Under the Knife: Derek Jeter, Ryan Braun, Matt Kemp and More MLB Injury Notes

Will Carroll@injuryexpertSports Injuries Lead WriterJune 11, 2013

Under the Knife: Derek Jeter, Ryan Braun, Matt Kemp and More MLB Injury Notes

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    There's not a fan out there that hasn't raged against injuries to his team. Fantasy players are worse, to the point of narcissism. When Felix Hernandez or Derek Jeter or half the Dodgers team goes down, they take it as a personal affront and wonder where their engraved invitation went that informed them. By definition, injuries are in large part random. 

    The Holy Grail of injury analysis is predicting injuries. I dabble in the dark art with the Team Health Reports. It's admittedly a blunt instrument. It is very good at predicting risk in a broad population and not so good at predicting any specificity. 

    Jeff Zimmerman, one of the data wizards over at Fangraphs, has put together a new system that he says can predicting pitching injuries. Maybe it works, maybe it doesn't, but the idea of it is very intriguing and if it does work, it's going to be exceptionally valued (so much so that I'll bet a team grabs him, much as they did with Sig Mejdal, now with the Houston Astros). 

    If nothing else, it's an interesting exercise to look at players like Jonathan Broxton and Lucas Harrell and wonder what the system is seeing, watching them a bit closer the next time they pitch. We know that we can't eyeball this, so any new tool that helps our lying eyes is worth the effort. 

    For now, let's look at the injuries that did happen around the league:

Felix Hernandez (Back)

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    Predicting injuries is a tough gig. We've learned that we can't do this with our eyes—no one can look at a player and predict injuries, much in the same way that no one does urinalysis with their eyes—and Felix Hernandez is object lesson one.

    Hernandez came up a phenom, but his crazy delivery, all tilt and angles and hair just looked so wrong that everyone expected his arm to explode, especially given the track record of other young starters in Seattle. Hernandez's delivery is still the same and so are the results. What we think we see must not match up with the forces going on, but we don't know

    Hernandez isn't without issues. While he's lost weight or at least matured out of the soft young body that made him look even more injury prone, he has also found the curse of a sore back. His delivery can't help that, though again, we don't know. His back tightens up occasionally and at times, as it did this weekend, it's very visible.

    The lower back seizes up, nothing more than a muscular issue, a spasm that seems to guide the ball up as his back refuses to bend without taking his breath. The medical staff will do what they can to manage this, but it's really no better or worse than that. It's unlikely to go away, leaving the Mariners hoping that the treatment between starts works. 

    Somewhere down the line, the issue might get worse, but for the time being, it won't cost Hernandez or the Mariners too much. The problem is that the "somewhere" might be next year or next week. Hernandez has always been risky; he's just a bit more so now. 

Ryan Braun (Thumb)

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    It would seem that Ryan Braun has bigger issues than a sore thumb these days, but the injury is the thing keeping him off the field. Braun says it's actually more the hand than the thumb, per MLB.com, but what he describes sounds like a more complex injury. 

    From Braun's description, it sounds like a UCL injury, similar to what Dustin Pedroia is playing with currently and similar to what cost Hanley Ramirez a month earlier this season. Pedroia's situation seems more germane to the situation as Braun has shown that he can play; he just can't play up to his lofty expectations.

    Braun has been playing with this for a while, so there's a chance that he and the medical staff will find a way to make his swing more comfortable and more functional. There's also the chance that he won't, leaving him here or maybe worse off. The team, knowing the spectre of suspension is there, is going to do everything they can to keep him on the field while they can, though their record gives them enough room to put him on the DL if needed.

    Braun is out for at least the rest of this week as they work on the thumb and keep a retro DL move a possibility. At this stage and given all the complexities, it seems as if Braun will be back this weekend. What to expect from him is tougher, but the Brewers and his fantasy owners are hoping that a few days makes a big difference. 

Derek Jeter (Ankle)

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    Derek Jeter went from nothing happening to quite a bit over the weekend. Andrew Marchand of ESPN New York details the new activities, including taking grounders and swinging a bat for the first time in this stage of the rehab. 

    Jeter progressed after visiting with his surgeon, Dr. Robert Anderson, who seems to have become more active in this process. Anderson will give the clearances going forward rather than the Yankees own medical staff, a change that could indicate Jeter's comfort level. 

    Of course, Jeter did all this before back in February and didn't have problems until late March. Given the extra healing, the further setbacks, and the timeline, it's nearly impossible to predict how this will go. The clearest milestone will be when Jeter is back running the bases, which is where he ran into issues last time. 

    The Yankees are sticking with the "after the All-Star break" timeline, but that's very open ended. To make that in the strictest sense would be less than a month, meaning Jeter would have to accelerate the rehab speed greatly. Watch to see how the pace moves over the next two weeks. Any progress now will give us more clues about when he'll shift to those key stages. 

    One other note on this comes from the picture on this page. Taken on May 30, Jeter is playing catch prior to the Yankees game. That's not unusual, but it's not clear that Jeter is wearing any sort of bracing.

    Tape wouldn't show, but it would surprise me that the Yanks would be comfortable enough going from walking boot to a standard tape job given Jeter's history and value. We'll have to see what he wears (or doesn't) as he continues forward. 

Dodgers (Hamstrings)

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    I talked last week about how Sue Falsone, the Dodgers Head Athletic Trainer, was one of the top experts on functional human movement. Twice since then on radio interviews, this topic has come up in relation to the run of hamstring injuries that the team has had.

    The question is valid—why are the Dodgers having so many of the same injuries—but there's no good answer. I think part of the issue is the assumption that these injuries are "the same." While all of the injuries are clearly hamstring strains, the degree, the location and the rest of the attached players are not the same. Context is everything.

    The more worrisome issue is that these players are having setbacks in rehab, as pointed out here by ESPN LA. Both Matt Kemp and Hanley Ramirez have had significant setbacks and will be out for more time, a loss the team can't afford no matter what Yasiel Puig is doing to make everyone lose their head in LA. 

    The Dodgers' medical staff is well equipped to deal with all this. They ask the right questions as well, which means that this issue isn't being chalked up to bad luck or even the random fluctuations of injuries. I'll be very curious to revisit this a few months down the line to try to figure out what changes happened. 

    In the meantime, the Dodgers will make do with a patchwork outfield for a few more weeks while they try to get their expected team on the field, plus an exciting new addition, around the All-Star break. 

Matt Harvey (Back)

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    I love Mets fans. They might be the most reactionary and pessimistic of any fan base, but my god, are they passionate about their team. The last few years haven't been kind, so any injury to their bright ray of sunshine has to feel like yet another kick in the nether regions.

    Thing is, Matt Harvey's back isn't a big problem. It tightened up and as detailed here by the New York Daily News, it was quickly corrected. Harvey explained it was an issue with his hip, but the "adjustment" is a brilliant detail.

    It sounds as if we're dealing with a chiropractic style adjustment, but that's unlikely with the Mets trainers. Teams do have chiropractors at the ready, but the description of this sounds more like something that Harvey and the trainers have done before. 

    If this is indeed a chronic problem that is being managed, Harvey's pronouncement that he'll make his next start makes sense. The Mets medical staff is still distancing itself from an undeserved poor reputation, the result of one ridiculously bad year.

    The Mets are watching Harvey close and this episode wil make things even tighter. He will need to be managed as his fatigue level goes up, but even the most pessimistic Mets fan understands that.

Jake Peavy (Rib)

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    Jake Peavy has some weird injuries. Even with Herm Schneider and Don Cooper watching, Peavy has managed to do two things that suggest he's putting some unusual forces on his body somehow. Peavy once tore the lat muscle off the bone, though he's come back from that surgery well. Now, he managed to break a rib doing nothing more than pitching.

    There's not much that can be done here. Ribs, like any bone, heal with time and rest. At that stage, Peavy will have to build back some stamina, which could make his absence go up to eight weeks.

    The bigger question is how this happened. We simply don't know what forces come with each pitch and in Peavy's case, it's very unclear if this was one unusual pitch or if it's his normal forces.

    A biomechanical analysis would give more insight, but the White Sox are not one of the teams that regularly do this, nor were the Padres when Peavy was there. That leaves Peavy at risk of the next thing happening, somewhere down the kinetic chain. My worry right now would be the lower back, given the pattern. 

David Price (Triceps)

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    David Price is making progress. Fox Sports Florida details the plan for Price's rehab over the next week. It will start with a second bullpen session on Wednesday, increasing the pitches from his Monday session that was supposed to go 35 pitches and ended up going 38. Expect Price to be up at or near 50 on Wednesday.

    After that, Price will work a sim game on Saturday, again with a slight increase in pitches. After that, he'll head out on what Joe Maddon said would be a minimum of three rehab starts in the minors. Given Price's comfort and relative ease at getting over 50 pitches, it's just the Rays inherent conservatism that's pushing Price to three starts.

    Price says he's comfortable that the triceps/shoulder injury is completely gone and that the strains have healed fully. The only worry left is what the cause was. Some injuries like this are simple traumas, a one time occurrence that just needs to be treated to get back to the previous point.

    Others can be the result of increased forces or decreased muscular strength. This one seems much more like the former. That makes Price the same valuable resource he was prior to the injury.

    The three rehab starts mean that Price won't be back in the Rays rotation before the end of the month, but with Chris Archer living up to his expectations, the Rays have no need to rush their ace back. They need him healthy the rest of the way, especially if some of the Rays' young pitchers are used at the deadline to augment the offense.  

Clay Buchholz (Neck)

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    Clay Buchholz nearly had his head knocked off on an awkward play covering first. He nearly had his hand knocked off by a comebacker that hit him. It was neither of those things that knocked him out of the game.

    Instead, it was a sore neck that forced him from his last start. The Boston Herald details that it was actually the trapezius muscle that is sore, enough that the Sox have delayed Buchholz's between-starts work. With the recent AC joint issue, this is starting to look like an interconnected issue, perhaps one that indicates a nerve issue.

    While it's a bit of a leap here, this is similar to the symptomology seen in many NFL quarterbacks. The nerve coming out of the neck and down the shoulder into the arm can get extended. In some cases, it presents as a "stinger" and in others, simple pain and weakness.

    There are no details on exactly how Buchholz's situation is presenting, but it's definitely something to monitor. 

    Buchholz's throw day delay, along with the rest of Boston's pitching issues, could force a DL move or at least another pushed start. As good as Buchholz has been, the Sox are going to have to figure out if a short break might help him stay on this path. 

Alexi Ogando (Biceps)

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    There is nothing a medical staff hates doing like putting a player right back on the DL after they've spent weeks getting him off it. Jamie Reed and his excellent Rangers staff are tasting that bitter fruit after Alexi Ogando hit the DL after just one start coming off it.

    Ogando's injury isn't a recurrence, though the location is similar. This issue is more in the inner part of the shoulder, rather than in the biceps. Of course, the "biceps labrum complex" theory comes into play here, making this a potentially worrisome problem, one that could be long term or at the very least require extensive management. 

    MLB.com details that Josh Lindblom was brought up to get Monday's start and likely at least one more with Ogando on the shelf. The Rangers are seeing progress from Colby Lewis, who could restart his rehab. Given the makeup of the pen and how taxed it's been with a patchwork rotation, Ogando could once again be shifted back to the pen if there were enough solid starters in front of him.

    Expect the "#pricecheck" to continue, while Jon Daniels and his staff try to turn up some pitching help on the trade market. 

Michael Kirkman (Cancer)

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    Baseball has its bad injuries, but it's worse when life intrudes. Michael Kirkman has had a rough season in the long role for the Rangers, but a recurrence of cancer pushes all that aside.

    Kirkman has a recurrence of the cutaneous lymphoma that was first discovered in 2012, as detailed here by MLB.com. He'll have radiation treatments and the hope is that this was caught early. Any cancer diagnosis is bad and recurrences can be worse, but there is a positive prognosis for Kirkman.

    Kirkman is hoping to pitch through the treatment, but seeing his family in that video reminds me that baseball is secondary here. I know that through my own battle with cancer almost two decades ago that baseball can be a great release, but pitching in games and watching them are two entirely different things. We wish the best of luck to Kirkman as he faces this challenge.