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June 5, 2009

Under The Knife

Day to Day

by Will Carroll

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Will Carroll (3 DXL)
I should be listed first, since many of you—at least the non-Twitterers among us—might be wondering what the heck happened to me for three days. The simple answer is the flu. I went to a ballgame on Sunday with Jason Collette of Fanball, and both of us got the dreaded FLS, or "flu-like symptoms." Did I give it to him, or him to me? It doesn't matter. The good thing is that after spending Tuesday getting tests and missing what I hear was a great event in Chicago, it wasn't swine flu. That didn't make me feel any better, as I sounded like a NyQuil commercial—achy, sneezing, congested, and swollen sore throat—but after a couple of days loading up on fluids and rest and getting through my own DXL window, I'm back to catch up with the injuries. I don't like missing time any more than you do, because things move so fast. Of course, I do need to disclose that the ER insisted I use a banned substance—pseudoephedrine—without going through the proper waiver procedures. I can only hope the testers don't come in the next few days. So enough about me... powered by Powerade Ion4, on to the injuries:

Josh Hamilton (40 DXL)
The Rangers are essentially on hold with Hamilton pending a visit to Dr. William Myers in Philadelphia on Monday. He's with the team and undergoing normal treatment in the hopes that he can avoid surgery, but sources with the team say that Hamilton is ready to have the surgery as soon as Monday if it's needed. This isn't to say that he wants the surgery, just that he's ready for the possibility. I've seen some stories out there that are mixing this up. If he does have the surgery, he'll miss roughly a month, with my estimate of 40 days holding pretty solid. The post-surgical issues are very limited, and Ian Kinsler has shown that a comeback to level is relatively easy. Until Hamilton sees the specialist on Monday, there's no way to tell how this will go, so it's best to assume that he'll miss the month.

Miguel Cabrera (2 DXL)
The Tigers had a tough homestand, getting swept at Comerica for the first time this season. To make matters worse, they saw Cabrera leave Thursday's game with a hamstring strain. Last night, he said he thought he'd be able to play today, but players are notoriously bad at diagnostics, and hamstrings tend to feel much worse the next day. The Tigers will have the Angels coming in for a big series for both teams, so missing their slugger will be a big blow, but look for them to be conservative with Cabrera. His conditioning and his healing response are both major issues for how good he's going to be. The team will make a final determination once they see him on Friday morning, but I'd expect him to miss at least Friday's game and maybe a couple more.

Jose Reyes (20 DXL)
Ryan Church (20 DXL)
Ramon Martinez (60 DXL)

Remedial medhead: A strain is a tearing of muscle or tendon fibers, and yes, every strain involves tearing. What's important is the degree of tearing. Reyes has a very small but significant tear near the bottom of his hamstring, where the muscle and tendon are difficult to differentiate. Since the term (strain) is the same whether it's muscle or tendon, there's really no reason to differentiate, and it depends on who you took A&P from in college as to what you call it. For baseball fans, all you need to know is that there's now a clear anatomical reason that he's had trouble in the back of his knee. The Mets are expected to give him a couple of days off from baseball activities, but not from treatment, though that will now change, and they still think they can have him back at or near the minimum. I'll stick with "near" given the clear cascade. (For those of you wondering about Gary Sheffield, who's describing similar pain and playing through it, I'll suggest that their skills are very different.)

The shortstop position must have some bad juju right now, as everyone there in Citifield is falling. Martinez is just the latest to go down, leaving them about four down on their depth chart when Jerry Manuel goes to fill out the lineup card. If Alex Cora hadn't just come back, I'm told that the team would actually consider shifting David Wright to shortstop, at least temporarily. Martinez's fractured pinky will need surgery, and he'll miss six to eight weeks, likely more near the long end, unless the team really needs their third-string shortstop back, which is possible.

The word on Church is about the only good news, since he's going to be ready to come back on Sunday after his own hamstring strain. Is this a situation like last year with the Yankees, where some conditioning problem is to blame? No, it's the same strength and conditioning and medical staff as last year. I don't see any weather factors, so this just looks like some combination of bad luck and a "death spiral" where injuries cause a medical staff to fall behind on preventive work due to having only so many hours in a day.

Kevin Youkilis (3 DXL)
"Reflexive strain" is not a term you'll hear very often, but when you do, it's almost always about the calf muscle. In theory, it can happen almost anywhere, but it happens so seldom because of the way the body is put together. The Achilles tendon is the most exposed tendon in the body, and when it is hit the calf muscle fires; it's the same thing that makes your knee jump when the doctor hits it with the hammer. It's a protective reaction that is so strong it can often cause the calf muscle to strain itself in the act. When Youkilis' Achilles was hit by the toe of the passing baserunner on Wednesday night, his calf reacted, and in doing so caused a mild strain. It's much better than tearing an Achilles, so even with this pain, Youkilis will take this in trade. The Red Sox let him try to play through it on Thursday, but he tightened up and is likely to get a day or two off to make sure this doesn't get any worse.

Asdrubal Cabrera (30 DXL)
Cabrera is going to miss at least the next month of the season after separating his shoulder. As the shoulder joint came apart briefly, his acromioclavicular joint suffered a sprain. It's his left (non-throwing) shoulder, so he might come back at the low end of estimates if he can show some strength gains and a lack of laxity, but he's still going to be at risk of re-injuring the shoulder if he gets back out there too quickly. It's not like the Indians can slap a "no diving" restraining order on Cabrera and hope that the shoulder stays healthy. Their rash of injuries and the discussion of possible trades might factor into the timing of his return as much as anything.

Jose Valverde (40 DXL)
While Valverde is getting closer to a rehab assignment—one that looks as if it will start next week—the reporting on his injury is doing him a bit of a disservice. His injury started as a strained calf, but turned out to have a more serious issue, called compartment syndrome. Calling this a strained calf is understating matters, even though it's not technically incorrect. Hopefully this helps explain why Valverde has missed so much time on what might otherwise seem in some places as a simple or even minor injury. It's not, and Valverde's lucky that they caught it early and drained it. It does have a tendency to recur, but knowing that the possibility exists should keep the Astros mindful. Expect Valverde back about this time next week if all goes well in the minors during that rehab work.

Milton Bradley (5 DXL)
Geovany Soto (0 DXL)

The good news is that Bradley's strained calf isn't as bad as the Cubs originally feared. The team doesn't think they'll need to DL him, but they aren't sure exactly when he'll be back either. In the meantime, Bradley's hitting isn't enough to make first base an option, and with no DH there's some thought that he could miss as much as a week, leaving Lou Piniella shorthanded again. It's also beginning to make people wonder if Bradley might not be shopped to some American League teams. The downside here is that the deal would have to be payroll-neutral, and unless Bradley really picks things up between now and the deadline, that's going to be very tough to make happen. (It's not just Bradley; Jim Hendry can't take on any new salary until the team's new ownership is in place.) In other news, the Cubs have benched Soto for a few games, though they insist that the shoulder is only a small part of his current issues. If Koyie Hill can hit even a little, they'll keep Soto on the bench for as much as a week. There's even some talk about Jake Fox putting the gear on for a game. I remain unconvinced that Soto's problems don't have a larger physical component, and I will continue to follow this closely.

Quick Cuts: Evan Longoria will be back by the weekend, but remember this is a conservative organization when it comes to handling their hurt players; if he's not in the starting lineup Saturday, it's not a setback. ... Aramis Ramirez will begin a throwing program this weekend, but is shooting for the All-Star break for a return. ... Color me a little surprised that Kelvim Escobar is back in early June; he was never good during rehab starts. Don't expect too much. ... Shane Victorino has a mild strain of his hip flexor, which will affect him more in the field. He'll miss a few games. ... Jake Peavy will make his next start after illness put that in question. I also followed up with a source close to the pitcher who continues to insist that Peavy will not accept a trade to any team at this time. ... Mark Teixeira's bruised ankle is still sore, but he played through it and was a difference-maker on Thursday. ... Travis Hafner will be activated for today's game. ... Ryan Sweeney has a nasty bruise on his knee. Chalk up another win for the wall in the eternal battle between man and immovable object. ... The Cards have Joel Pineiro scheduled to start Sunday, but no one seems real confident about it; Brad Thompson will be shadowing him. ... Things look equally bad for Kyle Lohse, who re-injured his forearm fielding a bunt. He could be headed for the DL. ... Jed Lowrie is hitting off a tee, but "weeks away" from a return. ... Maybe it was the fever, but I think I saw something like that liquid metal in T2 when Albert Pujols sprained his ankle sliding. ... Scott Kazmir has begun throwing bullpen sessions and has three more before the team will decide where he'll make some rehab appearances. With Jake McGee having a mild setback in his comeback from Tommy John, the team still doesn't appear to be considering Kazmir for a bullpen role. ... Does it strike anyone else as really odd that Leo Mazzone still doesn't have a job?

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