Under The Knife 9/12/25

Free Friday

I’m going to try something new next week … probably Thursday. There’s been a live chat function here on Substack for a while and I haven’t used it. I’m hoping there will be enough questions to make it worthwhile, so think about them and ask me anything, I guess. I’ll have more details once I lock it down, but for now, let’s get to the injuries:

LUIS GARCIA, SP HOU (inflamed elbow)

Luis Garcia was supposed to be a big upgrade for the Astros as they head into the playoffs, or at least a stabilizing, been-there arm that isn’t worn down. Instead, he’s back on the IL with elbow inflammation in just his second start back. Garcia has had nothing but complications and delays with his Tommy John rehab, so another one shouldn’t surprise us, but it is unusual for the nearly rote process.

Part of the delay might be that the team is on the road. They could obviously send Garcia back to see the doctor (or consult with others, depending on the diagnosis) or he could stay with the team on the road trip. There are MRIs and doctors in Toronto, or next stop in Atlanta, but in some cases, teams do wait, especially if the expectation is that the timing isn’t going to matter to the case. I couldn’t tell from video whether Garcia was with the team on Wednesday or Thursday, nor could I get confirmation.

For Garcia, the latest setback is brutal and the look on his face as he pointed to his elbow told a sad story. If Garcia is lost again or worse, headed for more surgery, he could end up non-tendered heading into his final arbitration year. The Astros did just that with Jose Urquidy, though Garcia would have a rough case given the nearly two full seasons lost and is making less than $2m this season. With nine pitchers on the IL, this is a real issue for a team trying to hang on to the division.

AJ Blubaugh comes up to take starts, though the Astros will go with a bullpen game on Friday as they adjust the rotation. With shorter rotations in the playoffs, the Astros are still clear, but they have to get there and maximize their position. The Mariners and Rangers are still right there and I’ve said over and over that injuries might be the difference between the three teams. You tell me who’s the healthiest.

ANTHONY VOLPE, SS NYY (torn labrum)

You know I hate ex post facto injury explanations. Back in May, Volpe dove for a ball, said he “felt a pop”, and missed a couple days. Here’s what I wrote on May 5th:

From all information, I don’t anticipate Volpe missing much more than a game or two here and that there should be no issues or consequences once it heals up. There is some recurrence risk, but since his was impact rather than just popping out of place on a throw or something benign, we’ll just have to hope he doesn’t do that or similar again too soon.

I’ll stand by that and if there was consequence, if the Yankees thought that the shoulder was part of his issue at the plate this year, no one whispered it before now. Now, Aaron Boone is saying that he has a partial labrum tear and the hope is a cortisone shot gets him through the rest of the season.

With every caveat about asymptomatic labrum tears, and the note that Boone clearly said this has been bothering him since, well, okay. It explains the deal for Jose Caballero some, but it also means they’ve been exposing Volpe to withering criticism and poor results in the meantime without doing much. Part of this is Boone sticking with “his guys”, but part of it is everyone else, including Volpe, letting it happen in spite of what Boone is saying is evidence that this was holding their player and the team back.

Can the injection help? Sure, but it’s at best a short term thing, with the note that there’s not much season left. Best case, six weeks or so (of season, not the injection), and if the Yankees don’t get the bye or sweep a series, there’s not going to be a gap in the schedule to do another one without him missing games. If the injection does suddenly free him up, that raises a whole new series of questions before we even get to the off-season surgery decision.

There’s little question that next year may be an open competition where George Lombard has a real chance to nudge Volpe aside in the spring. Lombard is age-20, the third youngest player in Double-A (before Jesus Made came up, which I’ll have more on soon), and while it would be an un-Yankee-like jump, it’s not impossible either. Bo Bichette would be the big dollar SS available and after that, the drop-off is steep, so this is more likely to stay in house.

REID DETMERS, P LAA (inflamed elbow)

Reid Detmers season is likely done, just on timing and because the Angels have called up Chase Silseth, who … well, anyone who can explain the Angels plan for next year, or for pitching, or just anything, please feel free. I can’t do it. He came out of his last outing saying that he didn’t like how the ball was coming out of his hand and as he hits the IL, the Angels are calling it elbow inflammation. Imaging should be coming, but there’s no confirmation or even mention of that that I can see.

While Detmers could return for the final weekend of the season, it’s unlikely that will be the case. Whether they simply let him go and start working on 2026 now, or whether they hold him to do a full rehab over the next weeks and months remains to be seen, but Detmers still has three years of control, is still just age-25 this year, and transitioned to the pen well. He could shift back as a starter if necessary and there’s a lot of factors that will go into that decision and again, I’m not clear on the plan. What could alter that is a serious elbow issue, one that takes him out for a year or more. We’ll see on that soon.

WILL SMITH, C LAD (bruised hand)

The thing about managing an injury is there’s really only so much that can be done. There’s this “just spike him” mythos that has built up because of bad movies and bad reporting. Players can’t have something like a numb hand and still function, nor can they take a general anesthetic that would slow reactions. We end up with things like rigged pads and tape jobs, magic spray and cold stares. Catchers have even more of a “don’t be soft” mentality, eschewing pads and trying to never show pain.

Unfortunately, pain is a signal and for Will Smith, that bone bruise on his hand is still problematic. The team needs three catchers, for nights like Thursday where Smith simply couldn’t go. This isn’t necessarily an indication that the hand is worse, but it’s not getting better. When we talk about healing times, that’s without setbacks or exacerbations, which is what Smith and the Dodgers are doing while he plays. It’s a known, accepted risk, but something that might heal in two weeks of rest and treatment could take much longer trying to manage it through. That’s what we’re seeing now and will through the end of the season.

MASYN WINN, SS STL (torn meniscus)

Speaking of management, there’s another side. “Hey, it can’t get worse” is easy to say, but it takes real trust and a sense that the team is on your side for that to stick at all. For Masyn Winn, his meniscus issue is one that could easily wait until the Cardinals are out of it and even in the most extreme case - a full repair - be back in time for the spring. The question becomes - why wait? The Cards aren’t winning the World Series. They’re not even going to be in the playoffs, so does Masyn Winn make any difference between now and the end of the season, or does someone say “go get the surgery, see you in January”?

Winn’s meniscus issue isn’t well defined. It could be anything from an annoying small tear that could be fixed easily to a full repair, which can take six months to get back from (and doesn’t often happen in baseball.) Winn will be one of those making the annual pilgrimage to a surgeon and we’ll know more at that stage. In almost all cases, it will be minor, he’ll be back well before spring training, and it will be all but forgotten by then. There are long term consequences, but I’m talking decades, not years, in most cases.

NOAH SCHULTZ, SP CWS (inflamed knee)

My sister recently went to a White Sox game and aside from the idea of ICE running roughshod through Chicago, there’s also the concept that the southside remains a rough spot. It’s not the projects and Bridgeport-adjacents it was, but it’s not exactly Mr Beef and Tweedy instrumentals that some people think it is, nor is it a crime-ridden place that can’t handle a ballgame if you have some sense about you. She was fine and had a good time and yes, I have family. Speaking of, the Doctor is doing well, thank you.

The Sox aren’t good now and will need to keep young pitchers like Noah Schultz healthy. He’s missed the second half of the season with a knee issue - the Sox haven’t released details, but bone bruise and/or meniscus issue fits - keeping him at just 75 innings and only a couple starts at Triple-A. He’ll now miss the rest of the season and the Fall League, where he was originally listed as a participant, due to the same issue and that kind of lingering either means a more serious issue or a chronic one.

There is some young talent, when healthy, and Schultz is one of the key components if the Sox are going to get out of this cycle. We’ll see if the new “ownership” will add payroll in an interesting free agent pool, especially with the CBA on the horizon and a new stadium still rumbling.

Quick Cuts:

Mike Trout is back on the board and one homer away from 400. It was his first in over a month and he’s become streakier, which makes me wonder if something like a knee is manageable, but in bursts. When it feels good, he feels good? … Do musicians need #paddedgloves? Jose Iglesias did, though he avoided a fracture. His time missed will depend on his response after the HBP … Chase Dollander is hitting the IL, which will functionally end his season. No details on the knee issue, but even a minor one is enough to shut him down … Johnny DeLuca had another injury, this time a quad strain, while rehabbing in Durham. His season is over … Chase Burns (elbow) will return this weekend, but pitch out of the pen. That’s a bit odd given his normal pre-game routine, so he may be functionally a tandem with a known starting point, as in “Burns will take it from the sixth” … Gerritt Cole throwing is nice, but he’s on a very standard rehab plan as part of his medical recovery after elbow surgery. Given the timing of the surgery, we should see a relatively normal off-season as the rehab and the ramp look much the same. Could he be ready for the start of the season? Yes, but it’s unlikely the Yankees will be anything but conservative with him … In one of my conversations for UTK, a source mentioned that if the Yankees go out early and Aaron Boone is dismissed, the Yankees are very likely to promote Shelley Duncan, who’s managing their Triple-A club. He’s well liked, well thought of, and he certainly has experience with coaches.