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May 31, 2010

Under The Knife

Monday Update

by Will Carroll

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David Huff (concussion)
Huff is OK. That's the great takeaway from this after he was hit just over the left ear by a blazing liner. Watch the video and you'll see that the ball ricochets hard off his skull and into right field. This is actually a good sign, as the energy was still in the ball and not his skull. (Compare that to one of the worst I've seen, the similar injury to Bryce Florie.) Watch closer and you'll see his glove come very close to catching it. If the timing is a bit different, we see that one as a "web gem" and not a near-fatal injury. Yes, it's an uncommon injury to be struck by a liner. Some estimates have it as one in 50,000 over all levels, but there are a lot of near misses and let's face it, it's the one that worries me. We've had story after story this summer about this type of injury, including this great article which details not only those injuries, but some attempts to prevent them in the future. MLB players will likely fight wearing any sort of protective device, much in the way they deride the "Gazoo" helmet. I don't worry so much about Huff (who says he's against any sort of protection) as I do the kids like Cole Schesner, who's wearing a helmet now in all the worst ways. I don't have a solution, but I'd love to see MLB take the lead on this. Take a million bucks—the same they've thrown away on steroid education that hasn't happened—and put it into an "X Prize" contest for the best solution to head protection. Anything is better than nothing, which is what we have now. As for Huff, he's fine, though I'm sure he has quite the headache. He'll be monitored for post-concussion symptoms, but it's not even clear whether he'll even miss a start, let alone go on the DL. (Larry Granillo from Wezen-Ball has a great article on the history of batting helmets, which gives some needed context.)

Grady Sizemore (arthritic knee, ERD TBD)
The Indians aren't ruling out anything when Sizemore goes under the knife this week. He'll let Dr. Richard Steadman take a look inside the knee and assess the stability of the cartilage before deciding how to proceed. Lonnie Soloff, the DMA-winning head trainer for the Indians, was asked about microfracture surgery, and he wouldn't rule that out. On the upside, this could be nothing more than a cleanup that would cost Sizemore a month or so. On the downside, Sizemore could be facing the same path that Carlos Beltran is still jogging down. We won't know a timeline or a prognosis until after the surgery, and the Indians have been very tight-lipped about this entire process. Despite this, their history tells us that they'll be aggressive after being thorough. Don't be surprised by anything, even if Sizemore is forced to have microfracture surgery. This is the point on which things will turn when we discuss Sizemore's career and perhaps the next few years of the Indians franchise.

Kendry Morales (fractured lower leg, ERD 9/1)
Maybe the Braves had the right idea, walking away after the "walk off." After Morales' freak injury in the celebration of his walk-off grand slam, the Angels have apparently banned that type of celebration. Watching the video, it's unclear exactly what happened, but I think as Morales jumped, someone pushed him on the shoulder, almost pulling him back and down. It's unintentional to be sure, but as he hit the plate—a solid surface that can be slick to someone in spikes—he rolled over the ankle and it seemed to catch as he went from plate to dirt. The result? A fracture at the lower part of the leg. He had surgery yesterday to fixate the bone, and early indications are that the fracture is in the tibia. That means he'll be out until at least September, though there have been some big advances in fracture rehab. By that point, Morales might be shut down, unless the Angels can hold on in the standings without him.

Torii Hunter (bruised hand, ERD 5/31)
The Angels did have some luck on Saturday. Not only did they get the win—amazing that a walk-off grand slam is the forgotten part of the Morales story—but Hunter came back from x-rays with a good result. Hunter took a pitch off the hand and left the game, but it looks like he'll have nothing more than some soreness. Hunter was held out of yesterday's game, but sources tell me that he could have played in the mythological "if the playoffs started today" sense. Hits like this, when they come up short of fractures, tend to be very short-term injuries and have few consequences. I feel a soapbox about protective equipment coming on, and I've already had one of those today, so I'll just say expect Hunter back today or tomorrow.

Josh Beckett (back spasms, ERD 6/15)
I always pause when a team uses mechanics as an excuse for anything a pitcher is doing. Flat out, there's only a handful of teams doing anything with biomechanical analysis, so for most, it's a cliché at best. The Red Sox and John Farrell do take this seriously, but without the analysis necessary to really figure out what's going on or at least confirm what the pitching coach is thinking, as the Diamondbacks have been saying about their analysis of Brandon Webb, it's not much. The Red Sox are saying that they're pulling back on Beckett's rehab until his back is better due to a change in arm slot during his last throwing session. I'll admire the concept while doubting whether there's much more to this than simple back pain. If any team had said, "we're shutting this pitcher down until his back is 100 percent," we wouldn't make much of it. Unless it was the Mets, which might create some sort of panic in the media. By throwing in some things that sound smart, whether true or important, the Sox create a little bit of sabermetric smokescreen for a pitcher that is slightly behind schedule for a return.

Joey Votto (strained neck, ERD 6/1)
The Reds are taking an interesting tack with Votto and his neck injury. It's one thing to be slow and conservative, letting a day-to-day injury take its course and seeing if he can come back while holding on to the possibility of a retro move. Sources tell me that while that's the public face of this, the reality is that the Reds don't have anyone better to call up. That's right, they don't think they have a better option than Miguel Cairo at first base. Yonder Alonso, their former first-round pick, is just up to Triple-A and there's some logic to saying he's not ready, but this one gets tough for a team that's supposed to be in contention. Votto is making some progress, working out on the field both days this weekend, and seems to be ready for a comeback early this week. Missing six, even seven days and not using the DL is a smart move if there's a reasonable replacement available. That there's not a suitable replacement has to go onto the Cincy front office, and in a year where the division could come down to one game, that's something that could cost them just that.

Jorge Posada (fractured foot, ERD 6/10)
Posada isn't messing around. The day after getting his walking boot off, he was on the field at Yankee Stadium throwing long toss. The challenge for him isn't going to be throwing or hitting, but catching. How much Joe Girardi is willing to play Posada at DH will determine when he comes back. (Yes, fouling a ball off his foot is a risk, but one that can be compensated for with a pad.) With Francisco Cervelli hitting well and playing solidly behind the plate, indications are that DH is just fine. Certainly Girardi should understand the demands of the position and seems well-suited for figuring out just when Posada can be deployed. At this stage, Posada could avoid a rehab assignment, but we'll get a better indication once he starts hitting off live pitching. That should happen in the next week. I'm moving the ERD up about 10 days.

Jair Jurrjens (strained hamstring, ERD 6/12)
The Braves have been very quiet about Jurrjens. That's why it seemed jarring that he went from "light running" to a full mound session yesterday. If you look back, it's right on plan. At the time he had the setback to his hamstring injury, the team said they'd shut him down for a couple weeks and that they thought he'd be back shortly after that. Seems they knew exactly what they were doing with that. Jurrjens' session went well, but wasn't a full-go outing. He's still a couple weeks from a return as he builds his stamina. Expect one or two more side sessions before they decide where he'll go for a rehab outing. The Braves have most of their minor-league clubs close to home, so they're likely to go more on who's closer than the level.

Nelson Cruz (strained hamstring, ERD 6/15)
The Rangers have lost Cruz to a hamstring strain again. This time, it's on the other (left) side from what put him on the DL back in April, but it's possible that the two are interrelated if not a strict recurrence. Despite having pinch hit on Friday, the leg wasn't getting better and strength tests showed that Cruz could have had this go from bad to much, much worse with one wrong step. The team is saying that they don't think he'll be out over the minimum, but the recurrence does have to make them wonder. Expect the team to take their time with this and make sure that any strength imbalance is addressed during the rehab process. With a division race at hand, while every game counts, maximizing the resources is even more important for the Rangers.

Jose Reyes
No one seems to notice this, but Reyes has 11 steals in 12 attempts. He's unlikely to get back into the 50s, let alone a tally near his career high, but this is in a season where many wondered if he could stay healthy at all. Instead, he's had no problems despite getting only one day off since returning and seemingly playing the same style of baseball that made him a centerpiece of the Mets' hopes. The speed is one thing, but let's check the other boxes off if possible. Scouts I've spoken with over the last week say that Reyes seems physically back to the place they were used to seeing him. The various defensive stats are predictably schizophrenic about his range and defensive value, but none seem to indicate that he's lost range. Speed, scouts, stats... they're all in alignment for Reyes. Just remember, that hamstring is a ticking time bomb, the same as it was before it cost him much of 2009. It might never go off, or it might blow up tomorrow, taking the Mets' hopes with it.

 Quick Cuts: So much for Roy Halladay being worn down by his workload, huh? With two perfect games in a month after only 18 others in baseball history, is that more or less statistically significant than having so many 50-plus homer seasons during the "steroid era"? ... Brad Lidge did well in his Saturday rehab appearance at Clearwater. He wasn't sore yesterday and could be activated today. ... Several readers have noted that Ricky Nolasco has lost some velocity. I'm not a fan, and I'm even less a fan of people trying to read the Pitch-f/x tea leaves. Velocity is variable, and doesn't worry me until we see significant (10 percent) loss. ... Bud Norris is not Chuck Norris. He had a cortisone shot in his pitching shoulder to calm the tendinitis and should be back throwing this week. ... Justin Duchscherer had hip surgery and is done for the season. He came back from surgery on the other one, so he's got that going for him. ... Zach Miner had Tommy John surgery and will miss the rest of the season. ... Derek Holland left his start last night with numbness in his hand. There's no word yet on the cause, but look for him to head for tests and perhaps the DL. ... Jason Bartlett's hamstring strain won't cost him much more time, though the Rays can be conservative with a couple of shortstop options on the roster. ... Ryan Hanigan broke his thumb and will miss a month. The Reds called up longtime backup Corky Miller and were forced to shift Chris Dickerson, who'd been making progress after wrist surgery, to the 60-day DL. Dickerson will be out until early July now. ... Word that Albert Pujols is dealing with a knee problem continues to swirl, but my sources tell me it's his heels that have recurred. ... Nick Swisher hit the wall not once but twice yesterday. His shoulder is sore, which makes sense. He'll be OK ... Orlando Hudson had a nasty collision to close out yesterday's game that reminded many of the Jacoby Ellsbury collision. Hudson stayed down a while, but walked off under his own power.

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