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July 30, 2009

Under The Knife

Save the Date!

by Will Carroll

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Carlos Beltran (8/15)
Carlos Beltran is coming back. That was always the plan, but how he's going about it speaks a lot to where he might be in the future. Beltran has decided to accelerate the pace of his rehab, hoping to come back towards mid-August, matching up closely with Jose Reyes, Carlos Delgado, and Billy Wagner. That's an infusion of talent no team will be able to match with trades, but it might also be too little, too late as the Mets continue to slip. Beltran made the informed decision based on the near certainty that he will need microfracture surgery and could miss much, if not all, of the 2010 season. He'll do everything he can to avoid it, but that's the worst case scenario and he's willing to give it a go. His success will be based on pain tolerance and management, as well as Jerry Manuel's ability to spot him in and out. It's unlikely he can play CF, though no one has said much about where he will actually play. It's a calculated risk that Beltran and the Mets are taking. Given the success - or lack thereof - with microfracture in MLB, it's a big risk and perhaps Beltran's last hurrah.

Gil Meche (8/6)
Gil Meche made it through a 50-pitch sim game and the Royals have told him he'll make one rehab start before returning to the Royals rotation. Meche came through the pitching okay, but he's still got soreness in his lower back. Most of the problem, he told MLB.com, is not the pitching itself, but the sitting. However, the sim game didn't appear to cause him too many problems. No one I spoke with knew what Meche did between "innings" in the simulation, but he didn't come off the field long. By this, I mean he wasn't going into the clubhouse or riding a stationary bike, two of the things you might expect. That's a good sign, I guess, but it's also a bit of an unknown. How did Meche go from achy to not achy in a matter of days? Back injuries change a lot, so maybe he just got better. If Meche doesn't have a setback, he'll have that one rehab start this weekend and be back in the Royals rotation this time next week.

Roy Oswalt (8/6)
Bud Norris

Roy Oswalt went to see a back specialist after returning to Houston. An MRI confirmed a small herniation in one of his discs, in the same location and amount as last year. He was able to pitch through that with only an epidural injection, which is what was done again. Oswalt will miss a start, but should be back in the rotation for his next scheduled turn after that. Given his success in getting through the injury last year and the lack of problems through the first half, we have to expect similar results. Of course, that similar result is pointing to there being a fatigue component to this issue, which has to be concerning the Astros. Speaking of fatigue, Oswalt's teammate, Bud Norris, is now going to be exposed a bit more. He's already over his career high in innings (102), but the Astros say that he'll finish out the season without what they termed "aggressive limits." At 24, Norris isn't a young, high-ceiling arm, even if he is the best the Astros terrible system has. Assuming he isn't abused on a game-to-game basis, this is pretty reasonable, especially if the Astros stay close in the division. This has to be a team in win-now mode.

Francisco Liriano (8/4)
Any elbow injury to a post-Tommy John pitcher is always a concern, but inside the "honeymoon period", it's just odd. Francisco Liriano is having trouble with his forearm. Sources tell me the problem is in the "belly" of the muscle, the thick part nearer the elbow. An MRI showed no structural problem, but the Twins saying that the diagnosis is "forearm irritation" is just a description of the symptoms, not an analysis of the cause. It's interesting in that the doctors cleared Liriano to pitch Wednesday, but that the Twins decided to play it safe. Remember that Liriano had issues with communication both before and after his Tommy John surgery. While indications are that Liriano will be back in for his next turn, this one will bear watching. There are off days both today and next Monday, which buys Liriano a bit of extra rest.

Alexei Ramirez (7/31)
Carlos Quentin

Alexei Ramirez sprained his ankle trying to break up a double play. While they don't believe the injury is serious, he will be on crutches and have x-rays as a precaution. The team actually expects him back on Thursday, though they'll be cautious and it could be longer. The team has Jayson Nix as the fill-in, but a longer term absence might shift Gordon Beckham over to his natural position. Carlos Quentin hit a home run, but was in clear pain as he rounded the bases. WGN showed Herm Schneider working on his foot in the dugout, so that fasciitis is still in full effect. Afterwards, Ozzie Guillen was also in full effect. "Carlos looks like an old drunk," he told reporters. Quentin is "coping" with the pain, he says, and we'll see if he's forced to miss any time. Luckily, no one took his Jeffrey Leonard-paced home run trot as an insult.

Ian Kinsler (7/31)
Ian Kinsler has to cringe when he sees August creeping up. He's had some issues making it through a full season and it was about this time last year where his possible MVP campaign ended with a sports hernia. This time, it's a simple hamstring strain and it doesn't appear to be too serious. Kinsler is expected to play, though Ron Washington might be in his office now doing a rain dance - yeah, go ahead and try to get that image out of your head. Rain is expected in the Metroplex tonight and Washington might hold Kinsler out anyway. No one has questioned Kinsler's conditioning, so why does he seem to break down? One theory is the heat of playing in Texas, but that seems just too simple to me. I don't think Kinsler is the player equivalent of Chris Young (SD), a solid player who just can't make it through a full season.

Edgar Renteria
Even as the Giants picked up a new 2B, their SS is having a big problem. Renteria has a bone spur in his throwing elbow that will require surgery, but the team is hoping he can fight through it. It's going to take a lot of pain management and gritting of teeth, but it's possible that he can make it through. The downside here is that Renteria is going to need time off and he's going to be very risky down the stretch. Brian Sabean would be smart to see if he can't upgrade the backup position by picking up one of the many Triple-A-level glove wizards out there, though one source told me that Double-A SS Brandon Crawford might be an option in September "on his glove only."

Adrian Beltre (8/4)
With the Mariners still in the AL West race, Adrian Beltre might make more impact than any trade they could make. Beltre is coming back from having his shoulder scoped to take out chips in late June, but could be back in the lineup by next week. He's hitting, fielding, and throwing without pain. Surprisingly, the team isn't going to have him go on even a short rehab start, which I'm told is a function of both Beltre's ease in his comeback and the knowledge that at this stage, every game counts. Having Beltre in cold has to be an upgrade on the 600 OPS "offense" the team has been getting from his replacements.

Quick Cuts: Kevin Millwood will make his next start after his last one was a pain in the butt. Kevin Goldstein and I will take a close look (at him, not his butt) on Sunday, which is Newberg Night at Rangers Ballpark ... Ryan Hanigan had an epidural for a cervical disc "protrusion." He should be back before the weekend ... Edinson Volquez has an 80-pitch target for his sim game, then is expected to go to Dayton for a rehab start mid-week ... Pedro Martinez will start in Triple-A on Friday, but he may relieve for the Phillies, now that the team has Cliff Lee ... Jeremy Bonderman will pitch a sim game Friday and could be activated if it goes well. He'll pitch in the bullpen to build strength rather than heading to the minors, but he will be a starter before the season's out, according to the Tigers ... Bartolo Colon hits the DL with elbow inflammation ... Joel Zumaya is headed to see Dr. Andrews. He's done for the season, but this visit could tell us if he's just done (for good) ... And if you're an old school cat, the print edition of Football Outsiders Almanac is on sale now at Amazon. You might not be a football fan, but believe me, my in-depth article on rehabilitation has big implications for baseball as well.

Related Content:  Carlos Beltran,  Back,  Ian Kinsler

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