Under the Knife: MLB Injury Analysis on Tulowitzki, Tanaka, Harvey and More

Will Carroll@injuryexpertSports Injuries Lead WriterJuly 31, 2014

ANAHEIM, CA - JULY 04:  C.J. Wilson #33 of the Los Angeles Angels of Anaheim throws a pitch against the Houston Astros at Angel Stadium of Anaheim on July 4, 2014 in Anaheim, California.  (Photo by Stephen Dunn/Getty Images)
Stephen Dunn/Getty Images

The trade deadline is always an exciting time around baseball, but if you look closely, team health feeds the deadline. Teams are replacing players they expected to have. They're buying expensive pitchers to soak up innings that young pitchers can't handle. They're valuing prospects not just on talent, but risk. 

Front-office types will be burning up the phone. Scouts will be watching and reporting. Medical staffs will be called in to check files and physicals will be taken. With everything that is measured in baseball now, they're still left guessing in many situations about injuries, risk and value. 

Again, we have an asymmetrical situation. Some teams will have more information or analyze it more accurately. Some teams will miss something or ignore an element they shouldn't have. A trade will succeed or fail based on an injury. Go ahead—look at some of the deals from a few years back and tell me how many injuries you see.

There's no area in baseball untouched by sports science and sports medicine, but too many teams leave those areas underserved and underfunded. The injuries of tomorrow might have been noted today, but from out here, we'll probably be left to guess. Maybe the trades that weren't made were successes because an injury acquisition was avoided. 

It will be hours before we know who moves at the deadline. It will be years before we know whether the deals worked, or maybe a couple months, when a team moves into October. For now, let's look around the league at the injuries this week...

Troy Tulowitzki

MINNEAPOLIS, MN - JULY 15:  American League All-Star Derek Jeter #2 of the New York Yankees speaks with National League All-Star Troy Tulowitzki #2 of the Colorado Rockies during the 85th MLB All-Star Game at Target Field on July 15, 2014 in Minneapolis,
Hannah Foslien/Getty Images

Needles. Groin. You never want to hear those two words in the same sentence. Troy Tulowitzki—yes, with a T—got to experience dry needling this week in hopes of avoiding another groin surgery. Tulowitzki was checking in with his surgeon and, while surgery isn't happening yet, it's still on the table.

Dry needling is a relatively new technique that's not far off from acupuncture, though it doesn't use the same principles. Essentially, it's just stimulating an area. You may not want to check out this video if you're squeamish, but it does show things clearly.

Tulowitzki's groin is problematic, chronic to a point and certainly makes it difficult for the trade that whispers have him pushing for. It's more likely that he'll have to wait until the offseason for a move.

In the meantime, he'd like to get back on the field to show that he's healthy enough to trade for. We won't get much of a chance until mid-August, if then, but look for any signs of physical activity, even jogging, to get a sense of which direction this is going.

Masahiro Tanaka

Tony Dejak/Associated Press

Masahiro Tanaka reported last week that he was still having some pain in his elbow. This week, things are getting better every day. What changed? Well, nothing.

Tanaka had a PRP (platelet rich plasma) injection into his elbow. That injection is designed to inflame the area slightly and accelerate the healing process. Several doctors have told me that soreness in the first week after the injection is very common, especially if the injury is still in the acute phase. 

If Tanaka's progress really is progress, and if the PRP is helping even in a small way, it's a huge, massive win for the Yankees. Timing is almost irrelevant here since, if he does need Tommy John surgery, he'll miss all of 2015.

He could go all the way into December or January and not truly affect a 2016 return, so there's no rush, though certainly if he shows that he can come back and pitch, the Yankees would love to have him back.

We should get more indication in the next 10 days. Tanaka will likely play catch around that point and it will be very telling. Matt Moore couldn't make it past that easy stage and headed for surgery, which isn't uncommon. While we still don't know which way it will go with Tanaka, we're getting closer. 

Edwin Encarnacion

OAKLAND, CA - JULY 05: Edwin Encarnacion #10 of the Toronto Blue Jays lays injured on the ground after a play at first base against the Oakland Athletics during the first inning at O.co Coliseum on July 5, 2014 in Oakland, California. (Photo by Jason O. W
Jason O. Watson/Getty Images

The Blue Jays don't have the best record of team health, but they're actually very good at keeping their position players healthy. It's a bit surprising that Edwin Encarnacion has taken as long as he has coming back from what was said to be a mild quad strain. The absence is going to force a rehab assignment now, pushing his return back at least a few more days.

Sources tell me that the setback he experienced a few days ago wasn't any re-strain of the muscle, but was merely some excessive soreness. Because of the location of the injury, low near the tendon, the Jays elected to back off a little, add some therapy and see how it went. So far, so good.

Encarnacion isn't a speed player, but injuries like this can throw off a player's hitting base. Joey Votto is an extreme example, but watch to make sure that Encarnacion is hitting well, not missing and showing some signs of power when he does go out on his rehab assignment.

If it happens this weekend, as is possible, he could be back by next week. 

Brandon Morrow

Keith Srakocic/Associated Press

Brandon Morrow is closer to a return, but he won't be back as a starter. Instead, the oft-injured Jay will work out of the pen. It's not the worst idea, but my question is whether he'll be used to the best extent, assuming that the organization isn't doing it because they don't think he can stay healthy as a starter.

The job descriptions are telling: starter, reliever, closer, lefty specialist. But shouldn't it just be pitcher? Bo Porter, manager of the Astros, barked earlier this season that he didn't care about roles, just that his pitchers get outs. Easy to say when the pen didn't really have any standouts and the team isn't winning. Porter hasn't really had much in the way of innovative pen usage either.

Morrow, assuming everything is normal with his finger when he does return, is clearly not a one-inning guy. He's gone multiple innings, even complete games in the past. A finger injury shouldn't change that.

If John Gibbons and the Jays can't figure out how to leverage a player like this, using him as a long man, a swing starter or a shadow to keep the workload down on Marcus Stroman, then I just don't think anyone will buck the book.

Managers will say they don't manage to a stat, but with the pen usage of modern baseball, it's worse than that. They clearly manage to the save, leaving their best arm sitting in key situations. They won't use the eighth-inning guy in the seventh, despite the leverage. They're often lost in extra innings and nearly unwilling to use a quick hook. 

Morrow's situation isn't unique, but it is as clear an opportunity as I've seen for a creative, thoughtful usage of an asset. The Jays consider themselves contenders and need to maximize every possibility. Not using an asset like Morrow to his fullest reasonable extent is simply poor management. 

Ryan Zimmerman

Jack Dempsey/Associated Press

A Grade III hamstring strain is about as bad as it gets. In most cases, it's a rupture—a complete tearing of the muscle. It can be used when the tearing is bad enough that any load will damage it further, where the structural integrity is damaged. It can often be surgical, though it depends on which of the muscles and the location of the tearing.

In other words, this is bad for Ryan Zimmerman, if you believe Bill Ladson's report (and I do.) Already plagued by shoulder problems, Zimmerman now has a significant leg problem to add to it. He's already not the fastest player, but dropping more speed might make playing the outfield even tougher. 

It's extremely unlikely that Zimmerman will make it back this season from a severe strain like this. It's not impossible, especially if he does a Kirk Gibson and hobbles up as a pinch hitter when rosters expand. The Nats are sticking to their eight-week timeframe, so while in most leagues, I'd say drop Zimmerman now, deeper leagues might want to wait just a bit.


If you follow the trade deadline closely today, you'll likely hear someone say that a player can't be dealt if they are on the disabled list. That's untrue. Any player, no matter their injury status, can be traded. As in most cases, a player has to be accepted, meaning they "pass" the physical. 

A "pass" doesn't mean that a player is injury-free. It's essentially saying that they're willing to sign, or in this case, transfer, the contract as written. The acquiring team is also taking responsibility for the player, incurring any further medical costs. That's a big deal, but not insurmountable in the right situation. Some have even suggested it could be a market inefficiency. 

Justin Masterson is just the latest example. He's on the DL now, expected to be activated on Friday for his start, though the Cardinals (assuming his knee and the rest of him pass the physical) may change that schedule. John Mozeliak knew he could make a deal for a DL player and is counting on his medical staff to make it work. Now you know. 

Matt Harvey

NEW YORK, NY - AUGUST 26: Pitcher Matt Harvey #33 of the New York Mets talks to the media about his partially torn ulnar collateral ligament (UCL) on August 26, 2013 at Citi Field in the Flushing neighborhood of the Queens borough of New York City. (Photo
Rich Schultz/Getty Images

Matt Harvey has been cleared to throw from a mound starting Friday. It's another step in the deliberate process the Mets are taking with his rehab.

Don't expect huge things from these early sessions. They're not about velocity or stuff, just merely getting in the work and stepping forward. There's still a chance Harvey gets a late-season cameo, even with the Mets being as conservative with this as they have been.

We'll definitely see Harvey in games this year, probably in Brooklyn not Queens. 

Wil Myers

Need to sneak another bat onto your fantasy roster? Wil Myers is getting ready to start a rehab assignment in the near future and should be back for Tampa in mid-August.

He didn't hit well before his injury, something of a sophomore slump, but he still has talent. The Rays are playing well right now and getting Myers and Jeremy Hellickson function as deadline acquisitions.

If Myers hits quickly and well, he's a big boost, but don't expect power to be instant after a wrist fracture. Look for any signs its coming, like hard-hit balls and gappers. 

Michael Bourn

Tony Dejak/Associated Press

Michael Bourn is a speed player. He has a chronically bad hamstring. Surgery didn't cure this, as it often doesn't. The advantage is that Lonnie Soloff is charged with getting him back out there and Soloff has experience. He first got noticed for his work with Ken Griffey Jr.

Bourn's a much different player than Junior, and if the speed isn't there, he'll have to adjust.

The Indians would settle for seeing him on the field right now. Bourn is closer, taking batting practice, but there's still no date for a rehab assignment, according to the Cleveland Plain Dealer. He's at the long end of the three-to-four-week estimates, but the Indians will want to see him not only play, but recover, so don't expect him back too soon.

Derek Holland

ARLINGTON, TX - SEPTEMBER 28:  Derek Holland #45 of the Texas Rangers looks down after pitching during a game against the Los Angeles Angels of Anaheim at Rangers Ballpark in Arlington on September 28, 2013 in Arlington, Texas.  (Photo by Sarah Glenn/Gett
Sarah Glenn/Getty Images

Derek Holland is coming back from knee surgery that has cost him the season so far and, with the paucity of success of microfracture in baseball, he's going to have to beat the odds as well.

It was a good first step for him in Frisco (AA) where he got in two innings of work. He didn't have great control (two BB) but he did dominate with four strikeouts. He'll step up the stamina next time out and should use most of the 30 days of his rehab before a possible return to Arlington.

C.J. Wilson

C.J. Wilson made it through his Monday rehab start, going 81 pitches over five innings for Arkansas (AA). He didn't have any apparent trouble with his ankle or the hip that he now says was the real issue.

His stamina is already up there, so it should be a normal start for him Saturday. Watch to see if his feet are moving well, especially the back leg where Wilson says the real problem was.

Starling Marte 

Gene J. Puskar/Associated Press

The Pirates were involved in a lot of trade rumors this week, including some about Jon Lester. To get Lester, they'd need to have a package of prospects, and Marte could be the kind of game-ready, under-control player who would fit in nicely in Boston.

Of course, the Pirates would rather keep him alongside Andrew McCutchen and Gregory Polanco, but sacrifices are sometimes made to long-term plans, even when it's Neal Huntington at the helm.

Marte is still having some issues with his concussion, according to the Pittsburgh Post-Gazette, wavering with symptoms. This isn't uncommon at all, and the Pirates are monitoring him closely. He won't be off the concussion DL when eligible, but there's no way to say just how long he'll be out. There's no sign this will be extended, but concussions follow no pattern. 

Gerrit Cole 

Gerrit Cole looked great in his first rehab start, done at Indianapolis (AAA). He'll have one more start, this coming Saturday at Indy's Victory Field.

If he can show the same kind of stuff and have no setbacks with his strained lat, he'll be back in Pittsburgh for his next outing. The velocity was back for sure and Cole seemed to be focused on the attack, which is a positive.

No one seems too worried about a lat strain here after his shoulder injury, but it isn't a great pattern. Sources tell me the Pirates want to keep Cole healthy and focus on some changes in the offseason that they think will help.

Mark Appel

Bob Levey/Associated Press

Wondering why the Astros sent Mark Appel to Corpus Christi (AA) despite a poor run in Lancaster (A)? The answer isn't entitlement, but system. A source tells me that the Astros have a system called Kinatrax installed in Corpus Christi, though I could not confirm this. Given some of the statements that came out about additional tools, this makes some sense now. 

Kinatrax is a multi-camera markerless biomechanics system that can show many things that could be used to analyze Appel beyond the results. (Corpus Christi also has a Trackman system installed, but those are pretty widespread. They're pretty easy to spot as well, with a flat radar panel installed directly behind the plate.)

A couple teams, including the Mets, have been testing this kind of system, but the results are unknown. We'll see how the Astros use it. With someone like Brent Strom running the pitching program, it could be a big weapon. I wonder if there were any mentions of this system in the Ground Control leaks.


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