UTK 8/28/20

Free Friday: Yankee Blues, Jay Blues, and Mets Bloopers

You got a bit of a free bonus yesterday, as I opened up the first Black & Blue Report - my NFL injury piece - up to everyone on the list, not just subscribers. I hope everyone enjoyed that. (By the way, football injuries will normally be Thursday and Sunday night. There won’t be a Sunday night column until we have games.) For now, let’s look at a couple new injuries, plus a recap of what you may have missed from earlier in the week if you’re not a subscriber:

Aaron Judge OF NYY (strained calf)
Gleyber Torres SS NYY (strained hamstring)
James Paxton SP NYY (strained forearm)
D.J. LaMaheiu 2B NYY (sprained thumb)
Giancarlo Stanton DH NYY (strained hamstring)

Wow, New York Yankees. That’s a lot of injuries, the kind that really alter a season. But before we go through these, the amount of cackling on social media is a little ridiculous. I get that some of this is the normal amount of anti-Yankee trolling that fairly goes both ways, the kind of hate that’s been around since well before “Damn Yankees” was just a musical. The specific part - that the changeover of their medical and performance staff is shown as a failure by this season’s results - is just silly. Yes, the results are bad, but given all the surrounding circumstances, judging anything by 2020 is tough.

I’ll agree, results are results and not all teams are seeing this, but anything based on a system and a process seems to be collapsing this year. Whatever job you do, has this year been an easy time for change or to try to shift what you do to a new paradigm? Sports don’t usually have a long leash and results should count, but for the Yankees, I have a harder time connecting their injuries to what they publicly stated was going to change. This was something that was going to play out over years, even if everything went right.

But the injuries exist. Aaron Judge is heading back to the IL, with Brian Cashman saying he’ll need “twice as long” on the list. It was 11 days last time, so pushing him out almost a month puts the calendar in sharp focus. Judge might not be back before the end of the regular season, but with the expanded playoffs, even with all these injuries, the assumption is that the Yankees should be there. The question will be, how much are the Yankees or any team going to value the playoffs? My guess is that there’s still some Steinbrenner DNA in there.

Judge’s calf is said to be a mild Grade I strain, but that the location is problematic both in the structure of the muscle and painful for him when he’s trying to bat. The Yankees medical staff will work to heal the muscle as best they can, but Judge’s body is going to do the bulk of the work and it’s difficult to speed that up. How they integrate Judge back with almost no time is going to be tough as well. If Stanton is back, Judge has to be in the outfield even with a bad leg.

Speaking of Giancarlo Stanton, he’s at least a week away from returning from his hamstring strain. Again, the stable base for the big swing is the key and no, there’s no way they put Stanton in the outfield, even for Judge. There’s always a recurrence risk, but at a point where seemingly every other player is down, Stanton is likely to be pushed back to some extent. His key of course is power and we should see him taking batting practice early next week. Making sure that he’s ready and holding him back any amount of time is going to show us just how this team is thinking. The decision and the success of that decision could well decide how the Yankees do this year.

More? James Paxton’s forearm strain is likely to cost him the rest of the regular season, putting him in the “how do we bring him back” camp like Judge, but with the added complexities of a starter. Stamina and build-up is the key, so think less about the time Paxton will be on the IL and focus more on how much time he’ll be off before getting back to throwing. Let’s assume that there’s just no way that he can get back to a five inning load - how then do the Yankees best bring him back?

The first job is getting the forearm strain to heal up. We don’t know the exact location in terms of is it more muscular or more tendinous. More than one doctor I’ve spoken with during this outbreak of forearm strains has commented on how relatively weak the tendon is compared to the rest and almost all of those comment on the similarities to the Achilles tendon.

Once Paxton is healed, the only way to bring him back as a starter is to piggyback him or functionally piggyback him without saying it. Maybe he could get four or five innings, but the Yankees could go with a “Pair of Aces” strategy as well. Throw Paxton and Gerritt Cole for three or four innings each and bring them back on short rest, which teams regularly do in the playoffs anyway after standard starts. Given the short first series, this could work with some extra days off in there.

More? Yes, Gleyber Torres might be the worst of the bunch, with a multi-system strain that I honestly haven’t been able to get any clarity on besides the announcement. He’s listed with both a quad and hamstring strain after initial reports focused on the hamstring, which is something that seemed pretty straightforward. How the quad got involved is unknown here, but the complication takes Torres from a relatively simple two week hamstring to a six week recovery, which sure indicates something more serious. That timeline ends Torres’ regular season and could functionally be a shutdown, especially if there’s some complex mechanism or deficit.

Let’s end this section on some good news, with D.J. LaMahieu returning as soon as this weekend from his thumb sprain. It took a couple weeks, but didn’t necessitate surgery. That didn’t shorten things up much - the standard surgery has a recovery period of a month or less and as a bonus, almost wipes out the chance of recurrence. The watch here is whether LaMahieu’s grip is affected, so look for any sign of loss of bat control. That shows as swing-and-miss swings that badly miss, as the grip doesn’t allow for the kind of fine bat control that makes those in-swing adjustments.

Here’s some bonus food for thought: Is Brian Cashman a Hall of Famer? GMs as a whole don’t get into the Hall, but they also weren’t strongly regarded figures until late last century, apart from the occasional Branch Rickey. That changed and changed a lot, as owners slipped into the background. There are cases to be made for Theo Epstein and Billy Beane, but Cashman has been the Yankees GM for 20 years now, so long that kids today don’t get it when you talk about the Yankees going through three managers a week. Cashman as GM has only had, what, four managers in his entire tenure? He’s got wins, championships, big deals, and I don’t think there’s a good case that Cashman himself shouldn’t get credit for all of that. I say he’s in.

Salvador Perez C KCR (blurred vision)

I will flat out admit that I know nothing about central serous chorioretinopathy. That’s the diagnosis for Sal Perez and explains the blurred vision he was having. The plus is that the vision issues aren’t concussion related, but the doctors I was able to speak with didn’t indicate this was a very worrisome condition, but that there’s not much doctors can do.

If you read this explainer on CSC, you’ll see there’s a couple interesting points. The condition often happens in “competitive or stress males” and can be exacerbated by corticosteroid use. If you don’t think Perez has those two, you haven’t watched him much. If this was a reaction to one of the injuries Perez has had recently, which could be treated normally by a corticosteroid pill or injection, that’s problematic, because Perez is likely to need something like that again and will have to find an alternate treatment.

Given the lack of guidance on this, I’m not going to guess. Perez will remain out until this not only clears up, but stays cleared up. The Royals will have to go with their backups for a while and contemplate a short and long term future where their catcher is unavailable.

Trent Thornton SP JAY (inflamed elbow)

Nate Pearson SP JAY (inflamed elbow)

Matt Shoemaker SP JAY (inflamed shoulder)

Buffalo may be bad for arms. Admittedly, that’s just how it seems right now for the Blue Jays, losing three of their top pitchers. At this stage, neither has a serious problem, but being without both is going to be a serious issue for the Jays as they try to - get this - keep pace with the Orioles.

Trent Thornton returned from his issue with elbow inflammation and only made it an inning before experiencing more pain and inflammation. It’s the worst case scenario for the medical staff, seeing a recurrence this quickly. The root cause is acting quickly and harshly, so they’ll have to try something else if they’re going to keep Thornton functional. We have to assume that there’s not an underlying structural problem since that’s what they found at first and this seems to be a one-for-one recurrence. That means they didn’t find the true root cause.

The story is similar with Nate Pearson, their uber-prospect and someone who’s been coached and managed not just for velocity but for workload management. That he’s coming up with elbow issues is a surprise, even with his high velocity. The team is waiting on the results from a second opinion, but the story is that the pandemic has delayed results. It’s hard to imagine that would be an MRI - the doctor would want those before a visit rather than after and I can’t imagine the team wouldn’t have done this for their own purposes. If the elbow is intact, I’m a bit stumped at what tests or even procedures like PRP could have been delayed. This one bears watching, but all sources seem to think that the Jays are more inclined to shut Pearson down if there’s any risk.

Matt Shoemaker is a little different from Thornton and Pearson, in that his injury is shoulder rather than elbow. After pitching well in his last outing, Shoemaker was pushed to the IL as a bit of a surprise. The reports are that Shoemaker has inflammation in his shoulder, with sources saying it is “broad rather than focused.” That means that his whole shoulder, rather than just an area, is experiencing the swelling. That normally occurs in an overuse situation, which would seem odd given it occurred after a normal outing. This one might seem the easiest to deal with, but the Jays are going to have to figure out what caused this if they’ll be able to keep Shoemaker in the rotation.

With these three out, the Jays are deep in the depths. Getting Chase Anderson back means they’re at three of their expected starters, but two more means they’ll be at 8 or 9 on the chart for whoever ends up taking the starts. Right now, it’s unclear who that will be, but the Jays are running out of options. Thomas Hatch and Anthony Kay might take starts, but the Jays will have to use a lot of pen, if not a full bullpen game, to get through. They’ll be watching the waiver wire and might be forced into the trade market.

Wade LeBlanc SP BAL (fractured elbow)

If the idea is to prevent injuries, did the Orioles medical staff succeed or fail with Wade LeBlanc. LeBlanc goes to the IL with what was called a “stress reaction.” This is basically a fracture waiting to happen, a spot that can be seen on imaging ahead of an actual fracture. See below for more:

LeBlanc’s problem was in his pitching elbow and when we’ve seen fractures there, the injuries have been devastating. Think Jarrod Parker, though his injury was a freakish one and no, I’m not showing the video. By catching this, LeBlanc has been saved a lot of pain and time, so I’ll call this one a big win for the O’s.

The question is, how did this happen? Obviously, the imaging was done after there were issues and pain. Would it be possible to use imaging to catch more injuries? The simple answer is yes, but it’s not simple. You can’t do X-rays and MRIs after every outing. Well, a team could but it’s not practical. The use of smaller tools, like a portable ultrasound, is used, but not widely, despite the fact that they’re cheap and small. (If someone wants to test those on pitchers, I’d gladly use it with my UIndy pitchers this upcoming season.) Imagine being able to look at muscles, tendons, and ligaments quickly and easily. In a season where we’re seeing more injuries than ever, it seems this kind of technology would be more in use than ever.

Merrill Kelly SP ARI (blood clot)

It was more than just a simple scratch. The Diamondbacks pulled Merrill Kelly from his last start just before the game after he complained of “tightness” in his pitching shoulder. It was a blood clot and he had surgery to remove it and repair the situation. This is related to, but not exactly, thoracic outlet syndrome, but the repair is extremely small. The severity is more in the possible consequences and now clear, Kelly has no further danger from this instance. Not just pitching, but life.

The big worry is recurrence. I don’t want to compare Kelly to someone like Chris Bosh, who’s career ended due to recurrent blood clots, but that possibility exists. The normal course will involved medication and that effect on Kelly and his ability to pitch is an unknown in the short term. The guess is that his season is likely done, but that he does have a good chance to return well in ‘21, assuming the clotting situation remains under control.

Lucas Giolito (no injury)

This could have been the intro, but I decided to push it down here. Lucas Giolito had a great game - a no-hitter at just over 100 pitches. Efficient and effective, but don’t rely completely on a pitch count to measure just how stressful a no-hitter is. For years, pitchers that have gone deep for no-hitters or have come close often see injuries just after. I think it’s that every pitch in those last few innings becomes very high stress. That’s a lesser worry when you’re in the ninth at under 100 and you’re California Cool like Giolito, but it’s not nothing.

I’ve had long talks in the past on this with pitchers like Johan Santana and Nolan Ryan and all agree that it is more stressful, but had no way of quantifying it. We’re closer to that and I know that the White Sox have technology that will give them a really good look at exactly where Giolito is. Bud Smith might be asking where that was for him.

All in all, I think these have to be considered a much higher stress outing than even an efficient pitch count would show and absent better data, we should probably err on the side of caution and give extra rest, even if you’re tempted by a Vander Meer.

Quick (New) Cuts:

We kind of have to start today with “Mets (self inflicted wounds)”. That team needs new ownership in the worst way and if you haven’t followed what I’ve written about the need for a new commissioner - which will happen soon - then it’s a good time to check the archives … The Red Sox will push Nathan Eovaldi back a day. His calf was cramping last time out and they want to make sure his mechanics are stable. I’m told that the Sox are using some form of biomechanical tracking that is giving them an idea of what changes Eovaldi and others are making in real time … Madison Bumgarner is close. He’ll throw a sim game this week and my guess is he’ll push to take a start at some point later this week. How many pitches he goes in the sim will give us a lot of info … Keone Kela hits the IL with his strained forearm. Remember that this doesn’t preclude a trade, but it does make it harder to get done from a value standpoint … The Brewers are worried they’ve lost Manny Pina for the rest of the season. He injured his knee Thursday and if it’s a meniscus, even the short return time on that would push him past the end of the schedule … I’ll be donating any subscription income from today (and all weekend) to The Players Alliance. Thanks to Cory Schwartz for the idea.