Under the Knife: Latest MLB Injury Updates

Will Carroll@injuryexpertSports Injuries Lead WriterSeptember 25, 2013

Under the Knife: Latest MLB Injury Updates

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    Travis Hafner. Erik Bedard. Brad Lidge. Colby Lewis. Jake Peavy. Marco Scutaro. Chris Snelling. Jayson Werth. 

    Those guys all debuted in 2002. Some are still going strong, and some aren't. They've all spent some time in my column, Under The Knife, in its various incarnations and locations. I share something in common with them. We all debuted in 2002.

    I sent an email out to three friends—Jim Callis, Rob Miller and Lee Sinins—and asked if people would be interested in reading about injuries. All of them encouraged me, and in the weeks to come, it went from three to 10, from 10 to 300, from 300 to 3,000. Peter Gammons talked about my column on Tony Kornheiser and I nearly drove into a telephone pole. Rob Neyer made me his "Link of the Week" and I was astounded.

    I still am, every time someone reads this column.

    I spend most of Monday sitting and waiting to talk about the Manny Machado injury on MLB Network. I spent time on my phone, watching MLB.tv.

    Think about this for a minute. None of this existed in 2002. A cable network that's nothing but baseball? A phone where you could watch games? Jet packs!

    And all because of you. You read this column. You love it and sometimes hate it. You call me on every slight mistake and make me work to be better. You learn something, I hope, along with me. In 12 years, I've never stopped enjoying the game or writing this column. It's not easy, but the idea remains the same. Telling stories through the lens of sports medicine is something I hope I can do 12 more years.

    There's more people than I could list here to thank and many of them are sources, so I couldn't name them. So to avoid skipping any of them, I'll just tip my cap. I hope they all know who they are and how much I appreciate them.

    I started this season just a few weeks after a heart attack nearly ended me. Standing on the field at Miller Park on Opening Day, chatting with Gord Ash, Doug Melvin and Dan Wright, lifted my spirits more than I can ever tell you, and with each game, I remember why I love baseball. My boyhood hero, Ryne Sandberg, is now a manager, but as life goes on, like Terrence Mann said, the one constant is baseball.

    Thank you. See you in the playoffs and I hope I will see you all next season.

Manny Machado

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    I don't want to sound like this is a copout, but I don't have much to add to what I wrote about Manny Machado on Tuesday. One of the great things about writing here at Bleacher Report is the freedom they've given me. Instead of waiting for the next Under The Knife, I wrote about Machado just hours after the injury. That's progress.

    Machado's injury, a sprained medial patellofemoral ligament, is rare. Not unheard of, but especially in baseball, it's unique from what I can find. 

    Rare enough that when a source told me the problem was medial, I just assumed he was talking about the MCL and considered that a very good thing for Machado. We don't have a Baseball-Reference page of injuries. Even the best database barely goes back a decade in anything resembling usable accuracy despite hard work from several people. 

    What's great is that Machado has a chance to return and continue his young career. More than a chance really, but a likelihood. This kind of injury may recur, but it's now a known. Machado will rehab the injury and should be ready for spring training and, even on the downside, he should be set for Opening Day. 

    It's not the way Machado or the Orioles wanted to end this season, as they fell just shy of their goals, but it's just the final chapter of this season. He'll be back and so will they.

Jacoby Ellsbury

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    The Red Sox are heading to the playoffs in an epic turnaround from the disaster of 2012. John Farrell was exactly who the team thought he'd be. There was a mesh with the pitching staff, both with the expected starters like Jon Lester and Clay Buchholz, but also with the bullpen, which he patched together to great effect.

    The team found an identity like it once had with Terry Francona. More Amish than idiots this time, it's working.

    All that storyline might come down to is one injury and how the medical staff handles it. The Red Sox are a good team without Jacoby Ellsbury, but they're much better with him.

    Ellsbury is going to try to come back on Wednesday, according to The Boston Globe's Peter Abraham. While the Sox can be very cautious with him, they don't have much time to figure out what he can and can't do before the playoffs start.

    Ellsbury's foot injury is not fully healed, but the team needs to get some certainty. By playing him on Wednesday with the day off on Thursday, rest is built in for the medical staff to monitor how his foot reacts and to try to formulate a plan. Then they get a couple days to execute it and more rest. It's the best-case scenario for a tough and pivotal situation. 

Roy Halladay

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    Roy Halladay doesn't want to go out like this. He knew he had nothing left last time out, and despite the idea that he could be showcasing himself for 2014, either for the Phillies or another team, he's shutting things down. His shoulder is tired and getting a bit weaker each start. The toughest part of this comeback was always going to be stamina.

    A conversation with his surgeon, Dr. Neal ElAttrache, reminded Halladay that he was just weeks post-surgery on something that very few pitchers come back from at all. He was never at full strength, but he has a better idea now whether or not he can return.

    Don't discount the idea that Halladay remains close with Chris Carpenter, who struggled the past two seasons to come back and might end up walking away from the game.

    Halladay has always played baseball on his own terms. His shoulder looks like it could give him a shot to come back and pitch, if he wants to work hard to be a back-of-the-rotation guy. I'm not sure that's what he wants, even for a couple million bucks. 

Mat Latos

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    I do my best to work the phones in order to find out information on injuries, but I know there's always going to be some I miss.

    There's been no indication that Mat Latos has been fighting an injury. It turns out he has been pitching with an abdominal strain since midseason, according to MLB.com.

    He's done a good job fighting through it, though there's been some dropoff in his numbers. As far as I can tell, no one in the media suggested Latos was anything other than dropping off a bit from a solid first half. That should be a feather in the cap of last year's award-winning medical staff.

    Eno Sarris of Fangraphs has a very interesting idea that could help with a situation like this, but it amounts to a Band-Aid rather than a real solution. It's essentially a seven-man rotation with a long skip, if I'm reading Sarris correctly. Predicting or even sussing out these kinds of injuries remains something beyond all of us, for now. Maybe Sarris is right and it's certainly a workable solution in the short term, though I believe that fatigue management is going to have to be done in a very direct fashion.

    Latos doesn't have the chance for rest now. The Reds are in a tight race for the NL Central or home field in the coin-flip game at the least. With Johnny Cueto's status unclear, Latos hurting and Tony Cingrani uncertain for the postseason, Dusty Baker is going to have to manage with limited options, and that's before we even get to the bullpen. 

Justin Masterson

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    The Indians rotation, even with Justin Masterson back, doesn't look like one that is heading for the playoffs. Ubaldo Jimenez has had a nice comeback, but can any of you not alongside the Cuyahoga name the other four starters that have carried the Indians this far?

    Masterson is the clear ace of the group despite not having the ace-level stuff that Jimenez and Scott Kazmir had not that long ago. His hard sinker is a pitch that's taken a lot out of other pitchers, but Masterson has been pretty healthy. This oblique strain is just one of those things that seems to happen. The problem is less the injury than the timing.

    While Masterson is available, he's not ready to start. This is a lack of creativity. With an expanded bullpen, not using him in whatever role, whether that's a three-inning starter or a long man paired with Jimenez in order to have the latter ready to come back on short rest for the coin-flip game, shouldn't dictate how he's used.

    If the Indians come up short, it's little things like this that can make a difference in this parity-compressed playoff race. The only saving grace here is that it's not just the Indians, despite their forward-thinking front office. It's everyone at the same disadvantage.

Matt Holliday/Allen Craig

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    The Cardinals have the inside track on the NL Central title, letting the Pirates and Reds fight it out in the coin-flip game if things stay how they are right now. That's another astounding job by the Cardinals.

    Every year it seems we write them off and they outplay their true talent level yet again. It's more than Tony La Russa or any of the people who have left the team in one way or another. To me, it's proof that John Mozeliak might just be the most underrated general manager in the game. 

    To get another World Series ring, they're going to have to be healthy, and right now, they're not. Matt Holliday's absence at just the wrong time last season cost the Cards severely. His back is acting up once again, according to Jennifer Langosch of MLB.com. The team is working hard to get it under control, but Holliday is a physical player who is having a hard time as his talents slowly fade away. 

    Perhaps just as important, Allen Craig's physical status is a major question.

    Craig is still in the walking boot that is protecting his sprained foot. Mozeliak told MLB.com that Craig is likely out through the end of the regular season, which is going to make it tough to evaluate him. The playoff roster rules are tight. Don't be surprised if you see Craig off the NLDS roster and down in Florida rehabbing to see if they can get him back for the NLCS and World Series, if necessary.

Matt Harvey

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    The Mets front office is not scared of being second-guessed. You don't have to be around Sandy Alderson, Paul DePodesta or JP Ricciardi very much to know that confidence is not in short supply in Flushing. Their latest plan for Matt Harvey is bold and opens them up to a lot of second-guessing if it doesn't work out, but it's also very smart.

    The Mets are sending Matt Harvey to the Arizona Fall League, normally a prospect showcase league that can be short of pitching.

    Harvey's not likely to work much, but putting him into the most realistic game situation they can is inspiring. (Craig Calcaterra of NBC does raise an interesting question about Harvey's eligibility, but something tells me MLB might make an exception for the publicity.) 

    One of the hardest things to do in rehabbing a player and judging his readiness is simulation. A sim game or side session just doesn't have the intensity or adrenaline of a game situation. There are a lot of injuries that seem to be better, but when a pitcher gets into a game, it suddenly shows up again. This should avoid that.

    The "can't lose" part of this is that if Harvey's elbow is overstressed by pitching and isn't going to heal with just rehab, this is going to show that very quickly. It could mean that Harvey heads to surgery a bit quicker or it could be that the Mets front office gets a good indication that they'll have their ace on Opening Day, just like he said.

The Shutdowns

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    This time of year, I could do 20 more slides, probably more, of all the players being shut down. Sometimes, it's simply the easy and smart thing to do. A player has a minor injury and there's less than a week to go, so why push it and put more strain on the player and the medical staff? At other times, the team is looking at a young pitcher (or an older one!) and decides it's not worth another start. 

    As you hear about more and more players being shut down over this week and a few that have "season-ending injuries" that would normally be nothing more than a couple weeks on the DL, you have to be careful to put the injuries into context. Something simple can linger. An extra couple innings now might push a pitcher into a major problem or it could help him push further next year, when he can go deeper into the season without overextending himself.

    Teams sometimes do what I call the pocket shutdown. Like the political pocket veto we all learned about from "I'm Just a  Bill," some teams just leave a player on the bench and never let anyone know of a minor sprain or strain that led to it. The deep benches at this time of year paper over a lot of things.

    (Which reminds me. I'm finally fully on board with Doug Melvin's suggestion that we limit rosters in September. Call up as many as 40, but have only 30 active on any night, and there's less of a loss of integrity to the game. It also keeps giving young players like Billy Hamilton a chance to excite us.) 

    The season is 162 games, but there are very few players who make it into the lineup in all of them. Woody Allen said 80 percent of success is just showing up. If more ballplayers could do that in more games, the game would be better.