Under The Knife 2/22/23

Welcome Sheehan Readers!

Longtime reader (and friend) Rob Miller asks: “Something I've never understood, maybe you can help. Frankie Montas -- Why do seemingly so many players not have surgeries in the offseason and then come to camp and go "owwie?" I have no shares of Montas but he's just the most recent example. I dunno, maybe this is a topic for a newsletter?” It’s certainly a topic for an intro.

The timing of surgeries is always a tough one and is usually based on a couple factors. First, is this avoidable? Surgery is almost always the long road back, though sometimes the surety of knowing the problem is fixed is worth the time. Second, when do you need to be back? With an expected recovery time, teams (and agents) will look at the date and count back, saying we have to decide by X date on surgery. Since we don’t usually know that trigger date, the line in the sand is often an unknown for us.

For someone like Montas, with a known shoulder issue going back to last year, my guess is that they wanted him to do a rehab and strengthening program in the off-season and then dial things up. At the point he got to near-full intensity, which would have been over the last month, the labrum acted up again and the decision on surgery was made. Given there’s no surety on the timing here, it’s tough to say why the wait, but the most likely outcome is that he’ll miss the season, so six to eight months from now is really no different than six to eight months from last month in terms of his season. Yes, there’s the chance it’s less serious, but everyone I’ve spoken to seems to think he won’t pitch this season and it’s a bonus if he does.

Pitchers and players don’t just show up with an injury, unless it really is new or if they really did cover it up. Athletic Trainers are in contact with the players and their people (agents, physical trainers and coaches) on a very regular basis during the offseason and if something happens, the team is usually informed very quickly so they can be involved in the decision. Most teams I know want to “touch” a player at least once a week, but for key players or ones working on rehabs, it can be as much as daily or more.

So, TLDR: It’s usually about avoiding surgery, but then it’s about getting it done and is seldom a surprise. Thanks for the question and I hope more of you ask these. What’s the thing about baseball injuries you’ve always wanted to know? I often don’t have the answer, but I know who to ask. Let’s get to it:

DANIEL ESPINO, P CLE (strained shoulder)
CHASE DELAUTER, OF CLE (fractured foot)

Cleveland has long been one of the top rated medical staffs around, so losing not one, but two of their top-rated prospects this early in camp is a bit of a shock. But this is why you don’t build a team around a prospect, but around a basket of prospects. Cleveland in large part built the Wall Street portfolio approach to baseball, which many now call Moneyball. No one wrote a book about Cleveland baseball — Major League had just been done, after all — but what they’ve done through a handful of execs in charge and a ton of trained-in-Cleveland execs, starting with Paul DePodesta, is the base.

Daniel Espino is a top pitching prospect (TINSTAAP) that throws real hard. He’s not real big, so there’s always been a question about this even though there’s no evidence of bigger pitchers staying healthier. It’s force transference, as Goliath once learned facing a smaller man. We don’t know how David’s elbow and shoulder held up, but he had a sling and didn’t throw 100 rocks that day, as far as we know. Espino was shut down last year with patellar tendinitis, but he had a shoulder issue as well. I’ll give the Cleveland staff a truth pass here since they’re very good and usually very open.

The downside now is that Espino’s shoulder injury is worse, with additional muscular involvement. That’s usually rotator cuff, but the “additional” makes me wonder if it was the cuff in the first place. I couldn’t get confirmation on either, but hope the beats in Arizona will get more. Espino is shut down for at least a couple months, which puts his ‘23 debut out a ways and a question about him missing another year is in play.

The news isn’t great for hitting prospect Chase DeLauter, another top rated prospect. A toe injury is going to cost him a couple months after surgery in January. I haven’t been able to get details on this, but four to five months for a toe seems extreme. There’s a couple possibilities, none of them good, unless they’re just being very careful, which is possible given he broke the same foot last year. It puts him back in June or so, which gives him a half season and likely a trip to the Fall League. That’s not bad for development, especially for someone that could come quickly. My curiosity here is if it was actually the toe or a Jones fracture, which is just above. One report had it fixed with a screw, and that would the Jones. It doesn’t take as long to heal, but it could have issues with foul balls. I’ll keep digging on this, but I’m not as worried by this injury as the time would make you think.