Under The Knife 9/3/21

Free Friday: All Eyes on the Bay

A reminder: Theo Epstein is quietly positioning himself to be the next Commissioner, not the next President of the Mets. As I’ve said before, I think it’s more likely than not that Rob Manfred is pushed aside gently after the CBA is done. I’ve written pretty extensively about this, so you can dig around in the UTK archives for more on why I think this is happening. The big holdup is the CBA and the potential for some sort of stoppage as neither side appears to have made significant progress in even saying what they want from the next CBA. The owners want to pay less, the players would like more, but seriously, what are the bargaining points at this stage?

As for the Mets, well, we’ll see. It sure looks like there’s going to be an opening, but for what? Sandy Alderson is in the role Epstein would take, with the assumption that Epstein would bring in someone to take Zack Scott’s role. Everyone has a price, but would Epstein come in to any team without significant ownership and would Steve Cohen be willing to share when one of the conditions of his ownership was buying out the myriad minority owners that had happened as the Wilpons raised cash? There’s too many questions there in my estimation, especially with Epstein whispering how happy he is in his current position.

With Jerry DiPoto re-signing in Seattle, the only opening right now is Colorado and that one’s been open with a very quiet, very small search ongoing. If the Mets opens up, especially if there’s a couple positions - let’s call it President as the top guy, essentially a Sandy Alderson understudy, and a GM, who’d be doing the baseball-focused stuff - then it gets very open. There will be a push for diversity, but there was last year and the Mets selected Porter and Scott. The ideal would be someone of color with a baseball background and squeaky clean. I think there are plenty of candidates there, but the baseball background sadly narrows it.

The standout for me would be Tyrone Brooks, a name not well known, but who has extensive experience with teams, in the Commissioner’s Office, and among a group of people around baseball who he’s helped as head of diversity over the last five years, as well as a networking group he founded years back which has led to many hirings. Brooks hasn’t been at the top of an organization, but he’s well known, well liked, and as buttoned-up as can be in terms of skill sets for the position. Better, he would come with a long list of connected front office types which would make cleaning house and building the Mets back up as easy as that can be, at least internally.

We’ll see where the Mets go, but for now, let’s get to the injuries:

Max Scherzer SP LAD (strained hamstring)

Max Scherzer felt some hamstring tightness in warmups, but he still went out in a big game and came out in the sixth. It reminds me of the story that before Sandy Koufax’s perfect game, he felt terrible in the pen and threw a lot more there than normal. The downside here is that while Scherzer did fine, the question is more will it have any cost. The Dodgers have a big series with the Giants, though they’ll miss Scherzer, just on schedule luck.

While everyone is downplaying the issue, my job is to raise the question that Scherzer could miss his next start and with the Giants still right there with the Dodgers, despite all predictions, every start is going to count. Winning the division means skipping the coin flip game and that is huge, especially considering who they’ll likely play.

Scherzer is scheduled to do his side work over the weekend and that will tell us a lot about next steps. It won’t help that the Dodgers are on the road in terms of what they can do, but teams are used to dealing with this. It wouldn’t stun me if the Dodgers sent Scherzer home, but I doubt that’s the way they’ll go here. There will be plenty of notice, though the Dodgers pitching depth is starting to look very thin again.

Johnny Cueto SP SFG (strained elbow)

One letter means a lot. Look, I know “strain” and “sprain” are easily confused. It’s an easy typo, or mishearing what someone says. Strain is muscle or tendon, sprain is ligament, but even knowing that, we can’t always contextualize, so I’m not knocking anyone in the media that missed “elbow strain” for Johnny Cueto and thought Tommy John possibilities.

Instead, the Giants say this is a mild strain of the flexor, though they haven’t been clear if the issue is in the tendon or muscle. Regardless, they say it’s minor and that they expect a minimum stay here. The timing is bad so it has to be serious enough that the rest is the strongest possible way to get him through the season.

That leaves the team searching for that fifth starter, or fourth until Alex Wood is back off the COVID list. Jose Quintana will step in for one with Sammy Long taking the other over the weekend with the Dodgers. That’s hardly ideal matchups, and with Long forced to the rotation, Anthony DeSclafani will need to work deeper than he did in his first start back. Gabe Kapler will have to be creative in a huge weekend series.

Aaron Civale SP CLE (sprained finger)
Shane Bieber SP CLE (strained shoulder)

Cleveland’s barely had their rotation together all season, for one reason or another, but none of them are long term injuries. That means getting a look and having some confidence in who will be back next year - and that they can stay healthy - is going to be key as the team changes name and hopefully turns a page back towards winning rather than tearing down. If a salary floor comes in, Cleveland has the lowest current salary by most calculations so things could get busy this winter.

Aaron Civale should be the 2 or 3 next year, assuming his sprained finger heals well. Things have looked good in his rehab and he’ll make a third start at Double-A Akron. The expectation is he’ll get to 75 pitches and at that point, he’s a candidate to come back up. He’d been great before the injury and has shown his normal stuff, but a quirky injury has thrown off a top pitching season.

The same is even more true for Shane Bieber. Last year’s Cy winner has been coming back slowly from a strained shoulder and he did what amounted to a sim game in the pen, minus the hitters. His rehab time has been very conservative, which is partially due to the context of Cleveland’s season and the need to be very sure he’s ready. Bieber would have been important this year, so a healthy Bieber is absolutely key for next year. There’s no indication he’s speeding up the rehab work to get to the minors and it may not happen before the end of the year.

Ozzie Albies 2B (bruised knee)

Ozzie Albies got lucky. Fouling a ball hard off his kneecap caused only significant pain and swelling, but no fractures. The patella (kneecap) is a very hard bone, so when it does fracture, it has a tendency to basically break like a plate, forcing the fix to be more involved with pins, wires, and even more reconstructive techniques that look more like carpentry than medicine.

Albies could be available as soon as Friday, but there’s some indication that he’ll be pinch hitter only through the weekend. That’s still a very positive step given how bad things looked just a few days ago and a strong indication that further testing showed no problem besides the bruising and inflammation, most of which would have cleared by now. I will be curious to see how Albies runs, as there’s some worry that an altered gait could turn into a muscular issue with either leg.

One bonus Braves note: I’m told that both Mike Soroka and Ronald Acuna Jr are doing very well in their ongoing rehabs. Don’t expect to see much visible from those as the Braves are conscious of how things look after showing off Soroka early last year. Both should be ready for the start of spring training. Yes, both.

Kyle Freeland SP COL (hip impingement)

“Left hip impingement” is both descriptive and uninformative. I’m not knocking the Rockies med staff here at all. I think they’re leaning more to the former and discussion of the treatment - an anti-inflammatory injection - points to this being something structural rather than muscular. That’s problematic in the long term, but the Rockies think Freeland could be back without even delaying, let alone missing a start.

All of that points to this being some sort of hip labrum issue. That’s not an uncommon or difficult surgery, nor is it a difficult fix, with a high rate of return across sports, including baseball. There’s likely lots of players with asymptomatic issues like this, so if the Rockies can get Freeland’s calmed down this quickly and easily, surgery might not even be a consideration.

Given where the Rockies are and that Freeland is likely one of the decision points for whoever takes over this franchise. He’s been mediocre at best, will be age-29 last season, but he’s shown flashes and pitches at Coors making any judgements tough. The hope has to be that Freeland pitches through the end of the year with this hip issue cleared up and manageable. If nothing else, the Rockies have a lot of division games left in an NL West that’s far from decided yet.

Kenta Maeda SP MIN (sprained elbow)

I’ve been writing about InternalBrace surgery for a while now — almost five years! — but Kenta Maeda is the highest profile pitcher to have the surgery. While early reports are that Maeda will miss 9-12 months, the surgery itself has the potential to return pitchers faster than that.

InternalBrace has been used on many athletes. It’s a common technique for thumbs (Andrelton Simmons, Mike Trout, Chris Paul) and for ankles (here’s more on that from one of the fathers of this type of surgery, so using it in elbows is neither new nor special. The key is that the brace - the Suturetape overlay - protects the ligament from almost day one. It needs healing time for it’s anchors, but after that, the Kevlar is as strong as it will ever be.

The other interesting factor here is that Dr. Keith Meister is reported to have done the surgery. There’s a small number of doctors that do pro-level elbows and fewer that have done the even smaller number of InternalBrace elbow surgeries. Adding Meister to that latter list is another indication that we’re going to see more and more of these, as appropriate.

There’s some confusion about calling this “Tommy John surgery” as well. That moniker is the colloquial name for elbow reconstruction, where a tendon is transplanted to replace the damaged ligament. In most InternalBrace situations, it’s a repair not a replacement - the ligament is stitched back together, as in a tendon repair. There are times where the replacement has been done with an InternalBrace in other parts, but I’m not aware of any with the elbow. It’s a bit of an unknown, but every elbow operation is not Tommy John.

The timing on Maeda’s surgery means he could still miss much or all of 2022, but he’s signed cheaply through 2023. A six to nine month recovery would really get noticed, so while we likely won’t see much from Maeda until spring training at best, the Twins will be watching him closely in the offseason, given their uncertain rotation for next season.

Quick Cuts:

Noah Syndergaard’s COVID setback to his rehab hurts, but the hope is he can get back and it will restart once he’s cleared, despite some reports to the contrary. A source tell me that the hope is he can do a quick couple sessions in the minors and get back up quickly for a short relief role … Dakota Hudson had another nice rehab outing. Stepping up to Double-A and going 43 pitches, word is he’ll make his next start at Triple-A and go around 60 pitches. That could be it for rehab, meaning he’d be back with the Cards in time to make two or three starts and position himself well for ‘22 … Luis Severino could return to his rehab next week. They’ll decide over the weekend what the plan is and if it’s realistic to get him back to the Yankees in some role … Didi Gregorius could be back this weekend, a boost for the Phils … Same timeframe for James McCann but the Mets are kind of past the boost stage right now … Brett Anderson took a comebacker off his shoulder, stayed in the game, but when the adrenaline wore off, it’s enough of a bruise that he’ll miss one start … For those wondering about the Rockies, yes, they’re waiting until the end of the season, largely because there’s a couple names they want to interview more in depth that are very likely to be in the playoffs. That would be Jeff Kingston (Dodgers), Billy Owens (A’s), Matt Kleine (Brewers), Zack Minasian (Giants), and what I’m told is an “outside the box” candidate, which usually means not in baseball or at least not in a front office so I’m not sure what the hold up would be. My guess is that’s a woman, though I don’t know who. Add that to the known list of Thad Levine, Michael Hill, and Jeff Luhnow.