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April 26, 2010

Under The Knife

Another Call for Pitcher Protection

by Will Carroll

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Chris Jakubauskas (concussion, 5/15)

I'm not saying that I have any answers, but that I'm at least asking the question. When Jakubauskas went down, taking a powerful liner off the bat of Lance Berkman directly to his head (WARNING: graphic video), all I could think was "it's happening again." I'd been having this conversation on Twitter, where some are ignorantly arguing against the idea of additional protection. While I don't want something extreme like an L-screen, I do think we could do something simple, like an unobtrusively padded hat or some modification of a Petr Cech-style helmt. Actually, what I'd like to see is baseball have an "X Prize"-style contest to get the best possible solution into production. Invent something that reduces the impact of a ball to the head while weighing less than a pound and you win. While the headline of this article makes my stomach turn a bit, I understand what the writer and the pitchers quoted are getting at. They can't think about it, but then again, they shouldn't have to. A batter doesn't "think" about getting beaned, though they're conscious of the possibility. They also have a helmet on, maybe a leg guard to help with fouls. Pitchers? Nothing. Jakubauskas is out of the hospital, but on the DL. His recovery from concussion will be closely monitored. His move to Pittsburgh wasn't expected to be long-term, but this could accelerate the call-up of former first-round pick Brad Lincoln. What's important here is that Jakubauskas is alive and should be fine. It could have been much worse and one of these days, it will be.

Brett Anderson (elbow cramp)

There was a bit of panic on Saturday among Athletics fans when Anderson came out of the game early due to an elbow problem. There wasn't much panic in the Oakland front office or medical staff, however. Anderson's elbow problem was nothing more than a cramp. While a bit odd, they've dealt with this before with Anderson. There's an element of fatigue here, since muscles don't cramp up for no reason. Last time it happened was during 2009 spring training, so call this one a bit of progress. One source compared it to dead arm, saying "Anderson's a big boy. He just has this reaction rather than that slow, dead thing some get." It's not a major concern and just like last time, Anderson is not expected to miss any time. The Athletics will watch him closely next time out and have enough depth to skip him through a turn in the rotation if necessary.

John Maine (elbow cramp)

It's been interesting to watch the difference between how Anderson's elbow cramp has been treated in the media and how Maine's cramp was dealt with. Anderson has dealt with the issue before, but much of the panic surrounding Maine is the heavy shadow of 2009's injury-riddled Mets team. Once again, it's nothing more. Maine has nearly the exact same symptoms, but in reading about it, you'll see "no idea what caused it" and "unlikely to make it through his next start" while Anderson's is more the journalistic equivalent of a shrug. Injuries are individuated, but in essence, the reactions to these two situations—I won't even deign to call the injuries—show much more bias than individuation. The real difference is that we don't know how Maine will react, just as the Athletics didn't last spring when Anderson had the issue the first time. The Mets will likely show the same caution they have all spring, but if Maine misses a start, it doesn't mean much at all.

Chipper Jones (undetermined hip injury, TBD)

At some level, a player goes from being an every day, "name in pen" player to an aging guy who has to figure out how to deal with the aches and pains of baseball. Some do it, some don't, but there's a broad continuum of how they adjust. While I haven't always agreed with how Jones and the Braves have dealt with his injuries, I understand why it's that way and I can admire the production. Beyond that, there's another level, where no matter the adjustments, a player just can't hold up. Jones is nearing that point and with a hip injury serious enough that he is saying he doesn't know when he'll be back. That time seems sooner rather than later. There's some poetry to the idea that Chipper and Bobby Cox would walk away from the game together, as tied together as any player-manager relationship that I can think of back to Billy Martin and Casey Stengel. In fact, I think Jones might end up in coaching. It's no less likely than Martin, from what I know of his playing days, though I imagine money is much less an issue for Jones given the economics of the modern game. (Which is a whole other issue—will we have less ex-player coaches given a lack of "need?") Jones is headed for imaging that will determine exactly what's going on and how long he will be out.

Brad Lidge (flexor tendon, 4/30)

Things have gone well for Lidge as he finishes out his rehab. He passed a big test, going back-to-back days without problem. Now, the team will push him a bit more, pitching him on Monday and Wednesday before an expected activation for the weekend series. It's not clear yet that Lidge will slot right back into the closer role, but his velocity has been solid during the rehab. More importantly in the long term, Lidge appears to have straightened out his mechanics. With the elbow and knee injuries, Lidge has spent much of the last year trying to stay effective while avoiding pain. If he's finally healthy, there has to be the expectation that he can get back closer to his '08 form than the '09 the Phillies suffered through. The key here is that Lidge's situation should be taken care of, one way or the other, very early this season. The team reached the World Series with both versions of Lidge, but if they need to go out and fill in around him or even replace him, they can. Certainty and flexibility are two things valued by Ruben Amaro Jr.

Kerry Wood (back spasms, 5/5)

Things got a bit complicated after Wood threw his simulated game on Friday. Reports came out that there was a setback, but it seems that it was less a case of something physical being wrong as it was Wood, a perfectionist, not liking how he threw. It's less about stuff at this stage than being able to do everything without a flare up in his back, but that's often tough to get someone who has competed throughout his entire life to grasp. Wood was back throwing on both Saturday and Sunday, so there was no physical setback. The Indians haven't set a timetable for when Wood will be back, but it's likelier now that he'll need at least a short rehab stint. The Indians have several local options, a big plus for situations like this. Expect Wood back soon, but don't expect him to get the full closer role back immediately. Instead, expect Manny Acta and the Indians brain trust to figure out the best way to deploy their bullpen. Wood's not going to be caught up in counting saves.

Vicente Padilla (forearm stiffness, TBD)

The Dodgers pushed Padilla to the DL with a sore forearm. This came without much warning and given the team's lack of pitching depth, has to be something serious or at least something where the team had no other option. Padilla had looked pretty solid in his last couple outings and there was no telltale wildness, usually the first sign of an elbow issue. Padilla will have an MRI on Monday in hopes of finding the root cause. Once we have that, we'll have a better idea on the timeline and the treatment. Padilla wasn't able to make his side session and didn't seem encouraged heading into the weekend, so this could be something more serious than a muscular problem. The Dodgers don't have another starter in place for Padilla's Tuesday start, which makes this a tougher situation. Normally, Jeff Weaver would be the easy choice, but he's out with a back injury.

Carlos Guillen (strained hamstring, 5/6)

Guillen has had hamstring issues for a while, so that's a plus and a minus here. It's a minus anytime someone has a chronic condition, but a plus in that both the player and the medical staff have a better understanding about where he is in the process. Guillen was shifted to the DL late last week, but it was more because the team wanted him to rest and to not play a man down. He could have been ready prior to the minimum, but the caution the team has shown with Guillen raised its head again. Jim Leyland has shown a willingness to play a man down, but this is a very tight division and even the slightest disadvantage could end up costing a team one game in the standings, a game that could be the difference between playing in October or just watching.

Manny Ramirez (strained calf, 5/8)

The Dodgers will be without Ramirez for at least 15 days, because that's the rule. Ramirez's calf was strained, but there was a debate about how long he would take to heal up. It was determined that the team would be best served by DLing him, but don't take that as an indication of severity. The MRI showed this as a Grade I/II strain, but it's not like Ramirez is a runner. There was some worry that limping on the leg would cause his balky knees to have more trouble, so the team pushed him to the list and called up Xavier Paul. Ramirez should be ready once eligible at the minimum, though as with all things Manny, it's hard to tell exactly how things will go.

Lance Berkman (arthritic knee)

This article makes it seem as if Berkman's hyperextension is no big deal, and in isolation, it isn't. Berkman is unlikely to miss much time, but there's a couple things that set off the alarm bells. First, Berkman has an imbalance in the strength of his quads between the left (injured) side and the right. That's not uncommon, especially given the amount of problems he had this spring, but it's often a longer-term issue. It can make him more likely to have quad or hamstring strains on the affected side or throw off his gait enough to cause issues on the non-affected side. Worse, the "hyperextension" could be the result of the lack of cushioning inside the "hinge" of the knee. Without the meniscus there and with some of the bone chipped and carved away to create a smooth surface, there's a bit more play in there. That can lead to a bit more laxity, taxing the ligaments or to movements inside the joint's articulation than can cause stresses that the body is simply not made to withstand. Berkman's knee is, in the most literal sense of the word, changed. It will never be the same. How Berkman deals with that remains to be seen, but you know how I feel about unknowns.

Not So Quick Cuts:

Daric Barton has a volar plate fracture, a type of avulsion in a hyperextended finger. No determination on a timeline at deadline, but it would be tough to play through this ... Nick Johnson's back issue isn't responding to very conservative treatment, so his return on Tuesday remains in doubt. It's not serious, but bothersome. With the Yankees' other options, they can afford to let Johnson rest some more ... Sources tell me that Ryan Zimmerman could have played this weekend, but that the Nationals wanted to be "100 percent sure there'd be no setback." Expect him back in the lineup on Monday ... Justin Upton fouled one off his shin. It stiffened up and he was removed as a precaution, but this doesn't look to be a serious injury ... this writeup of Cameron Maybin's collision with Gaby Sanchez is awesome. Maybin will be fine, just sore ... Josh Fields' season is over as he heads for hip surgery. It might save Alex Gordon, who was headed for Omaha or worse ... Brad Hawpe hits the DL with the strained quad that's been bothering him for a week ... If I still did "powered by", I'd have to say something about Steaz tea. Thanks, FTC ... Rick Ankiel missed Sunday's game with a quad strain that he suffered Saturday. The Royals have been very tight with injury info this year, so watch this one ... Chris Young, the pitcher, is due to start his rehab assignment this week. With the Padres playing and pitching well, look for this one to take near the full stretch ... Very interesting stuff here ... The Rays expect J.P. Howell to step up his rehab this week, progressing to throwing off a mound. He could start a rehab assignment early in May, which would put him on track for a mid-May return. Remember that shoulder rehabs often have setbacks. If Howell isn't back soon, the Rays may have to step up their pursuit of more pen help or consider using Jeremy Hellickson or Jake McGee in a relief role, ala David Price or Neftali Feliz ... While we're talking about Durham, there's some question about what's going on with Desmond Jennings. He's been out a couple days, but pinch ran, leading some to question how his wrist is holding up ... No one is saying what exactly the illness that scratched Dontrelle Willis was, but everyone I've spoken with insists it's not an injury and it's nothing more than an illness ... A lot of people are asking so I'll say it here: No, I don't think Rich Harden is hurt and, no, I don't think the Rangers should drop him from the rotation. I do wonder if he'd succeed in the bullpen down the line, the way Wood has ... Not just details, but lots of very specific details about Joey Devine's elbow in Susan Slusser's Athletics notes ... It's hard to say that Edwin Encarnacion's shoulder problems are any sort of cascade from his previous wrist issues, but these type of seemingly connected cases are always interesting. Encarnacion's shoulder is still inflamed and he's still at least 10 days away from any sort of return ... Michael Wuertz is doing well in his rehab outings, but there's no timeline yet for his return. There's not much left to show, so "soon" is a good guess ... Scott Proctor got blown up in his Triple-A stint to the tune of 18 hits and 10 runs in just eight innings. He's being sent back to extended spring training, but observers say he's got nothing left even if healthy ... Bobby Wilson hits the DL with an injured ankle and a concussion. Wonder if we should look at something for catchers to keep on in case of collisions. Bad timing for the injury since Hank Conger is nearly ready ... Riley Cooper was selected by the Philadelphia Eagles in the fifth round. The Rangers signed him last season, thinking they'd bought him out of football. We'll see how that decision works out for Cooper. My guess is he'll have more (relative) success than his roommate ... Just my opinion, but the Rays are going to regret the Ben Zobrist deal. Maybe not regret, but I think they'll look back on it as a less than ideal contract.

26 comments have been left for this article. (Click to hide comments)

BP Comment Quick Links

leites

Who is going to be back first: Nick Johnson or Juan Uribe?

Apr 26, 2010 08:11 AM
rating: -3
 
Mountainhawk

Re: Pitcher protection

Do the pitchers want something like that? I'm guessing no ... it might be something you have to introduce in the minors and allow it to naturally work its way into the game, instead of mandating it on the ML level.

Apr 26, 2010 08:16 AM
rating: 0
 
Ben F.

As a heads up, all the external links seem to have an extra http:// in them.

Apr 26, 2010 08:25 AM
rating: 1
 
cbirkemeier

I'm confused by the stuff about Chipper. He's been in the lineup every game since the 11th.

Apr 26, 2010 08:25 AM
rating: 1
 
BP staff member Will Carroll
BP staff

Wow, that's Chipper. Instead of an MRI, he wrote his name back in the lineup.

Apr 26, 2010 08:49 AM
 
Hoff

Coach Larry? If he manages the injuries of others the way he does his own, you're going to have a lot to write about in the next few decades.

Apr 26, 2010 12:14 PM
rating: 1
 
Tuck
(667)

Will, You've been fairly dismissive of Kinsler's ankle injury. But I saw over the weekend where he said that he'll probably be dealing with some degree of pain all season. Are these things just that slow to heal? So much for those stolen bases...

Apr 26, 2010 08:40 AM
rating: 0
 
BP staff member Will Carroll
BP staff

Not dismissive, there's just not much to say about an ankle sprain. It is what it is and when he can move laterally without significant pain, he'll be back. I can only say that so many times.

Apr 26, 2010 08:50 AM
 
dianagram

I assume any pitcher protection could NOT be secured with a chin strap, lest it feel "restrictive" to the pitcher.

Apr 26, 2010 08:59 AM
rating: 0
 
Andy

The bigger issue is that any protection can't look ridiculous. Concussion proof batting helmets are available but they don't look like something big, macho men wear. I could imagine some of the ballplayer comments about what a pitcher looks like when he has padding strapped to his head.

Apr 26, 2010 20:18 PM
rating: 0
 
BP staff member Will Carroll
BP staff

I think ideally, it would look more like the cold weather "Elmer Fudd" hats. A very thin layer of some type of padding wouldn't prevent injuries completely, but could minimize them. A padded version of this (http://www.underarmour.com/shop/us/en/sports/football/mens/pid8000071-Skull-Cap/8000071-100) wouldn't be bad either and several players are already wearing them.

Apr 26, 2010 22:51 PM
 
amazin_mess

They look ridiculous. I don't blame the players for not wearing them.

Apr 28, 2010 00:25 AM
rating: -1
 
acmcdowell

Regarding Daric Barton's injury, I know you don't have any information regarding the exact timeline the A's are using, but think you could ball park it for me? Is this a short DL stint type injury? Most of a week off type injury? Thanks!

Apr 26, 2010 09:36 AM
rating: 0
 
BP staff member Will Carroll
BP staff

See above.

Apr 26, 2010 10:13 AM
 
ashitaka

"There wasn't much panic in the Oakland front office or medical staff, however."

Understand that doesn't inspire a lot of confidence with A's fans...

Apr 26, 2010 09:37 AM
rating: 0
 
dotoole

Why are you thanking the FTC for Steaz tea?

Apr 26, 2010 11:03 AM
rating: 0
 
LouisArighi

I think this was in response to the FTC's recent decision regarding promotional consideration on blogs (see http://www.legacyaffiliateblog.com/affiliate-marketing-news/ftc-regulations-review-sites as an example), although my understanding was that one just had to disclose if one had been given the sample for free, or paid by the company, or what have you. But I assume that's what the reference is to.

Apr 26, 2010 12:45 PM
rating: 2
 
PapaGiorgio

Hey Will,

Wondering if you've been following the story of Gunner Sandberg. He's a HS pitcher here in Northern California who took a liner off the head and was subsequently in a coma for two weeks. He's currently undergoing rehab and for a little while it looked like it could be for the worst. It's the HS & College kids who would benefit most from some sort of pitcher head protection since it doesn't look like metal bats will be going away any time soon (although Gunner's league no longer uses metal... shutting the barn door too late).

Apr 26, 2010 11:30 AM
rating: 1
 
BP staff member Will Carroll
BP staff

I have, closely. I've consulted with some people on this so don't want to speak too much on it. Glad he's doing better. I read recently that kids under 17 have 8x more concussions from one activity than any other -- that activity? Skateboarding. Last I checked, the pros there all wore helmets and pads.

Apr 26, 2010 12:54 PM
 
PapaGiorgio

One only needs to look on the internet for hundreds of videos of skateboarding concussions. That's entirely preventable, though. As the current baseball climate stands, there's no way for kids to avoid what happened to Gunnar.

Glad to hear you're involved with the situation there. That school is my alma mater and I was actually supposed to go there with my neuroanatomy professor to help lead a guest lecture/lab on the day that Gunnar went into the coma. Our lab was cancelled and I was absolutely shocked at the unfortunate coincidence. One of the first things I thought of was, "I wonder what Will Carroll will have to say about this." Needless to say, everyone I know is pulling for Gunnar.

Apr 28, 2010 22:40 PM
rating: 0
 
DavidK44

Women's softball, and for that matter, amateur men's slow pitch softball pitchers have begun using masks like this - http://www.gameface.com/ or http://www.softballfans.com/shop/product.php?productid=2388&cat=9&page=1

It may not be the most comfortable, and it certainly looks funny, but I'm sure the same thing was said about the first hockey goalie mask.

Apr 26, 2010 13:05 PM
rating: 1
 
Swingingbunts

Hi Will, I read that Brandon Webb said "he has felt like he has taken big steps forward in his rehab". Any idea what that means?

Apr 26, 2010 13:20 PM
rating: 0
 
BP staff member Will Carroll
BP staff

Just normal progress. We'll know more as his throwing program gets closer to a return. Until mid-May, we're just guessing.

Apr 26, 2010 19:52 PM
 
kjohnson

Will, I read Felipe Lopez is going on the DL with elbow soreness which may have been aggravated in his recent pitching appearance. In your judgment, would it be better for a position player's health to simply throw to the catcher as if playing catch and hope to get lucky than to attempt to 'pitch'?

Apr 26, 2010 15:16 PM
rating: 0
 
BP staff member Will Carroll
BP staff

Good question. Only example of an injury I can think of from that is Jose Canseco. The risk is probably not high, tho you'll occassionally get someone who thinks they're Nolan Ryan or something.

Apr 26, 2010 19:54 PM
 
Brian Cartwright

Speaking of position players taking the mound, you might have thought it was only something you'd see in HS or college, but not Triple-A...last night with Indianapolis up a run on Louisville in the top of the 15th, starting pitcher Jeremy Powell pinch hit for relief pitcher Jean Machi, then in the bottom of the 15th stayed in the game - in right field, as the first baseman (who started the game at catcher) Erik Kratz came in to pitch - AND GOT THE SAVE!

Apr 26, 2010 23:00 PM
rating: 2
 
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