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April 7, 2010

Under The Knife

Post-Opening Day Hurts

by Will Carroll

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There's not much in this world that can brighten things in life the way that Opening Day can. I still think it should be a national holiday—who celebrates Columbus Day, anyway?—especially when Butler playing in the national championship game, making for a once-in-a-lifetime doubleheader. Joel Henard and I headed down to Cincinnati on Monday for the traditional Opening Day experience. While we missed the Findlay Market Parade, we saw pretty much everything else. Standing on the field and watching Joey Votto and Albert Pujols take batting practice is still something that amazes and excites me.

I can imagine, 25 years from now, seeing Ezra Pujols on the field, putting balls into the seats the way his father did. Maybe not, but I realized after Pujols' second homer of the day that it was just a few years ago, also in Great American Ballpark, when I saw Barry Bonds closing in on history. I think it was homer 750-something I saw, and I can clearly remember thinking that I had to take this in, that while Bonds was at the end of his career, that I'd probably never see another hitter this great in my lifetime. Instead, that hitter was already here and, with Jason Heyward crushing one in his first at-bat, maybe we're seeing the next one. Opening Day is about a new start, a new season, a new spring, and feeling that spirit inside us reborn again. It would be easy to get jaded in this job—believe me, there are a lot of sportswriters that don't seem to like sports much most days—but on days like this, it's a reminder of why I do this. There are only two reasons: I love baseball and I want to get you the best possible information. So powered by that, on to the injuries:

Cliff Lee (strained abdominal muscle, 4/21 ERD)
Cliff Lee went to the DL with his abdominal strain, which is no real surprise. Since he'll have to serve his suspension as well, it does give us some insight into how serious the Mariners are taking this. Lee will miss three starts, putting him back into the rotation about the point where the M's will need their fifth starter. It works out overall, but by giving Lee the time on the list plus the suspension, there's very little chance that he could have come back more quickly. In other words, there's been no reduction in the expected time for an abdominal strain despite an initial conservative treatment followed by a more aggressive use of PRP. The timing of his return will be based on how much he's been able to keep his arm strength up. If he needs a rehab start—which I'm told could come during his suspension—it pushes the timeline back slightly. The Mariners will know more when Lee has a bullpen session on Friday. Right now, he could come back as soon as mid-April, but adding a bit to it seems the right course.

Lance Berkman (arthritic knee, 5/1)
Cue my "theme song" and the Ed Rooney voice. Six times. That's how many times that Berkman has had his knee drained this spring. Before and after surgery, Berkman's knee is swelling up with even minor activity. Berkman had a cortisone injection with the last draining, likely keeping the swelling down artificially. There's no chance that Berkman is back soon. By soon, I mean within the next 10 days. After that, things are just as unclear. Berkman has yet to do anything nearing a full-go test and his "baseball activities" have been extremely limited. Yes, playing catch is baseball-related, but it's not much of a physical test. (If you or I can do it, it's not a challenge.) Berkman's knee will determine when he comes back and to do that, the medical staff will have to find some way to keep it from swelling. I'm going to say that May 1 is a decent enough goal ERD, but it's probably not accurate. If he gets close to healthy, I think the Astros will rush to get something out of him and see how much they can "squeeze the orange." If he doesn't get close in the next 10 days, the next steps are much more drastic.

Andrew Bailey (knee/elbow)
It was an aside in an MLB.com article that may have let that cat out of the bag. Bailey reportedly had microfracture surgery this offseason. His left knee has been problematic, including some issues during the spring, but there was never any indication that this was a problem on the level of microfracture. In fact, none of the signs or symptoms showed up publicly. As far as I can tell, no one—-including the beat writers who follow the team closely—even hinted at microfracture. Susan Slusser, the longtime beat writer for the San Francisco Chronicle, often has an interest in medhead-style stories and digging back through her archives doesn't bring up any suggestion of microfracture, so color me surprised, even stunned. That the A's were able to hide this is pretty impressive, if it's the case. This is only being reported by one source and I could find no one that would give confirmation. Without more information, we have to hold off any kind of judgments on how to assess Bailey's prospects. If he did come back from microfracture surgery this quickly, it's pretty impressive and perhaps a game-changer. Remember, Bailey is pitching now (he's available for Wednesday's game), so there's no ERD.

Ted Lilly (post-shoulder surgery, 4/22)
The Cubs placed Lilly on the DL, but this was an expected move as he comes back from shoulder surgery. He had a mild setback during spring training, plus some knee problems, though really, a mid-April return is pretty good on timing despite those pushes. The biggest question mark he has left is stamina. His high count for spring training was 67 pitches and while he was able to stay on schedule with his work, he often had some issues dialing it up after spring games. It wouldn't surprise me if Lilly needs some extra rest here and there during the first half of the season. He's not reliant on velocity, but if Lilly isn't fully ready to go, the Cubs could be facing a very slow start and a very deep hole in the National League Central.

Shaun Marcum (post-Tommy John surgery)
When I checked RUWT Monday afternoon and saw "Shaun Marcum, no-hitter through five", I about dropped my phone. Marcum had issues in his comeback from Tommy John surgery, but nothing too horrible. In fact, it's a lot like what Jake Westbrook dealt with and I like the odds of a solid Westbrook comeback. It's the problems that Toronto has had, not the problems Marcum has had, that color me here. Marcum proved that he still has stuff, though I'm more dubious about how it ended. Marcum never had good velocity, but by the seventh, he was topping out at 86 mph with effort. The game log shows that his velocity was dropping throughout the outing and that Cito Gaston left him in because of one number, the 0 in the hits column. We've seen time and again that even failed no-hit attempts are more stressful than normal starts, so I'm very curious to see how Marcum comes back next time out. He can't succeed like this with that kind of velocity.

Jose Reyes (thyroid condition/hamstring surgery, 4/11)
OK, Mets fans, hold on. I know you're not used to good news, so I want you to prepare yourselves. Reyes is playing baseball. He's stealing bases. He's looking as good as he looked a week ago, which was good then. His thyroid problem appears to be under control. There have been no significant physical consequences and he's on no medication. In other words, the only thing keeping him from being on the Mets' active roster is that they put him on the DL. I realize that they want to be conservative and be sure that Reyes is ready to go. I realize that the PR hit they'll take from any setback is greater than any reward they'd get for having him back. Still, Reyes is ready. Fantasy players are running out of time to steal him... and speaking of steals, it appears that Reyes is channeling his frustrations and taking it out on opposing catchers. He had two stolen bases in an extended spring training game, though it was an intrasquad game against non-MLB quality opponents. This could be fun to watch.

Huston Street (weak shoulder, 5/11)
"Everything looked great!" That sounds good, but even when coming from Jim Andrews, it's not really that great when a team's closer isn't expected back before May. The fact that there are no major structural issues gives some hope about Street's ability to come back, but with him, it also raises the question of why he's having such issues in the first place. Street's spring training was nothing but stops and starts as his shoulder continues to balk at full-go pitching. Rockies fans have to be comparing this to what they had with Jeff Francis last season and yes, that's a very good comp. Francis tried to rehab through labrum issues and simply couldn't, having to go under the knife. With no structural issues, the difficult-to-image labrum has to be suspected. Street will continue with his strengthening program, but we'll really know nothing until he's back on the mound, putting the shoulder under stress again. Even if everything goes perfectly up to that point, it's there where the rubber meets the road.

Kerry Wood (right lat strain, 5/10)
The latissimus dorsi is a huge muscle, so big that doctors can take half of it and use it in muscle grafts yet not lose any function in the upper back. To strain that muscle tells us a couple things. First, it shows the enormous energy the pitching motion contains and how it is transmitted through the kinetic chain. It also tells us that everything else is strong enough to hold up. In many ways, that's a positive. The best comp for Wood's lat strain is Ben Sheets. Both pitchers have had breakdowns up and down the kinetic chain, with the injury finding its way to whatever the weakest link is at that stage. Fatigue, mechanics, and dumb luck will move things around. For Wood, it's actually a bit of a positive that his previously reported "shoulder weakness" is actually lower, more specific, and addressable. He's due back around the first of May, but I get the sense that Cleveland will be conservative if Chris Perez establishes himself as the closer in Wood's absence.

Josh Beckett
The four-year, $68-million contract extension that Beckett signed Monday sets him up for life. Some will argue it's a bargain, but the market has been re-set by Roy Halladay's below-market deal and a better financial handle on the risks of pitching. Much of Beckett's deal was negotiated publicly, following a pattern from Boston of noting and pricing injuries. The Red Sox wouldn't re-sign Jason Bay because of medical concerns. They negotiated some tough clauses into John Lackey's deal. The lack of a fifth year, something Beckett clearly wanted, indicates just how risky the Sox think Beckett is. Beckett has a reputation as slightly fragile, back from the days when his blisters kept him from racking up crazy innings totals at a young age. It's not so much the injury risk but age. PECOTA thinks that Beckett will be solid until age-36 and slightly beyond, but PECOTA's not writing checks, John Henry is. The risk premium came there and shows that once again, the Red Sox not only have an advantage in many ways, but also that they have an organizational will to stand solid on those tough calls they have to make.

Quick Cuts: Daisuke Matsuzaka will make the first of three planned rehab starts on Saturday at Triple-A Pawtucket. He may shift minor-league teams depending on schedule and weather. ... Junichi Tazawa had Tommy John surgery Monday, with Andrews doing performing the procedure. Tazawa is expected back for spring training in 2011. ... Scott Kazmir will have one rehab start, Friday in Triple-A, before returning to the Angels' rotation. I wonder if he got a Snuggie.Ian Kinsler will head out for a short rehab assignment over the weekend. His ankle is reportedly ready to go and he'll just get some swings in. ... Yadier Molina showed no issues with his strained oblique. Tony La Russa told us before the game that he'd monitor him, but didn't expect any issues. ... Coco Crisp will miss a month with a broken middle finger. As with any grip injury, bat control will be the big issue. ... I asked Scott Rolen if he thought he could stay healthy this season. He gave me a look that would be unprintable, but did not respond. ... Luis Valbuena is expected back later this week. He was held out of the opener after getting hit on the hand in the last exhibition game. ... Alberto Callaspo could be back in the lineup as early as Wednesday. His oblique strain is being closely monitored by the new Kansas City medical staff. ... You might forgive James Shields for being a bit distracted Tuesday night. His wife is scheduled to have a baby today. … Mark Rzepcynski has a broken middle finger on his pitching hand and will miss a month or so. He also replaces Doug Mientkiewicz as spellcheck's Public Enemy No. 1. ... Jason Michaels has a stinger, a cervical nerve injury that is more commonly seen in football and wrestling. It's seldom serious in the long term, but it can be intensely painful. ... Chien-Ming Wang is on the 60-day DL, but there's not been a setback. He was never expected back before June. ... Joel Hanrahan will come off the DL April 13. He will begin a short injury rehabilitation assignment with either Triple-A Indianapolis or High-A Bradenton on Thursday, depending on the weather. … If you didn't check out Versus' "The Daily Line" the last couple nights, give it a shot. It's every weeknight at 6 p.m. Eastern and features FOBP Jenn Sterger.

Related Content:  Shaun Marcum,  Back,  Surgery,  Year Of The Injury

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