May 17, 2010
Under The Knife
Andre Ethier (broken pinkie, ERD TBD)
The Dodgers don't need an injury, let alone one to Ethier. Ethier injured the finger during batting practice, but it's unclear exactly where the break is. If it's distal (toward the fingertip) then it's less integral to the grip. If it's closer to the hand, it's tougher. As a lefty hitter, it's his bottom hand, so with each swing, it's going to be either pushed against the knob of the bat or have to edge over it and be even more exposed. It's going to be nearly impossible to splint the finger in a way that won't affect his swing. Then again, while we don't know exactly how the fracture occurred, it's reasonable to think that a padded glove might have prevented this. This week, I had the chance to ask a major-league athletic training coordinator if he thought that wearing a shin guard might help protect pitchers. His immediate answer was, "they wouldn't wear it." I understand that on one level—just look at the ridicule that David Wright and Francisco Cervelli have taken for wearing the best-available batting helmet. On the other hand, why is this about the player? A simple "protective gear" clause in a contract would be a pretty easy thing to do for a smart team. Ethier is going to wait a couple days and try to hit, seeing whether or not he can play with the pain and not make the fracture worse. Pain tolerance is a powerful force, so we'll have to wait for that test before knowing how long he's out. If he does go to the DL, it shouldn't be much over the minimum.
Justin Duchscherer (strained hip, ERD TBD)
A couple weeks back, Duchscherer felt his hip pop and said it felt "just like the other one." That 'other one' is his surgically repaired hip. Then in a matter of days he was back, scheduled to start. Then pow, during warmups, the hip injury was back and guess how Duchscherer described it? "Just like the other one." I'm not sure what to do here, because something's wrong. I talked about Duchscherer's reaction last week, and that could be happening again here, but it's much more likely that he simply was a problem waiting to happen. Since it's unclear what set off the hip before his start, it's hard to say that it wasn't tested before scheduling him. We've seen time and time again that no matter what a medical staff does to try and simulate things, the pressures and stresses of pitching at a full-go, major-league level are nearly impossible to replicate. We'll have to wait a couple days to figure out just how long this DL stint is going to be, but don't expect this to be a minimum stay.
Huston Street (strained shoulder/strained groin, ERD 6/10)
Setback. No one ever wants to hear that term when it comes to a rehabbing player, but think of it as new information and it seems a bit less negative. In Street's case, it was a groin strain and not a problem with his injured shoulder that derailed him. There's a bit of a concern that this could be a sign that his delivery was altered in some way, but that kind of change attacks the weakest link in the kinetic chain. That's seldom a strong muscle. On the other hand, groin strains happen in random ways at random times, so it's smarter to take it as one of those things. It doesn't make Street or the Rockies feel any better about it, but as team trainer Jeff Probst might say, "it is what it is." Street's comeback is going to be pushed by more than a couple weeks as he heals the groin and tries to keep his arm strength up. The best estimate is that he'll need a bit less than a month.
Brad Lidge (inflamed elbow, ERD 5/30)
If there's good news, it's that Lidge didn't blow up his retroactive DL move eligibility. That's not really good, since a pen session caused the same pain and inflammation that had shut him down earlier. Lidge is headed back to Philly and he's going to get a spike of some kind. For the first time, Lidge brought up the possibility of a joint lubricant, something like Synvisc. That means that there's a grinding of some sort that's the cause of his bone chips that could be reduced. Remember, bone chip removal is just that—it pulls the chips but does nothing to correct the root cause. The Phillies are hoping that they can control the inflammation and get something out of Lidge before it flares up again. With this kind of situation, it's always a matter of time.
Carlos Ruiz ("sprained capsular ligament in knee")
The Phillies have listed Ruiz as dealing with a "capsular ligament sprain." This is a very odd designation and one that has my sources in disagreement. Usually, we deal with one of the four major ligaments in the knee (ACL, MCL, LCL, PCL) when hearing of a sprain, and one doctor I spoke with said, "While I've never heard it termed that way, medical terms aren't standard. There [are] regional or 'passed-down' terms." A team ATC reminded me of this as well, with the pronunciation of the muscles 'abductor' and 'adductor' one of the easy ways to tell what school of thought ATCs belong to. (One school tends to do a clarifying pronunciation, saying it as "ay-bee-ductor" and "ay-dee-ductor.") Another suggested that Ruiz is dealing with a capsular strain, which matches the symptoms we've been given. While we could debate all day without much chance of a clarification from the Phillies, let's focus on the effect on Ruiz. His knee is sore, and the pattern with which they're resting him says that it flares a bit after games. Expect the Phillies to keep buying him rest where they can, chaining off days when possible, until the point where he's more comfortable after games. While the pitching staff has never bought into Ruiz fully, Charlie Manuel has and he'll continue to get the bulk of catching duties as much as he's physically able.
Erik Bedard (post-surgical shoulder, ERD 6/30)
Adam Moore (heel and knee pain, ERD 5/31)
Bedard has always been something of a gamble for the Mariners. They risked a lot in acquiring him and in re-signing him, and Jack Zduriencik risked a little bit more in hopes of getting something out of his predecessor's mistake. Instead, Bedard is struggling along with a throwing program, perhaps no closer to a return today than he was during spring training. The expectation was that Bedard would be ready around June 1, but a few simulated games crushed that hope. Bedard had neither the strength nor the recovery to start a rehab program. He hasn't progressed past 30 pitches and isn't on a "normal" schedule yet. Sources tell me that the team might push Bedard, sending him out for rehab starts in the hopes that a deadline will help him move forward.
Meanwhile, the M's are going to be without Moore for a while. He has both a heel and knee problem, but it's the knee issue that's more concerning. The heel bruise, done on a single, is said to be a stone bruise not unlike what Joe Mauer dealt with this month. However, Moore may have injured the knee shortly after as he tried to take weight off the heel. The Mariners say the knee is structurally sound, which suggests a meniscus problem. We'll have to watch this one to see if it's more than a simple injury. That ERD could shift significantly.
Matt Thornton (elbow soreness)
White Sox trainer Herm Schneider came out to look at Thornton's elbow on Saturday, but he finished out the appearance. Thornton had Tommy John surgery in 2002, and those of you that were with me in the inaugural year of UTK might remember that Thornton wrote a couple short pieces about going through the process. It was those articles that led me to find the so-called "Tommy John honeymoon," the period of five years after surgery where very few pitchers get re-injured. (Turns out that my "discovery" was well-documented in medical literature from previous research.) This far out, Thornton is just another pitcher that throws really hard on an inconsistent schedule, often in stressful situations. The risk premium on an elbow in that situation is pretty high, so this bears watching, even if he doesn't miss time now.
Doug Davis (pericarditis, ERD 6/5)
Davis has overcome a lot to be a player that people regularly say "stinks." He's a major-league pitcher, one with a 12-year career and nearly 100 wins on what we'd kindly say are non-contenders. He does this with durability. He had thyroid cancer and only missed six starts. Pericarditis, an inflammation of the lining around the heart, is painful and dangerous, but controllable. Davis will head to the DL as he has treatment for the condition, but he should come back pretty quickly. The question will be how much cardio capability he'll lose, and with that the ability to go deep into games. With the Brewers falling behind in the division despite scoring the most runs, their pitching has been the major failure. Davis has been part of the problem, and while there's no way that the Brewers will push him aside because of a condition he can't control, they are going to have to hold his feet to the fire on the things he can or should be able to control, like getting hitters out.
Drugs in Sports: The Brian Cushing story has brought up the real battle in the sports and drugs story: the one between faith and science. Just like "Lost," we have a division between people that want to believe, and the people that deal in facts. There's that middle ground there where speculation lives, in trying to fill in the facts we don't have, and that's the real danger zone. Comparing the reaction to Brian Cushing and Manny Ramirez is pretty stark: while writers in Houston have come out swinging in Cushing's defense, LA writers did everything but light the torches for a witch hunt against Ramirez. This is as much about the storyline that baseball and football have set up around the topic as anything, but it's mostly about likeability. This isn't a new battle, however, as Bill Simmons pointed out yesterday. His link to this Sports Illustrated article from 1969 is amazing. I can't imagine what the reaction would be if the Cardinals' team doctor came out and said 'uppers, downers, painkillers, and everything else we could think of' were being given to current players. People will ignore that Hank Aaron and Bob Gibson made use of what was available to them and continue to moralize about the "steroid era." This is not a new problem. If only someone had listened to Dr. Robert Kerlan (yes, one of the founders of the Kerlan-Jobe clinic and a Dodgers team physician.) While Bud Selig will be remembered in large part for how he dealt with the PED problem, maybe we should take another long look at Bowie Kuhn.
Quick Cuts: Brilliant idea. This should be required in every league, from college on down. ... Jimmy Rollins is expected to be activated for today's game. I don't anticipate any issues, though I don't expect him to run as much for first week or so. ... Jacoby Ellsbury will start his rehab assignment and could be back by the end of the week. ... Brian Cashman talked about Nick Johnson's wrist. If the cortisone shots he has had don't work, he'll need surgery, which could cost him much if not all of the season. ... Pablo Sandoval got a day off with a sore foot, but he was back yesterday without any noticeable issue. ... Dustin Pedroia was given a day off prior to the Yankees series to rest up a sore knee. No one seems to know what the root cause of the soreness is. ... Aroldis Chapman had a bad outing and some are saying he's fatiguing a bit. I'm curious to see how he adjusts. ... Solid return for Jeff Francis. Diamondbacks fans looking for some guidance on a best-case for Brandon Webb have to be hopeful. ... Nice article from Joel Sherman, but at what point do we get back to the 'four-man plus' rotation? ... David Hernandez was scratched from his start yesterday due to a sore shoulder. He'll be re-evaluated early this week. Watch to see if he makes his normal throw day. ... The Orioles will send Brian Roberts to extended spring training in Florida this week. He still has hopes of a June return. ... Coco Crisp is expected back in Oakland by the weekend, assuming his rehab goes as expected. ... I'll be at the Clippers-Bulls game tonight in Columbus, Ohio, checking out some prospects with Craig Calcaterra. If you're in the area, e-mail and I'll tell you how to find us.