Questions still surround Buster Posey's impending surgery, R.A. Dickey goes limp, and Rafael Soriano visits Dr. Andrews and gets good news.
Some of the more gruesome injuries one sees on a baseball diamond take place within 90 feet of home. Batters are beaned, pitchers are hit by line drives, runners trip over first base, and collisions occur at home plate. Baseball is different from some other sports in that it permits little protection other than catcher's gear and batting helmets, which can slide around and fall off easily (but that's another story). On those plays coming from the right side, catchers are akin to the punt returners who are looking up in the sky knowing that someone is barreling down on them, but who still have to catch and hold onto the ball.
The NCAA—despite all the differences of opinion one can have with them—has generally done a good job in regards to player safety issues and has a rule regarding collisions at home plate. It doesn't eliminate contact completely, but it does penalize malicious contact with no attempt to reach the plate. Considering there have been major injuries to two of baseball's bright, young catching stars (Carlos Santana and Buster Posey), maybe it's time we start looking at those rules before it happens again. Eliminating all contact would probably be going too far, but maybe being more like the NCAA would be a good start. We feel dirty for saying that.
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Jim Tracy believes Aaron Cook can return from a broken leg this season but that is highly doubtful.
Aaron Cook (fractured fibula, ERD 10/4) A broken leg might not be season-ending? That's pretty aggressive. After seeing Cook crushed in the shin by a Joey Votto comebacker (preventable, by the way), there was little doubt that we'd seen the last of the right-hander this season. However, Jim Tracy was holding out some hope. Cook was diagnosed with a non-displaced fracture of the fibula on his push leg. If you listen closely, you'll hear the crack of Cook's bone on this MLB video. Cook didn't have his leg planted, but the liner was probably moving at Aroldis Chapman speeds. There's very little real chance that Cook returns this season unless the Rockies go deep into the playoffs. The fact that it was the fibula helps, but I get the sense that Tracy was trying to be positive more than he was trying to be factual. Late word is that Jeff Francis will come off the DL to replace Cook.
The Injury Expert's countdown to his 1,000th column continues as he examines methylhexanamine, the substance that is causing minor-leaguers to get suspended.
Methylhexanamine. If you're like most people—including me just a few weeks ago—you have no idea what this substance is. It's now baseball's most abused performance enhancer. It's a powerful stimulant, described as a natural amphetamine, but legal. In the past months, eight minor-league players have been suspended in rapid succession for testing positive for methylhexanamine, a substance just added to baseball's banned list this year after WADA put the substance on its list. Please note the difference between banned and legal. "Banned" is a substance that is forbidden by a governing body, in this case MLB or WADA. "Legal" means it is not controlled by a government body. While methylhexanamine is banned in baseball and causing positive tests, it's also available at your local vitamin store or at hundreds of online retailers.
The Red Sox get Jacoby Ellsbury back but put Kevin Youkilis on the DL, along with other injury news from around the major leagues.
Kevin Youkilis (sprained thumb, ERD TBD) Jacoby Ellsbury (fractured ribs, ERD 8/4) If you'd asked me yesterday, I would have thought that Youkilis would be back in the lineup and that Carlos Santana would already have had surgery to repair his leg. Turns out, I was wrong on both. Youkilis is on the DL with a torn adductor muscle. This is one of the small muscles of the thumb that allows it to be such a useful digit. This particular muscle pulls the thumb in (adducts) toward the hand and is involved in the grip. When Youkilis got jammed and injured it, it was an unusual mechanism. Usually, this would be injured more in the way we saw with Chase Utley or David DeJesus, where there's a forced abduction (pulling away and back from the hand). In that case, the tendon is usually what goes, rather than the muscle itself. Because we don't know exactly where it happened and how, it's difficult to see exactly what happened that resulted in this injury... or is this the problem? Youkilis told NESN that this problem has been "going on for a while" so what we saw was the "last straw" rather than the real mechanism of injury. Youkilis is headed for tests that will determine if he needs surgery and how long he'll be out.
Some of the things Baseball Prospectus' resident injury expert ponders on a daily basis.
In the last 24 hours, I've had three men I really respect discuss three topics with me. One asked about pain and baseball. Another asked about the dangers of wall vs. player collisions. The last one asked about the cost of injuries. This is a bit of a change of pace for UTK, but it's all related, so I wanted to share the type of things I think about on a day-to-day basis.
A reminder that, like snowflakes, every injury and rehab is different, along with injury news from around the major leagues.
Rehabbing an elbow is always a difficult balance, but in most situations, doctors will tell you that it's always better to try and rehab through something before having the surgery. A surgery, even something predictable like Tommy John, has a defined period of loss, currently between 10 and 12 months. Using the example of Twins reliever Pat Neshek, the lost time in rehab might look like a loss—Neshek even told BP's Dan Wade that it "was the worst thing I could do" because of perception and the machismo of the locker room—but if Neshek had been able to come back inside the 2008 or 2009 seasons, it would have been a big gain. You can use the same equation I gave you in regards to why the Mets didn't put Jose Reyes on the DL, though the numbers get a lot bigger and the risks are hardly as well known. For situations like Neshek's and the hundreds of others—no, that's not an exaggeration—that face elbow surgery at all levels each year, the "right decision" is a moving target. Is it just to get the player back in the quickest amount of time? That does play into it, but does that mean "rehab might get him back in three months or might extend him out if surgery is needed"?
Magglio Ordonez and Carlos Guillen both go down for a team in the AL Central race, along with other injury news from around the majors.
Magglio Ordonez (fractured ankle, ERD 9/15)
The interesting part of the injury to Ordonez is less about the injury itself, but the ankle problems that he'd been dealing with in the week leading up to his traumatic fracture. Ordonez had a minor injury to the ankle, reported as a sprain, that was limiting him to DH. Could the two injuries be related? It's impossible to say, even now, but traumatic fractures are seldom a cascade's result. It's possible that Ordonez's ankle might have been weakened to the point where the fracture happened, when if he'd been completely healthy, it might have been more stable or the forces distributed in a different, possibly less damaging way. While it's a nice game of what if, the Tigers have to deal with what is. Ordonez's fracture has a wide recovery window based on what in fact is fractured. At a six-to-eight-week timeline, there's a couple possibilities, with the most likely being a distal fracture of the tibia or fibula. Assuming a normal healing period, Ordonez should be able to come back without significant consequences. If this slides towards the end of the timeline, Ordonez won't be able to get a rehab assignment in, which could be an issue. It's possible, even likely, that Ordonez returns this year, though the Tigers'status as a contender nearer that date will determine whether he'll be needed.
Stephen Strasburg was as good as advertised, now let's hope his name stays out of this column.
Someone asked me Tuesday afternoon why I spent hours on the phone and typing out my article yesterday, adding to the hype of Strasburg's debut. He called me after the game and said "OK, I get it. The kid's good." Yeah, 14 strikeouts and the start of a mythology will do that. This was the first time I got to see Strasburg pitch in anything other than highlights and grainy scouting video. Like most of America, I was impressed. His fastball was nasty with apparent movement and discernible velocity. His slider—actually more of a slurve—was a kneebuckler and as I wrote, an umpire confounder. According to PitchFX, the comparison to Jonathon Broxton's slider was apt. Broxton's went eight inches across and seven down, while Strasburg's went seven across and eight down. And a 91 mph changeup? That's illegal in six states. Simply put, there was nothing I saw out of Strasburg that was unexpected given all that I'd been told by scouts and other baseball people. Given that they had all showered him with praise in every one of those conversations, he did more than live up to their expectations and the hype surrounding an event start. The only thing I'll note is that about the time the announcers started talking about the possibility of him coming out, his pitches were slowing slightly (down to a mere 95-96.) In his last two innings, he amped it up and kept it around 99, dominating in a way that recalled Kerry Wood's 20-strikeout outing. Yes, Strasburg's good and let's all hope this is his last appearance in UTK. The only thing holding him back, as it was with Wood, Mark Prior, and every other young pitcher, is health. Which brings me to my next point...
Kendry Morales has a good chance of returning to the Angels' lineup this season, along with other injury news from around the majors.
Kendry Morales (fractured tibia, ERD 9/1) Morales didn't have surgery on Sunday as expected. His ankle/lower leg was still swollen and the doctors decided to wait until that swelling was down before going in and fixating the leg. That's reasonable and shouldn't affect the return time for the first baseman significantly. Examinations the last couple days have the Angels thinking that Morales will be back around the end of August or early September. The chance to get some at-bats at the minor-league level is key, as is the Angels' record at that point. Many have asked if this is a reasonable return time, so we look to the comps. The most recent comp is Scott Sizemore, the Tigers' second baseman who snapped his leg at a similar point during the 2009 Arizona Fall League season. Sizemore came back for spring training and the time period doesn't look good. Remember that there was no baseball three months after the point where Sizemore injured himself. A better comp might be Angels center fielder Torii Hunter, who went through a similar process when he had an ugly encounter with a wall. Two injuries that aren't good comps but came up in discussions were Robin Ventura and Jason Kendall. In both those cases, the player dislocated the ankle, which had ligament and tendon issues on top of any fractures. This injury should heal cleanly, especially once it's fixated, with few long-term consequences.
Grady Sizemore could be headed for microfracture surgery on his knee, along with other major-league injury news.
Grady Sizemore (bruised knee, ERD TBD) For the past couple days, things didn't make much sense. We heard that Sizemore had a bone bruise, but that surgery remained an option. That only makes sense in one context—that the bruise is inside the knee and is symptom rather than the cause. Now that Sizemore has headed out to see Dr. Richard Steadman, the surgeon that invented microfracture, things seem a bit clearer. I'll caution that Steadman does more than just microfracture surgery, and even in the case of Carlos Beltran, microfracture remains a last-chance kind of procedure. At 27, this kind of chronic knee problem is one that could alter how Sizemore plays the game and could take the Indians' center fielder out of the game altogether. Baseball's history with microfracture procedures is neither long nor storied, so expect a lot of interim steps if this is the road he's limping down. There's still no clear timeline for his return.
Grady Sizemore's mysterious knee injury lands him on the DL, plus other medical news from around the majors.
Grady Sizemore (bruised knee, ERD 6/10)
Paul Hoynes knows more about the Cleveland Indians than I'll ever know about anything. His tweet that Sizemore might need surgery after being diagnosed with a deep bone bruise was more than a bit confusing, however. A bone bruise can't be fixed by surgery, so what might "Hoynsie" have been saying? I called one of my favorite orthos and asked. "The bruise is a symptom," he said. "Maybe the meniscus is torn or even had been taken out. The [Carlos] Beltran situation would be the worst-case scenario, but that doesn't match up. Sizemore's only symptom is a bruise and a knee that's had a couple minor issues. He's run, he's played the field, and he has a pretty minor trauma. You're right, it doesn't add up." So we're missing information here. After several discussions with doctors and trainers, the opinion was that Sizemore may have an underlying cartilage issue that was aggravated by an earlier slide, but watch this video. Sizemore says that he "couldn't put weight on" the knee, but he walks off without much of a limp from what I can see. He had the leg tucked under him, so it's not that he stuffed it into the bag. This one's just a flat-out mystery with what we know not adding up.
Hurts strike down two of the Yankees' "Core Four" in Posada and Rivera, along with other medical news from the majors.
Jorge Posada (strained calf, ERD TBD) If you read what I told you about—or actually, passed on from Ben Wolf—on Friday, then the calf strain for Jorge Posada shouldn't come as much of a surprise. Posada's injury to the back of his right knee was in a bad spot and this kind of cascade is very predictable. The bigger cascade worry would be a knee injury, but a calf strain would be a close second. Wolf's insight doesn't help the Yankees, who now have to go with Francisco Cervelli in the meantime while hoping that Posada can heal up. The Yankees are anticipating that Posada will be ready by the end of the week, but a Grade I strain might not heal up enough for catching. They'll wait until the end of the week to make a decision on the DL, since they'll get the off-day on Thursday, but I get the sense that they don't want to go into the Boston series short-handed.