Under The Knife 5/10/24

We Didn't Have That

Going free today so please, consider subscribing. I’d love to write about injuries for another twenty years. Ok, maybe ten. Help me do that, while I continue to work on other projects to help keep this place a going concern.

David Schoenfield has a great article up at ESPN and it deserves a close look. He makes a great point that what the Sox are doing is simply throwing their best pitch more, throwing it over the plate earlier in the count in hopes of enticing hitters to try and hit their best pitch, and making hitters adjust to them more than adjusting to the hitters. Not rocket science but it brought up a point to me that I don’t think many people understand.

Here’s an example:

Whitlock threw a sinker 53% of the time last season and batters hit .326 and slugged .538 against it. In his four starts before his injury, he added a slider and cutter and dropped his sinker usage to just 22.7%. He has a 1.96 ERA in his limited time. Bello has a 3.04 ERA in five starts after scrapping a four-seam fastball that he threw 21% of the time and which batters hit .310 and slugged .646 off in 2023, now sticking with a three-pitch mix, throwing his changeup and slider more often to go with his sinker.

Simple info that you could look up on any number of sites now, quickly and easily. The teams surely get this handed to them and broken down in far more useful ways, probably with video. However, this information didn’t exist just a few years back.

IT DIDN’T EXIST.

I can’t find the exact date where it was tracked or accessible, but I’m pretty sure it’s 2002. That’s when I started covering the game, so it’s within not just my lifetime, but my career. Those kinds of splits don’t exist for Walter Johnson, for Sandy Koufax, for Nolan Ryan, or for Bobby Witt Sr, who retired in 2001! On the hitting side, we don’t have that kind of data for Mark McGwire or Tony Gwynn, who also retired in 2001. Man, sometimes I feel old, but this is not that long ago.

First, why does this video look grainier than re-runs of Sanford and Son? Second, none of this game, one of the most memorable ever, has any Statcast style metrics.

I could go the other way and say that right now, everyone playing and who will ever play will have that data. It might not be as accurate at the start as at the end, but it exists for Adam Wainwright. There’s some for Randy Johnson and Greg Maddux, but some not, straddling eras and highlighting what we’ll never know (though I do have hope that AI will learn how to pull some of this data from game tape, which should exist in completeness for those guys, if not someone like Ryan or Koufax.

There’s such a richness of information and presentation today that I think we’re a bit spoiled. It will probably get better - or worse - with the infusion of AI, but that could make it work for more people. Want a chart? Here. Want a video? Here. Want it in the style of Ring Lardner? Boom. I could say get off my lawn with this, but we simply didn’t have this information and we don’t know what we’re missing that will exist in another … how long do these cycles go? … year or so.

Today’s UTK is free for everyone, so let’s get to the injuries:

PAUL SKENES, SP PIT (no injury)

Ben Cherington did something brave. He told Jeff Passan that when it comes to Paul Skenes, the team really didn’t have a plan. I’ve been poking and prodding, asking sources for some indication of it, but it turns out there was nothing to find. Any plan could be wrong, so the Pirates have been doing this to what feels right, taking each outing as singular and making a decision when it felt right. Cherington’s a more patient man than I am, because it’s been clear to everyone Skenes was ready on a stuff and confidence basis.

Of course, the elephant in the room is that Skenes throws really hard and pitchers that throw really hard almost always end up having Tommy John surgery. His 100 mph fastball will put him on that Molly Knight chart of top velo that seems to come with a trip to TMI or KJOC.

But so what? Look, I wish we could save arms, but Cherington is at least acknowledging that no one knows how to do it in any usable way. Skenes is being the opposite of overused, which could end up as worrisome, but we simply don’t know. Skenes reminds me a lot of Stephen Strasburg, and yes, his arm could snap as quickly as Strasburg’s did. On the other hand, if you told Skenes now he’d have Strasburg’s career, including the World Series ring, what would he say? Wouldn’t you say he has at least as good a shot of being Gerrit Cole, who doesn’t (yet) have the Tommy John scar.

The longer I’ve done this, the more I’m comfortable saying “I don’t know.” I know Skenes has some of the best stuff I’ve ever seen and while I enjoyed watching him a couple times in Indy, it felt like a waste. I’m going to root for him now, the same as I root for every great prospect. I want him to succeed and to be a big part of the game. If some troll wants to predict Tommy John surgery, let him. I’ll continue to try and find the joy in baseball, thank you.

WILLSON CONTRERAS, C STL (fractured arm)

The consternation in Cardinal-land is at a fever pitch. Somehow, their endless pining for the past has combined with the untimely injury to Willson Contreras, who’s now apparently back in their good graces. With the fractured arm and resultant plating, Contreras won’t be back for at least six weeks (the Cards are saying ten, but I’m not sure how they’re defining “back”) and not back to catching for longer, leaving them with Ivan Herrera, who is decidedly not Yadier Molina. So of course, rumors of Molina’s imminent return started. None were credible that I can find and I’m sure someone suggested equally silly trades and signings.

The fact is, a fractured arm isn’t that bad. It’s not good and certainly painful, but there’s no reason to think Contreras can’t come back in season. Catchers are an odd bunch to begin with, willing to put up with a lot of dings, so add on a good forearm pad and my guess is we could see Contreras back around the All Star break. Whether the medical staff will do it remains to be seen, but bones heal. They heal predictably and are easy to monitor. If they recur, it’s because the behavior causing it persisted. Skateboarders have a lot of broken bones because they skateboard, not because they’re fragile.

Everyone I spoke with agreed with the timeline and likely way Contreras will return. If the Cards are willing to DH him - and why wouldn’t they? - he could return even more quickly. Depending on how Herrera settles in and handles the increased load, that could last longer. On Thursday, the Cards even used Herrera as DH, with Pedro Pages up from Memphis to catch. The path forward is clear and all there is to do now is wait.

Oh and the plating? I’m told the bone was just slightly out of alignment and that the surgery was merely the easiest way to know everything would heal properly. It doesn’t change the timeline at all.

CHRISTIAN ENCARNACION-STRAND, IF CIN (fractured wrist)

Travis Sawchik wrote an all-timer last year, explaining why it’s so difficult to diagnose things, even with all the technology we have to do exactly that. There’s art to looking at an x-ray or MRI, with a lot of it depending on things like positioning and the experience of the reader. If you or I have imaging done, in more than half the cases, it will be done by a doctor in India or increasingly by AI.

It’s something of a coincidence that the latest issue of imaging not being exact happened in Cincinnati, where Travis was walked through the process. The ability to clearly see something like a fracture or sprain depends on the equipment, the patient, and something as simple as how the patient is positioned and if he can stay still.

Which is all to say that something like this isn’t a mistake, but a process. That Christian Encarnacion-Strand had a fracture that wasn’t initially seen happens. The fact that they re-checked it shows that the medical staff was conscious of continuing symptoms and knew that an undetected fracture was a possibility.

Moreover, not much would have changed. Playing through a fracture is painful and often non-functional, but we seldom see a castrophic failure. At worst, the healing is set back, so at worst, this cost CES a week or so. How the treatment happened and how he was dealt with would have changed little. Would the Reds and CES wish they’d caught it quickly? Sure, but the result is largely the same.

SEAN MURPHY, C ATL (strained oblique)

Sean Murphy has seemingly been slow coming back from an oblique strain until you really look at it. He’s just shy of six weeks post and we’re just getting news that he’s swinging in the cage. No live hitting, but (theme of the year) that isn’t significantly different from hitting in the cage now for most teams. The Braves (and sources) wouldn’t confirm he’s swinging full go, but news that he’s days away from what’s likely a short rehab assignment is very positive.

Travis d’Arnaud has more than held his own in the interim, which is what backups and depth are supposed to do. The power numbers might largely come in spurts or even one game, but no one’s saying that d’Arnaud hasn’t held up his end. Murphy’s injury came up early enough that one could functionally just look at d’Arnaud’s seasonal line - 883 OPS, 1.1 WAR - and nod comfortably.

That’s not to say Murphy won’t be a plus. Last season at this point, Murphy was OPSing at 1040 and while you can argue random endpoints, I doubt anyone, including the Braves, would say they didn’t expect that kind of gap between Murphy and d’Arnaud in any month. Keeping the gap small as possible is good and why the Braves, even with key injuries, are just two games back of the Phillies.

MAX SCHERZER, SP TEX (inflamed back/inflamed forearm)

Max Scherzer is suddenly dealing with more than just a weird thumb issue. Now it’s in his forearm and while he wasn’t expected back this early from his back surgery, that was at least a relatively known timeline. This thing is both odd and shouldn’t be that big an issue when he’s not really pitching. Sure, there’s some in rehab and in his couple rehab starts, but unless this is a wholesale age-related breakdown, something happening this early is usually a bad sign.

People I’ve spoken to have alternated between “Max is old” and “One of those things.” As usual, the truth is probably somewhere in between, but there is an age-related corollary to the Iron Man rule. Player that have never been injured (or seem to ignore age) tend to hit a much steeper, often sheer cliff rather than the more typical slide down. Scherzer isn’t one of those like Justin Verlander, who was seemingly never hurt until he was, but his file isn’t Strasburg-thick either.

The thing here is that Scherzer is going to get lumped in with the injury issues that the Rangers are having (see below) and there’s no reason to believe that’s the case. He pitched in the playoffs, but he wasn’t overtaxed or even unusual for him. There’s a whole other discussion to be had about Scherzer and the playoffs but what should have been a win for the Rangers medical staff is now a complete unknown.

DANE DUNNING, SP TEX (strained rotator cuff)
JOSH SBORZ, RP TEX (strained rotator cuff)

I’ve talked about the Diamondbacks and the theory that they’re facing a playoff hangover. Look at the Rangers pitching staff and you’ll see it’s not just a ‘curse’ that hits the NL. Both teams went deep, unexpectedly so, and fatigue is real. With a ton of arms on the IL already, Dane Dunning follows with a rotator cuff that Bruce Bochy downplayed a bit. Even if Dunning isn’t out a long time, the sheer number of injuries and Dunning’s flexibility - he’s had to start this year, but was really hoped to be a swingman - leaves the Rangers forced to use Jack Leiter and Jose Urena rather than choosing to.

Add in that Josh Sborz is back on the IL with a recurrence of his rotator cuff strain. I’ll assume it’s a recurrence and not a discrete tear, given the closeness of the injuries. Neither would be good and he’s out again, meaning the bullpen gets juggled as the Rangers continue to try and figure out how to both be effective and stay healthy after winning last season. They’re still up in the division, but teams with big injury days that win usually planned for it well ahead of time. Think the Dodgers the last few years, spending big and very deep.

RYAN PRESSLY, RP HOU (inflamed back)

Nothing has gone right for Joe Espada at the start of his tenure. Is it just the wrong place at the wrong time, or the lack of “Dusty magic” as Baker’s friends are whispering in the media. If that’s the case, who aside from Espada would have a little of the same? The interesting thing about Dusty as a mentor is that he doesn’t have a deep “coaching tree.” It’s not as much of a thing in baseball as it is in football and basketball, but it should exist, right? As with Molina, there’s very little chance Baker is coming back.

Which leaves the existing Astros to deal with the loss of Ryan Pressly. He’s not on the IL, but has gone past the three-day retro mark, not pitching since last Friday. He’s playing catch and the team is minimizing it as “one of those things”, but they’ve been playing a man down … and losing. That’s not a combination that usually plays out well. While Josh Hader is clearly getting the saves, the leverage has still be there for Pressly and again, the depth is such that it’s not clear who should be taking those high value situations.

If Pressly can’t get game-ready by the weekend, the team will likely be forced to make a move. Part of the issue is - what move? Forrest Whitley or maybe Parker Mushinski are the available 40-man options. At nine games back of the wild card, there’s pressure on Dana Brown from above to do something to kick start this team. We’ll see if the braintrust above him believes that the Astros should be an acquirer or seller or if they believe this team will somehow right the ship. If it’s the latter, we’re going to see more pressure on Espada.

Quick Cuts:

Ryan Pepiot hits the IL after the ball hit him. The bruise was enough to make it uncomfortable to pitch, so the Rays will adjust and Pepiot should only be out the minimum … Blake Snell (quad) will throw a rehab start at Single-A San Jose. No word on how deep he’ll go, but it could be his sole outing before activation … Jorge Soler goes to the IL on a retro, as his shoulder isn’t healing as quickly as hoped. He could be down for a minimum if it goes as the Giants hope … Kyle Hendricks will throw another rehab start on Sunday. The Cubs won’t make a decision on next steps until after that … Matt Brash was shifted to the 60-day IL to free up a roster spot. I’m told no setback but that he wasn’t going to be back before late May anyway and probably longer … Darrell Hernaiz has a severe ankle sprain and there’s a question of whether he’ll need surgery. He’ll visit a specialist, but it could end the A’s top prospect’s season. Max Schuemann wasn’t even a full time SS at Eastern Michigan, so this could get ugly. Or they could get creative. Max Muncy is raking in Vegas and Jacob Wilson hit 455 at Double-A before a recent promotion … Zach Gelof (oblique) will be in Vegas this weekend on a rehab assignment, so maybe he can scout to save John Fisher some money … Nick Ahmed came out with wrist pain. Expect the Giants to send him for imaging …Deception in sport is an interesting topic and this BBC podcast really dives in. Worth a listen … Speaking of podcasts, I was on the SIS podcast with Mark Simon.