June 9, 2010

Under The Knife

Wednesday Update

by Will Carroll

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Stephen Strasburg
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...

Pitch Counts
As Strasburg was pitching, we were treated to a sharp turn in the discussion about the fifth inning. John Smoltz and Jim Kaat, great pitchers in their day, had done a solid job analyzing Strasburg's performance, but both went off the rails when it came to the idea that Strasburg would be pulled at the announced 90-pitch limit. I don't expect them to quote Keith Woolner and Dr. Rany Jazayerli's seminal work on pitcher workloads. I won't even suggest that one of them might have heard of the work being done at ASMI, including studies being done on workload in youth pitchers. With Smoltz at least, I do expect he knows where his right arm is. Smoltz can look down and see the scars, one on his elbow from Tommy John surgery (1999) and another where surgeons put his shoulder back together (2008). Smoltz had some outings that would shock the senses today, including one of 152 in 1989* when he was just 22, and 43 games of 125 or more in his career. He never really had high innings totals, though; Kaat had six seasons with more than Smoltz's career high of 256 IP. Smoltz even brought up the fate of Steve Avery, but seemed to abandon the lesson when convenient to his point. When it comes to saying perhaps we're taking pitch counts a bit too far, I'm with them and encourage that line of questioning. When it comes to saying the things they did on a highly-watched program, with casual fans tuning in to see the phenom, with kids who'll ask their parents for a Strasburg jersey tomorrow, I worry about the damage they did. They suggested that the pitching coach "fudge the count" at one point, before Bob Costas pointed out that the scoreboard at the ballpark had that number up in lights. Kaat and Smoltz were great pitchers in their day, so I'll forgive them for trying to recapture a little of the glory of, but you know what that leaves you with. For someone like Smoltz, who's on the "Council of Champions" at the Stop Sports Injuries Campaign, I expect more.

Claim Chowder
One of my favorite writers, Jon Gruber, often saves statements made by pundits in order to remind them of things in the future. He writes mostly about Apple, so things like Steve Ballmer saying that the iPhone wouldn't get any market share get to be "claim chowder." To close out the Strasburg discussion, I want to save something here. God knows I've said enough stupid things in my day that I shouldn't do this, but this just stood out: "At present, Mr. Strasberg does not have the skills and fitness that he needs to be a quality major league baseball pitcher." - Dr. Mike Marshall, February 2010, #145.

Homer Bailey (strained shoulder, ERD 6/15)
The Reds have an interesting summer ahead of them. They're in contention as June rolls on, really the only team that seems prepared to give the Cardinals any kind of chase. They've done this largely on pitching, but that's going to be their problem as we get deeper into the season, making August and September the really tough time ... and precisely the time where you don't want someone like Dusty Baker at the helm. Now, I'm not being kneejerk here on Dusty. The guy is genuinely thoughtful, but he's seldom analytical about the way he handles players. He handles them, I think, how he would want to be handled and sometimes, that holds him back from doing the necessary thing. He relies on players to do their part, expects them to be professionals, and from what I can tell, mostly leaves them alone otherwise. As this team heads into the latter portion of the season, they'll be faced with an increasing innings total on rookie Mike Leake, re-integrating Edinson Volquez, managing Johnny Cueto's fragile but talented body, and possibly phasing Aroldis Chapman into the big leagues. If that's all happening while contending, there are issues. They're not insurmountable, but does anyone reading this expect Baker or Bryan Price to sit down at a press conference and say "We're going to tandem Leake and Volquez" or "We're going to use Chapman for a couple or three innings every few days to maximize what he can give us while helping the pen." No, the pivot point for the Reds is going to end up being the health and productivity of Bailey. Bailey's shoulder injury shelved him and while he fought going on a rehab assignment until he was driving towards Louisville, it didn't get better once he got there. Bailey went 86 pitches in only 4 1/3 innings, getting knocked around by a Syracuse lineup for five runs. He didn't seem to have his best stuff, but he didn't make any of the motions he made when we last saw him on a mound. There are suggestions from some that saw him that he's "rusty", but I have a hard time with that. Bailey could be in line for another Triple-A start before returning. We'll see him on the side in a couple days and that will factor into the decision in a big way.

Aroldis Chapman
Strasburg was getting national attention and dominating on Tuesday. On Monday, the rumblings that Chapman was fatiguing and not making adjustments got a little louder. Chapman got knocked around, lasting only two innings against the same Syracuse lineup that would knock Bailey around the next night, so maybe that says something. Chapman's K/BB rate of less than 2/1 is already concerning to many, but it's how he got beaten that concerned one observer, who said "He still tries to blow it by guys when he gets in trouble and now he's not able to do it for some reason. His stuff is still there, so I think it's that they know it's coming and have adjusted. He hasn't and just keeps thinking his fastball's better than it is right now. His secondary stuff isn't developing at all and I worry about how max-effort he looked from the start." It's that latter part that stands out to me. Chapman's effort levels are going to affect his fatigue and for a guy who hasn't pitched deep into any season—his max is 118 in Cuba—fatigue is a major concern. There's no sign that Chapman is injured, but he's heading down a path that often leads that way.

Jacoby Ellsbury (fractured ribs, ERD 6/15)
Some of us had a woobie back in the day. If so, you'll understand why sometimes, a player needs to hear from someone they trust that they're ok. The most famous example is probably A.J. Burnett, who was flown to Birmingham a couple times so that Dr. James Andrews could tell him he was fine. Money well spent, which is probably how the Red Sox will think about sending Ellsbury to the Kerlan-Jobe Clinic. That's where Ellsbury will sit down with Dr. Lewis Yocum and make sure that the pain he's feeling from his ribs isn't causing more problems. After that, it's going to be up to Ellsbury and the Red Sox medical staff to figure out how to get him back out on the field. This is all about pain tolerance at this stage, so finding a timeline is tough. After seeing Jeremy Hermida get crunched by Adrian Beltre, I'm wondering if moving Ellsbury back to center field is more about keeping Ellsbury out of Beltre's sphere of destruction.

Chipper Jones (inflamed finger)
The Braves got Jones back in the lineup on Tuesday, as expected after his weekend cortisone shot. While he was hitting the ball out of the park during batting practice, things were different in the game. Jones went 1-for-6 against the Diamondbacks, who started Edwin Jackson, a guy who's inconsistent and "wild in the zone", exactly the type of hitter having difficulty with bat control would struggle against. Jones specifically told Dave O'Brien of the Atlanta Journal-Constitution that his grip was better, so as long as swinging the bat doesn't re-injure or flare the inflammation in his knuckle back up, we should see Jones on the field and at bat, at least until his next injury. My guess is that Jones will look better tonight against Ian Kennedy.

Aramis Ramirez (bruised thumb, ERD 6/28)
The Cubs seem ready to push Ramirez to the DL, for the thumb injury that has been vexing him for the last 10 days. His batting average is plummeting and his grip on the bat is clearly problematic despite the medical staff's best attempts at solutions using soft splints, tape, and adjustments to the bat. The thumb isn't fractured and "thumb" isn't really even the right designation. The bruise is more between the thumb and index finger, down near what is anatomically described as the thenar area. That soft area that allows the thumb to move in opposition to the hand has a lot of complex structures—ligaments, tendons, muscles, nerves and fascia—all of which might be affected here. The medical staff now has time to work on that without Ramirez re-injuring himself on every swing.

Carlos Beltran (arthritic knee, ERD 7/15)
The Mets have had Beltran playing in extended spring training and for the most part, things have gone well. Beltran is able to hit, but he's been limited, being told not to run. I've gotten various answers on how  that plays out on the field, but it seems he's not going all out on the basepaths. Since it's extended spring training, the rules can be changed pretty much at will, as the teams see fit. The problem is that extended spring training games are done this year—spring extends only so much, apparently. That leaves the Mets with batting practice, controlled workouts, and at some point, putting Beltran out on a rehab assignment. The normal 20-day rehab clock doesn't mean much here. With the swelling he's bound to have in his knees, it would be easy enough by the rules to stop and start the rehab. Unfortunately, that also means that we won't have as clear a guideline on the timing. Sources tell me that while the brace is helping and that Beltran could start that rehab assignment at the end of the month, there's also some frustration. Beltran was reading the news like everyone else and watched how Grady Sizemore's situation went. Beltran was part of the decision process that went this way rather than microfracture on two occasions, but that doesn't stop him from having some remorse.

Kendry Morales (fractured leg/ankle, ERD 9/1)
SI.com's Jon Heyman reports that there are fractures in both the tibia and in the smaller bones of the ankle of Morales. Morales is now scheduled for surgery on Thursday, a week later than normal, so don't believe the Angels when they say they still expect him back on the same time frame. It's possible that he returns, but far from probable. The key here is what has to be fixated. If it's simply the relatively large tibia, that's one thing, but if it's the smaller bones of the upper foot, that's tougher. Keeping the geometry of the foot is difficult with all the small, interconnected bones, much in the same way it's very difficult to deal with wrists. Knees and elbows are hinges, while the hips and shoulders are more complex ball-and-sockets. The wrists and ankles are even more complex structures with smaller bones to deal with and a maze of ligaments, tendons, nerves, and blood vessels. The wild card in all this are advanced techniques used to stimulate bone regeneration. I'll stick to the previous hope of a late-August or early-September return, but there's going to be a whole lot of intermediate steps between now and then, most of which we'll never see or hear.

Quick Cuts: MLB approved the move of Oliver Perez to the DL. They reviewed his medical records, but did not speak to Perez or doctors, I am told. ... Josh Beckett is scheduled for a side session on Saturday. No word on what that entails. My guess is that he won't be up on a mound for another week. ... Travis Snider is hitting off a tee, but his wrist seems very slow healing ... Magglio Ordonez was a late scratch due to some "tightness" in his oblique. Keep an eye on this one. ... Mark DeRosa is headed back to San Francisco after his short rehab stint. It's expected he'll need surgery to re-repair his damaged wrist. ... Justin Duchscherer had successful hip surgery. Word out of Oakland is that "there was a lot of damage." Duchscherer was able to come back from similar surgery on the other hip. ... If Bud Selig really doesn't believe replay should be expanded, maybe we should consider how to contract the Commissioner. I'm all for waiting until 2011—I just don't see how it can be put in place in season—but I'm all for replay. ... Nelson Cruz is expected to go on a rehab assignment this weekend. There's some question about whether the hamstring will hold him to DH duties upon his return, at least for a bit. ... Chad Tracy is expected to be called up for the Cubs. Indians fans should watch—he's one of the few major-league players to come back from microfracture surgery. Somehow, I don't think that will make Sizemore fans smile. ... John Baker had a setback in his rehab from a forearm injury. There were no specifics on how significant this was at deadline. ... I'm hearing very bad things about the setback experienced by Brian Roberts, but I haven't been able to confirm them. Roch Kubatko raises the spectre of imminent surgery. ... Ryan Doumit will miss a couple games after a concussion. The Pirates will monitor him for symptoms.

*: Smoltz's 152-pitch game stuns me. He had a four-run lead in the ninth. I guess Russ Nixon didn't go to Joe Boever outside of save situations, even back then.