Under The Knife: Training staffs again crucial to playoff contenders
White Sox, Reds, Rangers in playoff hunt thanks in part to medical training staffs
Josh Hamilton's blurred vision more a product of infection than excessive caffeine
Mark Teixeira likely will not be at full strength when he returns for the Yankees
I've been lucky enough for the past decade to tell the story of baseball through the lens of sports medicine. One of the best parts of that is getting to talk about the men and women who make up the medical staffs: the doctors, athletic trainers and other assorted health professionals who help players through the season. Fans may not know those names or faces, but they know when the stars are missing. The medical staffs put in insane hours -- 18-to-20 hour days for much of the year -- and are accessible in stunning ways. I'm honored to tell their stories and for them to share with me what they do, making a difference not just to their teams but their communities.
Ten years ago, I wanted to reward those great medical staffs and to give them something to go on their shelves, an acknowledgment teams themselves could celebrate. I wanted to use the statistics I was gathering to come up with an award. The Professional Baseball Athletic Trainers Society gives out an internal award, voted by the peers, but my award, named for longtime Twins Athletic Trainer Dick Martin, is simply about results. The award, now given in association with my friends at Rotowire.com, is down to three finalists:
Chicago White Sox: Once again, Herm Schneider and the "staff of the decade" are putting up numbers that have kept a team with plenty of veterans healthy enough to stay ahead of the Tigers into the season's last week.
Texas Rangers: The Rangers have a risk-filled team, yet Jamie Reed and his staff have kept them healthy enough to contend. Perhaps more than any other team, they have outperformed in the actual-versus-expected days and dollars lost.
Cincinnati Reds: A Dusty Baker team that keeps its pitchers mostly healthy? Even with the loss of Ryan Madson for the season, Paul Lessard and his staff have kept everyone else so healthy that they could bring home not just a trophy, but a pennant.
What's really intriguing this season is that all three teams are in playoff contention. In fact, the difference in injuries alone between the White Sox and Tigers could be what decides the AL Central. The same holds true for the Rangers, whose lead in the AL West is less than the advantage they have in Injury Cost over the A's and Angels. We'll have to see how things go in October for all three finalists. No matter the winner, all three medical staffs deserve a big tip of the cap from baseball fans everywhere.
Powered by Verve's amazing Duromina, on to the injuries:
Hamilton returned to the Rangers' lineup Monday, but before he stepped into the batter's box, he stepped into my territory. Hamilton's diagnosis shifted from migraines and sinus issues to ocular keratitis, or swollen cornea. Hamilton suggested the problem came from too much caffeine, a condition about which I might be the world's leading expert. This type of eye issue is normally the result of a simple infection, such as mold on contacts, staph (often present in locker rooms) and herpes simplex (also, often present). Caffeine is often an issue with other eye problems, but keratitis isn't one of them. For people with glaucoma or ocular rosacea, caffeine can be a real problem. So can caffeine withdrawal, which can also cause similar but temporary vision issues. Hamilton's return seemed to go well, though the Rangers may elect to rest him and others once they have the division locked up.
Crisp has conjunctivitis. It's popularly known as "pink eye" for obvious reasons, but as with Hamilton, this is an infection of the eye. (Actually, weren't the Rangers and A's just playing?) Crisp's vision is compromised until this can be cleared up, the time for which varies greatly depending on the infecting agent and the body's response. Crisp has seen several doctors, but as yet, the best response has been to keep taking medicine and wait. Crisp was able to pinch run on Tuesday night, but could not hit. His eye was still visibly swollen and twice he seemed to have left early for second. That could be a bad read, but it could also be his vision.
Recovery was always going to be more of a tell than winning his first game back or even command. Kershaw was able to do his side work Monday and Tuesday and remains on track for his next start. That should come Saturday. I say "should" since the Dodgers are right on the cusp of elimination, and by Saturday the team's playoff hopes might be clear. The Dodgers likely will pull Kershaw at that point, shutting him down and beginning the process of getting him ready for 2013. That could include surgery, though no decision on that has been made by the team or by Kershaw.
The Yankees are seeing positive signs from Teixeira, but the schedule is working against them. Not only are they running out of time to get their first baseman back into the lineup, they're heading to Toronto, where the turf field isn't the ideal surface for a comeback. Teixeira is working in Tampa at the Yankees complex, doing most baseball activities, but not yet running full speed. It's quite possible that Teixeira won't be running full speed when he's back, and operating under orders to not push things. That will be tough in the heat of a playoff game, especially if the Yankees end up in a tight series. Teixeira injured himself pushing for that one play that he felt was meaningful and it's hard to think that he'll be able to consciously stop that from happening again. Ballplayers just aren't wired that way.
The Marlins' season hasn't gone as expected. About the only part that went to plan is that Stanton established himself as one of the premier sluggers in the league at 22. The power is there, but can his injury-prone nature change? A great comp is Miguel Cabrera, the former Marlin. Cabrera was younger when he came up and matured physically on the field, so it was more about adjustment to his body. Stanton is already a bull of a man and doesn't project as someone who will grow more. Stanton will need to find a balance so that his body can hold up to the violence of that swing and the weight of the muscle he carries. He's expected back from the oblique strain on Wednesday, but the Marlins will be cautious with him. Watch out in daily leagues, but his power is worth the gamble in weeklies.
Bourn injured himself on a head-first slide. It's a bit ironic since he's been a vocal advocate against the head-first slide, but it's instinctual, and in this case, Bourn was right. He injured his thumb on a slide when it was pulled back by the base. The Braves have clinched a playoff spot, so they can afford to rest him, but by Tuesday, he still hadn't seen much improvement. The team will continue to be very conservative with him but hopes to see some positive changes. We can only imagine Bourn will be sliding feet first once he's back. In the meantime, fantasy players will need to look elsewhere for steals.
Scary play and odd injury for Justin Verlander, but sounds like everything will be OK for the Tigers. ... Yu Darvish was a last minute scratch as he came to the park with a stiff neck. The Rangers will slot him back in, but wouldn't mind giving him a bit of extra rest. His innings totals are below what he's pitched in Japan, but he's never dealt with major league hitters or Texas heat. ... Ryan Vogelsong's stat line is almost identical to last year's, except for his ERA. Hmm. ... David Freese will miss the series with the Astros. He'll be back when they start to play major league teams again. ... Rafael Furcal won't be back this season. He's in the midst of a rehab that they hope will keep him from needing Tommy John surgery. ... The Rangers are hoping Mike Olt can get back this weekend. They'd like to see him play (and see the plantar fasciitis not hobble him) before they make postseason roster decisions. ... David Aardsma and Brett Gardner were activated from the DL. Neither is expected to be used in any significant role, but at this point in the season, you never know. Gardner could hit after some success in batting practice, which wasn't expected. ... Brett Anderson is seeing some positive signs, but it's not yet a lock that he can return. The bigger question is whether he'd be ready for the wild-card game, in any role. ... Randy Wolf had an MRI on his pitching elbow. No word yet as Wolf and the team consult with doctors about the results. At best, he'll return to the pen. ... Carlos Gonzalez had another MRI on his strained hamstring. There's a good chance he won't play the field again this season. ... The D'backs are being smart with 20-year-old Tyler Skaggs. He's at an innings high and showed some velocity loss. The D'backs are loaded with good young pitchers. Keeping them healthy will be the challenge, but if they can, they'll improve quickly. ... The Astros continue to find creative ways to lose. Fernando Abad left with an oblique strain in the second inning. ... Drew Storen has taken over the Nats' closer role. Odd time to change, but Storen's elbow has been solid since his return. ... The Phillies don't think Roy Halladay will need offseason surgery for his shoulder issues. They are planning to monitor him closely when he restarts a throwing program this winter. ... Josh Willingham had an MRI on his strained shoulder Tuesday. He could miss the rest of the season if there's any damage, ending what was a great season for the Twins' slugger. ... Chipper Jones says he's going to play in all of his last home games. That's a six-game series, so many are taking this as a sign that his knees are doing better. Key word in his announcement was "playing." Not "starting," though Jones is sure to push for that as well.
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