Under The Knife 8/4/25

Answering Questions with Statcast (or trying)

No intro today, because I’m trying something. There’s a long section on Mookie Betts and Mike Trout I think you’ll want to read, though it’s only for subscribers. If you are a free subscriber, I think you’re likely more interested (and likely to subscribe) if you get more of the injury stuff, one or two top injuries, then some of the stuff I just feel like talking about, like travel ball problems or Icelandic vacations. (And yes, I owe you a picture post on that at least.) Let’s get to it:

MARCELO MAYER, IF BOS (sprained wrist)

Marcelo Mayer got an injection in his sprained wrist and … well, first it’s a sprain, so the Red Sox medical staff knows specifically what’s going on and it’s not just general inflammation and/or pain. That’s good because it can be tough with wrist injuries, leading to a hit and miss, trial and error approach to treatment when it’s unknown.

I had a question from a friend about what actually gets injected. The term “cortisone shot” is still out there, but it is seldom if ever cortisone. The most used for quick anti-inflammatory effect is Kenalog, which is a corticosteroid. It’s usually mixed with a small amount of anesthetic like lidocaine, which provides immediate relief. It’s also common to do something like PRP or aspirated bone marrow, which get lumped in to what is normally called “biologics.” We also see Celestone, which doesn’t give as much immediate relief but can be longer lasting.

For Mayer, the indication and the quotes from Alex Cora indicate this is something more acute than chronic and that they’re looking to get him back on the field quickly rather than manage some condition. It takes about 3 days to let the injection work, so he’ll likely get checked on Tuesday and his response to that will dictate his next steps. He could be hitting as soon as Tuesday and back at the minimum, but there’s also the chance it didn’t respond and they’ll have to plan out what happens in that case as well, which has a much broader set of possibilities. The plus here is that the Sox (and hopefully us) don’t have to wait long to know.

JACOB MISIOROWSKI, SP MIL (bruised shin)

So much for protecting Jacob Misiorowski’s arm when it was his leg that took a comebacker. Honestly, this feels as much about the arm and the workload as anything about the shin, which remains bruised and painful. There’s some rumbling about not wanting to throw off Misiorowski’s sequencing and while true, this is also about the fact that the young pitcher is now right at his career high in innings as we still have two months to go in the season and potentially October for the Brewers.

It’s that latter part that the front office is calculating - how to maximize Misiorowski now, not overwork him, and have something left for the playoffs. The bigger issue is that the simple answer - less work - doesn’t help that. When we’re talking about things like chronic workload management, it’s about performance and risk. While keeping any pitcher de-risked is key, there’s still other risks as you take him to a place he’s never been while increasing the physical and mental stress.

If we look at sports that have much more load like track and soccer, the periodization for Misiorowski might be the issue. Should they make him more of a sprinter, with more frequent short bursts, perhaps using his throw day as an opener day. There’s studies that show in soccer - admittedly very different in physical demands - where that’s better for some players in their ability to sprint, a key skill. Would taking him to a once-a-week starter work? Possibly, but he’s never done it and the Brewers would have to fill in their rotation with an extra, lesser starter. Speaking of, that lesser starter for now will be Logan Henderson, who was called up to take the roster spot. The expectation is that Misiorowski will be out only the minimum.

A lot more pitchers making their rehab starts ahead of late season pushes, a very good reader question, plus a couple AL West outfielders, and a ton of other injuries in Quick Cuts. There’s also the info on Betts and Trout, as I said at the top. You know what to do if you want to read it all.