Under The Knife 5/8/26

Would You Like Fries With That?

I’ll let that one speak for itself.

EMILIO PAGAN, RP CIN (strained hamstring)

“Went down like he was shot.” That was the first text I got - sans context - about Emilio Pagan. Pagan did indeed go down hard as his hamstring severely strained, a recurrence of a recent strain and appeared especially painful. However, that pain and the way he grabbed it showed immediately that it wasn’t a Grade III strain, where the muscle retracted the way we’ve seen with some muscular injuries. Achilles ruptures are perhaps the most dramatic, but we’ve seen some biceps ruptures in baseball that were shocking. Miguel Cabrera comes to mind and there was a Ranger years back … third baseman? … Dean Palmer!* (Thank you, Scott Lucas.)

Pagan’s looked different because recurrent hamstring strains almost always do. The first injury compromises the tissue, but the bigger issue tends to be compensation. Pitchers alter mechanics subtly to protect the healing area, then overload another segment of the same chain while trying to ramp back to game intensity. Hamstrings live right in the middle of that kinetic handoff between drive and deceleration, especially for relievers who throw with max intent every outing. Pagan’s delivery has never exactly been low-effort, and once the hamstring starts barking, every kick and landing becomes a negotiation between explosiveness and self-preservation.

The Reds are calling this a strain again, but recurrence changes the conversation immediately. Recovery timelines get fuzzier because the medical staff has to answer two separate questions: has the tissue healed and can the player trust it enough to move normally again? Those are not always synchronized. We’ve seen plenty of pitchers come back medically sound while pitching like they’re stepping across ice.

That matters for Cincinnati because Pagan had quietly become one of the stabilizers in a bullpen that badly needed one. The velocity was intact, the command sharper than expected, and Terry Francona had started using him in the spots that reveal trust. Hamstrings tend to steal availability before they steal stuff, though once they become recurrent, the line between the two gets awfully thin.

Pagan’s injury led to a weird sequence of moves for the Reds. They sent Chase Petty back to the minors, moved Brandon Williamson to the 60-day, and brought back Tejay Antone, who’s got three holes on his Tommy John punch card. That 3X club is bigger than you’d think, kind of like SNL’s Five Timer gimmick.

CARLOS CORREA, IF HOU (strained ankle)

Carlos Correa’s ankle tendon finally gave way during what looked like an ordinary baseball movement, the kind players make dozens of times a game without thinking about it. That’s usually the tell with tendon ruptures outside the Achilles. The dramatic injury often arrives attached to a surprisingly mundane motion because the real problem has been building quietly underneath for months or years. Healthy tendons are extraordinarily strong. They’re built to absorb force repeatedly at levels most people would find absurd. When one snaps without a violent collision or obvious trauma, degeneration is almost always part of the story.

In Correa’s case, the rupture involved the peroneal tendon complex along the outside of the ankle, structures responsible for stabilization during cutting, planting, and rotational movement. For an infielder, especially one whose defensive game depends on balance and lateral control more than pure speed now, those tendons matter constantly. The foot hits the dirt, the ankle stabilizes against torque, and the tendon suddenly fails under a load it had probably tolerated thousands of times before.

The surgery itself is usually straightforward by modern standards. The damaged tendon gets reattached or reconstructed depending on tissue quality, often with cleanup of degenerative tissue and stabilization of the tendon sheath if instability contributed. Recovery is less about simple healing than restoring confidence in push-off and directional change. Baseball players can return from these, but the timeline tends to stretch closer to nine months than six once explosiveness and lateral movement enter the equation.

There are a few reasonable comps, though none perfectly clean. Max Scherzer dealt with peroneal tendon irritation in 2021 without rupture. Ozzie Albies battled recurring ankle instability after fractures altered mechanics lower in the chain. Tendon ruptures around the ankle remain relatively uncommon in baseball because it typically takes either substantial force or substantial underlying wear to get there.

Importantly, this is not the ankle that complicated Correa’s free agency years ago. That concern centered on the surgically repaired fibula and the long-term durability of the fixation from an old fracture, not some broad anatomical weakness in the ankle itself. Teams worried about how that prior repair would age over a decade-long contract. This rupture appears to be an entirely separate problem, just unfortunately attached to the opposite-side body part, causing confusion to some.

Yes, because this is a tendon rupture, this is a strained-with-a-T strain, not a sprain, which is of course more commonly associated with an ankle injury.

There’s a lot more injuries below the paywall - Tyler Glasnow, Cole Ragans, Tarik Skubal, Mookie Betts, and more. I’ll once again ask what more I can do to get you to subscribe so you can read all of it. I mean, I’m biased, but I think KNOWING more on Skubal alone is worth it. It’s 3,500 words of stuff you cannot find anywhere else.