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May 14, 2009

Under The Knife

Medical Mysteries

by Will Carroll

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Chris Carpenter (50 DXL)
Ryan Ludwick (15 DXL)
Rick Ankiel (15 DXL)

The Cards are shuffling through lineups like Tony La Russa deals with bullpens... oh wait. A lot of you questioned why I suggested that Carpenter might head to the pen. I didn't mean to suggest it was permanent-though I wouldn't put it past La Russa-but that it was an alternative to a rehab assignment. It's another way to turn a weakness into a strength. Even that might be out of the question now as Carpenter continues to impress with his side work. He'll have one more bullpen session on Friday before the team makes a final determination on when and how he'll slot back in. The Cards also placed Ludwick on the DL, which was a bit of a surprise, but he had some pain and more swelling than was expected on Wednesday morning. With Ankiel doing well and ready to come off of the DL at the minimum, the Cards are using some of their outfield depth to do some shuffling and avoid being caught shorthanded, though quantity never outdoes quality when it comes to a lineup.

David Ortiz (0 DXL)
Dustin Pedroia (4 DXL)

Ortiz was hit on the wrist by a pitch the other night, and we actually learned something from it. Ortiz felt the normal pain, I'm sure, but he didn't seem to have any other issues. He didn't appear to be bothered or frustrated by getting hit there, and that reaction, or rather the lack of a reaction, might indicate that there's less of a problem with the wrist than many have been thinking. While that's good news on one level, it removes the leading cause of Ortiz's struggles, and forces Sox fans to confront the fact that Ortiz may be losing it... or that his shoulder is more of a problem than anyone is letting on. Pedroia missed Wednesday's game, and Terry Francona covered for him, saying that the team wanted to be cautious with his groin strain. He's expected to play Thursday, but there are some rumblings that he could stay out until the weekend. Sources say that everyone is so impressed with Nick Green that they're willing to hold Pedroia out.

Jeremy Bonderman (60 DXL)
Dontrelle Willis (0 DXL)

There's been a dearth of information about Bonderman since spring training. The Tigers haven't needed to say anything because, well, there hasn't really been much to say. Even if you had all of the details of a strengthening program, you'd quickly become bored by them all. He's past the tedious part now, and will move on to the rehab assignment, probably starting this weekend in Single-A West Michigan. While the Tigers won't say how many outings they want him to have, it won't be a quick process, with some sources saying that the Tigers could use the full 30 days to build up Bonderman's stamina and to make sure that if any problems do occur, it won't affect the Tigers' record. We'll know a lot more about how this rehab process went once Bonderman gets on the mound.

The news on Willis is a little more complex. While he made it back to the major leagues and pitched passably, the actual diagnosis continues to confuse. Here's what he told MLB.com:

I was just playing bad, and that happens... Even when I went on the DL, I felt fine. You can ask anybody in here. I'm not a depressed guy. Maybe I'm hard on myself, but I wouldn't have gotten here if I wasn't. But there's a fine line to knowing what you can control and what you can't control. As far as how I feel, I don't have a condition. My condition is me going out there and playing baseball and having fun. If God doesn't want me to do it, then I'll find something else to do.

That doesn't exactly match the description of an anxiety disorder, but it does sound as if he could be downplaying that anxiety. It's impossible for anyone other than Willis to tell what he's been dealing with. It's still quite confusing, so I'll stay focused on the pitching, which is still a work in progress.

Aramis Ramirez (60 DXL)
Ramirez is still in pain, and that says a lot about how serious the dislocation that he suffered last Friday actually was. He is eventually going to need some sort of capsular tightening, a surgical procedure that's exactly what it sounds like, though there are several ways to accomplish that goal. Surgeons differ on how they prefer to do it, with the "thermal" version being the most popular, but it has its downsides. The Cubs still believe that he'll be back in six weeks, but all signs point to a more extensive stay unless the pain leaves quickly and some reasonable stability returns to the joint. At this stage, the likelihood of a recurrence is through the roof.

Frank Francisco (7 DXL)
The Rangers will keep Francisco on the bench for another day before re-evaluating his shoulder on Friday. Francisco is dealing with biceps tendonitis, which is painful and can degenerate quickly, but the diagnosis itself is rather simple, as are the protocols for getting him back on the mound. It's about 50-50 now as to whether or not he needs to go to the DL to get it fixed, but the Rangers have C.J. Wilson available as well as Eddie Guardado, who both have experience closing, though they don't have Francisco's raw stuff. This could also lead to the debut of Neftali Feliz, who could follow Derek Holland to the pen if Francisco goes to the DL. Either way, no one expects this to be a long-term issue. It's a common problem post-TJS, and one that tends to be passing.

Derek Jeter (2 DXL)
Jeter wasn't back on Wednesday, but he's saying he'll be back on Thursday. If you think about this, you'd rather have a "rolling tomorrow" expectation than a "Chipper Plan" of coming back too soon and exacerbating the problem, thereby costing more time overall. Jeter's oblique wasn't yet good enough to allow him to play, and his optimism, while trite, is the best indication that we have that he's not getting worse or merely staying the same. It's not likely that he'll get Pipped even if he needs more time, but Jeter does very well with injuries and seems to thrive on others underrating him. It's seldom discussed, but he does have a preternatural knack for being in the right place at the right time on a baseball field, and a mild oblique strain won't change that.

Quick Cuts: Joey Votto will be OK; he's dehydrated after a bout with the flu, and he tried to play too soon. Mark Sheldon has all the details. ... Travis Hafner will begin his rehab assignment on Friday at Triple-A Columbus. ... Carl Crawford downplayed a shoulder bruise he received while making a diving catch. He'll be re-evaluated today. ... Xavier Nady will start swinging on Friday, and he could start a rehab assignment as early as next week. ... Gary Matthews Jr. was held out Wednesday night due to back tightness. He'll be re-evaluated on Thursday, but this doesn't sound too serious. ... Brian Anderson is in Triple-A Charlotte now, but he could be back with the White Sox by the weekend. ... Brian Bruney threw in the pen and did well. There's no timetable for his return, but it is progress. ... Alex Gonzalez will be back for the Reds by Friday, unless there's a setback in pre-game warmups.

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

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jdavlin
(630)

Hey Will, great stuff as always. Any news on Adam Jones hamstring? O's say he's day to day.

May 14, 2009 09:20 AM
rating: 0
 
Dr. Dave

You beat me to it, jdavlin.

For the record: Jones injured the hamstring early in the game, and Dave Trembley (during his stupid from-the-dugout interview for the local TV guys) said mid-game that Jones had said he was fine, but that his job as manager was to not take that at face value.

...at which point he let Jones finish out a plate appearance in which Jones winced visibly and had to take 30 seconds to recover after a swing-and-miss. Jones, swinging very late, eventually hit a fluke ball into the right field corner, but could only make it as far as first base. THEN Trembley took him out, after any additional damage to the hammy had already been done and re-done.

May 14, 2009 09:31 AM
rating: 0
 
BP staff member Will Carroll
BP staff

You guys know what I know on this. There was nothing to add. Getting a read on muscle strains overnight is really difficult, as my Ludwick note yesterday reminded me.

May 14, 2009 10:10 AM
 
dmelody

Sticking with the Os, any recent news on Luke Scott?

Thanks, Will!

May 14, 2009 09:26 AM
rating: 0
 
dantroy

Did JJ Hardy simply have a headache last night?

May 14, 2009 09:47 AM
rating: 0
 
BP staff member Will Carroll
BP staff

That's what I heard.

May 14, 2009 10:09 AM
 
Meatpacker

Will, the language you are using to describe Aramis Ramirez's injury sounds similar to what was used when Scott Rolen hurt his shoulder in the collisions with Alex Cintron and Hee Seop Choi. It seems like Rolen never has really recovered. Can you comment?

May 14, 2009 09:50 AM
rating: 0
 
BP staff member Will Carroll
BP staff

Yes, wouldn't surprise me to see similar outcome IF the internal damage is similar. That part, I don't know.

May 14, 2009 10:09 AM
 
Dan

Do you see any justifiable reason the Reds didn't DL Alex Gonzalez? He last played on May 4th -- 10 days ago -- and he's been so bad overall that it seems like they ought to LOVE to have a chance to give him a short minor-league rehab stint.

As things stand now, he can't rehab in the minors, and the Reds have spent 10 days playing with a 22 or 23-man roster (I'm not counting Gonzalez, Darnell McDonald who's just terrible, and lately Votto.)

May 14, 2009 10:10 AM
rating: 0
 
Ira

Losing Frankie for any extended period would be a huge loss for the Rangers, who have had issues with their bullpen. But if he is on the shelf for any extended time (or even a short time) its unlikely that Feliz will be brought up just yet. Feliz has been battling control issues at AAA and needs to work that out before being brought up. On the other hand, they might bring Luis Mendoza again. Other options at OKC include Warner Madrigal and Brian Gordon. Mendoza and Madrigal have the advantage of already being on the 40 man roster, where neither Gordon or Feliz are.

May 14, 2009 11:45 AM
rating: 0
 
Chomsky
(103)

Feliz also was shelved at least briefly due to soreness in his shoulder. Rotoworld noted on May 8:

Neftali Feliz, who has struggled with his command this season at Triple-A Oklahoma City, will not make his scheduled start Friday after complaining of shoulder soreness.

A doctor told Feliz he has no structural damage. Still, Feliz will be shut down for two or three days at least. An injury could explain his 7.4 walks per nine innings this season.

http://startelegramsports.typepad.com/foul_territory/2009/05/bp-for-hamilton-shoulder-soreness-for-feliz.html

May 14, 2009 14:08 PM
rating: 0
 
krgrecw

Will a little OT but the ACC DPOY and All-American was diagnosed with cancer today. Ewings Sarcoma how bad is this? can he return?

http://rivals.yahoo.com/ncaa/football/blog/dr_saturday/post/Breaking-All-American-Herzlich-diagnosed-with-c?urn=ncaaf,163519

May 14, 2009 15:23 PM
rating: 0
 
pftodd

I do not agree with the assessment on Ortiz. The clicking wrist last year is his right wrist, the same one he had 2 surgeries on while with the Twins. But he was hit on the left wrist. The right hand generates the power in his swing, the left one is along for the ride. Also, his bad shoulder is the left shoulder and should not affect his swing as much as if he was bothered with a bad right shoulder. His issues this season certainly pre-date the HBP, and I do not see how you can rule out injury given his performance at 150 PA, 619 OPS, 0 HR given he is only 33.

May 14, 2009 22:35 PM
rating: 0
 
pftodd

I meant rule out wrist injury.

May 14, 2009 22:37 PM
rating: 0
 
VAYankee

maybe Big Papi is just now having to deal with life without PEDs....

May 17, 2009 09:57 AM
rating: -3
 
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