Under the Knife: MLB Injury Analysis on Trout, Myers, Teixeira and More

Will Carroll@injuryexpertSports Injuries Lead WriterJune 4, 2014

Los Angeles Angels’ Mike Trout watches his solo home run against the Kansas City Royals in the fifth inning of a baseball game on Saturday, May 24, 2014, in Anaheim, Calif. (AP Photo/Alex Gallardo)
Alex Gallardo/Associated Press

This Thursday's draft is huge for a lot of teams. Mike Rosenbaum does an amazing job covering it, so I'm not going to give you any news about specific players, but I do want you to watch for a couple of trends, not just in the televised rounds, but through the long MLB draft process.

Some teams buy injuries. Actually, all teams do, but some do it on purpose. At least one, probably two pitchers will go in the first round despite recently having Tommy John surgery. There are several more that have already undergone the procedure and have returned to the game. 

While Tommy John costs a year of development, there's some indication that it's not a lost year. Eddie Bane first realized that the predictability of the process might give him an advantage, which he used to get Nick Adenhart. It was a brilliant move.

Teams are willing to take on risk in the draft for the perceived rewards, but few do a very good job of measuring those risks. Scouts aren't doctors, and even the doctors don't get their hands on very many players. Scouts collect informationand some of this is needed, like film, medical records and injury historybut their job is not to assess medicals. Worse, there's no MLB combine. Teams can't do physicals until after the draft and biomechanics? Forget it.

There are plenty of teams that will listen to the advice of their medical staff, but some don't care. They'll take the talent and take whatever comes behind it. The Nats didn't care that Lucas Giolito came in with arm problems, and he blew out his elbow in his first pro start. He had the surgery and came back. While he's pitching well now, he didn't change his mechanics at all, so we'll see how his arm holds together in the long run. The talent is clearly there.

Once the names are read and the players start to sign, we'll be able to see more about the trends. Some teams will succeed, and some teams will just draft the guy who'll be known as the guy they drafted instead of the new star. Maybe we'll talk about that and some of the players I've watched leading up to the draft next week in UTK, but for now, let's get to the injuries:


Mike Trout

He may not have the trophy for most valuable, but few will argue that Mike Trout isn't the best all-around player in the game right now. About all that can sideline him is an injuryand that's exactly what happened this weekend. Trout has been relatively healthy throughout his career, showing that durability is just another tool he possesses.

The minor back spasms he had are only a worry if the Los Angeles Angels medical staff can't get in front of them. The worst-case scenario here is Matt Holliday, a similarly built athlete who didn't have serious back problems until he was 30. 

Worse, Trout did come back Tuesday night as expected, but he only lasted an inning and a half before being forced from the game with more problems. I asked Dr. Neel Anand, a top spinal surgeon, if the pattern Trout showed, going from "upper back stiffness" to "mid back soreness" was common.

He said "It is usually the other way round. Mid back pain causes muscle spasms and stiffness and the spasm in turn can cause further pain. Stiffness does not generally occur in isolation. Another factor or factors sets up the muscle spasm and stiffness."

This really bears watching now. For more info on Trout's back, click here.


ST. PETERSBURG, FL - MAY 7:  Wil Myers #9 of the Tampa Bay Rays doubles during the ninth inning of a game against the Baltimore Orioles on May 7, 2014 at Tropicana Field in St. Petersburg, Florida.  (Photo by Brian Blanco/Getty Images)
Brian Blanco/Getty Images

Wil Myers

The Tampa Bay Rays have been among the league's best at keeping their players healthy for over a decade. Even before they won, they were often healthy. Now as the team is struggling to win, injuries are an even crueler cut. Losing Wil Myers for six to eight weeks and losing his power for longer could be the straw that broke Joe Maddon's back.

Myers has a stress fracture in his wrist and will be in a case for at least a month, but we've seen over and over that power often doesn't come back right after a return. For more info on Myers' wrist, click here.


DENVER, CO - MAY 22:  Catcher Buster Posey #28 of the San Francisco Giants collides with first baseman Michael Morse #38 of the San Francisco Giants as Posey catches a pop foul by Justin Morneau #33 of the Colorado Rockies to end the fourth inning at Coor
Doug Pensinger/Getty Images

Buster Posey

Lower-back concerns and catchers are definitely a bad combination. When Buster Posey came up with lower-back pain and some involvement with his legs, the immediate comparison for many was Joe Mauer. Mauer's longstanding issues with his SI joint have reduced some of his effectiveness and finally moved him out from behind the plate. 

The Giants have been smarter with Posey, giving him ample rest, shifting him to first as much as possible and being very proactive with him on maintenance. That history has helped here. We could call it prehab, preventing the back injury from progressing further. Just a couple of days of treatment and rest and Posey was back on the field.

The Giants will watch him closely, and we could see a few fewer days behind the plate, especially in the short term. When Posey is healthy, the Giants are a significantly better team. Actually, when the team in general is healthy, they've won the World Series. Health is a leading indicator, so Dave Groeschner's work should be noted a lot more than it is. 


NEW YORK, NY - JUNE 03:  Mark Teixeira #25 of the New York Yankees hits an RBI single in the first inning against the Oakland Athletics on June 3, 2014 at Yankee Stadium in the Bronx borough of New York City.  (Photo by Elsa/Getty Images)
Elsa/Getty Images

Mark Teixeira

Mark Teixeira returned from a sore wrist, but there's a question about whether or not he did so to save his job. There was plenty of speculation out there about whether the Yankees would get into the bidding for Kendrys Morales if Teixeira was out. The worry now is that chronic wrist injuries sap power.

Since the Yankees haven't yet been able to control the wrist, even with a longer absence, it's tough to imagine that Teixeira is going to suddenly be healthy. The medical staff has a ton of work to do to keep that clubhouse healthy, and with extra work, it's tougher to do preventative work. This is a big challenge for the team. With Derek Jeter in his final year, you have to imagine they'll push big to win now, but it could be health that decides whether they do. For more info on Teixeira's wrist, click here.


BOSTON, MA - APRIL 23:  Michael Pineda #35 of the New York Yankees pitches against the Boston Red Sox during the game at Fenway Park on April 23, 2014 in Boston, Massachusetts.  (Photo by Jared Wickerham/Getty Images)
Jared Wickerham/Getty Images

Michael Pineda

Getting Michael Pineda back on a mound looked like a big win for the Yankees. They had been patient with him last year, and the payoff looked huge. The downside is that it didn't last. That's not uncommon for shoulder injuries. Pineda had an unexpected back/shoulder injury and then a big setback that reportedly involves the shoulder joint as well as the muscles. 

The Yankees have shut Pineda down completely and shifted him to the 60-day DL. That really doesn't tell us much since they needed to make a roster move and Pineda wasn't expected back for a while anyway. With a recurrent and moving target for the medical staff, it could be that Pineda's kinetic chain is broken. Moving him to the pen is one option, but not one that helps the Yankees' thin rotation. 

The Yankees are not shutting Pineda down completely, but there is a chance that his season is over. With Jurickson Profar having a similar issue and being essentially shut down after his setback, we'll have to keep an eye on Clayton Kershaw. He's been great since returning from the problem, so the Dodgers must have done something right! If we see more teres major injuries (and I think we will), Stan Conte's phone will be ringing.


Quick Cuts 

HOUSTON, TX - JUNE 01:  Nelson Cruz #23 of the Baltimore Orioles is hit by a pitch from Scott Feldman #46 of the Houston Astros in the third inning at Minute Maid Park on June 1, 2014 in Houston, Texas.  (Photo by Bob Levey/Getty Images)
Bob Levey/Getty Images

Nelson Cruz

"The Boomstick" got lucky. The MLB home run leader almost had that ended by a simple pitch inside. Players continue to resist using padded gloves, and I've never gotten a good answer as to why. (No, the fact that they signed an endorsement deal with a manufacturer that doesn't make a padded variety isn't good enough for me.)

Cruz was back on Tuesday, going long in his old stomping grounds on a night when things were flying out. Cruz got lucky this time, but it won't be the last time he'll be pitched inside. It would be hard to ask him to change anything right now when things are going so well, but I don't think the Orioles would mind. 


Yordano Ventura

As bad as it looked at the time, everything else has seemingly come up roses on Yordano Ventura. Despite a very vague diagnosis that points to future problems without a mechanical fix, Ventura's had no issues with his throw days and will take his next turn this week. Missing only one start is not only the best-case scenario, it's so good that it makes me worried. 

"Valgus stress overload" is precisely the mechanism that eventually or traumatically snaps the UCL in the elbow. Even with a so-called clean MRI, the overload's mere existence suggests that somewhere down the line this or worse is going to happen again. I want to think that the Kansas City medical staff knows something more here, that they're holding something back, but I can't prove it.

Ventura is the ultimate risk/reward player right now, which leads me to this question: As player after player from the Dayton Moore era falls off and the team slides, do you trust this administration to take the long view of perhaps its current most talented player? And if not, why does David Glass?


LOS ANGELES, CA - JUNE 03: Jose Abreu #79 of the Chicago White Sox hits a two run home run in the first inning against the Los Angeles Dodgers at Dodger Stadium on June 3, 2014 in Los Angeles, California.  (Photo by Stephen Dunn/Getty Images)
Stephen Dunn/Getty Images

Jose Abreu

The White Sox do a lot of things well, at least on the medical side. After returning Chris Sale and watching him be even more dominant after the short rest, Jose Abreu was brought back this week.

Abreu's ankle has been problematic for a while, perhaps since spring training, so we'll see if he gets as much of a boost as Sale, if that's even possible. Abreu shouldn't have issues, and he should be back in your lineup for all formats.


Matt Wieters

Matt Wieters is throwing. It's a rehab throwing program, so don't get too excited, but this is intriguing. Wieters' throwing indicates that the Orioles aren't satisfied with just getting him back as a DH—or maybe it's Wieters who isn't satisfied.

Some sources have told me that Wieters' decision on whether to have Tommy John surgery or not hinges on his ability to catch, not just hit. That means it could take a bit longer, but the signs are positive now. If he gets out to 120 feet, that's usually where rehab programs end, and it could indicate a rehab assignment is close.


HOUSTON, TX - JUNE 03:  Josh Hamilton #32 of the  Los Angeles Angels of Anaheim is greeted at the plate by teammate Howie Kendrick #47 after Hamilton hit a solo home run in the eighth inning off Tony Sipp #29 of the Houston Astros at Minute Maid Park on J
Scott Halleran/Getty Images

Josh Hamilton

Mike Trout didn't make it through Tuesday's game, but Josh Hamilton did. It's not all bad, and for Josh, at least it wasn't that weird. He missed just shy of 50 games while rehabbing from surgery to fix his sprained thumb. The rehab went well, though it had some stops and starts.

Hamilton is showing a bit more swing-and-miss from the minors up to his first game back, but he's such a streaky hitter that it's difficult to say how much is the lingering effects of the thumb. He hit a homer in his first game back, but staying healthy would be a better positive. 


A.J. Pollack

Pollack, like Cruz, could have been saved by a pair of protective gloves. His broken hand will need surgery, and he will miss six to eight weeks. Given the way the season is going for the Diamondbacks, he might be pushed back a bit while Tony La Russa gets a look at some of the other options. Players tend to come back from this kind of injury fairly well, but Pollack doesn't have as much margin as most players.


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