don't expect it to be KG-style. Just look for me @injuryexpert. ... Someone find out where I said that Phil Hughes should be the one in the bullpen. I said it, but can't find it, and after seeing him tonight, I feel like a genius. ... David Ortiz was diagnosed with dry eyes after his exam. Something tells me that's not the issue. ... Miguel Cabrera played in the field because he said he was getting tight sitting on the bench as a DH. I know some teams keep a stationary bike in the tunnel or clubhouse, but hey, if this is what works for Cabrera, that's fine. ... There are rumors that Boston might switch to a modified four-man rotation once John Smoltz joins the team, with Smoltz as the five. I'm not sure how that would work, if true. ... I love Boog, but really? ... Rich Harden had a nice 70-pitch outing at Iowa; his next start will be for the Cubs. ... Where did Lou Gehrig go on vacation?

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