Under The Knife: Bailey's return as mysterious as details of ailment
Andrew Bailey may need 6-8 weeks of recovery before he can throw again
Tim Lincecum's biggest health risk may be in amount of flexibility in his back
Rays not concerned with BJ Upton's back but are taking conservative approach
Greetings from California. After a great rehearsal and some In-N-Out Burger, I'm ready for a great season of baseball. Teams are making their last preparations for Opening Day -- which should be a national holiday -- and the disabled list is already filling up. Many fans think some teams "fake" injuries, hiding players on the DL. It happens, but not nearly as often as most think. The DL has defined procedures and rules that prevent it from being used like that.
Speaking of prevention, it was mentioned by Rays GM Andrew Friedman as the next big idea. I'm not disagreeing, but I still don't understand why teams don't spend more (or in some cases, any) dollars on prevention. Even the agents aren't doing much, if anything. It will be another year in which divisions and fortunes will hinge on injuries, something teams are leaving to luck. At least it keeps me in a job. Powered by Rome, on to the injuries:
The Boston Globe is reporting that Bailey will need surgery on his thumb. He'll head to Cleveland to see Dr. Thomas Graham, one of the top hand surgeons in the country. Graham did Kevin Youkilis' thumb a couple years ago, so there's some familiarity with the Sox. Bailey has an extensive medical history and has had issues almost from the start of camp. The thumb injury is still something of a mystery. Apparently it occurred on a play at first base, though I couldn't find anyone who really saw the play stand out. Tests showed that the UCL needs to be repaired and will be done on Wednesday. This is the UCL of the thumb, not the more well-known elbow UCL, which is replaced in Tommy John surgery. It's still a 3-4 month recovery on the low end, and it could be a season ender. A fair timeline right now is the All-Star break. The Sox will turn to Mark Melancon in the interim, making him a smart pickup in the 97 percent of leagues he was available.
The parallels between Pineda and Phil Hughes are too perfect. Well, not perfect, since we're talking about young pitchers and injuries. Hughes injured his leg, started overthrowing a bit, and ended up with a sore shoulder. It set back his career more than we realize, even now. Pineda came in out of condition, still showing signs of last year's workload, and finally admitted that his arm was hurting.
Pineda's issue is in the back of his shoulder. Many immediately thought the worst, that the injury was to the either rotator cuff or labrum. An MRI came back with "no structural damage" and the calming diagnosis of tendinitis. Don't be fooled. The biceps tendon is a structure, one that's important to a pitcher. One of the buzzwords in sports medicine is the "biceps-labrum complex." Essentially, the labrum and biceps tendon work in concert, in ways doctors are still figuring out. The classic "buckethandle" labrum tear might have a different mechanism than doctors long thought.
As for Pineda, he might be better served looking to another starter on his staff for a better comp. CC Sabathia had some shoulder issues early in his career. A trip to Glenn Fleisig's lab in Birmingham helped him change some things, and the results speak for themselves. Why Pineda isn't heading down there is beyond me. Expect the Yankees to be very cautious with him, especially if Andy Pettitte is ready on the same timeline.
At one time everyone expected that Tim Lincecum would end up on the pitcher's scrap heap. His unique delivery, size and velocity seemed to conspire against him, but while everyone was focused on his elbow and shoulder, I was watching his back. All of March, I had reports from scouts and other people that saw Tim Lincecum pitch that he was fine, but one scout I know told me that his back was still something of an issue. Not that it was hurting him, but that the flexibility, the "arch" that Lincecum uses as a big part of his force generation, wasn't quite there. It's admittedly subtle and I have no way of knowing how much of an issue it is, but it's simple to explain why it's an issue. Lincecum is throwing at his normal velocity during the spring, so the total force is the same as well. If he's not getting the same amount from his back, something is working harder. Maybe it's the legs or maybe it's his shoulder. Don't include me in the doom and gloom camp convinced that Lincecum is bound to break down. But it should be noted.
Remember what I said about tendinitis being a real issue for Pineda? Well, everything is relative. Storen had some mild tendinitis and tightness in his shoulder. The Nationals are being conservative with their pitchers (gun shy?), and Storen is just behind. They'll give him a couple extra weeks to make sure the arm is not only healthy, but ready for a long season. Relievers have it tough, in that they don't have the normal tools to measure their workload. That the Nats are watching Storen so closely is a good sign for all the pitchers there, though they might go a bit too far if Stephen Strasburg's innings limit is any indication.
The Rays aren't too concerned about Upton's back, which he injured in a collision during the spring. While he's sore, the long-term issue is minimal. The Rays are almost always conservative with injuries, especially this type, which is the kind that can extend into something chronic. If there's a defining characteristic to Ron Porterfield's medical staff, it's caution. Upton will be back quickly since the DL move is backdated, something several teams will do and are keeping open. Upton should be fine once he's back, though watch to see if the Rays rest him at home due to the turf. It could cost him a game a series or so through April.
The Pirates are still saying Burnett won't be back until May. The results on the field make that conservative estimate either wrong or just wrongheaded. Burnett was able to go 54 pitches in "three innings" of a camp game. Camp games are essentially scrimmages and are tough to get real reads on, but the word was that Burnett had no issues, a couple strikeouts and gave up a hit to Starling Marte. He's not going to be ready to start the season, but it doesn't appear that he'll need more than a of couple starts to build stamina. If the Pirates slow him down much more than that, I can't think of any real reason for it.
Troy Tulowitzki was plunked Sunday by former teammate Ubaldo Jimenez. The X-rays showed no fracture, but watch to see how Tulowitzki's elbow responds ... Johan Santana's likely to get the Opening Day start for the Mets. That's a big positive for him, but I'm still slightly concerned about his ability to recover between starts ... Stephen Drew is making good progress with his ankle. There's still no firm date for his return, but I'm expecting a mid-April rehab assignment ... Nick Swisher played six innings against the Marlins, but said he "played it safe". That doesn't mean he didn't anger the Center Field Cthulu. It meant he didn't test his strained groin. He should be fine ... Josh Hamilton will be ready to start the season, but the minor groin strain has to worry Rangers fans. The only hole in his game is health ... Franklin Gutierrez has begun throwing, but he's probably at least a month out from playing after missing the entire spring ... Brennan Boesch had some minor neck spasms, but he'll be ready for opening day ... Mike Morse will play about a week in the minors before rejoining the Nats. The lat strain appears to have cleared up ... Jed Lowrie is unlikely for Opening Day. His thumb sprain is slow healing, which shouldn't surprise anyone that's followed Lowrie ... Check your trivia. Mike Carp is the first game-injured player of 2012. He'll miss a couple weeks with a shoulder sprain ... Jason Castro isn't Buster Posey, but he's coming back from his own surgery. His reconstructed knee has held up well in the spring ... Joey Devine has been shut down, again.
Will Carroll writes about baseball injuries in Under The Knife, which Peter Gammons called "the most important column of the last decade." He also writes about football injuries here at SI and is a regular contributor to Rome on CBS Sports Network. Email here or follow him on Twitter: @injuryexpert.
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