Under The Knife 7/5/24

Flying Flags

Writing a column the day after a holiday can be a flex. “Oh I work so hard.” Look, baseball still happens and honestly, I didn’t do much on the Fourth anyway. I watched some ball, the British elections, and my dog hated the fireworks. I don’t know how many of you will read this, but hey, some of you will I hope. I hope your holiday was great, filled with all the things that make America great.

Since we’re celebrating freedom, let’s make this UTK free for everyone. Raise a glass and let’s get to the injuries:

MOOKIE BETTS, IF LAD (fractured hand)

I’ll skip almost all the #paddedgloves talk and get right to when Mookie Betts could get back. Betts hasn’t yet grabbed a bat in full sight yet, but I’m told he’s doing some gripping work and lots of work in the cage and with “other tools” - my guess is something like WinVR - to keep up his batting eye. The grip strength will come as the bone heals, but there is a lot of force from a swing and remember that bones usually aren’t fully healed when players come back. They’re healed enough to do most activities and we’ll have to see just how the hand responds since there’s no real test besides the real world. Betts is likely out through July, but we’ll get signals soon about the progress.

Betts has been able to maintain his fitness throughout - his legs aren’t injured - and has been seen fielding. That’s one interesting part here, in that Dave Roberts mentioned Betts might come back at second base rather than short since Miguel Rojas has been solid. Yes, he’s hit out of his mind for a couple weeks, but I’m surprised someone isn’t nudging Roberts about small sample size or telling him the story about how Juan Pierre went on a massive heater just after replacing Manny Ramirez.

MIKE TROUT, OF LAA (torn meniscus/rehab)

Jeff Fletcher had the most low-key scoop I can remember in a while. Almost in passing, he said that Ron Washington talked about seeing video of Mike Trout on a “normal treadmill.” I’ve known that for a couple weeks, he’s been on an Alter G (or something like it. Maybe a newer model? It doesn’t look exactly like what I’ve seen before), but even when seeing those, you can’t tell what level it’s on. An Alter-G can hold an athlete up … oh look, I went to get a link to Alter G to explain it and there’s the new Alter G Neo, which is what he’s been using. Anyway, the Alter G uses air pressure to hold an athlete up, putting less pressure with each stride. How much pressure can be adjusted, so unless you know how much, it’s hard to tell how much someone is progressing.

If Trout is now on a normal treadmill, that’s progress. He’s already well behind the normal timeline for a meniscus trim. There’s no reason to rush him back, but every game he misses puts his legacy a day behind. Normally, I would skip the calculations, but oh my god, ChatGPT can do Favorite Toy calculations. It doesn’t have up to date totals, but going back to 2023 - and since Trout hasn’t played that much, I feel okay about this - he has a 23.9 percent chance of getting to 500. (I’ll be honest, this feels low and I don’t have a huge degree of confidence in this because the age assumptions are really negative, especially in concert with his contract.)

At best, Trout will be back after the ASB, which means he’ll be about double what the normal expectation for this particular knee surgery would be. There’s no reason for this, but he’s been about double of an expectation before, with his calf strain a couple years ago. Again, context, but maybe he’s just a slow healer. Let’s say he gets back right after the ASB, which seems reasonable if he starts doing baseball activities in the next week — would someone start looking at him for a trade and would the Angels consider it? That part I don’t know, though it seems a long shot.

ROYCE LEWIS, 3B MIN (strained groin)

It’s no surprise that the Twins pushed Royce Lewis to the IL after a muscle strain, but it is a surprise that the groin strain was as severe as testing found. It was also on the opposite side and no, I have no idea what happened there. It could be reporting or it could be something else. I had a wrestling coach that taught us that if we got hit in the testicles, grab your hamstring. I can remember seeing a lot of kids first grabbing for their crotch out of reaction, then adjusting. Maybe it’s something like that? I’m hoping the beats get an answer on this one.

For Lewis, the groin strain (adductor, if you want to be technical) isn’t as mild as thought either. A Grade II was reported which could keep him out through the ASB and perhaps to the end of the month or more depending on how he responds and if he needs a rehab assignment. These tend to be pretty straightforward in treatment and healing, but I guess this one already hasn’t been straight forward and Lewis’ history does complicate things slightly.

The Twins called up Brooks Lee, one of their top prospects and a recent number one pick, to take Lewis’ roster spot and position. By the way, anyone noticed how good Byron Buxton has been over the last two weeks, hitting almost 400 with some power, now that he’s on a run of health? The Twins have to dream on a roster where they have Buxton and Lewis healthy. Timed right, that could be one of those late season or October storylines.

JORDAN ROMANO, RP TOR (inflamed elbow)

One of the things I’m more confident in after doing this job this long is saying “I don’t know.” My sources don’t always tell me things and sometimes, they don’t answer texts on a holiday, even if it wasn’t in Canada. Romano underwent a scope on his elbow to “remove an impingement.” While that sounds technical and exact, it’s not. What was removed and from where? I don’t know that.

Per the release, Romano will be shut down for about six weeks and then begin a throwing program. That sounds more serious than a bone spur but less serious than something like a nerve transposition. The other thing to keep in mind is that the surgeon would have directly checked the UCL and other structures while he was inside and knowing how that is doing is pretty key. Yes, the tiny camera is better than MRIs and in almost any operation, they’d take the time to check the elbow. (I do know of one situation where the player told the doctor not too, since the team might have access to that information in an upcoming negotiation.)

BRYCE HARPER, 1B PHI (strained hamstring)
KYLE SCHWARBER, DH PHI (strained groin)

Both Bryce Harper and Kyle Schwarber were said to be near-minimum stays on the IL with their mild muscle strains. While different areas, the effect is the same. Both are running at what Rob Thomson called “75 percent” for Harper and “90 percent” for Schwarber. That’s a good solid run and the motion is similar if not the full force, especially of acceleration. There’s enough to know - and there’s surely more evidence like ultrasound - that good healing is happening and not being set back by the activity. A player could play and be told “just don’t run more than 75 percent”, but the team acknowledged that was tough for Harper last year when he was coming back from his elbow reconstruction.

What might hold them back is the team’s lead. There’s no need to rush them back (or JT Realmuto, who’s also making good progress), but if players are healthy, there’s no medical reason to not play them. Especially for intense players like Harper, sitting on the bench might lead to other activity. I remember a player about ten years ago having a major setback with his hamstring because when they held him out through a road trip, he got on an unfamiliar bike and rode too hard, damaging the not fully healed muscle.

CLAYTON KERSHAW, SP LAD (strained shoulder)
YOSHINOBU YAMAMOTO, SP LAD (strained cuff)

Clayton Kershaw and Yoshinobu Yamamoto are both throwing. The downside here is that neither is doing it for the Dodgers. With Kershaw, it’s almost expected. Getting him back before August was the best case scenario. Losing Yamamoto before August, or anytime, is the worst case scenario. The Dodgers have actually come through this in first, with depth, so the expected scenario hasn’t really happened. Whether that’s good or bad remains to be seen. Losing deGrom and Scherzer is bad, but raising that trophy was good for the Rangers. The Dodgers would take a similar deal.

Yamamoto has been shut down since hitting the IL, but Dave Roberts told the media that YY is nearly ready to begin throwing again. His use of “program” implies they’re likely not just testing things out and they’re confident they know the cuff issue is healed (or healing) and that they can re-load his arm and get him back to the rotation. How long that might be and what pitfalls might show up remain to be seen, with cuffs being one of the most dangerous injuries for any pitcher. While we see fewer cuff injuries, the ones we do tend to be severe and often recurrent.

Kershaw’s issue with soreness has passed enough - or been treated enough - that he’s back to throwing a pen. The next step, per Roberts, will be a sim game that I’m told will be over the weekend. If that goes well, he could re-start his rehab (new clock) next week, again likely towards the weekend. The hope is that he will need two or three starts to build, but there has been some discussion of bringing him back as a tandem, in order to get him back earlier and give one of their younger pitchers like Gavin Stone some in-season rest without de-loading them too much.

Quick Cuts:

Michael Harris has begun some running and will amp things up. The hamstring strain will keep him out past the ASB, but this is a positive step (literally) … JT Realmuto (meniscus) could be back before the ASB, but there’s an element of Phillies staff asking why. The lead is strong and there’s simply no need to rush unless it’s absolutely clear. (Go ahead and contrast his recovery at three weeks to Trout’s) … The Astros made it official, saying Justin Verlander (neck) will be out through the ASB. That doesn’t answer when he might start a rehab assignment … Xander Bogaerts (shoulder) started his rehab assignment this weekend and is expected back within a week … Bryan Woo will have a rehab start this weekend in nearby Everett (A-ball), which is mostly about keeping him on schedule with the ASB. I wouldn’t be surprised if he sticks for another start thru the break … Luis Rengifo is headed for an MRI after injuring his wrist on a swing. He’s out through the weekend, but they’ll wait on results before determining an IL stint … Jason Heyward is headed for an MRI. His jump at the wall had an awkward landing and the initial worry has to be meniscus … I watch what the Tour de France riders do for recovery after and the focus on nutrition, then look at baseball players. I get that they’re not the same and don’t have the same demands, but why doesn’t a team try putting that kind of attention, focus, and money just to see what happens?