Under The Knife 6/19/26

Things Happen Fast

WENCEEL PEREZ, OF DET (bruised face)

Wenceel Perez was hit in the face when a resistance band snapped, which sounds like one of those bizarre injuries that only happen once until you remember Colts QB Anthony Richardson suffered a very similar injury last year. The difference, at least so far, is that Perez appears to have avoided the worst-case outcomes. Reports indicate the band struck just below the eye, his vision remains intact, and doctors aren’t expecting any long-term damage. (Late news is that he’ll go to the IL as a precaution.)

That’s the good news. The bad news is that eye injuries are one of the few situations where “everything looks fine” doesn’t automatically mean an athlete is ready to play. Vision is more than eyesight. Baseball players depend on depth perception, tracking, focus changes, and the ability to process moving objects at extraordinary speeds. Even minor swelling around the orbit can affect comfort and confidence. A player might technically see 20/20 and still not feel right standing in against a 98 mph fastball.

The Richardson comparison is useful because it shows how much worse these injuries can be. His resistance-band accident resulted in an orbital fracture that required surgical fixation. Perez appears to have escaped that outcome, but teams still have to rule out a long list of complications: orbital fractures, retinal issues, double vision, muscle entrapment, lingering swelling, and concussion-like symptoms from the blunt force itself. That’s why predicting a return date is difficult. The tissue will heal on its own schedule, but the Tigers also need to know that Perez can track pitches normally and trust what he’s seeing. Those are two different milestones.

The encouraging part is that vision appears unaffected in the long term. In the short term, swelling and simple pain might be an issue. If that remains true, Perez should avoid the long recovery timelines associated with more serious orbital injuries. The concern isn’t permanent damage. It’s whether a player whose livelihood depends on seeing a spinning baseball can convince himself everything is normal again. That’s often the last thing to return, even after the bruises fade.

HUNTER GREENE, SP CIN (inflamed elbow)

Hunter Greene is finally headed into games, albeit at the Arizona complex, which means the rehab is no longer about healing. The bone chips were removed back in March. The elbow has had months to calm down. Once a pitcher is throwing bullpens, facing hitters, and now heading into a rehab assignment, the question shifts from “is he healthy?” to “is he ready?” Those are very different questions.

The Reds could absolutely shorten this process if they wanted to. The old model says Greene should spend much of the 30-day rehab window rebuilding volume, climbing from two innings to three, then four, then something approaching a normal starter’s workload. The modern model is a bit more flexible. Teams increasingly recognize that pitchers can build some of that volume in the majors, particularly if the major league club is willing to manage pitch counts aggressively. Given that his first start pushed him to 54 tells me the side work counts. All reports are that his stuff looked good, though I had varying reports on velocity and command.

Greene is a perfect candidate for that approach. He doesn’t need to prove he can dominate Arizona Complex League hitters. He doesn’t need to prove his velocity is back. If he’s healthy, everyone knows what 100 mph looks like. The real question is whether the Reds believe they’re in a position where every start matters.

If they do, it’s easy to envision a scenario where Greene makes only a couple rehab outings before returning to Cincinnati with a strict pitch limit. Four innings from Hunter Greene is often more valuable than six innings from whatever alternative is currently occupying the back of the rotation. (Actually, that’s Rhett Lowder, so if he keeps pitching well, the timing question gets a bit more complex, though he’s never going to block Greene.)

The encouraging thing is that this wasn’t a ligament reconstruction or a major structural repair. This was a cleanup procedure. The danger isn’t the elbow. The danger is the temptation to rush the workload. Terry Francona has generally been good at resisting that temptation. The Reds would like Greene back before the All-Star break. They’d like him available after the All-Star break even more. That’s usually how smart organizations make these decisions. The first start back is exciting. The twentieth one is the goal.

NOTE: Obviously, Bobby Witt and Mike Trout, two big names to be sure, were injured last night, leaving the game early with a knee issue and a hamstring strain, respectively. I don’t have any further information as of publish, but I am monitoring them and if needed, I’ll do a UTK Flash.

More on the Dodgers - including Shohei Ohtani’s mystery injury - and some key young players for contenders. It’s five bucks to get everything every time I write, but you probably knew this. For the literal thousands of you that don’t pay and just get to read up to this point, what would it take to get you to subscribe for just one month to see what you’re missing? That said, Substack is looking at advertising and one of the offers is “unlock a post.” An advertiser would pay to slap an ad on here and let everyone read today’s post. Might mean more readers, might mean less subscribers. Not sure how I feel about it, but I’m more curious how you do.