April 20, 2010

Under The Knife

Woe Are The O's

by Will Carroll

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I hate covering these but for over a month, I've been getting whispers that there was a PED suspension being appealed. The process can be an extensive one, involving hearings and testimony, as well as some negotiation. There's no room to "plead down" on a positive test, so the attack is usually on Christiane Ayotte and her Montreal lab. Yesterday, I learned that a high-ranking baseball executive spoke off the record about the suspension being announced. He said it was a pitcher, but I couldn't get any solid confirmation of that fact by the time I posted on Twitter. (And yes, I did feel some pressure to get this out, but I also realized that by doing so, I was pretty much guaranteeing that someone else would break the name first.) I feel very confident in my information on this, but still have no idea about the name or the substance (though it's not an amphetamine.) It's pretty amazing that in a world where the new iPhone is pictured on the net, that baseball could sneak through the entire multi-week process with no leaks. That speaks well of the process put in place by the OIC and the MLBPA. While I expect the announcement today, baseball moves at its own pace

Brian Roberts (herniated disc, 6/1)
Felix Pie (strained lat, 7/1)

The news keeps getting worse for the Orioles. It's not bad enough that they're getting beaten on the field, but they're talent keeps dropping off. An O's fan e-mailed me over the weekend asking if the team got what the Mets had last year. While I still believe that the O's have some hope for the first time in a while, injuries can sap that quickly, at least for the short term. This isn't likely to be a Mets '09 situation and looking back, there's more a feel of Rays '06. There's a plan and there's pieces of it in place, but it still seems a ways off. The team will be without Pie and Roberts for a while. Roberts saw a back specialist and came away with discouraging news. The herniation is a real problem and may yet need surgery, but baseball operations president Andy MacPhail told reporters that Roberts was looking at "weeks, not days." That's better than months, but that's what enough weeks strung together end up as. Since the herniation is recurrent and had a setback at the slightest provocation after weeks of rehab, it's hard to say how this run at it will be any different. Roberts will start another strengthening program, but any setback could push this to surgery. With Pie, it's an odd one. Pie has a torn latissimus dorsi, the large muscle of the upper back. I can't remember any non-pitcher having this injury, but with the O's saying Pie could miss up to three months, it must be a devastating tear. As there are no good comps, I don't really have any direction on this, though the key will be how it affects his swing and his powerful throwing arm. 

Conor Jackson (strained hamstring, 5/15)

It's hard to deal with a Jackson injury without mentioning the wild-card effect of his fight with Valley Fever. While he's over the fungal infection that cost him nearly all of 2009, there has to be some question about his strength and stamina beyond any other effects. Jackson's hamstring strain Sunday didn't seem any more than the garden variety, but it was. As you can see on the MLB video, Jackson pulled up after he made the catch, but continued off the field under his own power. It looked painful, but hardly too worrisome. Sources tell me it's a significant Grade II strain right in the belly of the muscle (you can see where he grabs). He'll head to the DL while the Dbacks hope that he can come back quicker than the four weeks they're currently estimating. Gerardo Parra will take his place in the field, though the team elected to call up a pitcher to take his roster spot in the short term.

Carlos Beltran (knee surgery, 5/15)

Here's how much Mets fans panic—and how the New York media goads them into it. When the announcement came that Beltran was heading to Vail, the immediate reaction from the media were jokes about surgery, followed by the normal handwringing that Beltran hadn't yet run. Fact is that Beltran is heading to see his doctor to get just that clearance. Somehow it's been spun that a normal landmark checkup is a negative. That's not to say that there's been progress. Dick Steadman might look at the knee and say no, it's not there yet. All the signs and the timeline point to the next step being in place. As we've seen with Lance Berkman, the return from recurrent arthritic knee problems can be difficult and filled with setbacks. If Beltran is cleared and assuming none of those setbacks, he'll start running lightly and would be on track for a mid-May return.

Kelly Shoppach (knee surgery, 5/30)

Kelly Shoppach had knee surgery early Monday morning in Tampa. His knee sprain was visualized but not repaired. Instead, it was a tear in the meniscus that happened at the same time as the sprain that was causing continuing pain and swelling. The catcher will now miss about six weeks after the scoping, but in the medium-term, he should be able to come back without much issue. No surgery is ever minor, but in addition to the meniscus being corrected, the ligament will have time to heal up as well. Shoppach will begin the rehab process immediately and given the facts we know, it wouldn't surprise me if he ended up ahead of schedule.

Joe Blanton (strained oblique, 5/4)
J.A. Happ (strained flexor tendon, TBD)

While the Phillies pitching is hurting right now, with two of their starting five out, that doesn't appear to be a long-term issue. Blanton threw 60 pitches in the pen and will head out on a rehab assignment tonight in Single-A. The plan is that he'll have a short outing tonight, then one or two more starts at upper levels before returning in early May. Strained obliques do carry a risk of recurrence, especially early, but the Phillies have done this before and understand that moving slow is the best defense. They're watching Blanton closely and being conservative with their timeline on him. The luxury of having a Roy Halladay is that it alters the schedule for pitchers, both at the back of the rotation and in the pen. Blanton may not be an ace, but he's certainly someone the Phillies are looking forward to having back in the rotation. They're also hoping that Happ is back quickly. The team will have him throw a pen on Thursday and will determine when he comes back based on that. If he's relatively pain-free or at least making progress, he'll slot back in to the rotation early next week, but there's still a chance they'll need to push him to the DL. It's one thing to skip the fifth slot in the rotation and a whole different thing to try and skip the fourth.

Daric Barton (bruised elbow, 4/21)

Getting hit with a baseball hurts. That's no secret. When Daric Barton got hit on the elbow, he and the medical staff both saw enough—and I'm sure Barton felt enough—to worry about a fracture. After x-rays were inconclusive, he had an MRI which showed a deep bone bruise. That's much better than a break, even though the pain is just the same. We've heard a lot more about bone bruises over the past couple years, especially with knees, because of advances in imaging technology. Just as we can now visualize hip labrums more clearly, MRIs are now allowing doctors to look "inside" bones to see the damage done by compression injuries like being hit with a baseball. The treatment for injuries like this is simple, usually amounting to rest, some anti-inflammatories, and some electrical stimulation, which seems to have a positive effect on the bones even at much lower intensity than those used on muscles. Barton should have little or no trouble coming back once he gets over the stiffness and pain.

Russell Branyan (herniated disc, 4/20)

The Indians could use a little power infusion, something they'll get when Branyan is activated. He's expected to start at first base, shifting Matt LaPorta to the outfield. In today's defense-focused sabermetric world, a team starting three DHs is counterintuitive, but I guess someone has to hit the balls that everyone else is trying to catch. Branyan's long-term issues with a lumbar disc seem to be under control for now, but the Indians medical staff will be in full maintenance mode for Branyan in addition to him needing regular rest. Branyan's power has always given him chances and now, smart teams like the Mariners and Indians seem as focused on what a player like him can do (slug) as what he can't (pretty much everything else.) MLB.com had an interesting interview with Branyan about what he did in the off-season. Hearing that he worked out with Khalil Greene perked up my ears.

Quick Cuts: Ian Kinsler will run today and if that goes well, he could be across town on a rehab assignment by Thursday. Once his ankle is ready, the Rangers will be aggressive getting Kinsler back in the lineup. ... Given that it's a stoner "holiday" today, I think this should serve as a reminder that MLB does not have a suspension policy for the use of marijuana. They do test for it. ... Cliff Lee will throw a sim game on Tuesday. If it goes well, he'll make one rehab start, then go into the rotation on May 2. That doesn't seem to account for the suspension, so we'll have to see how that appeal goes. ... Ted Lilly had a nice outing in Peoria. He should be back in the Cubs rotation soon. ... There's some concern about how Jake Peavy is pitching, but I don't see any evidence for a physical problem, unless you consider age a physical problem. ... The Pirates expect Andy LaRoche to be back in the lineup. He's been out since Friday with back spasms. ... Desmond Jennings is back on the Durham roster. The Rays prospect has missed the start of the season with a wrist injury, another in a list of maladies that has held him back. ... Contrary to prior reports, Cliff Pennington did have an x-ray after having his hand stepped on. It was negative, so no big deal here. ... The Blue Jays will skip Brian Tallet's next start to give his forearm some extra treatment and rest. ... Miguel Tejada thinks he'll be in the lineup on Tuesday after a quad strain. I'm not so sure he's not pushing back too soon, Chipper Jones-style.