Under The Knife 6/12/26

Better Late Than Never (And Free!)

SETH LUGO, SP KCR (no injury)

The ball bounced. That’s one of the keys to look for anytime you see something like the 107 mph rocket that went off Seth Lugo’s head. In the most basic terms, you want the energy to go to the ball rather than the skull. If it drops, the skull or other bones likely acted as a crumple zone, not unlike a car, failing under the force. The Royals didn’t mess around even though Lugo got up, sending him for scans. Those showed no damage and assuming he doesn’t get any symptoms - I’m told there’s actually little bruising or swelling beyond what was initially seen - then he’ll make his next start and that seems miraculous.

One thing worth remembering is that exit velocity isn’t the best measure of danger. It’s the easiest one because we have it immediately, but physics is messier than a single number. The exact point of contact matters. The angle matters. Whether the ball glances off, compresses, spins, or transfers energy directly matters. A 107 mph liner can be survivable while a slower ball striking a different spot can create a much worse outcome.

That’s part of why Lugo’s outcome feels so fortunate. The human skull is remarkably strong, particularly in some areas, and the fact that the ball deflected rather than driving through the contact point likely helped disperse the force. It caromed, not killed. Had the ball struck slightly differently, we might be discussing facial fractures, orbital fractures, concussion symptoms, or worse. Instead, Lugo appears to have escaped with little more than a scare and a very good story.

That doesn’t mean everything is fine. Every time a pitcher walks away from one of these incidents, there seems to be a tendency to treat it as proof that existing protections (ie, none) are adequate. It’s actually the opposite. Lugo got lucky. We should celebrate that. We should also remember that luck is not a safety protocol. Pitchers remain uniquely exposed on the field, standing less than sixty feet away from increasingly harder-hit baseballs with very little time to react. One fortunate outcome doesn’t change the risk.

GARRET CROCHET, SP BOS (inflamed shoulder/strained lat)

When Garrett Crochet went on the IL, the Red Sox described the issue as shoulder inflammation. Then low-grade lat strain mixed in during the rehab. Now Crochet himself is saying it’s “a lot worse” than originally thought and that he has no idea when he’ll even be cleared to throw. Somewhere in Boston, a communications staffer is staring at a whiteboard and wishing injuries would stop evolving.

The problem with lat injuries is that they don’t care much about optimism. The latissimus dorsi is one of the key force generators in pitching, helping create the pull-down action that transfers energy from the torso into the baseball. Pitchers can sometimes manage around minor shoulder discomfort. They generally can’t fake their way through a lat problem.

What’s concerning here isn’t necessarily the severity. It’s the uncertainty. If Crochet still doesn’t know when he’ll resume throwing, that suggests the recovery has stalled somewhere between healing and functionality. That’s why the upcoming imaging matters. The Red Sox need to determine whether they’re dealing with a strain that’s healing slower than expected or something more significant that wasn’t apparent on the original scans.

There is a bit of irony here. The Red Sox acquired Crochet from the White Sox in one of the rare trades that looks like it might work out for everyone. Crochet immediately became the ace Boston desperately needed, while Chicago received a package highlighted by Braden Montgomery, who continues to look like a legitimate cornerstone piece hitting walk-offs. Those deals are supposed to be win-win and that one really appears to be. They’re less fun when one side’s prize acquisition is sitting in the training room.

The timing couldn’t be much worse. Boston has spent much of the season trying to decide whether it’s a contender, a retooler, or a team searching for its next direction. An ace tends to make those decisions easier. A missing ace does the opposite. For now, the biggest takeaway is that Crochet’s timeline has become much less certain. That’s never a phrase you want to hear attached to a pitcher, especially one whose left arm was supposed to be carrying the franchise through the second half.

Apologies for this being later than normal, but life gets in the way sometimes. If you subscribe, you get all of this, every time, but today, I’ll make it all free so you can see how much you’re missing when you just get the free version. I’ll also point you at Injury Territory (like and subscribe, etc etc), which not only has a new episode up today, but I have an interview with Dr. Michael Freehill, who’s the Athletics Team Doctor as well as a founder of GripFusion, a new device that’s very intriguing. That will be out Sunday. In the meantime, enjoy UTK and have a great weekend.

RONALD ACUNA, OF ATL (strained hamstring)

For the second time this season, the Braves looked at Ronald Acuna, their record, and said losing him for the short term is more valuable than risking him in the longer term. A mild hamstring strain puts him on the IL, again for the same left leg. The recurrence is slightly worrisome, but as a PT I trust said “it really doesn’t matter which one - he needs both.”

What’s interesting is how quickly the Braves have adapted to these interruptions. A few years ago, losing Acuna felt existential. Now it feels inconvenient. That’s a credit to the organization’s depth, development system, and willingness to build a roster that doesn’t depend entirely on one superstar, even one as talented as Acuña. They still miss him, of course. Everyone would. But they’re no longer paralyzed by his absence.

Whether that’s a good thing depends on your perspective. For Atlanta, it’s excellent. For Acuna, it raises some longer-term questions. Not about his talent, which remains obvious, but about the shape of his aging curve. Players whose value is built around explosive athleticism often force organizations to think differently as they move through their late twenties and into their thirties. Acuna isn’t there yet, but the conversation has begun as Acuna moves past his below-market long-term deal with the Braves holding $17m options on him the next two years which are sure to be picked up, meaning he’ll be a free agent at age-30 with a history of injuries.

The concern isn’t that he’ll suddenly become slow. It’s that lower-body issues have a way of accumulating. ACL reconstruction, knee wear, recurring hamstring strains - all of them chip away at the margin that separates elite athletes from merely very good ones. The Braves will likely continue looking for ways to manage workload, whether through more DH days, fewer stolen-base attempts, or simply more rest.

Ferraris require maintenance. The question over the next few years isn’t whether Acuna can still be great. It’s how Atlanta preserves enough of the explosiveness that makes him different while accepting that availability is becoming part of the equation, especially if the cost goes up at the same time wear often shows up.

ELLY DE LA CRUZ, SS CIN (strained hamstring)

Speaking of guarding valuable hamstrings, that’s why the Reds made the same move with Elly De La Cruz last week. When De La Cruz pulled up and immediately protected the hamstring, I pointed out that one of his greatest strengths may have saved him from a much longer absence. Elite athletes often have an incredible sense of where their body is in space and what it’s capable of doing. Elly felt something, stopped, and didn’t try to be a hero. That’s harder than it sounds.

Now, a couple weeks later, the Reds say the MRI shows the hamstring is 90 percent healed. That’s an interesting number because it sounds precise while telling us almost nothing. Muscles don’t really care about percentages. The question isn’t whether the tissue is 90 percent healed. It’s whether it can handle Elly De La Cruz doing Elly De La Cruz things.

That’s where the final ten percent matters. For most players, a nearly healed hamstring might be enough. De La Cruz isn’t most players. His game is built on explosive acceleration, violent changes of direction, and speeds that make infielders rush throws they shouldn’t rush. The Reds don’t need him jogging around the bases. They need him stealing second, going first-to-third, and turning routine grounders into close plays.

That’s why the discussion about a rehab assignment is less about baseball and more about stress testing. Can the hamstring tolerate a full sprint? How does it respond the next day? Does he trust it? Does the medical staff trust it? Those answers matter more than any MRI.

The encouraging part is that Cincinnati appears to have avoided the mistake it made last year when De La Cruz tried to play through a quad issue and looked like a different player. The Reds have been patient, and the result is that they’re likely getting back the real version of Elly rather than a compromised one. That’s worth a couple extra days every time.

ONEIL CRUZ, OF PIT (fractured hand)

Oneil Cruz has been having a crazy season. He’s hitting and running, but playing what Craig Calcaterra creatively said was “an adventurous center field.” His hand injury turned out to be more significant than initially believed, with the Pirates eventually diagnosing non-displaced fractures of the fourth and fifth metacarpals. The delay isn’t especially surprising. Hand fractures can be tricky in the immediate aftermath because swelling, pain, and loss of function often look similar whether you’re dealing with a severe bruise, a ligament injury, or a small fracture. Initial imaging can miss subtle fracture lines as well, particularly when the bones haven’t shifted. Sometimes the body’s response over the next 24 to 48 hours tells the story more clearly than the first examination.

The good news is that “non-displaced” remains one of the best words in orthopedics. The bones are broken, but they’re still where they’re supposed to be. That makes healing much more predictable and keeps surgery off the table unless something changes. They’re saying he’ll miss a month or so, but the return could be more complex.

The challenge for Cruz isn’t healing. It’s returning as Oneil Cruz. His game is built on ridiculous bat speed and equally ridiculous force. Plenty of players can come back once the fracture heals. Cruz has to come back able to whip the bat through the zone at speeds that look more like a physics experiment than a baseball swing. That means grip strength, hand strength, and confidence all have to return. The Pirates won’t just be asking whether he can swing. They’ll be asking whether he can swing violently.

The roster implications are interesting too. Billy Cook’s recall feels more like a placeholder than a solution. When a team loses one of its most dynamic players and responds with a player who posted a .380 OPS in his last major league look, it tells you something about organizational depth. More importantly, it identifies a spot where Pittsburgh could upgrade at the deadline if it continues to hover in contention. Losing Cruz hurts. How the Pirates respond may tell us whether they truly believe this season is different. (See below for more on this.)

WILL SMITH, C LAD (strained neck)

The Dodgers use their pitchers like replaceable parts, knowing all they need is a minimum at any given time. With their depth and development, they’ve seldom had to panic and after 2024, the system is even more refined. A lot of arms were literally scarred by that season. They don’t do the same with the position players, but there’s an understanding that they’re aiming for October, not June, and for Will Smith, a break means a chance to see what they’ve really got in Dalton Rushing over an extended period. Does a hot June wear him down, or lock him in with the pitching staff? I don’t think this is a Drake Baldwin situation, but Rushing does need to make the best of this.

As for Smith, the neck issue is not considered serious or long term, but not something worth fighting through. Again, the Dodgers had depth and are using it for precisely what it is supposed to be. Understudies have to go on sometimes.

That’s especially true at catcher. More than almost any position, the wear accumulates in places that don’t show up on injury reports until they do. Catchers spend hours every night with the neck flexed, extended, and rotated while receiving, blocking, framing, and managing a pitching staff. A little irritation can become a bigger problem if you insist on pushing through it, particularly in June when there’s no reason to borrow trouble from September.

The Dodgers understand that better than most organizations. They’re not sitting Smith because they’re worried. They’re sitting him because they don’t need to be worried. If the neck settles down after a few days, great. If Rushing proves he can handle more responsibility, even better. That’s the hidden benefit here. The Dodgers aren’t simply surviving Smith’s absence. They’re gathering information. Good teams use injuries to fill holes. Great teams use them to answer questions before they have to ask them in October.

SHOHEI OHTANI, SP/DH LAD (inflamed knee)

Shohei Ohtani’s knee inflammation appears to be exactly what the Dodgers hoped it was: something minor. Dave Roberts’ concern level is low, Ohtani has a strong chance to play Friday, and unless something changes dramatically, this looks more like maintenance than medicine. The short-term story isn’t very interesting. The long-term one might be.

One of the more fascinating developments over the last couple seasons is how willing the Dodgers have become to save Ohtani from himself. By all accounts, Ohtani would play every day, hit every day, pitch every day, and probably sell tickets in the parking lot if someone asked. The Dodgers have increasingly taken the opposite approach. More rest days. More recovery days. More caution. Sometimes seemingly against Ohtani’s wishes.

At first glance, this sounds ridiculous. Why would anyone want less of the best player in baseball? Because less Ohtani might actually create more Ohtani.

The Dodgers aren’t trying to maximize his Tuesday in June. They’re trying to maximize his October. More than that, they’re trying to maximize the next five Octobers. Ohtani isn’t just an MVP candidate anymore. He’s a two-way asset carrying workloads that baseball has never really seen before. Every inning pitched and every sprint around the bases comes with a cost. The Dodgers have decided that managing that cost is part of the job.

What’s interesting is that they’re making this decision from a position of strength. Most teams can’t afford to voluntarily take a superstar out of the lineup. The Dodgers can. Their depth allows them to trade a handful of regular-season plate appearances for what they hope is a fresher, healthier version later.

The larger question is one baseball has never really answered. Is it better to get 100 percent of Ohtani for 140 games or 90 percent of Ohtani for 160? The Dodgers appear increasingly convinced it’s the former. That may feel unsatisfying when he misses a game with knee inflammation or takes another scheduled day off, something that could feel akin to the NBA’s issue with stars taking games off. It may also be the smartest thing they’ve done. Ohtani’s peak is so absurdly high that preserving it becomes more valuable than squeezing every possible game out of it. That’s not load management - that’s asset management on a scale baseball has never really encountered before.

Quick Cuts:

The Tigers will have Tarik Skubal back on Saturday, making his official return in 38 days from NanoNeedle elbow surgery. We know it was, in fact, possible to have been significantly shorter than that … Justin Verlander (hip) gave up four homers in his Triple-A rehab start, to the likes of Matt Wallner, Victor Sabato, Kyler Fedko, and Gabriel Gonzalez. Only the last of those is on a prospect list and two scouts I spoke with say Verlander just had no stuff. He did go 86 pitches … Max Fried (elbow) will throw more, getting out to the not-magic distance of 120 feet and he’ll have some imaging done to check the healing and response to throwing … Drake Baldwin will drive down the road to Gwinnett over the weekend to test his oblique. The assumption is he’ll be activated for Tuesday’s games with the Braves … No idea what Tony Vitello is saying when he says Wily Adames is having “knee to hip soreness.” Is that two things? A quad or hamstring? They were chaining an off day to get some rest and he’s expected back for Friday’s game … Matt Brash has had a recurrence of his lat strain. He hits the IL and was sent back to Seattle. Early word is “significant” and he could miss months, not weeks … Ben Joyce is still shut down after he had recovery issues between outings on his rehab. Labrum surgery has gotten much better, but its still full of pitfalls, especially for someone who throws this hard … Quinn Priester was pulled from his rehab assignment. The Brewers will do a full reset and see what they can do to get him back on track after his shoulder issues … Johan Rojas was playing to get back from his almost expired drug suspension when his elbow gave out. He’ll miss the rest of the season after Tommy John, but should be back for 2027 … Vegas will play a day game Sunday with a prediction of 109 at game time. That would tie the record, which happened two ballparks ago in Arlington. At least they’re building a dome.

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What if we’re thinking about the deadline all wrong?

The assumption every July is that teams like the Pirates, Athletics, and sometimes even the Cardinals exist to supply talent to richer clubs. That’s usually true. It’s also based on a payroll landscape that might be changing dramatically. MLB’s opening proposal in labor negotiations included not only a hard cap, but a salary floor of roughly $171 million. Whether that specific number survives is almost beside the point. The owners have now put a floor on the table, which means many low-payroll clubs may eventually have to spend significantly more than they do today.

If you’re Bob Nutting, John Fisher & Co. Las Vegas, or Bill DeWitt, why wait until 2027 to start spending?

The math gets interesting at the deadline. Acquiring a player in July means taking on only a fraction of his annual salary. A player making $25 million may cost only $8-10 million for the remainder of the season. Add another year or two of control and suddenly the acquisition serves two purposes: helping you win now while gradually moving payroll toward whatever floor eventually emerges.

The Cardinals are the easiest fit. Chaim Bloom has done the hard part already. The farm system is healthier, the books are cleaner, and the roster is younger. Sonny Gray is the kind of player that makes sense, but I don’t think a boomerang is in the cards, no pun intended. More realistically they could target controllable veterans on clubs headed nowhere. A player like Luis Robert if the price collapses on health concerns, or a starter with multiple years of control, fits both Bloom’s timeline and payroll realities.

The Pirates are the most fascinating. They already have Paul Skenes, Jared Jones, and what they hope is a future star in Konor Griffin. The obvious move isn’t another prospect. It’s a grown-up. Somebody making real money. A bat like Eugenio Suarez, if available, or a corner outfielder under control through 2027. The Pirates are in an interesting position, but one where almost all of them could be addressed by handing Ben Cherington just a little more flexibility and a wad of cash.

The Athletics might be the sneakiest buyer of all. They have young talent, a weak division, and a move to Las Vegas looming in the background. Spending becomes easier when you’re trying to sell tickets in a new city. A player such as Willson Contreras or another veteran with a meaningful contract and multiple years remaining suddenly makes more sense than it would have two years ago.

That’s where the NBA analogy comes in. In basketball, teams often acquire contracts as much as players. Baseball may be drifting toward something similar. A contract that looks burdensome to a rebuilding club might look useful to a low-payroll team trying to raise spending while adding talent.

We’ve spent years asking which contenders will buy and which sellers will cash out. This year, the more interesting question may be which traditionally cheap teams realize that tomorrow’s payroll floor can become today’s market inefficiency. If the floor is eventually real, the smartest time to start spending may be before everyone else realizes they have to.