Under The Knife 2/29/20

Every year, teams deal with illness. A flu or virus will go through the clubhouse, people will make jokes about it really being a hangover or something nefarious, and a couple days later, everyone forgets all about it.

It’s different this year. COVID-19 is on everyone’s mind and two teams I spoke with already have plans in place for both their athletes and if they have to close the doors to their stadiums the way Italian soccer had to this week.

I’d bet that most other teams have similar plans in place, or will have soon. Baseball stadiums are big giant collectives of 20 or 30 thousand people and not all the same. Every season ticket holder doesn’t go to every game. I’m not sure how the math breaks out there, but it’s a serious vector if you get a couple sick people coughing in the stadium.

If it does get into a locker room, it could spread quickly based on what we know. There’s really more danger for a team than individuals - these are healthy young men - but if even one gets it, quarantine for many could throw off everything. There’d be no games, no workouts, and whether that happens here in the midst of spring training or at the start of a season, that would be difficult to overcome and how could it be dealt with, absent a mass change to the leagues schedule?

I’m not being alarmist here. I’m no more worried about COVID-19 than I am a particularly nasty flu strain. Baseball dealt with SARS, most notably in Toronto, and did fine. It’s just a health issue that has the potential to tax baseball on both a sports medicine and a philosophical basis. Now, on to the injuries:

Madison Bumgarner (SP Diamondbacks)

The whole rodeo story is a bit of a sideshow to me. Yes, roping has some inherent danger, jumping off a horse in boots around big animals that can often be unpredictable. The bigger issue for Madison Bumgarner and the Diamondbacks is not how well he can get along some little doggies, but whether he can still pitch.

Bumgarner has an odd pattern to his pitching. Most pitchers that get above the 190-inning mark will stay there until they don’t, then never get back to it. There’s exceptions, but not many. Bumgarner dropped down in ’17 and 18, then bounced back. The odd thing is how he did it. Yes, he stayed healthy and available, but his K rate was only slightly up and his walk rate only slightly down. His pitch velocity and selection was roughly the same as before.

So what changed? The likely answer is nothing. Bumgarner projects well, all in about the 175-200 range with similar raw stats, but there’s significant downside risk as well. Despite the solid DBacks medical staff, there’s not a leap from the Giants, who are also solid and are used to Bumgarner. At age-30, Bumgarner feels like Roger Clemens or Justin Verlander at the same stage. It took a new pitch for one and a new approach for the other to keep them at ace-level into their 30s. Bumgarner doesn’t appear to have changed anything but his address so far.

Mike Clevinger (SP Indians)

Mike Clevinger is about two weeks out from his meniscus surgery and is getting ready to start his throwing program, according to the Indians. I’d be surprised if this is technically true. Clevinger is likely to do what most pitchers do in this situation and throw from a chair, or hopping. Maybe he’s smarter than most, but throwers want to throw, even when its a bad idea.

Clevinger’s two week timeline tells us this was likely a trimming rather than a repair. That’s not bad, though repairs are more often done in sports where running and jumping are more key. It’s not that Clevinger doesn’t use his front knee. In fact, that’s what I’ll be looking for once he throws with some intent. Can he get over that knee and use the leg as he normally does as part of his high-effort mechanics?

While the expectation seems to be that a “six to eight week recovery” means he’ll be ready for opening day, that would be a pretty quick ramp if he de-loaded for the last two weeks (or didn’t have a really high chronic workload built up, which I don’t know.) The Indians may have to do without their titular new ace for the start of the season, if they want to keep him healthy all year long.

Griffin Canning (SP Angels)

The Angels got “good” news on Griffin Canning. He doesn’t have a sprained elbow, but he does have what the team called “chronic changes” to the UCL. What does that mean? It means that there’s been damage to the ligament but that currently, it’s not sprained. Damage to a ligament shows up in a couple ways - laxity, scarring, or cellular changes. All are the result of previous sprains and the healing responses. We have to assume that Canning’s UCL isn’t loose or he wouldn’t be out there pitching.

He’s not out of the woods. With no mention of PRP or similar biologics, it appears the Angels are taking a conservative wait-and-see approach to his return. Even if all goes well, he won’t have time to ramp up by opening day, at least properly. This leaves the Angels in the same position they were yesterday - uncertain about how they’re going to get to 1000 starter innings without a trade.

That’s the easy way. The hard one would be to go to a four-man rotation with shorter, more frequent outings and let the bullpen pick up the slack, at least in the short term. Innovation comes from either desperation or domination. I have to think that even with a new manager at the helm, spending money around Mike Trout is going to cause this current from office to get a little bit desperate. Let’s see how creative they can be.

Miles Mikolas (SP Cardinals)

PRP - platelet rich plasma - injections are pretty standard and only slightly controversial. There’s still no solid understanding of how it works, even if it works. The last decade has shown that it’s easy, can have some positive results, and no one is worse off from it. Add in that it’s cheap and available and why the heck not?

Miles Mikolas is the latest data point in the PRP debate, if we can even call it that. He had a PRP injection in his troubled forearm last week and has seen some improvement. The Cards will get him throwing soon and hope to start ramping him up without seeing the forearm strain dial him right back down.

The Cards rotation is all about durability. I doubt they can keep all of the Mikolas-Adam Wainwright-Carlos Martinez axis healthy for a full season, let alone Alex Reyes and still-rehabbing Jordan Hicks. The US-to-Japan express is a route that works for pitchers, but like Japanese-posted players, there seems to be a higher than expected injury rate. The Cardinals need to find a way to keep Mikolas useful, even if that means not having him for the start of the season.

James Paxton (SP Yankees)

“The Big Maple” is one of my favorite modern nicknames. Nicknames are a lost art in modern society. We get “A-Rod” and “Jeets” more than we get “Stubby” or “Dizzy.” James Paxton’s name belies a bit of instability Paxton had last year after his breakout season overtaxed him slightly. His shoulder didn’t break down but the Yankees did have to hold him to just 150 innings in order to keep things from getting worse there. His back, on the other hand, did give, resulting in minor offseason back surgery, likely a microdiscectomy.

His back has recovered well, as is common for this standard surgery. It’s still too early to tell if his mechanics are back to normal, but the Yankees are likely to be cautious with him early as they make sure everything’s in line. I’m curious if being able to bend his back more normally will return some of the ground balls he lost last season.

Remember, “Big Maple” is not a big innings guy. 160 innings is his career high. If he can bend his back, get his grounders back, and throw the change he worked on early last year and abandoned, he could have a very different looking season in pinstripes.

The clip below of Al Leiter breaking down Paxton is one of my favorites on MLB Network. Leiter is so good at breaking things down from both a “former player” and an analytic basis. I wish he’d do it more!

Edwin Encarnacion (DH White Sox)

I try not to have any sort of bias with teams, but I will admit that the things that the White Sox are doing and the people doing them make it much easier to root for them. If the team is going to compete in the wide open AL Central, they’re going to need to stay healthy and find more than a bit of luck. Edwin Encarnacion might be the epitome of this, so back spasms early in camp aren’t a good sign.

Encarnacion was back on the field quickly however, the spasms cleared up and his big hacks back in place on Friday. This is the kind of thing you want to see, even if you’d rather not have needed to see it. Quick returns, especially ones that don’t have any recurrences, are a good sign for any team. He’s universally projected to put up very similar numbers to last year - 30+ homers, 80 or so RBI, and a WAR held back my defense. If he’s the DH, as expected, there’s upside here even at age-37 and he’s the kind of player that could do that for a few more years. Three years of 30 puts him in the 500 homer club.

Stephen Piscotty (RF A’s)

Stephen Piscotty adjusted well to a platoon role last year. He still takes huge swings and strikes out a lot, but he’s a very useful player for a team that’s famous for finding ways to make flawed players like Piscotty into useful pieces on a winning team. Part of that is keeping those parts healthy, but then again, replacements are usually cheap and available. That’s the case here, with Piscotty down with an intracoastal strain. There’s a handful of guys in camp that will take his spot, probably about six deep at this stage, led by Robbie Grossman and Tony Kemp, until he’s ready.

Big swings and rotational injuries aren’t a good combination, but these sorts of torso injuries have increasingly good results. Back in the late 1990s when there was a huge upswing in intracoastal and oblique injuries (or more likely, when there was a big uptick in reporting them), teams were bad at getting guys back, with recurrence a common theme. Now we have better tools to diagnose and treat, as well as much more experience. Piscotty will miss some time but should be back for the start of the season, assuming that setback is avoided.

Quick Cuts:

The Philies announced Andrew McCutchen will start the season on the DL. That’s no surprise given he’s about eight months post ACL reconstruction. A May return to the field and a June or July return to the majors is standard … Brent Honeywell is progressing in his comeback from Tommy John surgery. No, the screwball does not necessarily put more strain on the UCL, though I don’t know if the Rays have biomechanical data on him. I’d expect him back midseason with at least a handful of starts at Montgomery or Durham … Brad Wieck had a cardiac ablation. It sounds worse than what it is, but treating his irregular heartbeat with this common procedure could save his life. He should be back to normal in days … Jordan Hicks was mentioned above, but while he’s on the 60-day, he’s throwing and progressing on schedule for a June return. Don’t expect saves early, but we should start seeing heat by early May … Yes, I’ll have more on Tua Tagovailoa soon. Still figuring out how to fit football news in here at this point of the year. Short version - teams haven’t been surprised by his medicals.

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