May 13, 2010

Under The Knife

Back To The Drawing Board?

by Will Carroll

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Brad Lidge (elbow soreness, ERD TBD)
Consistency isn't a word you think of from Lidge, but that's why he's headed back to Philadelphia. What happened to him during spring training occurred in much the same way. While the trainers are there every day, working on the players and understanding how things are changing and feeling, it's tougher for the doctors. At best, they see the players during homestands and treat them in much the same manner as a normal patient. (Actually, at best they never have to deal with them outside of a physical.) By making sure that Lidge is seeing the same doctors consistently and as he has problems, the Phillies are making sure they have the best possible situation for managing his injuries. By managing this consistently and holistically, the Phils and Lidge have a shot. Don't read too much into the trip back to Philly. The soreness sounds like scar tissue breaking loose, but there's a chance that this could be analogous to the Joe Nathan situation in the worst case. Like the Phillies, we'll just have to wait and see. Jose Contreras—yes, really—will get the save opportunities in the meantime, though you can be sure that Ruben Amaro Jr. is checking in on Heath Bell and some other usual suspects.

Mark DeRosa (damaged wrist nerves and tendon, ERD TBD)
It's very seldom that you hear that a surgery was a failure. To most surgeons, success is when the patient wakes up at the end, but honestly, surgery is almost routine these days. At times, if you watched a surgery, you'd think there was much more carpentry than artistry going on, but the skill and experience necessary is intense. Hearing that DeRosa's off-season wrist surgery has "failed" seems a bit harsh, but the result is the same. He didn't get the relief he wanted and now there are nerve and tendon issues in the same place as last year. At 35, injuries aren't uncommon, but DeRosa's multi-position athleticism has always worked in his favor. Wrists can be quick, but not athletic. The numbness he has in his hand is the big problem, obviously giving him problems with grip and bat control. He's headed for more tests, more opinions, and quite possibly, more surgery. He may be remembered as Randy Johnson's last victim if he can't come back from this, and yes, that's a real concern. Suggestions that this signing shouldn't have happened should be looking upstairs rather than in the training room. At the point where he signed, all signs seemed positive for DeRosa and there were multiple teams making offers. Pushing this onto the medical staff clearing him is both revisionist and ridiculous.

Jason Marquis (bone chips in elbow, ERD 7/15)
If you're an optimist—which is de rigueur for Nats fans, I think—then you'll note that bone chips can be one of the least serious things a pitcher can have wrong with his arm. If you're a realist, you'll note that Marquis is still going to miss the better part of the next two months recovering from having those chips removed from his elbow. Marquis has always been a durable pitcher and that was the biggest draw for the Nats as they look to have someone, anyone, munch up some innings to protect the young arms and not have to tax them too much. Stephen Strasburg is mowing down minor-league hitters, but he's still going to be very limited with his workload once he gets to the bigs. The Nats will juggle their rotation in the meantime rather than making the easy move to bring up Strasburg. I continue to think that the Nats will be buyers this year as they look to find innings. That search is probably happening now.

Mike Cameron (strained abdominals, ERD 5/15)
Jacoby Ellsbury (fractured ribs, ERD 5/21)
Things are moving slowly with the return of what the Red Sox thought would be two-thirds of their starting outfield. Cameron is having issues with soreness while on his rehab assignment, causing the Red Sox to keep him down through Friday while they try and determine if he's facing a recurrence or if it's just a normal thing. While Cameron is still expected back by the weekend, there's an increased risk here. There's nothing a team and a medical staff hate more than having to DL a player shortly after activating him, so they'll be working hard on this one over the next couple days. As to Ellsbury's recovery, it's still about pain tolerance. While he's made progress, he's still not comfortable enough to make the Red Sox comfortable starting the rehab clock. Even small rib fractures are intensely painful. I'll spare you the glory days story of breaking my ribs with a month left to go in wrestling season. It sounds as if the current plan is to keep monitoring him through the weekend as he goes through more and more physical activities, including batting practice, and then make a decision to send him out. All indications are that absent a setback, he'd head to Pawtucket on Monday.

Matt Harrison (biceps tendinitis, ERD 5/22)
While a lot of people are pointing to Harrison's 120-plus-pitch outing and looking over at Nolan Ryan, the fact is that Harrison is not destroyed by one high-workload outing. The part of the pitcher abuse points work done by Dr. Rany Jazayerli and the Cleveland Indians' own Keith Woolner that's ignored by most is that the evidence points to a short-term reduction in effectiveness as well as a long-term increase in injuries. The simple thing to do is to follow a long outing with a shorter outing. J.C. Bradbury and others have some interesting data points on this, showing that just as high-count starts have fallen, so have low-count starts. I think this is the increasing specialization of bullpens and pitching in general. Managers can't have a quick hook because they don't have that available swingman and can't ask a LOOGY to take on three innings, leaving him unavailable for tomorrow's game. It's as much a lack of imagination that's hurting pitchers as anything physical. Harrison is playing catch and should be on track to come off the DL when eligible, though there's a chance Derek Holland pushes him to the pen.

Alfredo Aceves (sore lower back, ERD 6/1)
Same ol' song and dance for Aceves. Actually, the sore back would probably prevent the dancing. Aceves had a recurrence of the lower back issues that cost him a rotation slot this spring and now, it could be worse. Sources tell me that Aceves is having "shooting pain" down his leg, an indication that there's some nerve entrapment caused by the disc problem. In the spring, it took a couple weeks to clear this up, so with his move to the DL, he'll have at least that time to get back on track. Any back problem can be serious, especially when someone's already lacking game opportunities. The Yankees brought up an outfielder to replace him for the time being and we will watch to see how they'll manage the bullpen. With Mariano Rivera back and Joba Chamberlain settling into his role, there's room to maneuver.

Erik Bedard (damaged shoulder, ERD 6/25)
The Mariners gambled with the devil they knew when the oft-injured Bedard was re-signed. They'd already sunk a lot of money and effort into him, so it makes some sense that they'd be willing to spend a bit more and see if they could "squeeze the orange" a bit with him in '10. The idea that there could be a payoff is starting to show up, as he threw a simulated game on Wednesday, keeping him on track for a June return and 12-15 starts if he can stay healthy. There are a lot of bonuses in his contract and almost no real risk to the Mariners. If he hits the bonus thresholds, the team will be getting value, and if he doesn't, it's not much (more) of a sunk cost. Bedard is likely to use a lot of the 30-day rehab limit once he heads to the minors, though there's another school of thought in that if he's ready, he needs to be used quickly and hard. 

Yovanni Gallardo (lower body injury, ERD 5/18)
Ryan Braun (bruised elbow, ERD 5/14)
Adam McCalvy of MLB.com called it a "heartstopping, season flashed before your eyes" kind of moment. It was. Luckily, it could have been a lot worse. Gallardo faced the worst-case scenario: a Jason Heyward rocket up the middle, low and sizzling. The ball hit him on the calf rather than the shin, kicking off to third base with enough force that Casey McGehee was able to field it and throw Heyward out at first. Gallardo was up quick as Roger Caplinger came out and it seems that the ball just missed the bone. Let's call it a "lower body injury" and make Gord Ash smile. Gallardo stayed in the game, but the bruise stiffened up and he was removed. At this point it looks like Gallardo could make his next start, but he'll be spending a lot of time with ice on that leg between now and then. We'll know more on his throw day, but this gives me a chance to ask why pitchers are out there without any protection besides a glove. At less than an ounce each and unobtrusive, soccer-style shinguards are lightweight options. Even just one on the plant leg would be an improvement. The Brewers medical staff is getting some practice with bruises, since Braun is still out with his elbow bruise after an HBP. Ken Macha is chaining off days and Braun is expected back Friday.

Quick Cuts: Just ask yourself, what if it had been Chris Coghlan instead of Brian Cushing? It's enough to make me want to just walk away from the NFL altogether. Oh yeah, they'll walk away in 2011. ... Jeff Francis came through the Double-A portion of his rehab assignment so well that he's making a case to skip straight to the Rockies' rotation. They're considering it. ... Kurt Suzuki is still having some issues with his intracostal strain, leading the Athletics to keeping him in Triple-A a couple more days as they work on ways to reduce the problem. ... Brian Roberts was shifted to the 60-day DL, but there's been no change in his status. It's a procedural move, nothing more. ... Pretty amazing story, but Tim Stauffer will miss around a month. ... For all those asking whether Scott Kazmir is injured, please consult the people asking whether Rick Porcello was hurt last week. ... It's the kind of game that Roy Halladay had Wednesday night, and the lack of starts, that will keep him from winning 30, as some people have been memeing lately. Look, 20 is great these days. ... Evan Longoria is day-to-day, or at least his hair is. Yowza. … The Jays think Edwin Encarnacion will be back in the lineup before the end of the month. There's some question as to whether he'll be able to play third base or just be the designated hitter at first. ... This "interview" is just sublime.