March 6, 2009

Under The Knife

Spring Forward, Falling Back

by Will Carroll

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Alex Rodriguez
I was researching Marion Gaborik mid-week for my Puck Prospectus column, and I had to do a ton of work to try and figure out how a hip injury would affect a speedy winger. Little did I know that Rodriguez would end up with the same issue, and probably the same surgeon. While initial reports all focused on a reported cyst, that's actually a result, not a cause. The cause is a torn labrum, resulting in irritation within the joint, and in this case, a cyst. The cyst was aspirated: they jammed a big needle in and sucked out the material inside. It's painful and unpleasant, though I'm sure many of you are enjoying the image of Rodriguez and needles. It's the cyst that's causing the pain, and what sources are describing as a "slight instability," which is likely more the result of the body's compensation to avoid pain rather than an actual instability of the joint.

The key here is that surgery is not a given. The aspiration may give enough relief that he can play through the season with only occasional setbacks and more aggressive monitoring. It could be that it gets better and a strengthening program adds to the stability, allowing him to only miss a few weeks. The danger is that the conservative measures might fail, which would push his return date back further than it would have been had they gone straight to surgery. We have to remember that the gamble of taking conservative measures comes with a high payoff. Let's say for the sake of this example that Rodriguez will miss no time if the aspiration works, four weeks if he just needs the strengthening program, and twelve if he ends up having surgery. It's not as if this is a 1-2-3 game; the Yankees will know quickly that the aspiration is working if there is a reduction in his symptoms. He'll begin the strengthening program immediately; if he's falling behind, or if there is no reduction in his symptoms, they'll shift gears.

It may seem as if hip injuries are becoming viral right now. Two other elite-level infielders, Mike Lowell and Chase Utley, are both recovering from labral repairs. We haven't seen much of this in the past, with pitchers being the usual occasional sufferers. So what's the root cause here, and why are we seeing this type of injury now? I'm still working on that question, and I hope to have a better answer for you soon; I'm just not willing to guess or speculate. What we do know is that surgery is likely, but the timing of the surgery is the key. Whether this plays out as it did with Utley, who played through some pain and had off-season surgery, or the way it did with Lowell, who was unable to deal with it and had to be shut down just before the playoffs, may end up being the difference for the Yankees.

Rodriguez's hip won't let him play in the Classic, but beyond that, it's a matter of how things play out, his pain tolerance, and the decisions made by the Yankees' medical staff. Knowing their history with rehabs, I won't bet against them. I'll continue to follow this story closely, and I'm consulting with some experts on how this should play out.

Jorge Posada
As if the Yankees don't have enough problems, Posada had a bit of a setback with his shoulder. The team shut him down for a few days, and while he has come back, it raises questions about his stamina. I'm not sure stamina is the right word here, though I do know that "recoverability" isn't either, though I did hear one source try to sneak that through. Posada's shoulder does look to be in the range that the Yankees were hoping for, but there's still a possibility that he's going to need time off from catching, which will push him to DH. In that case, Hideki Matsui is pushed out of the lineup altogether, and the flexibility that the Yankees might have had begins to disappear. This is definitely an injury that's going to have to be monitored closely throughout spring training, whether you're considering drafting Posada, or if you're just rooting for the Yanks.

Johan Santana
Across town, or rather, across the state of Florida, the Mets aren't getting off any easier on their injury front. They're still watching Santana closely, and signs have been positive. He's thrown a couple of times and looked good doing it, though he's neither gone full-out nor used his slider since the onset of the elbow soreness. That will be the next step before getting him back onto the mound in a game situation. The focus in the media has been on his status for Opening Day, and not as much on his long-term function as the staff ace. It's likely that Santana could pitch the opener (assuming that there are no setbacks), if they can keep him on a hard innings limit and curtail his use of the slider. Whether he could still be effective remains to be seen. He is behind schedule, and it seems no one can give an accurate assessment of where he'll be a month from now.

Jimmy Rollins
One of my favorite things to watch is a backpedaling player. Rollins played the game after news had leaked that he was having trouble with his back. "Just tightness," he told the media, and that was that, since he went out and showed no sign of any discomfort on the field. Guess what? It's never that simple, and what we have is not some damning insight, but just another piece of information. Rollins has never had any major problems with his back, but he's also never been to a World Series, or had these kinds of demands placed on his time. Did he become complacent, or did he just have a bad morning? I don't know, and it's likely that he doesn't either. We just collect these pieces of information and use them to make value judgements as best we can... I'm not too worried here.

Joe Mauer
The minor kidney surgery that Mauer had last winter is still affecting him. A local nephrologist gave me a description of the surgery, and trust me, I'm still cringing. I'll spare you the gory details, but suffice to say that in the long-term, it is minor, and Mauer should be fine. In the short-term, however, it's going to make more sense than ever to keep him out from behind the plate. He's yet to play, and he had a setback after trying to catch. While it's still too early to say, he's definitely having more difficulty than anticipated, and some are wondering if he'll be ready to open up the final season at the Dome. I'm not sure that it's a bad thing if it forces Ron Gardenhire to consider Mauer as a DH, though the roster is clearly not constructed with that in mind. His progress will be another one of those items that we watch closely this spring.

Brandon McCarthy
Things looked rather bleak for McCarthy last week. It seems as if he's been injured since he got off the plane at Dallas-Fort Worth. This spring, he showed up in Surprise all bulked up and ready to see how some late-season adjustments would work. Instead, shoulder stiffness has kept him on the back fields so far. Most worrisome here is that McCarthy told the press that "it might be a fatigue thing." Given his new body, this would indicate that instead of resting during the offseason, he was in the gym trying to do something that may end up being counterproductive. With some options between McCarthy and the next wave of Rangers pitchers, and some time before rotation decisions become critical, the Rangers are using patience.

Shawn Hill
It's not quite the first pitch, but it is our first "heading to see Dr. Andrews" of the spring. Hill is leaning that way after experiencing pain in his forearm. There are conflicting reports on where exactly the pain is, but given that he just had the elbow cleaned out last September, this is a bad sign. Hill's injury is going to be a definite setback, both for him and for the Nats, making his availability for Opening Day very iffy. If it's not just a false alarm, the Nats will go from choosing between Colin Balester and Jordan Zimmerman at the back of the rotation, to needing them both. This is one place you might see Pedro Martinez pop up. It's also important to note that we can no longer automatically use the phrase "going to Birmingham" now that Dr. Andrews is doing some of his work in the new Andrews Institute in Gulf Breeze, Florida.

Bartolo Colon
The Sox do a good job with reclamation projects. Whether that's because of Kenny Williams or Don Cooper or Herm Schneider doesn't really matter, as long as the job is getting done. Over the past couple of years, the Sox have always been among the best teams at preventing injuries and keeping their DL days low. Colon has looked good in camp, but like last year, the worry is more about just sustaining his performance than it is about getting him to reach a certain peak level. Unlike last year, Colon is not just a patch for the rotation that's buying them time, but an integral part of the winning plan. It's also possible that the Sox have Jose Contreras returning, giving them a few options at the back of the rotation. The risk is that there's a real drop-off behind those two. Yes, Clayton Richards is there, but while he showed he can pitch effectively, no one believes that he's more than a back-end guy. Colon is the key, and even with the early positive signs, I'm dubious.

B.J. Ryan
I'm a little confused here. Ryan showed up in camp saying that he'd never felt better™, and then just a few days later he pulled out of the Classic saying that his mechanics were wonky and he needed to head back to Dunedin to fix them. His mechanics have never been good, so I almost have to take this as just one of those half-hearted excuses necessary to get out of service to your country. On the other hand, it might show a bit of self-awareness that Ryan has never exhibited before. In returning from Tommy John surgery, could he have developed a better sense for what things are actually supposed to feel like? He never had full control of his slider last season, but either way, this bears watching. It feels like a positive.

Charts: I debated putting this into Quick Cuts, but it deserves its own section. We've had a few errors in the graphs running with the Team Health Reports. For that, you have my heartfelt apologies. We're working hard to fix it, and to make sure that all 30 are accurate. The graphs are just an interesting visual of the relationship between injuries and the standings; they aren't really much more than an "oh cool" kind of thing. Still, errors are something we strive to avoid at Baseball Prospectus, and incidents like this bruise our credibility. I assure you that Brad and I have done everything possible to make everything, including the graphs, as accurate as possible. We're human, so thank you for understanding, and for calling it to our attention. I learned a few years ago that I couldn't do everything, so I re-committed myself to being the very best at one thing-injury coverage. Sadly, graphs fall a bit outside of my purview, as this has proven.

Quick Cuts: Josh Hamilton's Achilles soreness isn't expected to be a big problem, though the Rangers will be cautious. It could also force some moves if he needs to be shifted to right field or to DH part-time. ... Rich Harden is making progress, and while I'm still not expecting 200 innings from him, I think that expecting something similar to last season's performance is very reasonable. ... Blue Bottle Coffee. It's very, very good. ... Adam Miller has been shut down for ten days while his finger heals. Ever wonder if he and Kerry Wood just look at each other and don't even have to say a word? ... An MRI already on Rich Hill? Bad sign, especially that it's his elbow now. ... Brad Penny is having as many problems with his shoulder as Dollhouse is having with the ratings. The start of the season looks very iffy for Penny, and the Red Sox may have to shift Justin Masterson from the pen, or let Clay Buchholz start the season in Boston. ... Is it just me, or is right field cursed for the Rays? Matt Joyce is getting closer to a spring training debut at their new complex, but any leg injury in Tampa's outfield is worrisome due to the turf. ... Braden Looper has an outside chance of being ready for Opening Day after an oblique strain set him back. The Brewers think that he'll return before they need a fifth starter.