September 1, 2009

Under The Knife

Thinking Big

by Will Carroll

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History was made when Ryan Dempster stepped up to the plate wearing the new Rawlings S100 helmet. Yes, it's bigger, but be honest, did you notice a big difference as he stood at the plate? You can see that there's not a lot of support in the dugout either. Lou Piniella was shown trying it on and concludes his test by taking it off and saying "F**k that." It's reminiscent of the Bengals' recent showing on NFL Films' Hard Knocks; in the second of four episodes, the Bengals focus on injured players like Ray Maualuga, who was out with a stinger. His coach chides him about missing time, all but questioning his manhood and parentage in the process. Players are given oversized hats to single them out... except of course the star quarterback, who's hatless despite being in a walking boot. The culture of macho is strong in both the NFL and MLB, but when it comes to safety, the machismo should step aside for common sense. I doubt Lou Piniella's Mercedes lacks airbags. I hope that Jeff Francoeur uses his seat belt and locks his doors at night. I'm going to continue beating the drum for safety equipment because it seems like no one else is doing it. Kudos to Rawlings for their new helmet, but now it's time to work on the next problem that could be solved.

Carlos Beltran (9/10)
It's not surprising that Beltran is going to play in rehab games, or that he could be back as soon as next week for the depleted Mets. What is surprising inside those reports is that he was cleared to play "without a knee brace." That's a good sign, right? No, actually, it isn't at all. Beltran's problem is bruising inside the knee, from bone-on-bone impact between his femur and tibia. The issue is cushioning or the lack thereof, but has never been about stability. I spoke to a respected surgeon who has not seen the images on Beltran's knee, but he said the idea that there's a brace in play at all indicates that not only is the lack of cushioning an issue, but that the compression and/or absence of the meniscus has changed the geometry of the joint, loosening ligaments and tendons as well as allowing bone to bone impact. I don't think I need to explain to you that this could all go horribly wrong, that the Mets and Beltran are gambling, or that the possibilities if this doesn't work might be even worse. Yes, the Mets and Beltran need to know if he can play with this at all or if surgical intervention is necessary before the '10 campaign, but that's about the only upside here.

Chad Qualls (10/4)
Dislocating the kneecap is not only painful, it's downright difficult to do. Chad Qualls did it on the last play of the game, one of those quirky, everything-happened-in-just-the-wrong-way kind of things. He was in obvious pain, and imaging showed why. In addition to the dislocation, which was reduced moments later, Qualls tore his patellofemoral ligament and will need surgery. The ligament essentially holds the kneecap (patella) in place, and without it Qualls could not only not pitch, he'd be at significant risk for additional dislocations doing such strenuous activities as "standing" and "walking." There's no good comparisons here, but the expectation is that Qualls will need about four months to recover and will be working his way back into pitching shape during spring training.

Daisuke Matsuzaka (9/9)
Tim Wakefield (9/8)
The back end of the Red Sox rotation used to be a place where we could point and say "ahh, depth." Now, not so much. The Sox barely got Wakefield back before things cascaded up to his back, while Matsuzaka looked less than effective pitching for Portland this weekend, lasting only two innings in Double-A, but the spin is that he was working on things and that the hittability was a result of that. We'll get a better look on Friday when he shifts back up to Triple-A Pawtucket. Wakefield had a cortisone shot in his back after his last start, and his next scheduled turn has already been scrapped; Junichi Tazawa will likely slot back into the rotation in his place after he's recalled today. Counting on Tazawa and Paul Byrd at this time of year was not what the Sox originally had in mind for their playoff push, but it's what they have.

Tim Hudson (9/1)
Hudson had a deliberately paced rehab, going slow so that he'd wait on the roster expansion, but also to make sure that he had enough stamina to be ready for the rotation. While some questioned me when I off-handedly said that Hudson was going to slot back into the rotation last week, there was little question of it in my mind. There's simply no reason to work on stamina the way they did if the Braves just planned on putting him in the pen or shutting him down. The question was who would step aside for him, and it looks like in the short term that the answer is no one. There have been indications from Braves beat writers that the team will go with a six-man rotation, as this does give them the opportunity to limit the workloads of Tommy Hanson and Ken Kawakami. (Note that there are also indications that Kawakami will be lifted from the rotation immediately, though the Braves haven't commented on this.) Hudson's return from Tommy John isn't as automatic as some will say, but I do expect he will be effective for this season and should head into 2010 as a "normal" pitcher.

Nate McLouth (9/10)
The Braves got good news, relatively, on McLouth. Imaging showed that he's merely set himself back to where he was, a tough Grade II strain in his hamstring rather than making it worse. McLouth is precisely the type of player that has to be protected from himself, and it appears he just went too hard, too soon in coming back from the strain. The early estimates that he'll miss an additional week seem a bit optimistic given the setback. The team will have to be a bit more conservative this time around to make sure he doesn't do it again (or make it worse). McLouth won't have much problem once he does get back, but I'd expect it to be more like ten days to two weeks before that happens.

Randy Johnson (9/14)
Signing Brad Penny signals that the Giants aren't giving up on the Wild Card or even the NL West race. Of course, Penny stinks in the second half, so the team is hoping that Randy Johnson will be able to slot back in over Penny, or at least push Penny down to the fifth slot. Johnson is working out at home with his personal trainers, and estimates that he'll be at 90-91 mph when he returns. He'll return to the team when they get back off the road and showcase what he has in a bullpen session. That puts a return somewhere around the middle of the month, which is very risky, though at this stage Johnson merely wants the chance to pitch on his own terms and to have another chance at a ring. That gives the Giants more leeway to be aggressive and creative with how they use him. In fact, they could end up pairing Johnson and Penny, especially if they elect to skip the fifth slot to get Tim Lincecum and Matt Cain some extra starts late in the season.

Sergio Mitre (9/8)
Anyone noticed that we could have a Hardcore Extreme World Series? If the Yankees and Phillies meet in the World Series, both players suspended for their use of 6-OXO Extreme (or rather, the banned substance that the supplement was tainted with) could be there. J.C. Romero is still trying to come back from a forearm issue, while Mitre took a comebacker off of his forearm during his last start. Because of the bruising, Mitre wasn't able to complete a "normal" bullpen-he played "light catch" instead, according to Joe Girardi-and his next start sounds likely to be taken by Chad Gaudin. With roster expansion, the Yankees can afford to get a little cute with their rotation and give Mitre the time to heal up. There's no indication that Mitre is anything more than bruised, so he's likely to slot back into the rotation next time his turn comes around.

Joba Chamberlain
The Joba Rules have been modified again, putting Chamberlain back on a normal schedule, but severely limiting his innings. It's essentially a case of putting him in a tandem role, though it doesn't appear that he has a designated partner. I'm not sure if this will do anything more than limit his innings, but shutting him down might be a better plan if they're that concerned. The thing that gets me is that the team was earlier saying that Phil Hughes couldn't come out of the pen and move back into the rotation (not that he should have!) because of de-conditioning. That's essentially what they're doing here. With Andy Pettitte throwing well, Chamberlain is the clear fourth starter. That means he might or might not be used in the playoff rotation, and could be worked out of the pen. Why not start that now, with limits on how often he can be used? Without any doubt in my mind, Chamberlain's a starter, now and in the future, but roles change in the playoffs.

Standard September 1 Note: Remember that in September (and October this season), the DL loses it's raison d'etre. Since roster relief isn't needed, teams tend to stop using it in all but the most extreme cases. This doesn't mean that players aren't just as injured, just that there's no reason to use the List anymore. It does make it tougher to track injuries at times, and certainly reeks havoc on some of the Days Lost measures, but otherwise, nothing changes.

Quick Cuts: Jake Peavy's elbow doesn't have internal damage, according to imaging, but with the trades made on Monday night, it's possible that the Sox will shut him down anyway. ... Adrian Gonzalez's pinch-hit last night is the best sign we have that his biceps injury isn't too serious. ... Trent Rosecrans breaks the news that Brandon Phillips has been playing with a hairline fracture in his wrist, though he's obviously playing through it. Rosecrans' new website should be in your bookmarks. ... I was told early Monday evening that Jarrod Saltalamacchia was heading for surgery to correct thoracic outlet syndrome. T.R. Sullivan later said it was "50-50," so keep your eye on this. ... While there's still been no decision on whether to have it or not, here's a reminder on why surgery for Jose Reyes' hamstring problem isn't that big a deal. ... Marco Scutaro is back in the Jays lineup after his beaning; all looks well with him. ... Speaking of all being well, Akinori Iwamura sure looks solid since returning from knee surgery. ... Joe Crede denies that he'll retire due to back problems. He also wants to try and return this season if the Twins stay in contention. ... Troy Glaus is expected to be called up by the Cardinals. No one seems to have anything more than a guess on how he'll hold up or be used. ... Jeremy Bonderman and the Tigers are going to take a hard look at his time in the pen heading into next year. ... The A's are shutting down Dallas Braden for the season. ... The Padres seem to be debating shutting down Kyle Blanks due to plantar fasciitis. He's already on the DL, so this is about making sure this doesn't happen again. ... Kerry Wood's stiff shoulder has the Indians a bit worried. They're contemplating how to best get him work next year, especially if he ends up in a set-up role for Chris Perez. ... The Phillies are "proactively" shutting Kyle Drabek down for the season; there's no injury. ... I'll have more on my adventures in radio later this week, but I can say with some confidence that I think we proved that it could be done. I learned a lot about what could work if broadcasters wanted to do a smarter broadcast, moving from subjective to objective while not causing numbers overload for their listeners.