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Under the Knife: MLB Injury Analysis on Harvey, Fielder, Lee and More

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Under the Knife: MLB Injury Analysis on Harvey, Fielder, Lee and More
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Baseball tends to move at a glacial pace, and even when they do make changes, as with the new replay rules, they tend to do even that at a measured pace. Baseball has had no real public response to the cluster of elbow injuries, but behind the scenes, there's more going on as they try to protect guys like Matt Harvey, Jose Fernandez and other talented pitchers.

Baseball's medical committee is not often seen or heard from, but there are reports, including this one from the AP's Ron Blum, that they were in New York at the commissioner's office, summoned by Bud Selig to see what could be done in the short term. Dr. James Andrews was said to be in attendance as well. Don't expect any quick decisions or rash action, but this kind of step is a positive.

Baseball needs to respond, but they need to have the right response, guided not only by the best experts but by the best information. Losing players like the stars that fill Andrews' waiting room each week isn't good for anyone. "Next man up" is a nice slogan, but that next man is never as good as the "last man down." There's a reason why someone is the starter or made the rotation instead of another.

Perhaps we'll see more pitchers pushed forward, the way that Bill Barnwell suggested so articulately. Honestly, I've been working on an article on a similar topic since spring training and could never put it together. My former colleague at Football Outsiders saved me the trouble. 

For now, we have another full column of UTK and too many injured players to talk about, so let's get to it:

 

Paul Bereswill/Associated Press

Matt Harvey

Matt Harvey is making progress in his return from Tommy John surgery. He's hoping to make "six [or] seven starts," as he told Tom Verducci of SI.com in an interview, but the Mets are put in the difficult position of telling both Harvey and their fans that they don't really want that to happen.

Harvey is pushing for a return at the low end of the 10 to 12 month recovery period from Tommy John. The Mets have long said that they're hoping for Harvey to get through the rehab, then have a full offseason and spring training in order to make a big push in 2015. That's reasonable, but so is Harvey's timeline given how he's currently progressing.

Harvey could start a rehab assignment as soon as July given his progress, but the Mets are likely to pull back on the reins a bit. With Harvey already a Boras client, any tension between the team and the ace pitcher heading into his prime is going to end up a major tabloid narrative. For more information on Harvey's rehab, click here.

 

Mike McGinnis/Getty Images

CC Sabathia

CC Sabathia is kind of The Mountain of MLB. He's a gentle giant, however, but I always wonder with people of that size, where do they get crutches? That question was answered by someone, as Sabathia was on crutches after having stem cells taken from his hip injected into his injured knee. The hope is that the injection will help heal up any damage inside the knee and get Sabathia back on a mound. It will take some time to see whether there's a positive result and longer still to get him back into the rotation. The Yankees will be without Sabathia until around the All-Star break. This puts more pressure on Masahiro Tanaka, though he's clearly become the ace of the staff right out of the gate. For more on Sabathia's knee, click here.

 

Mitchell Leff/Getty Images

Gio Gonzalez

The Nationals have trouble keeping their players healthy. Things were looking up last year, when they were sixth among teams in terms of days lost to the DL. Losing Gio Gonzalez won't be devastating for the Nats, but it won't help either. Gonzalez's sore shoulder should be something that is short term, but in the long term, it adds to what the Nats' medical staff will have to maintain day after day, start after start. Watch to see when Gonzalez gets back on the mound. Right now the team is hoping it will be a near minimum stay and that he won't need a rehab assignment, but we'll have to see when Gonzalez can start throwing again. For more info on Gonzalez's shoulder, click here.

 

David Banks/Getty Images

Jose Abreu

Jose Abreu has made the major leagues look easy. If there was any adjustment period, we haven't seen it, and it's hard to imagine he can do much better than he's done in his first couple months in the majors. The only downside is health. Abreu has been dealing with a sore ankle since spring training and had to go to the DL to let the Sox medical staff work on it. The hope is that he'll be back near the minimum and be able to keep hitting bombs. Watch to see when he's back in the cage. If they can get him back there within the next week, he could avoid a rehab stint. For more on Abreu's ankle, click here.

 

Joe Robbins/Getty Images

Joey Votto

The Reds got "good" news with an MRI on Joey Votto that showed a problem in his quad rather than his twice-repaired knee. What they haven't gotten is Votto back in the lineup. Bryan Price thinks he'll have his all-star back this weekend, but the team can always push Votto to the DL with a retro move if needed. Votto is continuing with rest and treatment, but there's not much in the way of information since the initial diagnosis. Votto remains in Cincinnati, where the Reds and Dr. Tim Kremchek have amazing facilities for treatment. For more info on Votto's knee, click here.

 

QUICK CUTS

Cliff Lee

Late news from Philadelphia on Cliff Lee's elbow. Lee has been pitching with soreness, but the team did an MRI after Lee told them about it. The findings were somewhat positive, with a low-grade strain of his flexor muscle. It's got no involvement with his UCL, which is what had many Phillies fans heading for the ledge. The team placed Lee on the DL, saying they would rest him for a week and re-evaluate at that point. We'll have to wait and see on this one, but Lee has been durable.

 

Jim Cowsert/Associated Press

Prince Fielder

Prince Fielder was out for the weekend and expected back on Tuesday after receiving an epidural injection in his neck. Fielder has a bulging disk in his neck, an unusual injury for a hitter. We've seen this in pitchers like Chris Carpenter and Hiroki Kuroda, but neither is a good comp for the slugger. Fielder was scratched early on Tuesday after reporting weakness in his arm during batting practice. This is the first indication that there's nerve impingement, but this may not be new. The team will try to manage the symptoms, but the DL is a possibility for the very durable Fielder. 

 

Josh Hamilton

Josh Hamilton is expected to start a rehab assignment this weekend. He's at the low end of the timeline after thumb surgery, which is good news for the Angels and for the Nationals. Remember, Bryce Harper's injury is very similar to Hamilton's. Hamilton will be working on his swing, likely at Inland Empire. Watch his strikeout numbers and whether he's hitting breaking balls. The rehab assignment could be pretty short, meaning Hamilton could be back in Anaheim by next week. Kole Calhoun should be back this week after tearing up Salt Lake on rehab, so the Angels should get their expected outfield of Mike Trout, Calhoun and Hamilton back quickly.

 

Andrew Nelles/Associated Press

Chris Sale

It's one thing to keep your players healthy. Prevention is always better. The White Sox are also pretty good at getting guys back quickly and keeping them productive once back. All three phases are key, as they're showing with Chris Sale. His elbow strain—strain, not sprain—necessitated rest and treatment, but they've almost got him back. His first rehab start in Charlotte went well over the weekend and he made his bullpen session. The plan was to have one more rehab outing, but the Sox could elect to just activate him for Sunday, according to Dan Hayes. 

 

Jason Motte

Jason Motte is finishing up his rehab assignment in Memphis, but what the next step is remains unclear. Some relievers have had a hard time coming back from Tommy John surgery, though they usually do make that next step. Motte is a pure velocity guy and those numbers have been fine, but even if all goes well, he won't be right back in the closer role for the Cardinals. Activate him for your fantasy team if you're looking for strikeouts, not saves right away.

 

Mat Latos

Mat Latos is coming back from three different issues. The elbow and knee problems should be fine after the extra rest, but the elbow is worrisome. Bone spurs happen for a reason, and some, including Astros team physician Dr. David Lintner, believe they are a response to UCL laxity. Latos is back on a mound and will throw live batting practice this week. A rehab assignment isn't far off, likely at Dayton or Louisville depending on schedule, with a return to the Reds expected by early June. With the way Johnny Cueto is pitching right now, a healthy Latos would be a big boost to the Reds. 

 

Uncredited/Associated Press

Andrew Cashner

Not all elbow pain is leading to Tommy John, but in the case of any pitcher with elbow pain, it's easy to see why that's where most people immediately go. For Andrew Cashner, he's always been very good when healthy, but all too infrequently healthy. He throws with a violent motion and very hard, which is why he was a closer in college. The Cubs and Padres both have shown that he can't stay healthy in either role, so at least with starting, they can maximize his value. Cashner's elbow showed no structural damage, but there's no clear cause and no clear timeline for his return.

 

Jason Kipnis

The Indians have one of the top medical staffs around, but early this season, they've faced some challenges. Getting Jason Kipnis back on the field has to be a top priority for this team and he's close. His oblique is healing well, enough that the team is expecting to send him out to one of the nearby minor league affiliates this weekend. He'll need a couple games of at-bats before they bring him off the DL, but it shouldn't be long if he shows that he has his timing.

 

Marcio Jose Sanchez/Associated Press

Corey Hart

The Mariners took a risk bringing in Corey Hart but knew the upside if they could keep his legs healthy. His damaged knees likely led to movement pattern issues and his recent hamstring strain. The strain isn't significant, but the Mariners' medical staff will take some time to make sure Hart not only gets back, but stays back. It's a big test for them in keeping both Hart and Logan Morrison healthy, which goes on top of the need for rehabbing their young pitching staff. Even as one of few medical staffs with three full-timers, that's a tall order. 

Have more injuries you have questions about? I can't fit all of them into UTK, but I'll try to check in on the comments and do my best to answer questions there.

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