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June 29, 2009

Under The Knife

Known Unknowns

by Will Carroll

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Mike Lowell (0 DXL)
Alex Rodriguez (0 DXL)

Lowell may end up having a Synvisc injection in his hip. Synvisc is essentially a lubricant, one that looks remarkably like motor oil. Is this a bad sign, coming less than a year after his hip surgery? Rodriguez dove to his left, landed on his hip, and while he stayed in the game, he's also had fatigue issues. After the game, Joe Girardi said that Rodriguez "would have told me" if he was hurt, but does anyone believe that a player who's been savaged for a night out with a starlet might not fudge a bit to stay in the lineup, whether it's smart or not? In both cases, we're left wondering if the hip operation that was done on both is starting to hit Pumpkin time, and whether Chase Utley ought to be looking over his shoulder or not. Since we know a little more than nothing in regards to this operation, it's hard not to look at two of the three that have come back and begin implicating even the most minor of problems going forward, but the same sample-size issues apply here. Whether it's an enforced rest schedule or an injection, we simply don't know if it's a result of the operation or something particular to the individual-or if it's neither in this case. We have to not only beware the sweeping generalizations, but even the educated guesses.

Adrian Beltre (60 DXL)
If it's possible to be both at once, the announcement that Beltre will have surgery on Tuesday to remove bone chips from his non-throwing shoulder is as surprising as it is unsurprising. It was surprising in its timing, in that we didn't know when this was coming, but it's not surprising in the sense that the shoulder problem has been something he's been playing with for a while and would have needed to be corrected eventually. Beltre's surgery negates much of his trade value, though this and his contract make it possible that he could become a waiver-trade guy in August. The expectation is that he'll miss about two months after the surgery, but much of that will depend on what is found when Lew Yocum gets inside the shoulder. There's the positive sign that Beltre has come back from this before, but that he came back so quickly isn't a positive. Even the slightest setback will end the Mariner portion of his career.

Scott Kazmir (0 DXL)
The Rays got the version of Kazmir back on Saturday, as he showed mid-90s form and... wait, Sampelor just showed up. He's the patron saint of sample-size issues, looking like that He-Man villain from the '80s and sounding a lot like Joe Sheehan. There's a real question about what we can learn from any one start, whether it's someone coming back from an injury or not. Kazmir's work at ASMI is deservedly going to get some of the credit, but for any of it to stick to them, Kazmir will need to stick around as a top-level starter. The hardest part of pitching is maintaining consistency. All of the pitchers at this level have the talent and the stuff, so for almost all of them, the difference between being a great pitcher and another guy at the back of the rotation is consistency. Some would argue that this is just another definition of "winning without your best stuff," but it goes well beyond that. Watch video of Greg Maddux, and without the uniform, you can't tell the difference. Tom Glavine? Same thing. Even John Smoltz, for good and bad reasons, is the same. Granted, all three were Braves, but I think that Maddux would have been pretty darn good if he'd stayed in Chicago or gone to LA years earlier. Like so many good young pitchers, Kazmir lacks consistency, which leads not only to inconsistent results, but also to injuries.

Bronson Arroyo (0 DXL)
Edwin Encarnacion (75 DXL)

Dusty Baker is about as old-school as they come, which makes me wonder how he reacted when he heard that Arroyo was considering surgery for his carpal tunnel. The thing is, Arroyo isn't feeling any of the effects when he pitches. Granted, he is saying clearly that this surgery, if it happens, will be an off-season thing, and he certainly has the right to do whatever he wants when it doesn't affect his employer in any meaningful way. Still, the thought just has to burn Baker up, and it makes me wonder what the Reds would do if they had any other option in the rotation right now. The Reds are also keeping the rehab of Encarnacion at a slow pace, as he'll stay at Triple-A Louisville for at least another week, pushing his return to after the All-Star break.

Josh Outman (90 DXL)
Building a team around young pitching seems to make sense, but then something happens. Young pitchers are risky, like a beach house. Sure, the view is great, but when the hurricane comes, it can all go horribly wrong. Outman is proving that point as he heads for Tommy John surgery in the midst of a solid rookie campaign. The A's can't really be blamed for any of the hallmarks here; he's not overworked in any classic sense, and they didn't develop him. They're also doing a good job of using the "shotgun defense" for young pitching. About the only way to keep a rotation full of young guys is to have a bunch of them. That works, but it relies heavily on the kind of scouting that Oakland's never getting credit for. Outman should be back about this time next season, crossing the injury nexus with a small triangular scar to show for the journey.

Tommy Hanson (0 DXL)
Hanson, one of the best young pitchers in the game, almost got scratched. Instead, he went six innings and got the win against the Red Sox, perhaps the best team in the game right now. Throwing 97 pitches is hardly much to get worked up about, but contemplate the facts in context: Hanson threw a normal game, for him, on normal rest and without significant struggle. Despite this, we know he was sick enough to make Bobby Cox seriously consider skipping him in the rotation. Did Hanson suddenly get better, or did he gut through it? I'm betting on the latter, and if so, did that take more effort than usual? Is the illness plus the workload worse when it comes to fatigue? How will the illness affect his recovery time? There are a lot of unanswered questions here, but that pitch count alone tells you nothing.

Xavier Nady (160 DXL)
Remember that "worst-case scenario" that Brian Cashman mentioned? That's what it was, and Nady is headed for Tommy John surgery. The thing is, the worst-case scenario is not that bad. Sure, Nady and the Yankees wished the PRP had worked, but that was the sports-medicine equivalent of a Hail Mary pass anyway. Nady has the perfect comparable for this-himself. He's had the surgery before, and he came back. He was younger, but he was also unestablished. The idea that second surgeries are less successful is unfounded. First, there are no major league position players that have had a re-do. Most that had a re-do have done something to screw it up in the first place, assuming it's a short-term situation. Nady has been through this, and that gives us more information than we'd have with most. Position players come back from this surgery in about six months, though the arm isn't 100 percent at that stage. Unless we find out after surgery that something more has happened in the elbow, even the worst-case scenario would have him back at the end of spring training.

Aaron Boone (150 DXL)
Boone has been cleared to start baseball activities. Let's think about this. At the time that it was announced, the rumor going around baseball was that the Astros were going to sign Pedro Martinez. Pedro is still a free agent, and Boone had heart surgery. That we're even talking about Boone returning is amazing, but that he will likely lead a long and healthy life is even more important. He isn't expected to be a big part of the Astros' season, but he could well be back for September.

Quick Cuts: One doctor I spoke with this week said that the Mets "have gone off the rails. Cortisone shot after shot, delay after delay. They've gone from one of the best around to one of the most messed-up overnight." It's hard to push this off on luck. The Mets have always been good at getting guys back, but the problem is that keeping them off of the DL is not their strength. ... Josh Hamilton will begin his rehab assignment on Monday at Double-A (and close-by) Frisco. He'll lead off to get the maximum number of at-bats. ... Aramis Ramirez continues to do well taking batting practice; he could begin a rehab assignment this week. ... Erik Bedard had a good bullpen session over the weekend. He'll have another mid-week, and if that goes well, he could pitch next weekend. ... There are reports that Daisuke Matsuzaka will be out until September. Those reports are wrong. ... Jed Lowrie's knee has healed up, allowing him to get back to work on the wrist rehab. He's at least a week of at-bats away from a return to Boston. ... If you want to learn something about labrums, here's a really nice article on the subject as it relates to Brandon Webb's having his repaired. ... Craig Counsell will play through a mild hamstring strain. ... So will Nate McLouth, after missing a few games as a precaution. Anyone still hate that trade? And if you do, look at Nyjer Morgan's defense. If you still hate it after those two looks, we'll just agree to disagree. ... Gerald Laird only missed a game with mild back spasms, something he says he's never had before. Be a little wary of this. ... Jumbotron operators everywhere must be glad that Fu-Te Ni was called up by the Tigers. The Monty Python clips shall now commence. ... Ryan Doumit will join Ian Snell in Indy later this week, and he should be back in Pittsburgh after the break. ... Ryan Sadowski made his debut with the Giants, but I don't know if he wore the hat insert that he used in the minor leagues. He started using it after taking a comebacker. My question is, why doesn't every pitcher? ... Did you know that the count for how many surgeries Darren Dreifort has had has reached 22?

Related Content:  Tommy Hanson,  Back,  Surgery,  Josh Outman

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