UTK 7/28/20

Pandemic Elbows and Outbreak Shoulders, plus more

There’s a million words, maybe more, out there about what happened with MLB and the Marlins outbreak over the last 24 hours. I could add to the count, but I don’t see anything I have to say that hasn’t been said. Don’t take this as me diminishing the importantance in any way. This is, to date, the most important and defining event for 2020 sports, not just baseball. But there’s plenty of injuries aside from this, so let’s spend some time on those, shall we?

Justin Verlander SP HOU (strained forearm)

I went back and watched the Justin Verlander start again in context of knowing about his injury and I don’t see anything. He looked like the normal Verlander. He made his pitches, he was at his normal velocity, and didn’t seem to go up or down. It’s a first start so you’d expect some variation but it could have been any start as far as it went for Verlander. As much as I could, I tried to see what he did as he walked off. Did he go to the Athletic Trainer or to Brent Strom? Again, it seemed as normal as any other start I’ve watched from him.

Which leaves me feeling that there’s some missing piece of information here. The Astros are never the most forthcoming organization, but in light of early talk about this being season-ending, then Verlander’s quick, personal tweet contradicting the report, this isn’t normal for any of the involved parties. I’m not sure what it could be.

That all said, the difference between a flexor strain and a UCL sprain is not something that any doctor/radiologist is going to miss. If you want to dig in, here’s a presentation done that shows a lot of the different elbow MRIs. It’s pretty in depth, but isn’t going to trigger any queasy stomachs:

MRIs are distinct and with modern ones, the views are better and more distinct. Let’s suffice it to say that with access to the best doctors in the world, this isn’t an issue of misdiagnosis or lack of medical acumen. Verlander is going to be an interesting case, but making this into a general cry against the ability of baseball medical staffs is shortsighted and frankly wrong.

There’s also late word that Chris Devenski and Austin Pruitt are dealing with elbow soreness. This could be coincidence or it could be pattern, but if these turn out to be a workload issue or an issue of some change that was made in the summer, the Astros are going to have to turn things around quickly, which is difficult.

Ken Giles RP TOR (strained forearm)

It’s not just the Astros, though Ken Giles is of course a former Astro and recently at that. Giles was diagnosed with a flexor strain after a Monday MRI showed a problem. He had left Sunday’s game with some pain, described by sources as a cramping. It was more than that, so we’ll have to see if Giles will be getting an injection, which is now standard for this kind of issue. (It wouldn’t surprise me if any of the pitchers with this type of muscular injury, including Verlander and Kluber, also got an injection of PRP or stem cells.)

Giles has had elbow soreness for the better part of a year, so this is more than just a pop up. This is a maintenance issue with a bit of a mechanics/kinetics component. Giles was able to avoid the IL last year but he was regularly unavailable and even when healthy, couldn’t be used on a normal pattern, suggesting recovery issues. He also found his command again last season and that at least seemed intact on Sunday. In the meantime, Anthony Bass should fill the role, but any extended absence is amplified this season.

Corey Kluber P TEX (strained shoulder)

Corey Kluber has a significant (Grade II) strain of his teres major muscle. This isn’t part of the rotator cuff, as I saw erroneously from multiple outlets. That’s the teres minor, but it’s close, obviously, and it’s not good. The thing is that the teres major in isolation is almost never injured, aside from in overhead throwers and it’s unusual there. (Unusual, but Anthony DeSclafani is dealing with the same injury, albeit less severe.) We’ve seen more over the last decade, as velocity/effort has ramped up, but that makes sense. There’s always a weak link in the kinetic chain.

The good news? It tends to heal up, but not quickly. If Kluber is down for a month, he’s going to lose some chronic workload and the Rangers seem to get that, saying that Kluber’s return would be as a reliever. That’s a great idea, especially if he becomes a “short pig” behind a younger pitcher like Joe Palumbo. (The “short pig” is the pitcher in a piggyback pair that takes the shorter stint.) It’s creative and realistic.

Kluber has an $18 million extension - really $17 since there’s a $1 million buyout - that seems like a no-brainer even with the injury in his history. Unless the Rangers have some piece of info that Kluber can’t stay healthy, they’re not going to get equivalent talent at that cost elsewhere, especially since there’s a lost season of pitching development for a lot of the internal options. The Rangers have been good about picking up this kind of project pitcher and Kluber maintains the upside he came in with in my opinion.

Bonus on teres major, courtesy Aaron Borgman.

Anthony Rendon 3B LAA (strained oblique)

Anthony Rendon will make his Angels debut on Tuesday and the team seems very excited. Sure, it’s like having to wait a couple days to get your Christmas present because FedEx screwed up the shipping, but as long as it gets there, right? Rendon’s oblique strain was “mostly minor,” to use the words of a source, but the team’s medical staff was pretty aggressive with it as well. We’ll have to see how that goes, but thus far, Rendon is back, swinging well, and available.

Oblique strains were once known as a recurrent injury, but we’ve learned enough about them through repetition that the treatment and rehab has gotten significantly shorter and significantly better, while mostly dealing with that recurrence risk. Rendon should be back to his normal self immediately, so adjust your expectations for him and your models for the Angels accordingly.

Juan Soto OF WAS (infection)

Here’s the opposite side of the COVID outbreaks. Without diminishing the seriousness of this infection at all, a high number of MLB players will have mild symptoms and return quickly. Even someone like Freddie Freeman who had significant symptoms has returned well in a couple weeks. Juan Soto is going to ben the next test and soon.

Soto needs the two negative tests required, but he has one and the next is pending. (He’s taken it and is awaiting results.) Since he’s been asymptomatic, the word is that he’s maintained his workouts, though he obviously couldn’t be around the team. It’s unclear if he’ll need any time to dial things back up, but he could be activated as soon as he passes his test. There’s no reason to think he won’t be more or less normal when he is activated.

Quick Cuts:

Clayton Kershaw made it through a 15 pitch pen on Sunday and will do another today. He’s eligible to come off the IL on Friday and it appears that’s what will happen … Masahiro Tanaka came through his sim game well. He’s wearing a cap insert, which is good, and has had no symptoms in a while. He’s very close to a season debut … Julio Teheran will throw a 60-pitch sim game on Tuesday as he builds up for an anticipated debut next week … Alex Reyes is back at the “alternate site” for the Cardinals after COVID. He’s expected to build quickly, though it’s unclear what role he’ll have once called back to St. Louis … Reynaldo Lopez hits the IL with shoulder soreness after his first start. No info yet on specifics, but the Sox already lacked starting depth. Losing Lopez for longer than the minimum is a real problem … “Just bad, not hurt” is the message my Angels sources all had about Shoehei Ohtani. He didn’t need a day off to recover, which is interesting, and he’ll be back out on his unique schedule … Jake Odorizzi will throw a sim game Tuesday or Wednesday, as the Twins hope they can have him back for a weekend game … Foster Griffin made his MLB debut on his 25th birthday, getting the win. Disney, until he left with a forearm strain that could end his season. The video of his postgame interview is heartbreaking … Andrelton Simmons has a sprained ankle. They’re waiting to discuss the severity, which is seldom a good sign. Watching this … Eloy Jimenez was light-headed after bashing into the outfield wall, but is not officially diagnosed with a concussion and having some symptoms when he tried to hit Monday. Diagnosis or not, the Sox are keeping Jimenez on the bench for now … Bo Bichette was a late scratch, which was a bit of a heart-racer. It’s a simple hamstring strain and how often is that the good news? … Got a great question which will be the basis of tomorrow’s column. If you have a question, make sure to email me (theinjuryexpert@gmail.com) and I’ll answer it here. Hoping to get lots.