Under The Knife 8/22/25

Playing All The Hits

This one’s going long already so let’s get right into it on Free Friday:

LANDEN ROUPP, SP SFG (sprained knee)

People often ask what the thing people don’t understand about doing this kind of job is and I kind of balk at the question. Look, I’ve been lucky enough to do this for twenty three years so I shouldn’t complain when a big injury happens on a Saturday night when I have a planned dinner or activity. I do complain, but I shouldn’t and I sit down and fire out the flash.

If there’s one thing that always comes back to me, it’s that one of the first times I was even credentialed, going to a Cubs-Rangers game at Wrigley Field and getting to ask questions, meet players, and be in a place I’d only seen in passing, its that all of that was ruined by the Daryl Kile passing as I started a drive home the next day. Kile. Tyler Skaggs. Nick Adenhart. Those are the stories I never want to write and when I see a pitcher take a comebacker off any part of their body, I worry I will have to be the one to write a story about another body. My hope is that I’ll slide out the sider door before one of those, but baseball runs on randomness and luck and it’s eventually going to run out for someone.

Landen Roupp was carted off Wednesday night after taking a ball off his leg. On first glance, I saw him go down but not where the ball hit and as he collapsed to a crawl, there was this brief “oh no” moment as I’d thought he’d been hit high and spun as if punched. He was moving and grabbed quickly at his leg. The ball basically hit him in the hamstring and the twist I saw was before the ball strike, not after and as a result. Roupp, on the replay, appeared to both twist his knee and jam it into the mound. That might be the worst of this, though for a moment, it did look much worse.

Word is a sprained knee and an IL stint, but there’s no word yet on severity. Roupp had an MRI on Thursday, but the results aren’t known yet. Depending on which ligament and how significant the sprain, the variance on Roupp’s return goes from weeks to a year. In the meantime, Carson Whisenhunt will come up to take the rotation spot while the Giants continue to fade. I know Buster Posey doesn’t like analysis but one number I know he’s seeing is six games under 500.

SHOHEI OHTANI, DH/SP LAD (bruised leg)

Roupp wasn’t the only pitcher that had one come back at him. I’d really love to know if this really is happening more or if it just seems like it. It’s always happened, I know, but the frequency or perhaps it’s the seeming severity that is changed. Part of that is being able to see every game, every highlight. Maybe this happened a lot, but the play didn’t read in the agate type of USA Today in the same way.

Shohei Ohtani did not have a good night on the mound, as so many do not in Coors Field. Worse, he took a 94 mph drive off his thigh. He continued on the play, not able to get an out on the play and ending it bent over in pain, as one would imagine. Ohtani continued on and word after the game is just a bruise, with no need for further imaging. That it stiffened up as the night went on is no surprise, so Ohtani missing a game or two here wouldn’t be a surprise either, but it would be a value cost. Normally, a pitcher would have the full rotation to get over this, but the two-way star doesn’t have that luxury.

Then again, a couple days rest wouldn’t be bad and the Dodgers could use the DH the way most teams use it, as half-rest, as a shuffle, and as a roster extender for a short bench. Missing a game of his bat in Colorado might be a bigger cost than most days, but he is expected to be back in the lineup on Friday for the Padres series.

KYLE TUCKER, OF CHC (fractured hand)

I do not love ex post facto injuries. People say that’s because I didn’t suss it out, but mostly it’s because it deprives the fan base of information and trust. If Kyle Tucker isn’t hitting because he’s fighting through a broken hand, how do the fans treat him differently if they know? No one’s calling him a bum or saying he isn’t fighting to make the Cubs a better team. I do not understand why teams continue to mistrust their fans in service of a myth that weakness equals targeting. No pitcher is throwing at Tucker’s hand if he’s out there fighting through it, any more than a hockey player can remember some guy has an injury he could target in the moment as they skate. That study was … gosh, 2008 I think, and while hockey absorbed it quickly, baseball never got the lesson.

However, given Tucker’s struggles, we can now look at this with more rigor. The reports say the injury is a hairline fracture of the distal second metacarpal - sometimes referred to as a boxer’s fracture - which sounds like something you’d tape and play through. That’s the index finger’s metacarpal, right at the knuckle, the part that drives grip and pinch strength. It hurts, sure, but for an athlete, pain is often negotiable. The problem is what happens after.

This bone doesn’t forgive. The second metacarpal is locked in tight to the wrist and lined up to the thumb. If it heals even slightly rotated, the finger won’t track straight. Make a fist and the index finger could overlap the middle finger, a malunion that doesn’t just look wrong, it changes how the hand works. Grip weakens. Pinch strength fades. The fix, if there is one, is surgery.

Stress on an unsplinted fracture also risks pushing the line into the joint. Once the cartilage is scarred, arthritis is waiting down the road. Even without that, callus can form unevenly, creating a ridge the extensor tendon has to slide over every time you straighten the finger. That’s pain and sometimes a snap or catch with every rep.Plenty of players gut it out. The tape job holds, the pain dulls, and the season moves on.

Is this the reason Tucker has slumped? We know grip strength is involved in bat control and Tucker has lost 20 points of OBP, which isn’t too much. He’s had a bad week or two, but at the point where the bone is said to be healed. To me, this feels like trying to take two facts - an injury and a slump - and pushing them together. If Tucker had a bad June, when the injury was fresh, I get it. Instead, he seemed to have played well; his OBP went up, not down in June, when he should have had the most trouble with the fracture.

FRANCISCO ALVAREZ, C NYM (sprained thumb)

A source tells me that the wait-and-see approach for Francisco Alvarez and his thumb sprain is two-fold. First, Alvarez believes he can play through it and if so, would be back ahead of when he would with surgery. It’s a riskier path and leaves the Mets with the chance he’s not back for the playoffs, but there’s multiple paths there - maybe he’s not back in two weeks, but is in three, or four, or five - but less certainty.

The second part is that the Mets have confidence in their backups, despite the fact that Luis Torrens is out-hitting Hayden Senger by 40 points of batting average despite hitting 214. The team has played without Alvarez before, several times, so they’re not without evidence. According to StatMuse, the team is 30-30 with Alvarez behind the plate, 38-30 when he’s not. In 2024, the WOWY breakdown with 48-55 with, 27-32 without, so not a big difference then. This despite the pitching being better with him, so I don’t have a good reason why.

Regardless, Alvarez will need surgery to repair the thumb at some point, just not now. We’ll know in two weeks if that was the right decision and the Mets will add some more numbers in the “without you” column for now while trying to hold on to wild card position at the same time.

TYLER STEPHENSON, C CIN (fractured thumb)

A fractured thumb is very different than a thumb sprain. It’s almost binary - fractured, yes or no? - though there are variations in fractures. Tyler Stephenson’s fracture is enough to push him to the IL and could end his season on calendar more than severity. Thus far, there’s been no indication this is more than what it is or that it will need fixation. Surgery wouldn’t change the timeline, just the complexity.

In the meantime, Jose Trevino gets more starts with Will Banfield up to back him up. None of the Reds’ three catchers are big offensive forces, so we’ll see if the Reds pitching is affected more than the offense while Stephenson is out. One of the Reds’ hot prospects, Alfredo Duno, is an age-19 catcher at Single-A, but scouts from multiple organizations think he could move very quickly. Injuries made him repeat in Daytona, but most think he’ll get pushed hard next year and is a 1-2 with Eduardo Tait at the position.

FELIX BAUTISTA, RP BAL (strained cuff/torn labrum)

Felix Bautista got the double whammy, with surgery fixing both his labrum and his rotator cuff. One is bad, but two is compounding interest on just how good he was in 2022 and 2023. Call it a Robert Johnson kind of deal maybe, but after missing 2024 after Tommy John, it looked like he was going to be great again. Instead, this knocks out another year and puts a career in question. It’s not impossible, but the idea that he misses all of 2026 is there.

The biggest problem is that the cuff is functionally the brakes of the arm, while the labrum adds stability. Losing both braking and stability? If we can continue the metaphor, that’s not a car I want to be riding in, let alone at high velocity. We still don’t have all the details on the surgery, but I’m most concerned with the cuff. We’ve seen improved results after a technical change in how the labrum is repaired over the past five years, but cuffs are still tough.

Bautista is a mountain of a man, more the size of a defensive tackle than a closer, but I’m not sure if that’s advantage or disadvantage for him. It’s unusual enough that comps are tough, but we do have the best one: Bautista himself. Sources tell me he was a worker during his Tommy John rehab and knowing how to do that and having felt success in coming back should help here. It’s a different rehab, and tougher, but there’s a baseline and a trust already in place. I said on the Ryan Ripken Show that it was 50/50 for Bautista to come back, so I’ll stick with that.

TAYLOR TRAMMELL, OF HOU (strained neck)

Taylor Trammell flat slammed into the wall and the medical staff did a great job of protecting him. The minute anyone says sore neck, things get more serious and the fact he was merely carted off says that the people on the ground saw very clear early signs that this wasn’t a spinal issue. That doesn’t make Trammell any less sore, but it’s a good sign.

Trammell’s neck is enough of a problem that he’s heading to the IL and remains in concussion protocol, though with the 10-day activated, the concussion becomes moot unless it doesn’t clear. The move is listed as “cervical muscle strain”, so this is one of those instances where no structural damage is very meaningful. It’s certainly understandable if you watch the play and the motion his head and neck make.

By the way, Trammell hit the padded wall hard and I still feel like baseball could do better. Is there really no better material? I realize it has to be durable, can’t be so soft that the ball doesn’t come off it (though couldn’t a soft outfield wall be something of an advantage?), and be protective at the same time, but it feels like material science had advanced faster than this has. I mean, just look at the changes in mattresses over the last ten years! The same is true for warning tracks - there just has to be a better way.

And this has nothing to do with Taylor Trammell, walls, or even baseball, but I watched Mission Impossible and it was fine, but Trammell Tillman was a standout. His work on Severance is amazing, but at age-40, how did a guy this clearly charismatic and talented not really do much else? I saw an interview that said he wanted to be an orthopedic surgeon early in life, so maybe there’s a world where Mr. Milchik is an Orioles team doc or something.

BUBBA CHANDLER, P PIT (no injury)

The Pirates are calling Bubba Chandler up - good - and there’s a couple interesting things about what they’re doing. First, they’re going a little old school and putting him in the pen. They did this with Braxton Ashcraft as well, hearkening back to Earl Weaver who wasn’t alone in starting young pitchers in the pen but codified it in his book. As well, it controls Chandler’s innings a bit. He’s already at 100 with a career high of 119 and he’s young (age-22 from a 2022 HS draft).

I actually love the idea of pitchers like this being the back/low part of a tandem, which is what he’ll essentially be. Weaver liked to “get their feet wet” and the Pirates used to have a “cup of coffee” thing they did bringing prospects up at the end of the year to incentivize them. Chandler and Ashcraft could well be the back of next year’s rotation and if Jared Jones is healthy, that should be four good pitchers out there, health and budget willing.

A source with the Indy Indians, where Chandler has been the last year, told me that he’s looked and acted fatigued for the past couple weeks and his results have indicated the same. He still walks too many, loses his concentration and mechanics, but no one questions the stuff or the competitiveness. If you really want to dream, Pirates fans, think about that potential rotation (Skenes, Keller, Jones, Chandler, Ashcraft) and back it with Konnor Griffin, who could get pushed after demolishing two levels a year after being the number 9 overall pick, and Antwone Kelly, who’s broken out at Double-A and could be the next in the line of Pirates pitching prospects.

Quick Cuts:

Adley Rutschman hits the IL with an oblique strain. Yes, another one … Kenley Jansen is unavailable because of “rib pain.” If that turns out to be an oblique strain, I will lose my mind … Roki Sasaki (shoulder) was better in his second rehab outing, but still lacked command. He did go 60 pitches and was up at 96, so if he makes another rehab start it’s because of performance and the fact there’s no room currently in the rotation … The Astros finalized a major league deal with Craig Kimbrel, which is interesting given all the front office talk about trusting their pen … The Pirates say Oneil Cruz is making progress and upping activity, but is still dealing with concussion symptoms. He could be activated at any time, but has to clear first … Tough day at the plate for the Rangers. Marcus Semien heads for an MRI as they worry a foul ball off his foot damaged soft tissue, while Evan Carter was hit on the wrist by a pitch. No word on his x-ray results after the game … Add Cole Winn to that injury tally. A nerve issue in his hand perhaps explains recent wildness and he’ll hit the IL … Jacob Wilson (hamstring) is expected to be activated this weekend, perhaps as early as Friday … Joey Ortiz left Thursday’s game with a hamstring injury. No more information at publish time … Then there’s Icehouse’s “Electric Blue” — yes, that’s John Oates behind the curtain — a hit that’s too smooth to ignore and just weird enough to belong in this company. Have a great weekend.