Under The Knife 3/9/20

Verlander, Judge, Calhoun, Betances, and more

I apologize for a quiet weekend. A lack of connectivity at the Holiday Inn Express led to a scheduled “Special” piece not going out on Saturday. You’ll see that soon, plus a lot more.The UIndy baseball team did win another series, played in howling wind, to go to 11-2 on the season. There’s plenty of injuries so let’s get right to them:

Justin Verlander (SP Astros)

Justin Verlander walked off the mound calmly Sunday in no apparent distress. That he came out of the game after two when he was scheduled for four innings of work was notable, but that the Astros said Verlander was being sent for “further testing” set off alarm bells.

The testing turned out to be an MRI and while the results aren’t back, Verlander is saying he feels better. There was some tightness in his triceps, I’m told nearer the elbow than the shoulder, but that there’s no concern about the joint, just the muscle. The triceps straightens the arm, which is obviously a key for any pitcher, but for a power pitcher, even more so.

The Astros will be cautious with Verlander, a pitcher who’s been very durable over his career, but not too cautious. He’ll be able to build his workload up to a normal level, assuming no further missed work, but I’m sure Dusty Baker will be under orders to not take him very deep into his first few outings of the season. This does bear watching to see if this is more a symptom of something than just an isolated muscle strain, which is what this appears to be.

If there’s any pitcher to comp Verlander to, it’s Roger Clemens. Where Clemens learned a new pitch to extend his career, Verlander learned how to use data. There’s no reason to think that, despite his age, Verlander is in line for a sharp breakdown. Then again, we seldom see those coming. This episode appears to be nothing and I wouldn’t alter how you have Verlander valued at all.

Willie Calhoun (OF Rangers)

Willie Calhoun was one guy several scouts had pointed out to me as a breakout candidate. The outfielder was still close enough to prospect status and talented enough that it made sense. One fastball up and in takes that out for a while. Calhoun fractured his jaw and will miss several weeks as it heals up.

Calhoun wasn’t wearing a “C flap”, which has become nearly universal since Giancarlo Stanton got hit a few years back. Even high school and college kids are wearing them, but they’re an addition, not part of the helmet. I don’t know why Calhoun didn’t wear one, but I don’t understand why anyone doesn’t at this stage. Plenty of players do well with it, so claims of vision blocking seem lame, especially considering the trade off.

Calhoun will be able to get back in the cage long before he gets back in games, so with no guidance from the Rangers yet about how long Calhoun will be out, I won’t guess. How the jaw is fixated will be the biggest part of it, then keeping Calhoun’s weight and strength up while his diet is limited is secondary. It’s a broad range of time he could be out, from two to ten weeks, so keep an eye on this.

Aaron Judge (OF Yankees)

“Remove the first rib” sounds pretty medieval. The topmost rib which lies just under the collarbone is there for a reason, but yes, it can be safely removed in several situations. The most common is to correct for thoracic outlet syndrome, which happens in pitchers but also bull riders, who take a lot more contact than outfielders. That’s not to say it’s desired or that it doesn’t take a while to come back from, but the results have been good. (This article I found details some of those results.)

They’ve also been almost exclusively in pitchers. I couldn’t find any position player remotely comparable to Aaron Judge that had the procedure. The time he would need to come back from it could be different from pitchers, in the same way that position players can come back more quickly from labrum or Tommy John surgery.

The bigger issue for me is the optics of this. The Yankees say this is a stress fracture, but that it’s related to a dive he had last August. The Yankees have great doctors, so I don’t believe they could miss something like a stress fracture for this long. Add in the quick discussion of the resection and I think that, for whatever reason, Judge is dealing with something more like thoracic outlet syndrome than a simple rib fracture.

We’ll have to see how this plays out. Will surgery be necessary and if so, how long will Judge be out? More, will it affect his power in the short and long term? All of these remain unknowns for now, so Judge has to be considered an unknown for at least the first half of the season. I’m adjusting his numbers down by that half, with a bit of upside, until we know more.

Dellin Betances (RP Mets)

I will admit to a mistake this week. I called a Yankees source to ask a question about Dellin Betances. Sometimes it takes a while to get used to player movements. Betances made his Mets — Mets, Carroll, Mets — this weekend and things went to plan. He topped out at 90, but this was about progression, not a finished product. 90 is a base, though the 97-98 that Betances threw before might not be reachable.

We don’t have many modern era power pitchers coming back from Achillles ruptures. It’s not a common injury and in terms of mechanics, very little is known about the involvement. There’s no reason to think that given advancements in the surgery and rehab that it will be much more difficult for Betances to come back than an NBA or NFL player, where this surgery is routine and returning in a shorter period.

Betances’ velo will be the easiest thing to see, but it will be more important that he gets to back to back days of throwing without any real issue. Again, there’s no reason to think that his Achilles repair should impair that, but we’re dealing with several unknowns. The velocity should come back as well, especially once Betances feels his legs under him, literally.

Carlos Carrasco (SP Indians)

Someone asked me recently if I felt Carlos Carrasco was ‘injury prone.’ I’m certainly not going to knock a guy who spent much of last season beating leukemia. Carrasco hasn’t been durable, but he’s been good when available and I think we should focus much more on the positive. The Indians will need him this season, which makes early inflammation in his elbow more worrisome than any tag like ‘prone.’

The inflammation is said to be minor, one where the Indians medical staff elected to alter his schedule to reduce risk more than any underlying issue. He’s also dealt with a hip issue this spring, so there may be some stamina issues as we saw in his return last year. The Indians are well equipped to handle this and I wonder if Carrasco could shift to the kind of “super-middle” role that Terry Francona used with Andrew Miller a few seasons back.

That shift will have to wait. The Indians are down a couple other pitchers and Corey Kluber is gone, so Carrasco was hoped to be in discussion for opening day starter with Shane Bieber. Instead, the Indians might have to open with their sixth-best starter in the rotation, which will test a very shallow rotation and Francona’s bullpen usage.

Griffin Canning (SP Angels)

Griffin Canning isn’t ready to go under the knife. Instead, the Angels starter has elected to have PRP and likely stem cells injected into his elbow in hopes that the significant sprain will heal up. The Angels have confirmed the former, but discussion of his hip - where stem cells would be taken from - lead me to believe both were done.

The success rate here is very mixed and very lacking in real research. PRP itself is controversial. At worst, it does no harm, but there’s no study that shows how or even if it works that is generally accepted. Still, there have been success stories with the procedure on small tears. We’ll have to see how this goes for Canning. He’ll take about ten days off before trying to throw again, so that will be one milestone.

It’s nearly impossible for him to ramp up even if things go well, so the Angels will have to start the season without him. It’s likely they’ll need to be without him a lot longer. Canning is basically a lottery ticket at this point for all but the deepest fantasy leagues.

Quick Cuts:

AJ Puk has a simple strain in his shoulder. The A’s sent Puk down to consult with Neal ElAttrache. He won’t ramp up in time to start the season in the rotation, but the news is positive … Jakob Junis is back throwing for the Royals after some mild back soreness altered his schedule. He can get back on track to start the season with the rotation by staying on this schedule … Some good news for the Yankees - Gary Sanchez is taking batting practice again. Word from their camp is he’s taking his back very seriously and has talked with some other players that have experienced similar situations. I wonder if Pudge Rodriguez is one of them … More good news? James Paxton will start a throwing program this week after his back surgery. He appears to be ahead of schedule but will still miss all of April at the very least … More players missing time with flu this weekend. Teams are being very cautious with this given COVID-19 issues, so expect to see teams sending anyone with a cough home.

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