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May 18, 2009

Under The Knife

Abuse

by Will Carroll

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This time of the year, I get a lot of e-mails from people talking about some insane pitch count that's been run up by a college or high school player. People expect outrage from me, a call for the coach's head, criminal charges, or all of the above. The problem is that the pitch count is simple-too simple-and that context is everything when trying to assess it. Reader Henry Fyfe sent me this story about a pitcher going 21 innings in 26 hours. Henry asked:

"Now, apparently the youngster did understand the risks involved. But do you condone this under any circumstance? I don't think he actually knows what he's getting into. Koufax couldn't even brush his teeth with his left arm late in his career. Maybe, though, he's trying to hook on somewhere after this. Is it worth it then?"

I won't say I condone it, but Fuller seems to have understood the situation and in all likelihood is pitching his last competitive innings. The high point of his career, and perhaps his sporting life, was to go out there and try to pitch his small school into the NAIA World Series. He'll be an accountant in a few weeks, not a drafted pro, so I don't really have much trouble with this. What's the worst that can happen here? He could blow out his elbow? Guess what-accountants don't need their UCLs.

On the other hand, several readers sent me this article. A high school pitcher goes 172 pitches in a doubleheader. He relieved in the first game, and then threw a 97-pitch complete game. While you could argue that he adjusted and was much more efficient in the start, this is a high school kid who's heading to Arizona next season, a top-tier program. I have a huge problem with this and think that, while the coach is clearly at fault, so are we. Arizona has no pitch-count rule, leaving this high school coach the option of risking a young man's future in the quest for a win. The NAIA doesn't have a rule either, but I'm not advocating a change there, since the application of the rule at the Little League level has led to an increase in innings. Elite players have shifted to travel teams, where they play more and pitch more, without the rules of Little League or the common sense of coaches. This only benefits the surgeons that will put the players' arm back together, and the coaches who win on the shredded shoulders of these youngsters, so while I can cheer that a college senior is willing and able to go deep into a game, I realize that the problem is that we've allowed this kind of situation to exist. In MLB, pitch counts exist because of the value of players. The teams are afraid to test the limits of players that they have millions of dollars invested in. I'd argue that Cory Bernard, Bryan Fuller, and some anonymous 12-year-old on a mound somewhere are worth just as much, and worthy of protection.

(Un)Powered by the broken left Shift key on my Macbook and the alteration to my typing routine, on to the injuries:

Carlos Delgado (60 DXL)
"Going to Vail" doesn't have the same ring of dread that "Going to Birmingham" does. While I have nothing but love for Birmingham and its metro area, it's also not exactly the vacation spot that Vail is. For baseball fans, the skiing mecca might begin to enjoy that same reputation for creeping doom, however. Delgado has an appointment and a flight to see Dr. Marc Phillipon, which means there's a likelihood that the Mets slugger is dealing with an acetabular labrum tear. Delgado will first see team physician David Altchek, so the flight out could be canceled if there's any news either way. What remains very, very unclear is how long Delgado will be out of the lineup. As far as magnitude, this go anywhere from a couple of days to ending his season, and anything in between. Surgery would cost him around two months, assuming he can have the same type of surgery that Alex Rodriguez and Alex Gordon had. There is even a lesser surgical option available if the problem is merely a bone spur in the hip causing the problem, which was the speculation last season. The Mets will try to get by with current backups at first base, but if Delgado is out for an extended period, you can bet that Omar Minaya will become active. Ken Davidoff has a great take on the effects.

Pat Burrell (15 DXL)
The Rays have always been a conservative team when it comes to sports medicine, but that works in two very different ways, even though both spring from the same underlying philosophy. That philosophy comes from the top down, and is part of the organization's plan, and even predates the Sternberg era. While the inherent conservatism sometimes keeps players off of the field longer to make sure they're 100 percent or that they're fully rested, it also works by keeping players available. With Burrell having recurrent neck problems, listed as a 'neck strain' rather than a bulging disk like Derrek Lee is dealing with, the team gave him every chance to get back without hitting the DL. They were finally forced to make the retro move, and think that Burrell won't miss much more than the minimum. The neck strain is worrisome in that a simple muscular strain should have healed or at least responded to treatment, so how Burrell does this next week will bear watching.

Travis Hafner (20 DXL)
Hafner is close to coming back, though the early results from his Triple-A outing this weekend were underwhelming. When you add that performance to an interleague matchup in Cincinnati that will take away the DH, Hafner might get a little more time to rest. The bigger key isn't that he's healthy and the shoulder is strong now, but the ability of the team's trainers to keep the shoulder in a productive state in the future. Whether that will involve regular rest remains to be seen, and would change his value a great deal, both for the Indians and on fantasy teams. Sources tell me that Hafner's visit to James Andrews helped. "He's not playing now so it's hard to tell for sure, but he seems like a weight was lifted off his shoulder, no pun intended," said a clubhouse source. "He was always worried about it every time he swung, and now I think he'll be a bit freer."

Chris Carpenter (50 DXL)
Carpenter will go from simulated games to real games, eschewing the normal rehab assignment even with Springfield and Memphis easily accessible. The Cards will have their titular ace back on the mound on Wednesday, though a limit of 75-80 pitches will probably to be enforced. While jumping into the rotation without any rehab-assignment starts isn't unheard of, it is unusual, raising concerns that the Cards are worried just how many pitches Carpenter has in him before the next breakdown. Sources tell me that the team feels confident that he and pitching coach Dave Duncan will make better adjustments at the major league level than Carpenter would have in the minors. It's hard to say when he might break down again, but look for him to be on some very conservative limits, perhaps even shadowed by a long reliever, though that would necessitate a second move when he comes off of the DL since the Cards just sent Mitchell Boggs back to Triple-A.

Daisuke Matsuzaka (45 DXL)
The Red Sox are hoping that Matsuzaka will come back from his rehab assignment and shoulder strengthening in much the same way that he did last year. One source described it as his "annual tune up," which isn't completely inaccurate. Matsuzaka does seem to have some issues maintaining his shoulder, and they have as much to do with the continual adjustments to his schedule as to his own work ethic. I'm not going to blame the WBC as the Red Sox have ben doing behind the scenes, but I do believe it's a contributing factor. I think that he'll have to 'get religion' concerning his shoulder program, but this kind of situation doesn't fit with the training he had before coming to America, so it goes beyond a simple solution and deeper into the cultural differences between baseball and yakyu. Once back, Matsuzaka should return to who he is on the mound; a talented, sometimes frustrating pitcher that the Sox need to anchor their rotation.

John Lackey (0 DXL)
We expected to see more than two pitches from Lackey when he made his season debut. Ian Kinsler didn't expect to see them coming at his head. Lackey's ejection leaves us wondering whether he's completely lost his control, or if he's just lost some self-control. It seems a no-brainer that Lackey could come back before his turn is up again, but don't forget that pitchers have routines. He didn't last long in the game, but he did go through a full warmup and prep for this start, and on the heels of an extended rehab program. Thinking that two pitches are all that were involved is short-sighted. That said, there's no reason to think that he can't come back and pitch on Monday, his normal throw day. He would already be on a pitch limit as he was on Saturday, so that wouldn't change significantly. Lackey showed no lack of control during his rehab starts, so there's little reason to believe he'll be as 'wild' when he comes back out. We can only hope he gets in a few more pitches next time around.

Edinson Volquez (0 DXL)
One of the medhead guidelines should be that "fatigue shows up in different ways." That holds true for Volquez, who left his Saturday start, which is not to say that this is anything more than the 'mild back spasms' that the team is saying he had, or that he'll miss any time. It's just that we have to consider the possibilities whenever we have a pitcher that had his kind of jump in workload. Volquez's jump also came with an increase in quality of performance, so it's hard to argue with the usage, but we have to be wary. At this point it doesn't appear to be anything serious, but the Reds are relying on their pitching staff's health this season. Homer Bailey may be pitching well in Louisville, but an injury to any of the Reds 'big three' would sink their hopes.

Joey Votto (NA)
Flu-like symptoms (FLS) is one thing; having them's no fun, and it can certainly debilitate a player, even one as gifted as Votto, but add dehydration to the mix, and things become much worse, as he discovered last week. He became dizzy and nearly fainted due to a combination of physical circumstances. Despite prompt care, he still hasn't gotten past this, continuing to have symptoms and making the Reds wonder if something more could be going on. While there's been some speculation, from plausible (mono) to ridiculous (concussion), this is one of those instances that causes a collective shrug and reminds us that even the simplest things can end up confusing even the best doctors and trainers. The Reds are sending Votto to one of their internal specialists-each team has an extensive list of doctors beyond the core team physicians, both in their hometown and minor league sites-to try to figure out exactly what's going on. It's impossible to know how long Votto might be out, or if he'll miss any time at all.

Carlos Quentin (10 DXL)
A lot of good things have come from my doing "The B.S. Report" the other day, but one of the best was a long talk I had with a biogeneticist that holds both a PhD and an MD. He's the kind of overachiever I'd probably hate if he wasn't so amazing at explaining things. I wish I could credit him, but he's working on a project that he's marketing to some sports teams, and he asked that I not complicate matters by mentioning that he's talking to journalists. After he crushed my hopes for Terminator technology, he told me that I was a bit too sanguine on the short-term possibilities of stem cells. That said, he did have some interesting takes on the use of genetics in baseball. He thought that its first application would involve understanding the body's inflammatory response. While much of the discussion went over my head-though I did enjoy the ironies of the "TLR signal"-he made it clear that the technology to understand how the genes affect a person's response to any inflammatory trauma is readable now. The classic case of the injury-prone player, he argued, is likely just the body's genetically-coded response. While we discussed the Drew family, my thoughts were drawn to Quentin, who has had a series of inflammatory injuries. He's dealing with plantar fasciitis now, something that has derailed power hitters like Mark McGwire and Marty Cordova. The Sox think that they can get Quentin through this without the DL, and while it's possible, especially with Herm Schneider and his staff guiding the process, I'm less sure that he won't need a break to get ahead of it, or worse, to be held out of the lineup off and on as they work on him.

Rickie Weeks (15 DXL)
Weeks might be a good player, but the Brewers and the rest of us have only seen glimpses, in large part because his wrists have never held up. Some would argue that the same wrists that gave him such great bat speed and made him a highly touted college player couldn't hold up-and like the Drew brothers, we have a sibling to watch to see if there may be a genetic component here. Weeks is headed out to see a hand/wrist specialist after feeling what he described as a 'tug' in his wrist. Given his history of tendon issues, that's definitely a worrisome description. It's likely that he'll head to the DL regardless, just as a precaution.

Quick Cuts: Kevin Youkilis heads to Pawtucket for a quick two-game rehab stint. The Sox don't expect any problems with his oblique. ... The Mets held Jose Reyes out for a fourth straight game with a calf strain. Many sources say that this is also serving as a mental break for Reyes, as he's been butting heads with the coaching staff. ... Josh Hamilton likely would run through a wall for his team, but if he keeps trying, he's only going to hurt their chances. He'll miss minimal time, if any, with a mild groin strain. ... Chien-Ming Wang won't replace Phil Hughes before his next start, but Hughes will be pitching for his slot. Wang has been dominant in Triple-A, and has made "amazing progress" with his hip issue. ... Scott Olsen heads to the DL with shoulder tendonitis. While this isn't considered serious, the Nats will probably use the opportunity to try and get him back on track with a few rehab starts. ... Eric Stults injured his thumb while bunting and is doubtful for his Wednesday start. The Dodgers will use Jeff Weaver as a fill-in. ... The Rangers don't expect Frank Francisco's stint on the DL to go much past the minimum, but one interesting thing I heard is that Nolan Ryan's pitching edicts might be making players frightened to admit to any soreness. ... Love me some Dirty Jobs, but Time Warp is a close second for that smart science content. They do so need to do a baseball episode. ... Tom Glavine throws a simulated game today in Atlanta that could determine his baseball fate. If things go well, he'll head out to the suburbs for a weekend start. ... With Tyler Yates headed to the DL, Tom Gorzelanny comes up to help keep the pen stocked. It's temporary, and Gorzelanny will be back down in the Indy rotation soon. ... Don't say that Dusty Baker can't learn. After Micah Owings had to be used in an extra-inning game, he'll shift Aaron Harang forward a day in the rotation.

28 comments have been left for this article.

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