June 4, 2010

Under The Knife

Friday Update

by Will Carroll

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Brett Anderson (strained elbow, ERD 7/15)
Josh Outman (Tommy John surgery, ERD 8/1)
Ryan Sweeney (concussion, ERD 6/6)
The Athletics only got two innings out of Anderson yesterday against the Red Sox before his elbow tightened up on him again. It's the dreaded recurrence, one that has to have the team's medical staff beside themselves. Anderson passed all the tests, but there's no way to truly simulate everything that goes into a real start against real hitters with a real crowd. That full-go setting pushed Anderson back to an injured state and likely back to the DL. The issue now is that from what we know about the injury, there's no real fix beyond waiting for it to heal. Given that he was just out for almost a month and almost immediately had similar if not identical symptoms, it's tough to say that it won't take significantly longer now. He'll have more tests, but Anderson is likely out until the All-Star break, if not beyond. It was a tough game for Oakland, especially Sweeney, who took a knee to the head on a defensive play. He was removed from the game with dizziness, a symptom of a probable concussion. He'll be monitored and miss a couple games, though I shouldn't have to remind you how unpredictable post-concussion symptoms can be. Let's toss in a little bit of good news for the Bay Area—Outman, one of the solid young Oakland pitchers, is back to throwing after a setback in his Tommy John rehab. He's about a year post-surgery at this stage, but just a bit behind schedule. He'll need to make it through the next month without issue if he'll be able to get back for anything more than a cameo this season.

Mark DeRosa (strained wrist, ERD 10/4)
Things aren't looking good for DeRosa. After a tough game for him in A-ball, he'll try his injured wrist in a Triple-A game. If he can't play through the injury, the Giants are likely to push him to the 60-day DL and surgery to re-do the fix from last offseason. The DL move would open up a 40-man slot for the recently signed Pat Burrell, so there are a lot of forces in play here. DeRosa's wrist is going to need to be repaired (again), so the only question is whether he can hold that at bay and be productive. Tonight's game is his last chance, though all signs so far have been negative. In theory, he'll be able to have the surgery re-done and come back, but as he's seen, there's a pretty high recurrence risk with this type of wrist injury. (Note: the 2010 season ends on October 3, so the ERD of "10/4" means that the expectation is that this injury is a season-ender. It's not CB code.)

Chipper Jones (inflamed finger, ERD 6/7)
The Braves are going to give Jones off until Saturday, to decide whether or not rest is enough. His injured finger remains swollen and painful, so the next step beyond simple rest and treatment would be a cortisone shot. (Dave O'Brien has some nice notes on the current treatment.) Given the need for a couple days off for the anti-inflammatory to do its work, that would put Jones out until Monday, if necessary, and beyond if that doesn't take. Either way, there appears to be about a 50/50 chance of Jones being put on the DL. Part of that is to protect Jones from himself. He's notorious about pushing his way back into the lineup only to do more damage. He's done that once already with the finger, so the medical staff isn't going to give him as much leeway. There remains some question as to the underlying cause, including some possibilities that could keep him out much longer.

Josh Beckett (ERD 7/5)
The Red Sox offered more of an explanation as to why altered mechanics shut Beckett down for 10 days. According to several reports, Beckett's sore back was forcing him into a more upright position with less shoulder tilt. As you can see in this picture, Beckett normally has his shoulders tilted, with the left shoulder lower than the right. Tilt between 8 and 33 degrees is "normal", according to Dr. Glenn Fleisig of ASMI. Without that tilt, Beckett's arm slot would appear to be much "lower" and would change the plane of his breaking pitches slightly. He apparently made some unconscious adjustments, raising his arm, to try and compensate for the lack of tilt. It caused some stress on the back of the shoulder and the Red Sox quickly shut him down. He'll rest and get treatment in hopes that when he does get back on the mound in about a week, he'll have a much more normal delivery. The delay does make it look like he might be out until late June or even to the All-Star break, if the Sox remain on a conservative path with him.

Brad Penny (strained latissimus dorsi, ERD 6/10)
The Cardinals are beginning to think they could get Penny back right around the minimum. Penny threw on flat ground both Tuesday and Wednesday and had no real problems with his strained lat during or after the session. He could be up on a mound as soon as Sunday with the expectation that he could use that as the normal side session before a start. He's eligible to come off the DL on June 7, so that date is a bit aggressive. More likely, it could be the end of the week. If he hasn't lost any stamina and has no physical issues, there's no need for a rehab outing and he'd slot right back into the third or fourth slot of the Cards rotation, depending on how you feel about seniority and the sustainability of Jaime Garcia's first two months in the bigs.

David Huff
This happened. But for Huff, it was little more than a headache and some media attention. Huff didn't miss a start and doesn't seem to have missed a beat. I won't blame the blow to the head for his continual insistence that pitchers don't need additional protection. Huff's seemingly miraculous recovery is being used as an example against what one player called "creeping nannyism" in a conversation this week. I'll just ask you to watch the ball smacking off Huff's skull again, watch how he lay on the ground, and to remember how your first thought was probably the same as mine: "I hope he's not dead." Huff didn't last long in his Thursday start, but it had nothing to do with his head.

Donald Veal (sprained elbow/Tommy John, ERD 10/4)
I was at Veal's last Triple-A Indianapolis start, so news that he was headed for Tommy John surgery really surprised me. His start was a typical Veal turn, with some good, some bad, and a lot of inconsistency. He didn't appear to have any real control problems beyond that inconsistency and really didn't appear to have any pain. After he was removed, I saw him standing in the dugout and didn't even see any ice or any other sign that there was anything going on. The big lefty remains a prospect and an easy guy to root for and, at 25, he should be able to come back from this.

Quick Cuts: Grady Sizemore is scheduled for surgery on today. Look for news in the afternoon or early evening on what was done, which will determine how long it will be before he's back. I'll try to put an update up in comments, so check back. ... Orlando Hudson is iffy for the weekend after the collision with Denard Span caused some inflammation in his surgically repaired wrist. The DL remains a possibility. ... My dog came home from the surgeon Wednesday, just 24 hours after two surgical procedures. He's up and about, if limping, but if Wes Welker crows about his quick comeback from ACL surgery, I'm not having it. ... Vladimir Guerrero is out after a ricochet off the batting cage made him look like a boxer. He should be back in a couple of days. ... The Rays pushed Jason Bartlett to the DL with a retro move, in order to make sure his hamstring strain heals properly. The move allowed them to bring Kelly Shoppach back without having to make a tough decision between John Jaso and Dioner Navarro. ... Jorge Posada was wearing a protective shield on his lower leg and foot during his at-bat on Tuesday. ... Casey Blake was scratched from Thursday's game due to back spasms. Sources tell me this is minor and he should be back this weekend. .. The Diamondbacks think Mark Reynolds will be back in the starting lineup tonight, avoiding the DL. ... Daniel Murphy is done for the season with a ruptured MCL. He won't require surgery, however. ... Takashi Saito left Thursday's game with a strained hamstring. No word on severity at deadline. ... Activated from DL, then struck out the side in first outing back. That's a good pattern from Franklin Morales, coming back from a sore shoulder. ... My weekly chat with Noah Coslov of Cinesport is up now, if you want to see.