Under The Knife 3/02/20

Welcome to a lot of you, or welcome back. I recognize a lot of the emails, some from as far back as the original Under The Knife newsletter. The announcement of the return of UTK went well and I’ll continue to give you free material leading up to Opening Day. (Honestly, it will probably be a couple days after that, maybe even April 1.) I’m hoping you’ll have a lot of questions that we can address here. If you haven’t gone back in the archives, I’m going to answer all email questions in the next column, though I’m still debating how to deal with “breaking news.” If you have suggestions or comments, please email me at theinjuryexpert@gmail.com. There’s plenty to get to today, so let’s get to it:

Aaron Judge (OF, Yankees)

Pectoral strains aren’t common in baseball. In the NFL, they’re a growing problem. For Aaron Judge, having an unusual injury is a real problem. This is one that’s affecting his swing and new imaging done last week didn’t show any clear cause. That means the medical staff will have to attack this with trial-and-error. That can take time and while there’s not a rush, the Yankees would like to have at least one healthy slugger available when the season starts.

The area itself where Judge is having pain is very complex. The pectoral tendon overlaps with the biceps tendon near where the collarbone and shoulder joint meet. “Impingement” is the catchall term, but given all the structures that can be the root cause, or worse, that they can be problematic in combination, this is tough. It’s easier in the sense that Judge isn’t taking hits, like JJ Watt did after coming back just weeks after having his pectoral tendon re-attached. That doesn’t make the function any less affected.

Right now, look for the Yankees to be aggressive in the sense that they need to at least get Judge back to function if not eliminating the root cause. That would be better, as just eliminating symptoms means recurrence casts a long shadow. With both Judge and Giancarlo Stanton dealing with nagging soft tissue injuries over the last two seasons, I’ll again point at the changes the Yankees have made in their sports science department as a positive. The Yanks have Judge scheduled for more tests this week, so I’m watching it closely.

Chris Sale (SP Red Sox)

Chris Sale is throwing. Yes, it’s limited and yes, it’s less than you’d like at this point in the season, but they’re ramping him smartly, so “less” is all relative. Talking to people that have seen him throw and understand the program he’s on, they’re all very positive about where he is and how he’s doing.

That all said, there’s no guarantee this works or that Sale will suddenly become the 200 inning workhorse everyone in New England seems to want him to be. He’s not that, but with a smartly managed workload, he could give 160 to 180 very solid innings and pitch into the playoffs.

Right now, Sale is on track, throwing live batting practice and a sim game as he works up to game action in the next couple weeks. The Sox have already said that he’ll miss at least the first few days of the season, though with the new rules on backdating the IL, I’m honestly not sure when he’d be eligible to come back, though I’ve asked a couple people for clarification. As long as Sale continues to push forward, not needing any extra days or time off, take it as a big positive.

Alex Verdugo (RF Red Sox)

As part of the Mookie Betts return and with other issues, having Alex Verdugo miss the start of the season would make it harder to win the fans over on a deal that frankly was impossible to win. The Sox wanted cash off the books, not fair value, and that’s exactly what they got. That’s baseball in 2020.

The stress fracture that ended Verdugo’s season last year was a known and checked issue at the trade, so it had to be healing well. The oblique issue isn’t directly related and shouldn’t set back the other, but getting Verdugo swinging soon is going to be key. I’m not sure they need him to have a set number of at-bats, but starting on the IL or in the IL (International League, that is) is again, a tough look for the fans.

The expectation is that Verdugo will start taking swings this week, gearing up quickly to live pitching and games by mid-March. All of that is a reasonable, standard rehab program so as with Sale, watching the steps happen is all we can do. Patience and the modern Red Sox fan aren’t quite as acquainted as they once were.

Xander Bogaerts (SS Red Sox)

Did I mention the Red Sox are dealing with some injuries? Xander Bogaerts is doing everything but playing in games but the recurrence of pain in his ankle indicates some sort of chronic condition. He played in his fewest number of games last year, though he was still very productive in both rate and counting stats as well as showing there might be more power in there. To do that, he’ll need a stable base, but he showed last season that he’s at least stable enough for 30-plus.

The Sox appear to be in no rush to get Bogaerts into spring training games. I don’t feel like this is just being conservative. It feels more like they’re trying to find ways to get his ankle pain-free and stable without introducing any real risk of injury into the equation. I’d call that a positive, though you’d hope they would have the situation figured out by this point, absent some unknown change.

There’s some risk in Bogaerts, but also an upside that puts him up with the elite shortstops and elite players. The Sox will need Bogaerts healthy and available at least as much as last year if the Betts drop-off can be avoided. With day-to-day injuries to Mitch Moreland and Andrew Benintendi keeping the Ft. Myers training room full, health is going to be as important to the Sox success as anything Verdugo or Jeter Downs do.

Blake Snell (SP Rays)

Cortisone shots … man, I could probably write a book about them. I’ll save all the gory details and tell you that Blake Snell had a cortisone shot near his elbow a day after his last start. He’s already got throwing sessions scheduled this week, so the inflammation had to have come out quick. That’s a good sign.

What’s not a good sign is that the Rays are having to go to shots this early in the season. Snell has had some elbow issues off and on throughout his career, but none of them have been serious. He miss time last year with some bone chips in his elbow, which were removed. That surgery almost never has any recurrence in the short term. It takes time for bone chips to build back up in most cases, if they ever do.

No one seems concerned about this elbow-related issue for Snell, but I’m reserving judgement here. Maybe the Rays are just being aggressive, knowing they’ll need Snell for the first week of the season and beyond, given their lack of starter depth. Watch to see that Snell makes his throwing work, has no setbacks, and once he gets back on the mound, that he shows his slider again.

Jay Bruce (OF Phillies)

“150 feet doesn’t sound too limited to me.” When someone says this about a thrower, feel free to discount anything else than comes out of their mouth. I will freely admit that I was a doubter about long toss, but Alan Jaeger, the guru of the genre, patiently explained his work, his research, and now I’m not just a believer, I’m an advocate. Yes, my pitchers do this and if you’d like to question methods, feel free to show me the guys you have at any level having more success.

Whew, deep breath. Baseball has its own divisions, like politics or religion, but with Jay Bruce, an outfielder coming off a flexor tendon strain, 150 feet is limited. He’s not going to get out to 250 on any regular basis, but watch the way outfielder throw on plays from deep and if you can, get a gun on them. Scouts do, and know exactly what these guys are throwing. More and more outfielders are starting to use the same methods to strengthen and protect their arms.

Bruce is throwing, on track to be ready in plenty of time for opening day, and if the Phillies can keep his arm healthy, he’ll get the big split of a platoon while Andrew McCutchen recovers from ACL reconstruction. That means Bruce could be a good late round value and a guy who could see a late-career resurgence in the short term. The power is still there.

Max Stassi (C Angels)

I will admit I can’t think about Max Stassi without thinking about Stassi Schroeder, though I’ve never watched an episode of any of the “Real Housewives of Anything.” If Top Chef didn’t exist, I might never turn on Bravo.

While that’s just my own weird quirk, the Angels should get Stassi back by Opening Day. He had hip labrum surgery in September and several baseball players, going back to Alex Rodriguez, have had this kind of surgery. Almost all have come back with no real issue and given that the surgery has been standardized and practiced for the last decade after Marc Phillipon first introduced it, so there’s no reason to think Stassi or a catcher can’t come back in the normal timeline.

Stassi hasn’t caught yet and doesn’t hit enough to be a valid DH in the Angels lineup. Look for him to get behind the dish by mid-March if he’s not going to go on the retro IL to start the season. The Angels have options in Jason Castro and Anthony Bemboom, if not good ones.

Quick Cuts:

The White Sox have a few players that they’re managing conservatively, with Yasmani Grandal being the one I’m most excited to see on the field. Grandal’s calf strain isn’t a big deal in the long term. With the DH available for him this season, I’d expect them to keep him well rested, at least through the first few weeks of the season … Most players lose a bit of power coming back from hamate bone (wrist) surgery, but Luis Urias doesn’t have a lot of power to begin with. I think the Brewers solid medical staff will have him back near if not on Opening Day … Aaron Hicks is on an identical schedule and rehab plan as Didi Gregorius was last season. We’ll see if the same results come, though I still think rehab times could be pushed down, especially for position players … Travis Jankowski left his Sunday game with what looks like a strained hamstring. No word on severity, but any significant time lost will make the battle for spots in the Reds lineup tighter … Jakob Junis had his scheduled start pushed back due to a minor lower back issue. My Royals source said it’s minor; a “pushback not a skip” … Seranthony Dominguez, who autocorrect hates, is close to a return. Expect a very cautious rehab schedule despite his age … UIndy Baseball swept a four game set this weekend to go to 9-1. Dominant pitching and some very long balls are putting the team in a good position heading into conference play.

I’ll have the first “special” UTK Tuesday, where I’ll talk about why we need to get pitch counts off the screen in MLB. I’m hoping to do one of these a week and believe me, there’s a lot on my mind in terms of MLB’s management of injuries and technology.

This is a free Under The Knife article. Please forward it to friends or refer them to sign up at undertheknife.substack.com. Questions to: theinjuryexpert@gmail.com.