July 19, 2009

Under The Knife

Surprise

by Will Carroll

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Yes, it's been a week since we last talked. It's as weird for me to not write as it is not have UTK up. It's a "near-daily" column largely because I don't think it can be done right any other way. Once a week doesn't show the flow of things, the daily changes, and how new information adjusts any one player's prognosis. Sure, I've been over at Twitter and even punched out my first football column of the year-as well as debuting my new NFL injury service-but I'm happy to get back to baseball. Sadly, there are always going to be injuries to write about.

Don't get too used to it, though, because come Wednesday, I'll be taking more time off, as I'll be headed to the DL, at least for a couple of days, as I'll be having surgery on Wednesday. Most of you know the situation already-I have a torn abdominal muscle that's essentially causing the same sorts of problems that Josh Hamilton had recently. The downside is that I didn't do mine hitting home runs or making big bucks. I hope to have an even quicker recovery, because I still won't be hitting home runs. It's as minor as surgery gets, and will allow me to get back on the road and to more games.

I'll also be doing a lot more events. I couldn't make it to the All Star Game, but I will be at Newberg Night in Arlington on August 2 (it's already sold out), in Indianapolis with Peter King (August 10) and in Memphis (August 21, tickets available soon). We're hoping to do something in Pittsburgh and Cincinnati, plus maybe a couple of others if we can get things working. Injuries and illnesses happen, but for the next couple days, I'll do my best, as always, to keep you informed. Powered by my enthusiasm for a rare Sunday UTK, on to the injuries:

Gil Meche (15 DXL)
Stop me if you've heard this one before: Kansas City has a player that is performing like they're hurt. The team sends this player back out, not just to play, but really pushes them, and he quickly winds up on the DL. It's the same old song-and-dance and same old results for the Royals, as Meche is the team's latest victim of a failed medical support system. In a game where players, managers, and front-office personnel are judged on results, that's what has to be the case for medical staffs as well. Meche went from dead arm to 121 pitches to the DL in short order, and it's not as if people didn't sound the alarm before, during, and after that start. The curious thing here is that it's back spasms that are the proximate cause, which hadn't been an issue before. It sounds like the dead arm may have led to a kinetic chain breakdown that hasn't healed despite the extra rest of the All-Star break. The team doesn't think he'll miss more than the minimum, but we'll see.

Ryan Braun (5 DXL)
Braun wasn't just hit on the hand, he was hit on the hands. The 87 mph pitch was clearly inside despite the announcer trying to make it sound like it wasn't; it hit Braun on the left wrist and then pinballed to his right thumb. That's hard to do, but there's something interesting to note here-as Braun walks to first, he's extending the thumb. That means that the ball didn't lose much energy as it hit the wrist, minimizing the damage there with a glancing blow. It doesn't mean that the thumb doesn't hurt, but since it's not fractured, Braun will just have to wait until any swelling goes down and his grip strength comes back. This shouldn't be a long-term concern.

Carlos Quentin (70 DXL)
At this point, the problem for Quentin is almost as much the presence of Jim Thome on the roster as it is his own plantar fasciitis. If Thome didn't have the DH slot locked down, Quentin would be back after knocking the rust off. Since that's not an option, Quentin has to prove to Ozzie Guillen that he's ready to play the field for a full game, game after game, and that's the biggest issue he's having on his rehab assignment. He's hitting is perfectly fine, and he's even showing power, but the foot is still giving him significant pain; this has become a pain-management and pain-tolerance issue for Quentin. Since rest and treatment have only gotten him this far in almost two months, it's hard to believe that playing every day is going to help. Expect Quentin to get frequent rest or even be limited to pinch-hitting duty for stretches, assuming that he can get off and stay off the DL.

Jay Bruce (45 DXL)
The Reds still haven't said which bone in Bruce's wrist was broken, and it's actually important, because there are differences in the expected time out and lingering effects, based on which bone. They've said that it's a clean break along the joint line, and that there's not soft tissue damage, but neither of those things tells us as much as announcing which bone it was. Based on the stated six- to eight-week timeline, the guess is that this might not be an anatomical wrist fracture, but instead something such as a Colles' fracture, which involves the radius, one of the bones of the forearm. A Colles' fraction isn't common in baseball (it's much more common in skateboarding and such), but can be caused by falling on the wrist in extension, as Bruce appeared to do with his glove, thought it's not the classic "catch yourself" mechanism; Bruce's wrist was forced into extension by the slide. If true, a Colles' fracture would be similar but not identical to the type of injury that Evan Longoria had last season. It's good news if this turns out to be a broken arm rather than a broken wrist, as it's a distinction that's important in baseball.

Jose Reyes (75 DXL)
There's some really disturbing information inside this Adam Rubin article, but let's focus on Reyes. Did Reyes have a setback in his rehab? Not in the normal sense of the word. While the Mets say that Reyes didn't pass on agility drills due to his current workout schedule, it's hard to believe that any writer would simply make something like this up. Ladder drills are part of Reyes' return, and are a commonly used agility tool. Still, it's not so much a setback for Reyes as it is an indication of where he is. Ladders are a far cry from playing a major league game, so Reyes isn't close, and hasn't made any discernable functional progress since the start of the month. With word that Julio Lugo is coming to Flushing Meadows, sort of a supersized version of the Angel Berroa pickup, as the Mets try to paper over Reyes' continued absence. The problem is, there's no known endpoint yet on that absence. We're already past the six-week mark with this, but not quite to the eight weeks at the back end of the originally announced expectations, but now there's little doubt Reyes will blow by that.

Chien-Ming Wang (40 DXL)
The announcement that Wang's pain-free is a bit surprising, given how we last saw him, as well as all of his results since his original foot injury at mid-season in 2008. The strained shoulder has healed up with rest and treatment, which means they'll be putting Wang back on the mound soon, though it will be a mound in their Tampa complex. Team sources are whispering about his seeing game action in about a week, and then an August return. No one's really sure what to expect from him, but the biggest concern is not whether he can get back to the rotation, but whether he can stay in the rotation. Look for some real tests early in the process, so that the Yankees can get some sort of decision made on whether they should shift Phil Hughes back into the rotation; significantly Hughes' recent appearances have been moving towards that in terms of both their duration and his rest intervals.

David Bush (40 DXL)
Wang, then Bush. Bush isn't having a good rehab experience, leaving his last outing and heading for an MRI. The imaging didn't show any significant damage, but Bush is left with a "fatigue and weakness" diagnosis in the meantime. Neither is a good sign here, especially given the Brewers' need for pitching and his initially expected return to the rotation this week. Instead, he'll rest, see a doctor on Wednesday, and perhaps have one more rehab start before he's back, though that sequence could change with even the slightest of problems.

Joel Zumaya (70 DXL)
Carlos Guillen (90 DXL)
A "slight little pop" seldom is just that for Zumaya. His shoulder might be able to get the ball into triple digits, but it can't hold up while doing so; he's done something again, and is headed back to the DL. Worse than the pop is the "significant pain" that he felt in the arm both at the time and the day after. Given his history and the unique problems he's had with his shoulder, it's hard to say anything with certainty, but none of this is good. Zumaya was pitching after having been rested, but sources tell me his arm was "hanging lifeless after the game" and that he couldn't lift it at all without pain. We'll know more after imaging. The Tigers aren't as worried about Guillen, mostly because while he is having some normal soreness in his shoulder while he rehabs, it is called "normal soreness" for a reason. (It doesn't hurt that they haven't really missed Guillen either.)

Quick Cuts: Seth Rogen? Really? Not that I'm angry by this sort of make-believe casting choice from Bill Simmons, but I just don't see it; he has hair and he's funny. ... Lance Berkman expects to play today, but the calf is still a lingering issue. ... Alfonso Soriano missed a couple of games after dislocating his pinkie, then showed it wasn't bothering him by clubbing a homer. Dislocations are painful, but heal quickly if there's no associated damage. ... Further proof that Twitter rules: we quickly learned that Joe Crede will have more tests to determine the extent of the damage in his shoulder, but he's sure to miss a couple of games. ... Scott Kazmir was just cramping when he was forced out of action on Saturday, but it's worth watching to make sure that's all it is. ... Rick Ankiel is still having some problems with the shoulder he tried to break the outfield wall with. He's having tests done to see what's going on. ... Mark DeRosa's wrist injury will need surgery, but he's going to try and play through the pain. We'll see how that works out quickly, perhaps as soon as next week. ... Matt Lindstrom will head out on a rehab assignment this week. ... Marc Rzepczynski? With a name like that, I just know he's going to end up in this column. Heck, he's a Toronto pitcher after all! ... Matt Harrison will start a rehab assignment this week; look for him to make at least three starts before he's back with the Rangers. ... Kevin Slowey will have to make it through two bullpen sessions this week before he'll go on a rehab assignment. ... A telling line from Jerry Manuel, however joking it was meant to be: "They're calling it cramps... surgery on Thursday." ... I'm hoping to get more on Jonathan Broxton's toe for tomorrow.