Under the Knife: MLB Injury Analysis on Fernandez, Sabathia, Wieters and More

Will Carroll@injuryexpertSports Injuries Lead WriterMay 14, 2014

Miami Marlins starting pitcher Jose Fernandez works the first inning against the San Diego Padres during a baseball game on Friday, May 9, 2014, in San Diego.  (AP Photo/Lenny Ignelzi)
Lenny Ignelzi/Associated Press

Epidemic of injuries? I'm not sure. I'm here every week and have been for better than a decade, occasionally feeling like a prophet in the wilderness who is derided by the people and unsure of his own pronouncements. But I know that every week there are more injuries to star playerslike the ones this week to Jose Fernandez, Matt Wieters and Martin Pereztoo often to the elbow. 

What I know is that we don't have the answers and that what MLB is doing currently is not working. There's no one easy answer, or the problem wouldn't exist. While the keyboard commandos of Twitter want to engage in angels on the head of a pin discussions, if they had the answer, a team would come knocking. Sabermetricians have matriculated from Internet outposts to positions inside the walls for one reason: They were seen as valuable. 

MLB is hoping more than working. Owners are wringing their hands, wondering why things are happening, but they're reaping what they've sown with a lack of research and a glacial pace of change.

If we start now, if we fund studies, we can help the next generation. If we do nothing, we'll get the same results. My father used to tell me the story of the man that was hitting his head on a brick wall. When asked why, he replied "because it feels so good when I stop." 

It's time to stop, MLB. It's time.

Lenny Ignelzi/Associated Press


Jose Fernandez

The news hasn't gotten better for Fernandez since I wrote about him on Monday. Fernandez injured his arm in his last start, seeing his velocity drop from the mid-90s down to 88. That's a huge drop. Add in that Fernandez was ill before the game and potentially dehydrated, which can have a massive effect on the body, and no one comes off looking good. 

It's Fernandez who will pay the price. An MRI was done at Kerlan-Jobe in Los Angeles and was bad enough that he was immediately sent back to Miami, where he met with team doctors and other officials. Late on Tuesday, news came out that Fernandez's tear is significant and that he will need to have surgery, per Fox Sports.

As normal, when Fernandez does have Tommy John surgery, he'll be out for somewhere between 10 to 12 months while he rehabs. While he will be back, that year he lost won't be. Given how little he worked, it's clear that pitch counts and inning limits didn't help him. Was it the mechanics? Sadly, without an analysis, we can only guess, which makes his return another race against time and a risk of another injury. For more on Fernandez's elbow, click here.

BALTIMORE, MD - APRIL 11: Matt Wieters #32 of the Baltimore Orioles waits to bat against the Toronto Blue Jays in the third inning at Oriole Park at Camden Yards on April 11, 2014 in Baltimore, Maryland. (Photo by Patrick Smith/Getty Images)
Patrick Smith/Getty Images


Matt Wieters

Wieters hits the disabled list as the Orioles and their catcher try to find a way to keep him productive while balancing the downside of possible Tommy John surgery. While the team tried to let him DH through the process, there was some discomfort and the decision was made to go with a more conservative course. The expectation is that Wieters will rest and rehab for the 15 days and then come back to DH.

If the medical staff can keep the elbow healthy, he may yet be able to avoid surgery, but there's a balancing act. Surgery on a catcher would cost at least nine months, pushing the rehab into the 2015 season. Wieters is unlikely to catch for the rest of this season, but his value is in his bat anyway. For more info on Wieters' elbow, click here.

MILWAUKEE, WI - MAY 10: C.C. Sabathia of the New York Yankees pitches in the bottom of the first inning against the Milwaukee Brewers during the Interleague game at Miller Park on May 10, 2014 in Milwaukee, Wisconsin. (Photo by Mike McGinnis/Getty Images)
Mike McGinnis/Getty Images


CC Sabathia

The Yankees have already lost a couple of pitchers, so losing CC Sabathia for even the minimum really stretches the rotation thin and threatens the bullpen. The back end of the rotation is now held down by guys without much major league track record. A couple of short stints could overextend a pen that lacks depth as well. 

Luckily, Sabathia's injury appears minor. The question now is what the cause of the inflammation in his knee is and whether it can be maintained. Sabathia's loss of velocity may well come back to the knee, if this has been going on for a while. Watch to see how he comes back and if there's any uptick. For more info on Sabathia's knee, click here.

DENVER, CO - MAY 05:  Starting pitcher Martin Perez #33 of the Texas Rangers delivers against the Colorado Rockies during Interleague play at Coors Field on May 5, 2014 in Denver, Colorado. Perez collected the loss as the Rockies defeated the Rangers 8-2.
Doug Pensinger/Getty Images


Martin Perez

The Rangers are having a hard time keeping pitchers healthy. They're waiting to see how Martin Perez responds to treatment for his elbow inflammation before pushing him to the DL, holding off on a move to replace him, though it will likely be Nick Tepesch taking at least his next start.

An MRI showed that Perez's UCL is alright, but the inflammation is acute and there's some underlying cause. We'll have to wait and see how Perez responds to treatment before knowing how long he'll be out, but it will be at least one start. With Matt Harrison heading to see his back surgeon on Wednesday, the Rangers rotation is getting tested again. Jon Daniels is going to have to get creative. For more info on Perez's elbow, click here.

Andrew Nelles/Associated Press


Chris Sale

Sale is making good progress from his elbow issues. The skinny Sox ace has been throwing in the outfield and off a mound without issue, indicating that the White Sox medical staff has done well in getting the pain and inflammation cleared up. 

The next step will be a rehab start. Sale is expected to make two of these starts, though they'll be very controlled. There's no location set up for this, though the Sox have a cluster of minor league teams in the Carolinas, giving them some flexibility. 

Sale should be back before May is up. Last time Sale had shoulder problems, he didn't miss much time either and pitched well on his return. Sox fans and fantasy owners are hoping for that again this time, and thus far, there's no indication that it's not at least possible.

JEFFREY PHELPS/Associated Press


Aramis Ramirez/Ryan Braun/Carlos Gomez

The Brewers had really bad luck last year with hamstring injuries, so Ramirez's problem is doubly worrisome. The slugger has had leg issues previously, so they'll have to watch to make sure his movement patterns don't create a cascade.

Watch for this one to be a bit conservative on the timeline for a mild hamstring strain. The Brewers do get Ryan Braun back at the minimum, as expected, which will make up some for Ramirez's loss. That is unless Carlos Gomez's back injury is serious. He left Tuesday's game with "back soreness." Keep your eye on this. 


Mark Trumbo

Trumbo is headed for a CT scan on his foot, the latest to check the progress of the fracture that's keeping him off the field. This won't release him, but by monitoring the progress, the doctors can get a better idea of how he's healing and at what pace.

The current projections have him coming back in mid-June, but the location on the third metatarsal is a tough one. If it doesn't heal properly, he could have significant problems down the line. The D'backs need all the help they can get as they fight for Kirk Gibson's job.

Danny Moloshok/Associated Press


Brandon Belt

Belt went for pins in his fractured thumb. This is yet another case where something like a batting glove could have kept Belt from having as severe an injury, yet very few players wear this type of protection. The shinguard has become standard for players, so why not hand protection?

Belt will miss four to six weeks while the fracture heals and then will need to make sure his grip strength is normal once he returns. Bat control is usually the most affected, so watch to make sure he isn't swinging wildly and looking bad during his rehab stint.


Carlos Beltran

Beltran has a bone issue in his elbow. I say issue because reports conflict on whether it's a bone spur or bone chip. MLB.com says spur, so I'll go with that, but they're essentially the same thing; a chip is usually a spur that broke off. In either case, its only a problem when it irritates the internal structures.

The Yankees hope that Beltran can be managed, but in the worst case, he'll need surgery. It's exactly like the old game Operation, a simple open and remove. Rich Aurilia once returned from this kind of surgery in the minimum 15 days, but the standard timeline is three to four weeks. 


Carlos Quentin

When Carlos Quentin looks back on his career, I hope he realizes that the White Sox made most of his career possible. He's always been talented, but it was really only his period in Chicago when he was healthy enough to make the most of it.

He was only 3-for-18 on his rehab assignment at Lake Elsinore, but he is adjusting to a new stance as well as rehabbing his injured knee. We'll have to see how it works out, but a scout that saw him play told me that his power is going to suffer from his standing-straight stance.

Paul Sancya/Associated Press


Rick Porcello

The minor oblique strain to Rick Porcello isn't that serious. It's not clear he'll miss any time, but I want to point to what Brad Ausmus did when Porcello argued to stay in the game: He listened to his athletic trainer, not the pitcher. He took the advice of the guy who is paid to keep the team healthy.

"How do you feel?" is a question that pitching coaches and managers should never ask. No pitcher has ever answered that question honestly. Ausmus wasn't swayed by emotion, and that bodes well for his success and the Tigers.


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