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June 4, 2010

Under The Knife

Friday Update

by Will Carroll

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Brett Anderson (strained elbow, ERD 7/15)
Josh Outman (Tommy John surgery, ERD 8/1)
Ryan Sweeney (concussion, ERD 6/6)
The Athletics only got two innings out of Anderson yesterday against the Red Sox before his elbow tightened up on him again. It's the dreaded recurrence, one that has to have the team's medical staff beside themselves. Anderson passed all the tests, but there's no way to truly simulate everything that goes into a real start against real hitters with a real crowd. That full-go setting pushed Anderson back to an injured state and likely back to the DL. The issue now is that from what we know about the injury, there's no real fix beyond waiting for it to heal. Given that he was just out for almost a month and almost immediately had similar if not identical symptoms, it's tough to say that it won't take significantly longer now. He'll have more tests, but Anderson is likely out until the All-Star break, if not beyond. It was a tough game for Oakland, especially Sweeney, who took a knee to the head on a defensive play. He was removed from the game with dizziness, a symptom of a probable concussion. He'll be monitored and miss a couple games, though I shouldn't have to remind you how unpredictable post-concussion symptoms can be. Let's toss in a little bit of good news for the Bay Area—Outman, one of the solid young Oakland pitchers, is back to throwing after a setback in his Tommy John rehab. He's about a year post-surgery at this stage, but just a bit behind schedule. He'll need to make it through the next month without issue if he'll be able to get back for anything more than a cameo this season.

Mark DeRosa (strained wrist, ERD 10/4)
Things aren't looking good for DeRosa. After a tough game for him in A-ball, he'll try his injured wrist in a Triple-A game. If he can't play through the injury, the Giants are likely to push him to the 60-day DL and surgery to re-do the fix from last offseason. The DL move would open up a 40-man slot for the recently signed Pat Burrell, so there are a lot of forces in play here. DeRosa's wrist is going to need to be repaired (again), so the only question is whether he can hold that at bay and be productive. Tonight's game is his last chance, though all signs so far have been negative. In theory, he'll be able to have the surgery re-done and come back, but as he's seen, there's a pretty high recurrence risk with this type of wrist injury. (Note: the 2010 season ends on October 3, so the ERD of "10/4" means that the expectation is that this injury is a season-ender. It's not CB code.)

Chipper Jones (inflamed finger, ERD 6/7)
The Braves are going to give Jones off until Saturday, to decide whether or not rest is enough. His injured finger remains swollen and painful, so the next step beyond simple rest and treatment would be a cortisone shot. (Dave O'Brien has some nice notes on the current treatment.) Given the need for a couple days off for the anti-inflammatory to do its work, that would put Jones out until Monday, if necessary, and beyond if that doesn't take. Either way, there appears to be about a 50/50 chance of Jones being put on the DL. Part of that is to protect Jones from himself. He's notorious about pushing his way back into the lineup only to do more damage. He's done that once already with the finger, so the medical staff isn't going to give him as much leeway. There remains some question as to the underlying cause, including some possibilities that could keep him out much longer.

Josh Beckett (ERD 7/5)
The Red Sox offered more of an explanation as to why altered mechanics shut Beckett down for 10 days. According to several reports, Beckett's sore back was forcing him into a more upright position with less shoulder tilt. As you can see in this picture, Beckett normally has his shoulders tilted, with the left shoulder lower than the right. Tilt between 8 and 33 degrees is "normal", according to Dr. Glenn Fleisig of ASMI. Without that tilt, Beckett's arm slot would appear to be much "lower" and would change the plane of his breaking pitches slightly. He apparently made some unconscious adjustments, raising his arm, to try and compensate for the lack of tilt. It caused some stress on the back of the shoulder and the Red Sox quickly shut him down. He'll rest and get treatment in hopes that when he does get back on the mound in about a week, he'll have a much more normal delivery. The delay does make it look like he might be out until late June or even to the All-Star break, if the Sox remain on a conservative path with him.

Brad Penny (strained latissimus dorsi, ERD 6/10)
The Cardinals are beginning to think they could get Penny back right around the minimum. Penny threw on flat ground both Tuesday and Wednesday and had no real problems with his strained lat during or after the session. He could be up on a mound as soon as Sunday with the expectation that he could use that as the normal side session before a start. He's eligible to come off the DL on June 7, so that date is a bit aggressive. More likely, it could be the end of the week. If he hasn't lost any stamina and has no physical issues, there's no need for a rehab outing and he'd slot right back into the third or fourth slot of the Cards rotation, depending on how you feel about seniority and the sustainability of Jaime Garcia's first two months in the bigs.

David Huff
This happened. But for Huff, it was little more than a headache and some media attention. Huff didn't miss a start and doesn't seem to have missed a beat. I won't blame the blow to the head for his continual insistence that pitchers don't need additional protection. Huff's seemingly miraculous recovery is being used as an example against what one player called "creeping nannyism" in a conversation this week. I'll just ask you to watch the ball smacking off Huff's skull again, watch how he lay on the ground, and to remember how your first thought was probably the same as mine: "I hope he's not dead." Huff didn't last long in his Thursday start, but it had nothing to do with his head.

Donald Veal (sprained elbow/Tommy John, ERD 10/4)
I was at Veal's last Triple-A Indianapolis start, so news that he was headed for Tommy John surgery really surprised me. His start was a typical Veal turn, with some good, some bad, and a lot of inconsistency. He didn't appear to have any real control problems beyond that inconsistency and really didn't appear to have any pain. After he was removed, I saw him standing in the dugout and didn't even see any ice or any other sign that there was anything going on. The big lefty remains a prospect and an easy guy to root for and, at 25, he should be able to come back from this.

Quick Cuts: Grady Sizemore is scheduled for surgery on today. Look for news in the afternoon or early evening on what was done, which will determine how long it will be before he's back. I'll try to put an update up in comments, so check back. ... Orlando Hudson is iffy for the weekend after the collision with Denard Span caused some inflammation in his surgically repaired wrist. The DL remains a possibility. ... My dog came home from the surgeon Wednesday, just 24 hours after two surgical procedures. He's up and about, if limping, but if Wes Welker crows about his quick comeback from ACL surgery, I'm not having it. ... Vladimir Guerrero is out after a ricochet off the batting cage made him look like a boxer. He should be back in a couple of days. ... The Rays pushed Jason Bartlett to the DL with a retro move, in order to make sure his hamstring strain heals properly. The move allowed them to bring Kelly Shoppach back without having to make a tough decision between John Jaso and Dioner Navarro. ... Jorge Posada was wearing a protective shield on his lower leg and foot during his at-bat on Tuesday. ... Casey Blake was scratched from Thursday's game due to back spasms. Sources tell me this is minor and he should be back this weekend. .. The Diamondbacks think Mark Reynolds will be back in the starting lineup tonight, avoiding the DL. ... Daniel Murphy is done for the season with a ruptured MCL. He won't require surgery, however. ... Takashi Saito left Thursday's game with a strained hamstring. No word on severity at deadline. ... Activated from DL, then struck out the side in first outing back. That's a good pattern from Franklin Morales, coming back from a sore shoulder. ... My weekly chat with Noah Coslov of Cinesport is up now, if you want to see.

Related Content:  Back,  Tommy John Surgery,  Surgery

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

BP Comment Quick Links

cooper7d7

@JockOuch

Jun 04, 2010 07:17 AM
rating: 0
 
BP staff member Will Carroll
BP staff

Umm, no. But I did smile.

Jun 04, 2010 07:28 AM
 
Swingingbunts

@injuriesexpert

Jun 04, 2010 07:25 AM
rating: 1
 
BP staff member Will Carroll
BP staff

I dont think a plural will make their legal dept happier.

Jun 04, 2010 07:29 AM
 
coyoteuuggly

@bodycarpenter

Jun 04, 2010 07:41 AM
rating: 0
 
parkerap

@debilitationdude

@casualtypro

@hurtexpert

Jun 04, 2010 08:03 AM
rating: 0
 
OTSgamer

Was the back issue the ultimate root of Beckett's early-season mediocrity, or were those two things independent of each other?

Jun 04, 2010 08:04 AM
rating: 1
 
BP staff member Will Carroll
BP staff

Good question, but unknown.

Jun 04, 2010 09:11 AM
 
OTSgamer

And as for your handle, just go with @WillCarroll. Build up the name, and besides it's probably easier for people to find you that way.

Jun 04, 2010 08:06 AM
rating: 0
 
BP staff member Will Carroll
BP staff

It's taken. Guitarist.

Jun 04, 2010 09:12 AM
 
OTSgamer

Sue the guitarist?

I'd just add "BP" to it in some way then.

Jun 04, 2010 09:47 AM
rating: 1
 
baserip4

@THEREALinjuryexpert

Jun 04, 2010 08:15 AM
rating: 0
 
prospero14

@injuryguy

The title of expert is one that others bestow, and not one that the expert need claim for himself. (Or so one could argue if one needed to stop saying "expert" to avoid a lawsuit.)

We know you're the expert; that's why we come to you.

Jun 04, 2010 08:36 AM
rating: 1
 
kmbart

@injuryinfoman
or
@undertheknife

Jun 04, 2010 09:27 AM
rating: 0
 
dianagram

@thehurtlocker
@thecouldbebighurt
@notadoctorevenonTV
@injuriousbasterd

Jun 04, 2010 09:31 AM
rating: 0
 
orindv
(464)

No Twitter name suggestions, sorry, but I do have a different one. How about an ERD of "2011" instead of "10/4" take make season-ending injuries stand out a bit?

Jun 04, 2010 09:33 AM
rating: 0
 
BP staff member Will Carroll
BP staff

Makes sense, but doesn't work with my notes system.

Jun 04, 2010 10:36 AM
 
hellfish

In regard to your previous note on Kendry Morales, bascially the longer the swelling precludes surgery, the less chance of him reappearing in September?

Jun 04, 2010 09:33 AM
rating: 0
 
dianagram

In a prior UTK, I believe Will mentioned that this long of a swelling-related delay could signal ligament/tendon damage beyond the bone break. If that's the case, you'll see Morales in 2011 most likely.

(Will, if I've misstated your wording, please correct me.)

Jun 04, 2010 10:25 AM
rating: 0
 
OTSgamer

Could the Cubs / Angels trading Lee rumors be stemming from the heightened concerns over Morales?

Jun 04, 2010 09:45 AM
rating: -1
 
Chomsky
(103)

Uh, ya think?

Jun 04, 2010 11:00 AM
rating: 0
 
bixology

@WalkItOff

Jun 04, 2010 12:40 PM
rating: 1
 
acmcdowell

Hey Will,
Any details about Brett Anderson? Mychael Urban quoted a team official saying "It looks like he's done". Can you think of why this would leak before the MRI results are even out?

Jun 04, 2010 12:46 PM
rating: -1
 
BP staff member Will Carroll
BP staff

Urban's very well-sourced. I dont have it yet.

Jun 04, 2010 13:52 PM
 
dantroy

@itsonlyafleshwound
@pitchingisbadforyou
@whoisvisitingDrJamesAndrewstoday
@astrainisatear
@WATG
@daytoday



Jun 04, 2010 13:42 PM
rating: 1
 
Karl T

@hipaasucks

But seriously, are your sources violating hipaa, or are pro athletes exempt?

Jun 04, 2010 14:28 PM
rating: 0
 
BP staff member Will Carroll
BP staff

My sources are often violating the rules.

Jun 04, 2010 15:17 PM
 
Matt Kory

@pleasestop

Jun 04, 2010 14:51 PM
rating: 1
 
bflaff1

AP is reporting that Grady Sizemore had microfracture surgery, and is expected to be out for the rest of the season (6 to 9 months).

Link: http://sports.espn.go.com/mlb/news/story?id=5253131

Jun 04, 2010 15:15 PM
rating: 1
 
BP staff member Will Carroll
BP staff

Here's the update we dreaded on Sizemore: Microfracture.

Details are still spotty, but the Indians announced that Sizemore did have microfracture as part of his surgery this afternoon. He is done for the season and faces a long rehab.

Jun 04, 2010 15:17 PM
 
OTSgamer

Hate to say I called that one on Sizemore, but I had a sinking feeling about his prognosis every time I read something about him.

How bad does it have to be for the Indians now? Attendance is shaping up to be several hundred thousand lower than expected, the team is on pace lose 100+ games, and about the only proven star you have in your organization is now out for the season and is facing potentially career-threatening knee surgery. Ouch.

Jun 04, 2010 17:29 PM
rating: 0
 
sephrath

Will, how many pitchers have been killed from a comebacker? If i recall correctly, more batters and fans have been killed then pitchers.... I think the last one (only one?) was from a 1920 game with the Indians and Yankees (ironic, no?)

I was in attendance at the Huff game, and my first thought was def "oh crap I think he's dead." But like many injuries, they look worse then they usually are.... i don't want a pitcher to be killed, but I am just not sure what can be done about it, and the fact that not one pitcher has been killed in 90 years (at the pro level) seems to point to it not being something that is a big concern.... However, I welcome all research that would potentially come up with something, should a pitcher choose to want to protect himself.

Jun 05, 2010 04:34 AM
rating: 0
 
BP staff member Will Carroll
BP staff

That's all I'm saying -- not saying wrap them in bubblewrap or put up an L screen. Let's just try to find something that will make them safer.

Jun 05, 2010 15:46 PM
 
airlifting

@rubsomedirtonit

Jun 05, 2010 11:05 AM
rating: 1
 
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