Under the Knife: MLB Injury Analysis on Harper, Wieters, Posey and More

Will Carroll@injuryexpertSports Injuries Lead WriterJune 18, 2014

Los Angeles Dodgers starting pitcher Chad Billingsley throws against the San Diego Padres during the first inning of a baseball game in Los Angeles, Monday, April 15, 2013. (AP Photo/Jae C. Hong)
Jae C. Hong/Associated Press

Every hitter wishes they could be Tony Gwynn. Like Ted Williams before him, Gwynn was as pure a hitter as you'd see, but what you didn't see was all the hard work behind the scenes. Not only was Gwynn the pioneer of using video for preparation, he was also much more diligent about his physical condition than most would expect.

Most think of Gwynn as a bigger guy, along the lines of Kirby Puckett or John Kruk. All were great hitters that somehow also looked a bit more like regular guys. But don't mistake some heft for laziness. All of them got bigger after they left the game, in large part because they no longer had to do the work necessary to stay at the MLB level.

Lenny Ignelzi/Associated Press

What Gwynn couldn't do is quit tobacco. It's devastatingly hard. I've watched smart people I know and love struggle over and over with it. It's been years since my mother died of cancer that I'm convinced was related to her smoking.

We don't see tobacco in baseball nearly as much anymore, which is a good thing. In fact, I haven't even seen Big League Chew, the gum that pretended to be tobacco, in a while. Society hasn't just changed since the smoke-filled days of Mad Men but in just a few years after deciding that tobacco wasn't something we wanted around any more. That battle's not over. 

The latest casualty was one of the greatest hitters of all time. His legacy will live on, both on and off the field. For now, let's get to the injuries...


Nick Wass/Associated Press

Bryce Harper

Bryce Harper is making progress. Nationals fans should be paying attention to Josh Hamilton, who's had a relatively simple return from his similar thumb surgery. Hamilton has made it through this process normally and not much is ever normal for Hamilton. News Wednesday from Dan Kolko of MASN was very positive, with Harper progressing to soft toss and two-handed swings. It doesn't sound like much, but it's a big step.

That could put him on track for a rehab assignment within the next 10 days. He shouldn't need much time there, just enough to get his confidence back and show Nats officials that he's ready to be back in the bigs. The key is bat control. For any hand injury, a loss of grip strength and fine muscle control will often lead to more swing-and-misses. For more info on Harper's thumb, click here.


Ann Heisenfelt/Associated Press

Matt Wieters

Matt Wieters went back to Dr. James Andrews Monday and faced a hard decision. He was basically forced to decide between helping the Baltimore Orioles now and helping his team in the future. What it came down to is his identity. Wieters believes he is a catcher, not just a hitter, and that tipped his decision to having Tommy John surgery now. His 2014 is over after surgery Tuesday, and there's some question about when he'll be ready to return next year.

Tommy John surgery isn't done very often on catchers. Let's be honest: John Buck isn't a great comparable for Wieters. While pitchers come back at about a year and position players come back at about eight months, catchers appear to be somewhere in the middle.

By having the surgery now, Wieters is giving himself the best shot to be ready to catch by Opening Day. It's not a guarantee, but there's little doubt that he'll be able to hit by spring training. It could seem ironic, but Wieters may be forced into the very situation at the start of next year that he chose not to do this year.

Wieters isn't making a rash decision. Dr. Andrews wouldn't be doing this surgery if he didn't feel it was necessary. The rehab was tried, and it didn't work. The only question is whether Wieters could have given the team a couple weeks of hitting, but by doing so, he probably couldn't have focused on the rehab. If it had worked, no one would be asking the question now.


Gene J. Puskar/Associated Press

Gerrit Cole

Correlation or causation? Is Gerrit Cole's current shoulder problem related to his high velocity, or is it simply a problem that happens to many young pitchers: 100 mph heat or not? Cole's shoulder is worrisome, but there's no structural damage in either the shoulder or the elbow. It amounts to something in between fatigue and dead arm, so rest should help, but the Pirates will certainly be ultraconservative with their ace. 

For now, Cole is expected to come back at or near the minimum. He threw a 34-pitch bullpen this weekend, according to Travis Sawchik of the Pittsburgh Tribune-Review, and the next step is a sim game. While Cole could be back as soon as next weekend, it's more likely that he'll slot back into the rotation sometime next week.

For more on Cole's shoulder (and some info on Justin Verlander), click here.


Marcio Jose Sanchez/Associated Press

Christian Yelich

I used to work in the financial services industry and something you'll hear there, over and over, is that past performance does not guarantee future results. It's a fancy way of saying that you'd better learn from the past. I won't make you think back too far for a lesson on Christian Yelich of the Miami Marlins. 

Yelich may not be a big star yet, but many think he could be. Outfield prospects like that usually love comparisons to Mike Trout, but this one isn't one he wants. Think back just a couple weeks to when Trout was having back spasms. While Trout only missed a few games and came back to treat pitchers like Oberyn Martell's head, a young player having back issues is definitely a negative. Read what I wrote here about Trout because it all applies to Yelich as well.

Yelich was shifted to the DL after the back spasms didn't abate for a few days. While it's unclear whether it will take Yelich the full 15 days to recover from this, the Marlins took the opportunity to get in front of this and to make a flurry of other moves. At the initial injury, it didn't seem too serious and I'm not convinced it is, despite the roster move.

It's a conservative move but should be considered a positive. If the medical staff can get ahead of this in the short term, Yelich can come back well. If he learns from this and corrects the root cause, he can play well for years. Watch for any sign that his rehab is progressing, including running. If he's able to get back to hitting and throwing inside of a week, he'll likely have only a minimum stay on the DL. 


Eric Risberg/Associated Press

Buster Posey/Michael Brantley

There were two concussions this week that bring the issue and MLB's concussion policy back up, showing the two key mechanisms and how baseball is dealing with the problem. Buster Posey took a hard foul off his mask and was lifted from the game once he complained of symptoms. For Michael Brantley, he was kneed in the head on a slide, a similar mechanism to what we've seen with Justin Morneau and others in the past. 

Posey was back in the lineup Tuesday, but Brantley is still out while undergoing tests. The policy is working, but there's some things that MLB could do better. For more info on these head injuries, click here.


Help is coming

Look at UTK any week and you'll see a ton of pitcher injuries. In fact, every injury after this in this week's column is to a pitcher. However, the more I look at what's coming in baseball over the next 12 months, the more I get excited. There's change coming. More than just a new commissioner and even more than just MLBAM's new player tracking system that will roll out big.

I wish I could do more than tease, but there's a new weapon coming in the battle against arm injuries. I'm working on the story now, but pretty soon, pitch count is going to be irrelevant and not just at the major league level. We'll have direct measures that are light years ahead of where we are now. I hate to tease, but I haven't been as excited about an innovation since the iPhone. Help is coming for pitchers and for the game of baseball.


Orlin Wagner/Associated Press

Adam Wainwright

Adam Wainwright has tennis elbow. That's better than more UCL damage—he had Tommy John surgery just a few seasons ago—but it's not good either. We've seen a rise of lateral aspect elbow problems this season. While they've been relatively minor, with Yordano Ventura only missing one start after his scary episode, it's also showing that there's a problem.

Wainwright has broken down his UCL before due to excess force and he didn't make any significant mechanical changes since the surgery. He's focused on conditioning to help, but we don't know that we can prevent injuries by working out any more than we can with pitch counts or innings limits. Wainwright isn't overused by any measure, but this problem is a definite warning sign. We'll see how the Cardinals react to this in the post-Dave Duncan era. 


Chad Billingsley

It was a big setback for Chad Billingsley. The pitcher was nearly back from his rehab from Tommy John surgery when new problems with his elbow arose. The transplanted tendon held, but his natural one in his forearm, the flexor tendon, did not. Billingsley will need surgery to repair that and will miss the rest of the 2014 season, as noted by Ken Gurnick of MLB.com.

Pitchers do come back from flexor tendon surgery pretty well, though it can often take up to a full year. What we don't know with Billingsley is whether there's a complication given his recent Tommy John surgery. He's a sample size of one.

The worry here is that the elbow simply cannot hold up to pitching any more, but he'll have a chance to try to prove that he can. If all goes well, he should be throwing before the end of the season, which could give the Dodgers a bit of direction for 2015 and beyond. Billingsley has a buyout on his three-year deal, so the Dodgers have options going forward. 


Jayne Kamin-Oncea/Associated Press

Bronson Arroyo

Bronson Arroyo is as durable as they come, but when he started the spring with elbow issues, it had to be worrisome to the Diamondbacks and to Arroyo himself. He came back well, guided by Ken Crenshaw, but the problem cropped up again, and this time, it's worse. Is this simply wear and tear from all the miles (or pitches, or innings) that Arroyo has racked up on his right arm? If so, should the Dbacks have seen this coming?

It's Arroyo's first trip to the DL, and it may be a lengthy one. Arroyo told Adam Lichtenstein and Teddy Cahill of MLB.com that he's going to take the next few weeks to rest and rehab, but that Tommy John surgery hasn't been ruled out. The diagnosis of a UCL sprain means that the Dbacks medical and field staffs will have consulted with Arroyo, so expect him to try to rehab his way past this though few can successfully do so. 

It looks like another Kevin Towers move has gone up in flames, but at least it's a dry heat in Arizona.


Clay Buchholz

Clay Buchholz went 62 pitches in his rehab outing last weekend. He'll go 90 or so when he heads back out to Pawtucket Thursday. His hope is that he goes north for his next start, back to the Red Sox rotation. If he can hit his pitch count, there's little doubt that he will. Unless he's just awful, the back of the Sox rotation needs all the help it can get. 

The Red Sox have used Buchholz's knee injury as time to work on some things with him. Given his seven-plus ERA, it's clear he needs the work. That said, Buchholz is a streaky pitcher and one that's shown he can take instruction. It wouldn't be outrageous to think Buchholz could come back rested, healthy and to some extent fixed. He's a definite buy-low candidate, especially if you can get it done before his last rehab start.


Joe Mahoney/Associated Press

Eddie Butler

When a top prospect gets that first call to the bigs, it's often hard to tell who is more excited, the kid or the team. The Colorado Rockies and Eddie Butler were certainly excited for his first start, a look at what many think will be the heart of the Rockies rotation for years to come, along with Jonathan Gray and perhaps Kyle Freeland. Instead, people are now hoping the rest of his starts are nothing like his first.

Butler left with shoulder pain and an MRI showed rotator cuff inflammation. The "no structural damage" line was trotted out, via Thomas Harding of MLB.com, but isn't the rotator cuff a structure? Cuff and labrum problems are among the toughest for pitchers so this early issue is a real problem for Butler, short and long-term. Butler was shut down but will start up a throwing program soon. Expect the Rockies to be very conservative with him, so his next Rockies start could be a ways off. 


Jeremy Hellickson

Jeremy Hellickson is expected to be a big addition for the Rays in the second half, shoring up the rotation that misses Matt Moore and could be missing David Price in the near future. However, Hellickson's first rehab start did not go well. He got shelled, giving up seven runs on 12 hits in just 2.2 innings at Durham (AAA). He didn't make his expected count, so we'll have to see what his limits are next time out. Getting Hellickson back around July 1 was always the plan after his minor arm surgery, but they need him both healthy and effective.


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

Michael Pineda isn't throwing right now, having been completely shut down for over a month. The Yankees aren't sure when he'll pick up a ball again, but if it happened tomorrow, he wouldn't be ready before August given a normal progression. In fact, sources have told me that any setbacks for Pineda would have the Yankees shutting him down and likely walking away.

Pineda is arbitration eligible and despite some promise from a handful of starts early this year, it would have to be a very team-friendly contract for the Yanks to keep him around. They simply feel that their medical staff cannot keep him healthy and would rather let them focus their resources on other players. Pineda will get another chance somewhere, but shoulder injuries are very difficult to come back from.


Johan Santana

There was a time when Johan Santana was the best pitcher in baseball. Maybe the Twins sold at the right time, but he's certainly had a tough time making it back from multiple shoulder injuries. The Orioles had him closer, but a freak Achilles rupture has ended his season and perhaps his career. Santana will have the tendon re-attached surgically and could start yet another comeback attempt for next season, but it's unclear if he'll try again. 


    Reds Fire Manager Price After 3-15 Start

    MLB logo

    Reds Fire Manager Price After 3-15 Start

    Adam Wells
    via Bleacher Report

    Controversial Trades That Would Ignite Fans 😡

    MLB logo

    Controversial Trades That Would Ignite Fans 😡

    Zachary D. Rymer
    via Bleacher Report

    Freeman (Wrist) Injured After Being HBP

    MLB logo

    Freeman (Wrist) Injured After Being HBP

    Alec Nathan
    via Bleacher Report

    Why MLB Must Consider a Shortened Season

    MLB logo

    Why MLB Must Consider a Shortened Season

    Jacob Shafer
    via Bleacher Report