August 17, 2009

Under The Knife

Caution Bells

by Will Carroll

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There are a lot of injuries to get to, so I won't bore you with this, but it's exciting. From August 28-30, I'll be joining the radio staff of the Ft. Myers Miracle, calling games with Zach Spear. He invited me down to see whether or not you can have a "smarter broadcast" the way that Ken Funck has talked about. I think we can, and you'll be able to hear me succeed or fail live on the interwebs to boot. It's a whole different kind of Baseball Prospectus Radio, but an experiment I think is well worth the trip to the humid confines of Ft. Myers in August. If you have ideas, I'd love to be powered by them, so let's get to the injuries:

Hiroki Kuroda (TBD)
The ball flew back toward Kuroda, and then almost rebounded into the stands. It's counterintuitive, but the distance the ball traveled was actually a good thing. Kuroda's skull held up and the ball deflected. Had it not, the ball would have dropped. I don't want to fault Kuroda too much here, but watching the video of the play, Kuroda was in a terrible fielding position, three-quarters of the way turned toward first base and with his glove up and at waist-level when he began to react to the liner back at him. He never had a chance at blocking it, let alone fielding it; I've often heard pitching coaches say that the best way to field is to not let the ball get hit at all. Kuroda never lost consciousness, though he was in obvious pain; there was not any broken skin, in the horrific way that we saw with Bryce Florie. There's no way to tell how much time he'll miss, though if he's asymptomatic for concussion, he could miss only a small amount of time. In other words, he's incredibly, insanely lucky, nothing more or less. The next guy might not be.

David Wright (TBD)
It was an earflap that saved Wright. The ball hit him directly on it, ricocheting up and out. Without that flap, the ball would have hit him in the temple, but even with the cushioning and hard plastic, there was enough force going into his brain to knock him senseless for a period of time. I don't mean that as an insult; it's a very literal meaning here. In some cases, the senses-especially hearing and sight-are knocked out. "Seeing stars" and ringing in the ears are common concussion symptoms. Strange smells are often noted, though they're more an olfactory hallucination than anything. Wright was kept for observation overnight on Saturday and was released, but he was still experiencing symptoms like headache, nausea, and some balance issues. These are all common and if there's one good thing, it's that Wright never seemed to lose consciousness or, if he did, it was only a second or two. Wright will be monitored closely over the next few days to see how he responds. The Mets have placed Wright on the DL in the meantime, and have acknowledged that he could be done for the year. His symptoms-or more properly, the absence of symptoms-will determine whether or not he can come back. With no playoff chase to conduct, the Mets can afford to be conservative, but to say he's not coming back when he could be fine in a couple of days or even a couple of weeks from now doesn't make much sense, either.

Scott Rolen (8/30)
As a reminder or example to Kuroda and Wright, Rolen is on the DL and just beginning to try some baseball activities. However, he's taking things very slowly, as he's still experiencing some headaches and balance impairment. There's no timetable for his return yet, but things do seem to be progressing. Concussions can be a "come and go" thing, but with the headaches being the biggest problem, Rolen will clearly know when those have passed. Unfortunately, he can't say "good enough," but he's known as a stubborn, play-through-it kind of guy. I have some worries here, so I can only hope the Reds don't get him back out there too quickly and risk a setback. "End of the month" is the most reliable guess I'm getting from sources and advisors, so we'll drop the ERD there.

Carlos Beltran (9/1)
"He'll try running in a straight line next." It's almost funny to hear that line as part of a rehab progression, but that's where Beltran finds himself. He spent part of Saturday shagging flies, which seems a bit funny as a pre-progression step to running, but it's just a glide, a jog, and with less lateral movement than you'd think. The knee is still problematic, with the bruising inside the knee not fully healed because there's still bone-on-bone grinding and "banging" with every step, whether he's shagging flies or not. I've heard that the Mets and Beltran are holding back on any decision about microfracture surgery in order to collect more information. They're watching Marlins utilityman Alfredo Amezaga's return closely, as well as that of Saints running back Reggie Bush, who one source said was a good physical comp for Beltran. They also believe that Beltran could have the surgery in October and be back in time for spring training. A lot will depend on the direction the medical staff takes this offseason, adding an element of uncertainty. If there's no change, look for the surgery to happen early so there's no "repeat of Carlos Delgado" charges. All of that said, Beltran still wants to try and play this season. I'm not sure why, and I'm not sure why the team isn't stopping him, but I do think we'll see Beltran on the field around September 1.

Jarrod Saltalamacchia (10/4)
Not again. Rangers fans are considering the possibility that yet another of their players might be headed for surgery to correct Thoracic Outlet Syndrome. It's not just unusual, but at the point where we have to actively question why this particular problem is hitting the Rangers so hard. There's no pattern here, especially with another non-pitcher. There's no consistently taught technique known to exacerbate or cause this condition, and a lack of consistency is where we might look due to the turnover in coaching. The symptoms fit here, and if Saltalamacchia needs corrective surgery, part of his next season could be in danger as well. It would be close, but we really don't have a good handle on how position players come back. Hank Blalock lost significant time, and it's very tough to read his career anyway. The fact that the Rangers have done so many of these rehabs helps, but it doesn't make anyone feel better.

Johnny Cueto (8/26)
I saw a Reds fan quoting my July DL days figure for the Reds in defending his favorite team. That was before most of the significant injuries, and as I've always said, days lost alone don't really tell the tale. I've looked at dollars lost, both real and in terms of "injury cost," in my attempt to make value more constant and tied to a player's real contribution. So when you look at the Reds and wonder what direction they're going in, is there anything there that doesn't include Cueto? With Edinson Volquez lost for next season and only the hope that Aaron Harang can come back to ace level, that team simply can't hope to win without a healthy Cueto. That the team isn't completely shutting him down is perhaps defensible; that they're not being ultra-conservative is beyond stubborn and into self-immolation territory. Cueto's hip problem is just the latest small thing, the signs that fatigue is breaking him down in small subtle ways, like rust before a collapse. If it's just a skipped start, the Reds just don't get it, and Hal McCoy's parting shots might be cannon-fire.

Carlos Zambrano (8/25)
I want to blame the workload, but more of the blame has to rest on Zambrano's shoulders for how his career is turning out. Or maybe the problem is a little bit higher up than his right shoulder. The issue now, his back, is a relatively minor problem, but since signing his big-dollar long-term deal, he's gained weight and lost effectiveness while dealing with a multitude of shoulder issues and other kinetic chain problems. Sure, he held up pretty well under the workload, but he's gone from reminding people of Fergie Jenkins to another Cubs great instead-Rick Sutcliffe. That's not a bad thing, given Sutcliffe's career, but look at the up-and-down nature of it; Sutcliffe was never bad, just inconsistent and average at worst. There are probably a couple more really good years left in Zambrano's arm if he buckles down a bit and gets focused, but no one seems too sure about that happening. He'll have a rehab start on Thursday, so we'll get a look at his motion. If that goes well, he'll be back in the Cubs rotation as soon as the 25^th, but he's fast becoming a bigger, Latin version of Rich Harden.

Tim Wakefield (8/20)
"Everyone thinks he can pitch. We'll see if he can field." That's what Terry Francona told reporters this weekend in reference to Wakefield's rehab start. Wakefield still has a noticeable limp when walking, and the Red Sox are trying to determine whether he needs more time or if pitching exacerbated his calf strain. The Red Sox almost got swept out by Texas, with only a blown save giving them a game in Arlington. John Smoltz is gone, Brad Penny is doing his expected fade, and Clay Buchholz isn't consistent, leaving the team hoping for something stabilizing out of Wakefield. He'll pitch on Thursday, but the Red Sox won't decide until Tuesday whether it will be for Boston or for Pawtucket.

Martin Prado (8/18)
It turns out that Prado might have a virus rather than simply a heat sickness, but while I talk with all seriousness about concussions above, heat illnesses are as deadly serious, and likely more deadly. There's bound to be a story or two of heat-related deaths in high school football over the next few weeks, just as there are every year. I'm stunned there's not more of a problem in baseball, especially in warmer climates like Arlington and Miami, and even more stunned that there are no issues in the Florida State and Texas Leagues. The fact is that ATCs do a great job, but is it enough? Are we seeing some injuries that are the results of longer-term heat illness or dehydrations? It's impossible to tell. We can only hope that feeling bad is all that Prado or any other player has to deal with.

Quick Cuts: I'm proud that my Slate article on labrums is still getting quoted, but it's obsolete. I need to update it just to get it off the first Google search screen or something. ... Hideki Matsui had his knee drained, but isn't expected to miss significant time. ... Chad Billingsley is expected to start on Tuesday, missing just one turn due to his strained hamstring. ... The Red Sox are playing it conservative and keeping J.D. Drew out of the lineup until at least Wednesday; the DL remains a possibility. ... The Red Sox think Daisuke Matsuzaka will get in some games before the GCL season is done, but no one has a prediction for the timing of his return to the Red Sox. ... Jim Thome is on-again with an on-again, off-again foot problem. He's not expected to miss much time, though the Sox could buy some rest for Carlos Quentin's foot in the DH slot if Thome's given a couple of days off. ... Torii Hunter looked solid in his first few games back from the DL. He's showing no real issues with the oblique. ... There's a great takedown of me in this article. I like when people fact check me and confront me with a reasoned response. I'll be honest, though, I still don't see a significant difference in most of those years. ... Eric Byrnes started a rehab assignment in Reno yesterday; it could be a short one. ... Nelson Cruz will start a short rehab assignment today, and replace the speedy Julio Borbon in the lineup on Wednesday. ... No truth to the rumor that Brett Myers injured his eye falling out of Jeff Kent's truck. Aside from that, it's still a mystery.