Under The Knife 3/12/20
All of MLB is day to day with pandemic
I am not a doctor and I’m definitely not an epidemiologist. I’ll leave the heavy stuff to others and focus on health, but MLB’s response to COVID-19 is both smart, needed, and very problematic. I have tried to talk to teams and the league, but no one was able to give me a definitive, on-the-record answer for how they plan to keep the players going through the shutdown, then ready to play again.
My guess is, they won’t. Instead, we’re going to get a couple weeks of extra “off-season.” The problem is, sending players back to APEC or Driveline is not the best idea either. Is there such a thing as small group training? If I were a team, I’d organize about eight pitchers per group with a coach and an athletic trainer assigned to each. For most teams, that would be about ten groups. Each would stay the same so there’s as little cross-contamination as possible. Add in a couple catchers per group and it’s manageable.
For the next two weeks, the pitchers would work on maintaining their chronic workload. It’s not complex, but a shutdown - even short, even necessary - would crater their workload, necessitating in a ramp up on the other side. This is why Chris Sale was missing time after he had pneumonia. (His elbow issues made this push back further.)
No one has done more work on this that Casey Mulholland of Kinetic Pro. The first team that brings him in to manage this will have a huge advantage. Here’s a link to a great thread Casey put together on Twitter on this topic:
(Make sure you click through and read the whole thing!)
We don’t have injury data for the 1995 season that’s valid enough to really look at whether the changed spring schedule of that post-strike year caused any spikes in injury. (There’s a Red Book somewhere that would probably note it, if anyone has one. The Red Book was the insurance summary of the season that was done through the mid-2000s.) My guess is there was some upward movement, but looking through Baseball Reference, I don’t see anything that really stands out as unusual.
Baseball is often the escape for us from the horrors of real life. In this case, for one of few times, it’s not there. We’ll have to see if college baseball is taken off as well, but we have to be smart not only in stepping aside to protect us all from COVID-19, but to make sure we don’t have an epidemic of arm injuries when that’s over.
Now, on to the injuries:
Trey Mancini (1B Orioles)
Some things go beyond baseball. A pandemic is one, but all too common is the healthy, active young man who’s living his dream only to be felled by cancer. The latest victim is Trey Mancini, who finally let everyone know the health crisis he’s been dealing with for several weeks. Mancini had a tumor removed from his colon. There’s no clear timeline for his return and there shouldn’t be. The hope is that Mancini will be healthy enough to return someday.
Mancini did not give an indication if he will need more treatment, but there’s a chance he plays relatively quickly, depending on the surgery and it’s outcome. On the low end, done without incisions and only minimal disruption at the tumor site, it could be weeks before he could be back rather than months. His condition, both from missing several weeks and any treatment or side effects, is the driver here.
The Orioles have some depth at first anyway so Mancini’s absence can be given all the time it needs. Renato Nunez probably gets the RH at-bats in his absence, though Ryan Mountcastle might get a early look.
For those who want to understand what HIPAA is and why it’s importat, Mancini’s case is an object lesson. No one has a right to know Mancini’s condition and his privacy is protected by this law. The Orioles have no right to know and neither do we. I know that might seem hypocritical since what i do is explain things, but I try to stay on the right side of this discussion by not paying for tips and trying to maintain standards of what I will and will not publish.
Aaron Judge (OF Yankees)
Aaron Judge will have some extra time to sort out what’s going on with his rib. The “stress fracture” appears to be stable enough to start working out with a plan in place to move to baseball activities if things go well. That’s likely to still be the case, though what that will be remains to be seen as we sort this whole thing out. How much so remains to be seen.
There’s still a lot we don’t know with this entire situation. Some of my best Yankees sources tell me that my theory that thoracic outlet syndrome was in play here is wrong, but none of them could give me a good explanation as to what exactly was going on and why it was being presented this way. I’d rather see the Yankees allow Dr. Chris Ahmad step up and explain things rather than letting Aaron Boone mistranslate something he was told, but that isn’t happening just yet.
Jake Arrieta (SP Phillies)
Jake Arrieta might have been the last injury before the COVID break. He walked off after 2 1/3 innings with an Athletic Trainer, saying that he has a “stiff shoulder.” Early indications were that the team doesn’t think its serious, but is taking it seriously. Yes, that actually makes sense.
The major concern here is that Arrieta is having a kinetic chain issue. Remember his ’19 season ended with bone spurs in his pitching elbow. With those surgically removed, moving down the kinetic chain* and seeing any sort of issue is a bad sign for his overall health. Arrieta is a weight room monster, so there’s always been some concern that his work ethic would end up causing overwork more than any sort of debunked “musclebound” arguments that you might have heard thirty years ago.
It will be hard to follow this one but as long as Arrieta can get back to throwing sometime in the next week, I wouldn’t be too worried about this. While I don’t think he can get back to his 190+ peak, I think he can do something similar to his ’18 campaign with a very good 175 innings.
*Even though the shoulder is physically “up” from the elbow, in the kinetic chain it goes “up” from the feet through the body to the ball. “Down” the kinetic chain is the opposite.
Miles Mikolas (SP Cardinals)
Miles Mikolas was scheduled to throw Wednesday but I can’t find any reports of it happening. There were obviously bigger issues, so lets assume it happened as scheduled. Mikolas is coming back from forearm issues, but a PRP injection seems to have gotten him to this point. While he was unlikely to be ready for the start of the season, we don’t know when that is now. Mikolas will continue his throwing program, absent the spring training games for now.
He can do a good bit of work, so there’s no reason to think of this as a setback for him. Most of rehab work is done away from game fields. Even if facilities are closed, Mikolas will have access to treatment and the medical team, somewhere, as well as going somewhere to throw. If he’s diligent, there’s no reason his return to readiness should be any longer given the unusual circumstances. What will be different is it will be much harder to gauge from the outside.
Yohander Mendez (RP Rangers)
Yohander Mendez was suspended by the Rangers for seeing a doctor that was unauthorized by the team. My phone buzzed for about ten minutes after the announcement with people around the league wondering what was going on. While I don’t have specifics on Mendez’s situation, it’s more than what it sounds. Players, like anyone, have the right to choose their own doctor, decide on their own treatment, and have second, third, even tenth opinions if they choose.
What’s going on with Mendez is likely something more. A player doesn’t have the right to see a doctor that is not certified or to seek treatments that are unapproved. This could be as simple as something like having Orthokine done in the US — yes, I know it is, but it’s not technically approved so many go to Germany — or a situation like what the Yankees allege with Jacoby Ellsbury.
Because this is a medical situation, I doubt the details will come out. Mendez hasn’t pitched due to a sore shoulder, but there was no indication that this was serious. While suspended, Mendez will still rehab with the Rangers, which seems a bit odd as well.
Question:
A reader asked if this shutdown changes the fantasy value of Mike Clevenger, given that the season will start later, meaning his missed time will in effect be less. The answer for Clevenger, as well as Judge, Mancini, and many others, is yes. If the league is not playing, then there’s no loss in value.
Clevenger’s knee rehab is essentially getting some extra time, though he’ll be at the same workload risks as everyone. A quick return - straight into games - could be an issue for players that were building up or missed it altogether, so they may need some time in the minors.
Players will need to re-assess relative value with the possibility of a shortened season as well. Clevenger will get a boost to his value, while some like Cole Hamels or Chris Sale, will see their time missed reduced as well. I guess we’ll all have some time to recalculate our fantasy rankings as we self-quaratine.
Quick Cuts:
Eugenio Suarez was due to make his spring debut on Friday but not now. He’ll continue his rehab, which per sources is going “pretty well” … Andrew Miller is about to be back to throwing, but he still doesn’t have a solid diagnosis on what’s up with his arm. It’s not thoracic outlet syndrome, which is good, but without knowing what it is, it’s hard to keep it from coming back … Jesse Chavez is expected to be in the Rangers rotation, but he wasn’t going to be ready for Opening Day after starting late after elbow surgery. That might happen now … There’s no NCAA tournaments, but it’s not just basketball. Right now it looks like all spring sports, including baseball, might get caught up in this as well. Scouts are going to have some real challenges.
So what happens to Under The Knife while there’s no baseball? I honestly don’t know. I’ll do more Specials, but like everyone else, I’m just going to wait and see how this goes. I’m not going to completely go away, but do expect a schedule change. Please keep questions and ideas coming in for things I can do while this break is on. I do know that I’ll extend out the free period until we actually get to Opening Day, rather than the planned April 1 date. I appreciate your continued readership and support.