May 6, 2010

Under The Knife

Pettitte Goes Into The Tube

by Will Carroll

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Andy Pettitte (elbow stiffness, ERD TBD)
When any pitcher is rushed for an MRI, the panic can start. Pettitte went almost directly from the mound to the machine, but there's actually a positive indicator when that happens. MRIs can be thrown off by inflammation, which is why it's often a couple days before an MRI can be taken after a trauma. Getting someone in quick has to be really quick, before the inflammation really gets going, or it tells us that there's really not that much inflammation at all. Since the Yankees usually do their medical work at the Hospital for Special Surgery, which is thirteen minutes away (more or less), it could be either. Pettitte's elbow issue is not near the flexor tendon, where he had previous problems, but instead seems to be in the "back" of the arm, near the triceps and could indicate some UCL issue. Joe Girardi indicated that Pettitte had some forearm issues earlier this season, so this could be some sort of cascade or a mechanical issue that's translating toward whatever the weakest point of the arm is at any moment. There's almost no chance that Pettitte will be ready to go as scheduled next Tuesday, but the Yankees will wait until then to make any decision on the DL. Information right now would lean toward a DL move, precautionary if nothing else, but we'll get more information by the weekend when we see whether Pettitte is able to do any side work.

Johnny Damon (sore calf, ERD 5/8)
Damon pulled up lame on Wednesday, straining his right calf coming out of the box on a popup. The footwork of a lefty batter coming out of the box is pretty intricate, and could explain how this happened. The right (front) leg is asked to not only slow the body's momentum forward, but to help the body change directions and start toward first. If you watch one of those slow-motion replays (there's one for you, Jeff!), you'll see that there's a delay in between contact and the actual shifting, what scientists would call a cognitive delay. That means there's a new signal from the brain saying, "Hey leg, do something else now." The body is well-suited for dynamic tasks, especially one as well conditioned as Damon, but one wrong move at the wrong time or from the wrong position can cause tearing in the muscle fibers, or what we'd call a strain. Damon's issue might not even rise to that description, and with the Tigers off today, he could be back as soon as Friday.

Jair Jurrjens (strained hamstring, ERD 5/15)
Jason Heyward (strained groin, ERD 5/9)
The Braves are going to be very cautious with Heyward. His groin strain acted up after his first at-bat on Wednesday, and Bobby Cox quickly got him out of the game. Heyward said afterward that it wasn't painful, but that it just couldn't get loose. That indicates a pretty low-grade strain, and that the body was tightening up to protect it. Given a couple days off and some uncomfortable sessions in an ice bath, Heyward should be back by the weekend, though if the Braves are really conservative, we might not see him until early next week. The DL doesn't seem to be a consideration at this point, and Cox often plays a man down. At the same time, the Braves will be without Jurrjens for a while, though not as long as you might think. The hamstring strain wasn't going to be healed and Jurrjens was pushed to the DL as expected. Kris Medlen will get the next start, but the roster spot was taken by Craig Kimbrel, a reliever. The Braves think with the retro move and the schedule that Jurrjens will miss only the one start.

Justin Duchscherer (inflamed hip, ERD 5/15)
Duchscherer had a cortisone injection in his left hip in hopes of calming the inflammation inside the hip. He had that "popping" sensation during his last start a week ago. The hope is that the shot will calm things enough to have him throwing by early next week. With the schedule, the A's wouldn't need Duchscherer (or a fifth starter) until May 15. That lines things up so that the Athletics will know quickly whether or not they'll need to recall Vin Mazzaro to take that start or whether the Duke avoids the DL. Sources tell me that while it's unclear just how this will play out in the longer term, Duchscherer is determined to take the ball and to pitch through any pain. The plan to have Ben Sheets and Duchscherer at the top, absorbing innings so that the younger pitchers wouldn't have to be tested too much, isn't working out as expected, but any competitive innings Oakland can get from the veteran duo is a real positive.

Huston Street (strained shoulder, ERD 5/20)
Small steps are a good thing in a rehab. If you're following Michael Schlact's blog about his rehab, you'll remember that he said it's a series of good days that lead to a good rehab, which makes a lot of sense. Street had a solid side session on Tuesday and will now throw in an extended spring training game. Don't be confused if it's called a start. Teams often use relievers in the first inning of rehab games just to control the situation. Assuming he makes it through, the plan beyond that's a bit unclear. Most likely, Street will have one longer extended spring training session and then go out on a more traditional rehab assignment. As I've often said, once there's some confidence that there's not going to be a short-term setback and that there's some effective pitches shown, it doesn't do anyone any good having a guy like Street spending much time in the minors. Watch to make sure that Street is able to recover normally, and if the Rockies push him for back-to-back outings during his rehab, it'll be an indication that they'll slot him back in as closer.

Jacoby Ellsbury (fractured ribs, ERD 5/10)
Sources tell me that Ellsbury could be back as early as this weekend against the Yankees. It's obviously a big series any time the rivals meet, as ESPN will gladly remind you, but this season more than others, the Red Sox early struggles have pushed them to try and close the gap between the two teams. Ellsbury was able to take batting practice on Tuesday and Wednesday, with Wednesday's session going even better. Ellsbury was popping some balls out of the park without any significant pain during or after the session. It's expected that he would need a short rehab assignment, but both Pawtucket and Portland are on the road. Combined with the big series, the Sox are at least considering putting Ellsbury right back into the lineup. A decision should be made sometime today on this, but either way, he will be back soon. He will likely run less, just to protect the ribs.

Adam Jones (strained hip, ERD 5/6)
Not much has gone right for the Orioles this season (aside from the BP event there, which was awesome). Losing Jones for any period of time would make things much worse, but the signs are positive. MLB's Brittany Ghiroli is reporting that he is expected back in the lineup today. Is this too soon? Was Jones' hip more than a simple "grab" or cramp? That remains to be seen, but there are all sorts of conflicting influences acting on this. We'll have to watch this one closely to see if Jones is asked to dial it back in order to keep the hip safe or if he's truly healthy. The Orioles aren't going to contend this year, but for an athlete like Jones, keeping his legs healthy now will pay big dividends the next time they are competitive.

Joe Mauer (bruised heel, ERD 5/8)
The Twins were encouraged by what they saw from Mauer on Wednesday. He was able to get out on the field, jog lightly, play catch, and squat for a period of time. He's not going to jump right back into the lineup and he's likely to start out at DH, but it's pretty clear at this point that Mauer's not going to hit the DL. It's possible that he could be back this weekend, but it's a guessing game as to when exactly things will line up for that return. It's a combination of medicals and matchup. By this time next week, Mauer will be back to the full-time catching gig, though Wilson Ramos' performance has been solid.

Quick Cuts: J.J. Hardy is out of the lineup with swelling in his wrist. He's had issues with that wrist in the past, so the Twins will be watching this one closely. ... If Brad Lidge's 2009 issues were all mechanical, as this article suggests, then why was no one able to tell us that last season? [Ed. Note: Per some comments in Eric Seidman's article last September on the subject of Lidge's struggles, both pitching coach Rich Dubee and Lidge were apparently saying then that the issues were mechanical.] ... The Indians think Asdrubal Cabrera will be back in the lineup tomorrow after missing some games with a strained quad. ... For those that regularly ask, there's no new news on Brandon Webb. He's long tossing and should progress to a mound by mid-May. ... Chris Young had his latest MRI sent to Dr. James Andrews. It sounds like there's still significant pain and swelling in the area he had cleaned up last year and that frustration is building. ... Barry Zito is having a heck of a month, but it's pretty amazing to think that while most have thought he had vanished since his Cy Young, he has actually had 86 wins in those intervening years. Compare that to A.J. Burnett, who has had only 80 wins while making a lot of money himself. ... Mark Lowe was DL'd with a strained back. Brandon League will take the eighth inning and some occasional save chances in the meantime. ... Jarrod Saltalamacchia will stay in the minors to work on his throwing mechanics. His back and shoulder have held up well, a positive sign for the near future. ... Sean Gallagher did not emulate Ryan Madson, but he did break his toe accidentally and will be pushed to the DL. ... Sounds like there's going to be one last bidding war for Eric Byrnes between broadcasters.