Under The Knife 2/14/25

A Little Love, A Lot of Injuries

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Happy Valentine’s Day to all who celebrate. It seems an appropriate time to start the (gasp) 24th season of Under The Knife. I’d like to say I have less to write about, that talking about injuries for this long would have changed things, but in that, I am a complete failure. I will continue to try, but for now, camps are opening and the injuries are starting so let’s get to it:

CLAYTON KERSHAW, P LAD (inflamed toe (rehab))

Clayton Kershaw signed with the Dodgers, as expected, for another year in what will be an incredible Dodger career. Is he the best Dodger pitcher ever? Most would think Sandy Koufax but his short career defines and limits him if we’re looking at career value, which is 49 WAR. The longevity of Don Sutton? He bounced around at the end of his career, but his Dodger time is worth more than 58 WAR. Actually, Dazzy Vance is higher than Sutton at 60, with most of that coming in the live ball if different era of the 1920’s. (Ha, can’t just say ‘20’s anymore!) Don Drysdale was highest at 67, which surprised me a bit. At 79 WAR, Kershaw is the best ever in blue, which is quite the accomplishment. If I’m doing the math right, I think Kershaw passed Drysdale sometime in 2019. I wonder if they stopped the game to acknowledge it. Actually, has any game ever been stopped for a sabermetric achievement?

Assuming Kershaw passes the physical - and he will, despite the known shoulder, back, and last year’s toe issue - he becomes an interesting piece inside the Dodgers’ pitching puzzle. I think everyone would acknowledge Kershaw isn’t going to get near 200 innings this year, but he can still be very useful. With as many as ten possible starters and the assumption that they’ll go with a six-man rotation, there’s going to be depth but also a necessity to keep workloads up. For those with options, the Dodgers will show them Oklahoma City or Tulsa even, but for others like Kershaw, rehab assignments might have some play. If Kershaw were to start the season on the IL and build up off the roster, he’d have 30 days to do so wherever as well. I’m not saying phantom IL, but just creative. (There’s late word Kershaw will start on the 60, which is a bit of a surprise but lengthens the timeline and reduces options.)

It’s safe to assume that what we saw in his brief time last year will hold true. He still had his stuff, which is always a question after shoulder and back issues. I don’t foresee any of the things he did between now and then really changing that, even if he’s not ready for the start of the season. I’m also curious if Kershaw is considering coaching, given his demeanor in camp the last couple years.

I’ll raise one other possibility here - could Kershaw relieve? He could, but I’m curious if his arm, back, and leg issues would do well with the quicker and uncertain warm up. Some of this depends on how much the medical staff has to do between and even ahead of starts. If it’s a big involved thing, the answer is no, but that big curveball could be nasty in late innings given so many of the Dodgers relief corps is largely based on power.

Oh yeah, Kershaw also had surgery on his knee for a mild tear in his meniscus. It should affect nothing, so feel free to ignore it.

ANTHONY RENDON, 3B LAA (inflamed hip)

Anthony Rendon will have hip surgery and likely will not play this year. The question is why this wasn’t addressed over the off-season. You probably won’t like the answer if you’re not Arte Moreno. The answer is disability policy. I couldn’t confirm that Rendon’s contract was insured; most are not, even at high dollar value because they are expensive and have such exclusions as to make many useless. Pitchers are near uninsurable, but for someone like Rendon, who came in with a relatively clear history, it’s possible.

However, almost all these policies have a 90-day elimination period. Think of it like the deductible on your medical policy. A player has to be out for the entire period before it pays. Since he played some last season, either he gets a bit of credit on that or it restarts with game one, depending on how the policy is written (and if there is one.) By waiting, the Angels may be locking in a full year of repayment for his big salary. When he’s placed on the 60-day, it will be his 13th IL stint since 2021.

However, don’t think this is fraud. First, he’s having surgery and surgeons (and people) don’t just do that for kicks, or because a billionaire asks. Add in that the insurance company is going to look closely before they just pay out millions of dollars, and they’d watch the rehab like a hawk to see if he could come back. Yes, that happens, and yes, payments have stopped when they thought the player could come back before the team did. There’s a real injury here and as long as he’s out - or as long as the policy pays - there’s going to be a reason why.

Functionally though, this likely means a season ender, again, for Rendon and with two years left on one of the worst contracts in baseball history, it could well mean he’s not only done in Anaheim, but just done. He doesn’t need the money and if the Angels did cut him loose, even at the minimum, I’m not sure there’s many teams out there who would see him as worth the risk. Maybe the Nationals for a good feeling of nostalgia, but we’ve likely seen the last of Rendon. With Yoan Moncada signed just a few days ago, I think we can safely say the Angels knew this was coming.

ZACH NETO, IF LAA (inflamed shoulder (rehab))

On the Angels front, things sound positive for Zach Neto coming off shoulder surgery but there’s a lot of details still missing and some context we need to really understand what’s going on. The most salient fact that MLB.com got was that Neto is not throwing yet, though hitting off a tee is something, I guess. For a shortstop and one that didn’t have a plus arm before the injury, this is worrying.

The speculation is that Neto had a labrum tear. The mechanism is similar to what Shohei Ohtani had during the playoffs and there’s a similar time frame. It’s his throwing shoulder, which makes it more of an issue but compare here. With likely a similar injury and date of surgery, both should be back around the same time. No two injuries are the same, but comparisons exist.

For Neto, the throwing arm makes this much more complex. He doesn’t hit enough to shift to DH, but the context of the ‘25 Angels means they don’t have to rush anything with Neto either. If Luis Rengifo is ready to go Opening Day from his wrist surgery, the Angels will have the depth to make sure Neto is healed up and back to one of the young players that might key an Anaheim renaissance.

EVAN PHILLIPS, RP LAD (strained shoulder)

The Dodgers don’t lack for power arms, but they will lack for Evan Phillips at the start of the season and perhaps well into it. Rumors had flown that Phillips’ NLCS injury was serious and it’s finally come out that it’s a rotator cuff strain. That’s definitely not good for the type of pitcher Phillips is, with high torque and max effort. In fact, it’s probably the worst now that surgeons have gotten a bit better with labrum tears over the last few years.

One of the things that’s tough to convey here is how people’s tone matters to a conversation. In several of the conversations I had this week about the Dodgers, people were positive about Kershaw, positive about Ohtani, and then I’d ask about Phillips. The tone changed and the language did as well. They’d hedge more, they were a bit more measured with what they said and that’s always been a thing. It’s something I try to convey, but hey, I can’t just play you tapes. (There’s no tapes.)

With no surgery, the timeframe is more about function. Healing should have happened, but that could definitely have reduced his buildup. Even as a reliever, that’s necessary and as yet, it doesn’t sound like he’s thrown at full go from a mound. Safely getting him to that point can take time and trust, so it will be a big early test for a Dodgers medical staff that’s already going to be thin on time for anything additional, and they know that’s coming.

SHOHEI OHTANI, DH/SP LAD (torn labrum (rehab)/sprained elbow (rehab))

The Dodgers haven’t given many updates on Shohei Ohtani, but we’ll learn some things soon on the hitting side. However, word from Dave Roberts is that Ohtani will not pitch in Cactus League games. That’s more than a bit of a surprise as he’s well past the point where he could throw and we know that he did last year, all the way through his elbow rehab. The shoulder (non-throwing) labrum surgery would prevent some things and set back his build up, but all the way through camp seems odd.

The easy answer here is that Ohtani will be kept on back fields or controlled situations to preserve an IL stint, but no one has suggested he won’t DH, even after the shoulder surgery. We’re barely a month away from the Dodgers’ first games in Japan, so with Roberts saying Ohtani would DH, he has to be hitting by now. We’ll see it in coming days, for confirmation.

Absent a big surprise, Ohtani should be hitting and throwing, which means the ‘no games’ thing might just be to control who sees him. I’m not sure Ohtani or any pitcher really needs in-game work in the spring if they’ve built up properly and with the Dodgers’ current depth, they could easily start Ohtani late or limit his innings - more likely a long pen than an opener - through at least the first half and not lose too much.

There is some speculation that Ohtani doesn’t need to pitch and that the Dodgers recognize that. That said, I think Ohtani will pitch and as yet, there’s no evidence to change that or think he won’t come back well from the elbow surgery that, regardless of what it was, was 18 months ago. Ohtani’s always treated differently so I won’t take this as a big negative until we have more information.

RHETT LOWDER, SP CIN (inflamed elbow)

There’s a couple interesting things about Rhett Lowder that make him worth watching. First, he’s one of the first big success stories of the Wake Forest Pitching Lab. It’s not the only reason he’s in the pros, but it sure didn’t hurt him or the rest of the program. Second, the Reds drafted a functional clone the next year in Chase Burns and having fast tracked Lowder because he was that good, there’s expectations that Burns will be closely behind him, matching the young, under control talent the Reds have on the player side. A healthy rotation of those two, plus Hunter Greene, Nick Lodolo, and any of the three or four other candidates would make the Reds contenders.

If healthy, that is.

Lowder wasn’t a lock for the rotation even after his debut last year, but coming into camp with an elbow issue probably means he’ll get some time in Louisville at least. An MRI showed “no structural issues” but there’s still a problem that has put him back at the start. Now, I know the Reds have known about this and that his buildup was halted a while back. The question is what caused this issue and how it can be fixed.

We know what it’s not. It’s not the UCL and it’s not muscular. Everything else, maybe. If this is time and rest, that’s not a plus. Lowder’s already behind and more time and rest puts him even further back. Not finding a cause is worse, because then they’re just treating symptoms. The Reds are smart and have great medical staffers, so there’s more than just hope they’ll treat this properly, even though we’re all still guessing.

NICO HOERNER, 2B CHC (strained forearm (rehab))

Nico Hoerner did not have Tommy John surgery. Thank you for coming to my TED talk.

Hoerner did have flexor tendon repair in his forearm, which is near the elbow, but since we haven’t come up with memorable nicknames for most surgeries, it’s tougher, especially if it’s something as simple as a technique. There are several ways to do what we call Tommy John, especially with the internal brace usage increasing. I wish we did have names as it would make things easier here.

Anyway, Hoerner’s recovery is going well and Craig Counsell was very positive. There’s always been the expectation in the Wrigley offices that Hoerner would be back at or near Opening Day, so that hasn’t changed as much as been vocalized and focused more on the “at” than the “near.” He’s not full go on either hitting or throwing, though he’s doing both and expected to have plenty of time to progress through what I’m told will be a near-normal spring, though “with guardrails” per one source.

The Cubs have plenty of options to hold second base if Hoerner needs a bit of time, but they’d rather have him back in. Hoerner’s projections are all almost identical to his last season, which is a bit boring honestly. I don’t see any reason they’re wrong, however and this shouldn’t change that or the playing time projections.

SPENCER HORWITZ, 1B PIT (strained thumb (rehab))

The Pirates have rotated through a number of first basemen over the last couple years, often with positive results. After the late season issues with Rowdy Tellez, some speculated that it might be tougher to bring in the next one. It’s unclear if that was the case, but they filled the position with a trade. Spencer Horwitz came from Toronto with a quick bounce in Cleveland in what amounted to a three-way.

Unfortunately, Horwitz had an injury in his off-season workouts. John Perrotto got the scoop that it was an extensor tendon strain on his thumb that was repaired. There’s a six to eight week timeline the Pirates expect, though we’ve seen similar surgeries have a quicker timeline with the use of an internal brace. My guess is that Horwitz is hitting by mid-March at some level, but whether he’ll be able to gear up in time for Opening Day or whether he’s ticketed for a short stint in Indy or Altoona remains to be seen.

For a hitter, this is a “better” injury. The extensor tendons straighten the fingers and thumb rather than affect the grip. For the thumb, it’s the “thumbs up” motion that is prevented and while moving your thumb is key for most things, it’s a lesser function for hitters. That could help Horwitz’s timeline as well. The worst case here is that he misses the first month of the season with the best that he’s back on Opening Day. When he starts hitting in earnest will tell us the rest of the timeline. In the meantime, UT gold glover Jared Triolo likely gets the starts, though his bat isn’t the typical 1B dynamic. How the RF situation plays out in camp might also push someone like Nick Yorke back to the infield.

Quick Cuts:

The Dodgers have a lot of pitchers in some stage of rehab, but Gavin Stone isn’t likely to end his this season. The Dodgers put him on the 60 as he recovers from major shoulder surgery back in October … Joe Musgrove is four months post TJ, but the Padres say he won’t throw until “midseason.” If the rehab plan for him is no throwing until seven or eight months, I have no idea why it’s so slow. Sure, Musgrove might not be back this season so why rush, but why change the rehab plan at all? I wrote about this last year and even with a lot of research from a lot of really smart people, this process remains broken and a possible advantage for the first team to fix it … Jorge Mateo won’t play in spring games, but his recovery from elbow surgery is on track. The Orioles sound like they’re expecting him back in April with some XST and minor league rehab time ahead of his return. Most position players come back from this in about six months, with very high success rates … Not so good for Trevor Rogers. He had his kneecap pop out of place, setting back his off-season. He won’t be available through most if not all of spring … Jordan Montgomery had imaging on his finger. The D-Backs don’t seem terribly concerned about the strain, but I’m also not sure they’re terribly concerned about Montgomery. Two reports from early spring said Montgomery is shedding pounds. Do I have to wonder if Ozempic is a performance enhancing substance? … Daulton Varsho is showing good recovery from his shoulder surgery. He’s hitting and throwing, though he’s got a ways to go. Opening Day is unlikely, but he may not miss much of April … BUSH … Is the Alex Bregman deal the first big deal where the team paid a higher than expected AAV in return for a shorter, potentially one-year time frame? Maybe. It feels like Bregman got a win with the AAV and the opt-outs, but most see this as a deal Bregman won’t want to opt out of, unless things go horribly wrong with the position switch.

In reaction to my piece about loaning players, several readers pointed out that this used to occur. Several examples from the 1960’s and 1970’s, including “Super Joe” Charbonneau and Joe Altobelli, were given where teams would loan guys, with some even making the majors. I’m not sure how widespread this was or when it stopped, but it does prove the concept is viable.

Someone asked me last year how UTK worked. It was honestly not something I’d considered, but it’s also an interesting question. It’s basically the same format it’s always been in its various residencies and not far off what is was on day one. That’s lucky, because I didn’t have time to adjust on the fly and this format, I think, just works. There’s the intro, where I talk about issues of the day. There’s the meat of the newsletter/column/whatever, where I discuss eight to ten player injuries, usually a couple grafs on each. Quick Cuts is the short but notable things, and where I drop the occasional treats. That’s pretty much how it works. As for titles, Under The Knife is both the name of the newsletter and the main column, like this. UTK Special is for almost anything else, but still baseball. UTK Off The Rails is when I go far afield. I’m still debating if my summer trip will be in there or if that’s just too far afield even for that. Thoughts?