Under The Knife 7/2/21

Free Friday: Rehab the Rehabs

The rehab start is outdated and should be scrapped.

Almost.

The fact is that while I don’t know how the rehab start actually got started, it’s been a part of the game as long as I can remember. A big search of the internet was resultless, much like trying to find anything about the medical history of the game. But here in 2021, sending someone to the minor leagues to build themselves up is not the best way to do things any more.

We know more about workload than ever before. We know more about biomechanics than ever before. We know more about how to prepare and recover pitchers than ever before. So why do things the same way?

This is where the “almost” comes in. The issue is that some pitching injuries don’t show up until a pitcher is well past 70 percent, even 90 percent, and there’s nothing like actual game action to force a pitcher to throw his hardest. I’d be very curious to know if there’s simple data, like velocity, on rehab starts to show whether top pitchers do actually throw at normal game speeds. Jacob deGrom was throwing 100 in his Single-A game, but I’m not sure that’s not an exception.

If that problem can be solved, then sim games are far better. I’d rather have those than batting practice and if you let the fans in to watch the latter, why not the former? Sending someone like Chris Sale out to do five rehab games is crazy. Can a team like the Red Sox - smart, creative, and winning - not find a way to bring him back even if he’s limited to four innings at the start? Tandem him for a couple, find a way to get him extra rest if needed, and use those 20 or so innings making the big club better.

There’s so many ideas like this that could save dollars and win games for clubs, yet the tradition-bound game continues to resist changing things that were likely set up by either Branch Rickey or Paul Richard, as seemingly most of baseball was re-invented by them. The irony is, those two would be the first to make changes again, even if it gave them just a small advantage.

Let’s get to the (all new) injuries:

Blake Snell SP SDP (illness)

I can’t wait to get back to “flu like symptoms.” Blake Snell hits the IL with illness symptoms, but in an age of COVID - and with an IL more flexible than the standard in place - the team put Snell on the list despite his vaccinated status. His symptoms are said to be minor and he’s not expected to miss another start yet. It doesn’t look like he’d need to miss a start, that he’ll have any limitations, or that this will linger.

In fact, Snell rejoined the team on Thursday and beyond his vaccination status, he also never tested positive. He’s still on the IL as of today and the Padres haven’t signaled whether they’ll just skip his turn and slot him back in or whether they’ll juggle the rotation a bit, given how they’ve been working to rest their starters as possible.

This isn’t abuse of the system per se, but this type of move shows that the COVID IL could be used outside of the intent, if not outside the letter. Baseball is right to be better safe than sorry at this stage, especially with the Delta variant and full stadiums, but some are worried that any loophole that can be exploited will.

Trea Turner SS WAS (sprained finger)

It kind of boggles my mind that the MLB record for cycles is three. That it’s that low a number tells you just how hard it is. That people as different as Trea Turner, Adrian Beltre, Babe Herman, Bob Meusel and John Reilly, rather than a bunch of people tied at three, is equally stunning. Turner is a singular talent and while it’s still difficult to contextualize his speed, it’s easy to appreciate it when it shows up in quirky but exciting ways.

To break the record, Turner will need luck, skill, and to stay healthy. Turner injured his finger in his last at bat, jamming his middle finger and being held out of the lineup on Thursday. No one thinks this will be a long term issue, but it shows how injury luck works for some players.

If Turner had played in the Herzogball era … yeah, phrasing … he might have had a chance at putting up some ridiculous numbers. Maybe not triples in the era of the cookie-cutter, multi-purpose stadium, but that guy on that era’s Astroturf? Tom Tango had an interesting estimate on Turner’s speed, saying he was likely a 10.7 100m guy based on Statcast data. Herb Washington’s fastest 100 yard dash was 9.4, which converts out to 10.3, which reminds us that Herb Washington was fast.

Chris Sale SP BOS (post-Tommy John)

Chris Sale looked great on the side, but what’s the next step? If you read above, the plan could be that he could make five rehab starts. Sources I’ve spoken with say that’s too many and that he’s likely to make “a couple.” Where hasn’t been determined, but Double-A and Triple-A are close by, which helps, and are new affiliates, so sending a star to amp up ticket sales is always nice.

Sale is throwing at near normal velocity, showcasing a great slider, and making hitters look silly, which is what he does when healthy. He’s not better, not throwing harder, but is finally healthy, which is all the Red Sox want at this stage. That and keeping him healthy, which shouldn’t be that tough, but given how it went through his rehab, pandemic aside, I can’t just wave my hand and say “most Tommy John guys are fine once they return.” Nothing has been normal lately, folks.

Given this path, of overcoming setbacks of all sorts, and just pushing forward as Sale checks off milestones, it’s hard to put any timeline on it, but its easy to focus on the goal of a positive return and a lasting return without further setback. That’s what the Red Sox have done, which is not the easiest thing to do in an aggressive city.

I think we’ll see Sale on a rehab as soon as next week and that he comes back just after the ASB. I’m not sure how much juice there is left to squeeze out of the former ace, but he’s as good or better than anything on the market and the Sox are already paying him. We’ll see how it pays off soon.

Corbin Burnes SP MIL (sore knee)

There’s not a lot of information but the Brewers’ Corbin Burnes left after 94 pitches after calling out the medical staff and looked to be in some discomfort. He’d had a good start and there’s no clear indication of what or even when something happened, so we’ll have to keep an eye out for word from the Brewers. In the postgame, Burnes said he stuck his cleat in the mound and injured his knee.

Burnes says he’ll make his next start and that as deep as he was, there was no reason to push things. Given how good the Brewers’ pitching has been this season - despite injury - this was the smart play, especially if Burnes makes his next start and keeps up his pace of strikeouts, command, and velocity. He hasn’t been as good as that first month, but outside of Pedro Martinez and Jacob deGrom, few have.

This will bear some watching for the Brewers. Burnes making his side work, showing no issues, and being schedule for that next start should be solid, but I’d lay off Burnes in the next start, just on the off chance they plan a short start just to help him rest it.

Mike Trout OF LAA (strained calf)

Mike Trout - remember him? - is making progress. He’s hitting off a tee. He’s jogging. He’s playing catch. For a calf strain, even a Grade II, the Angels are taking this one slow and methodically. The expectation is that he’ll be fine and step right back into the lineup, but the more I talk to people about this, the more this goes from “really cautious” to “really suspicious.”

If this is a simple calf strain, cutting Trout off from all activity is a bit extreme. We see hitters in the cages taking ‘dry cuts’ and ‘looking at pitches’, but with Trout, he’s just getting back to tees after a month. He’s just back to jogging, but nothing about something like an Alter-G? Either the Angels are sandbagging us all and able to do an entire rehab on the down low, or they’re not using all the tools of the trade.

My worry is - and I have nothing to back this up - that Trout’s calf strain is worried to involve the Achilles. If so, in these post-Durant times, it’s understandable, but still, a rehab should be a rehab and follow evidence-based practices, not cower in fear even when it is the best player in the game.

If Trout comes back quickly and effectively, I’m fine with the Angels sandbagging things. If this goes past the ASB, I’m going to want more answers and I won’t be the only one.

Quick Cuts:

Jacob deGrom struck out 14, allowed 3 runs, and it was his worst start of the season … Jose Ramirez missed a day after fouling a ball off his face. Not fun … Brandon Belt got his second and third opinions and has elected for rehab over surgery. His sprained knee is expected to heal, though there’s no updated timeline and there’s always the chance rehab doesn’t work … Ronald Acuna had another bout of back spasms, missing a game like he did last week. He does seem to recover well, but the recurring nature has to be worrying Atlanta … Yoan Moncada’s out for the weekend with swelling in his hand. He’ll be re-evaluated Sunday and the IL remains a possibility … Michael Kopech is back for the White Sox after his hamstring strain lingered a bit longer than expected. Kopech creates such ground force, it was better to delay a bit rather than risk a kinetic chain issue … Dinelson Lamet is playing catch and making progress towards a return. The Padres are hoping a rehab assignment won’t be necessary … Michael Lorenzen heads to Triple-A Louisville for his rehab assignment. The Reds will use him as a reliever, so this could be a quick trip if he’s effective in his first couple outings and shows he can recover … Chris Archer is beginning to throw again and if healthy, could take some innings for the Rays down the stretch to save some of their younger pitchers and fill that Glasnow gap … Dellin Betances will have shoulder surgery … Kole Calhoun felt some soreness in his hamstring when running, so the D-Backs have put his rehab on pause … Corey Seager was shifted to the 60-day IL, but it’s procedural. His timeline hasn’t changed since his recent minor setback with hand pain.