Under The Knife: Change in spring routines opens door to injuries

Here's my proof that Spring Training is too long: Over the next week, we're going to see a bunch of games where the goal isn't to see something or make a decision, but to try not to get hurt. Of course, that's usually when players get hurt, as you'll see by the long list of new injuries down the page. Changing anything -- even just dialing things down a notch -- often changes mechanics enough, or creates just enough of a routine change in a player's mind, that it can lead to a situation where injuries occur. Unlike in football, where most injuries occur early in camp, baseball saves its injuries for last, as fatigue, boredom, roster stress and anticipation set in. Let's hope we can avoid most of them as we head toward the first pitch. Powered by knowing that Opening Day is less than a week away, on to the injuries:

You know what scares me? The thought of having to write an obituary in this column. I wrote about the death of Steve Bechler in one of my first columns. I wrote about Daryl Kile, but as a part of baseball. We've seen player after player injured by comebackers, and while we've been lucky that none have been too bad, Juan Encarnacion aside, we haven't had something catastrophic. It's one thing if it happened to major leaguer, but I worry most about kids, ones who aren't making millions of dollars and spending the spring on defensive drills. When Easton introduced their pitching helmet, they did it with Gunnar Sandberg, a kid from Marin, Calif. who almost died after being hit.

As for Oswalt, he took the comebacker off the back of his head, off the bat of Manny Ramirez ... and walked away with nothing more than a bruise. It could have been so much worse; that it was all just luck shouldn't make us smile, it should make us scared for the next one and have us working to prevent it.

Another oblique strain? Yes -- and I'm going to have more on why this is happening in Monday's column -- and yes, the rates are up. While comparing apples to apples with Spring Training injuries is tough, it appears that this type of injury is spiking in 2011. Granderson strained his oblique early this week and the moderate strain is right on the edge of having him miss the start of the season. The DL seems possible, but the team will take all the time they have before making any decision. Joe Girardi has been more willing than most managers to play a man short for a few days despite not having the deepest or the most flexible roster. If Granderson is out, Brett Gardner will shift to CF and Andruw Jones will start in LF for the Yankees. This shouldn't move Granderson down draft boards significantly.

Gonzalez has been quiet through most of the spring, hiding on the back fields as he works to get his bat speed back up after shoulder surgery. He's passed a couple of tests over the last week, playing in back to back games and switching back to his normal bat. Things have been positive, though there's still a discernible loss of bat speed. Observers differ on their opinions of where Gonzalez is. Some think he'll be fine for the opener while others think that his slow bat can be exposed for the first few weeks. It's unlikely that a slow start will allow you to swoop in and steal him from an owner who's disappointed with the results from his high pick, but if you're the guy taking him, it's important to find a good backup 1B to swap in, especially in daily leagues. I'm not shifting Gonzalez any further down my personal draft board since I've baked in the injury and recovery time, but I am going to be smart about the late-round complementary picks.

When I heard that Morrow had come up with a sore elbow, I immediately ran back to check the Jays Team Health Report. Not only was Morrow a noted risk, but the ongoing issue with pitching injuries that I wrote about in the lede continues to confound me -- and the Jays. Until the Jays figure out what's wrong, they're left to treat symptoms rather than the cause. Some argue -- including several in the organization -- that this is purely random. There's a case to be made for that, but it's the default case. The Jays are a so-called "smart club" and leaving things to random chance isn't the hallmark of any kind of successful club, no matter how you define smart. While the injury to Morrow is relatively minor, it does bring up worries of last year's workload. The Jays handled him smartly, but for young pitchers, sometimes cautious isn't enough. We'll have to watch this one closely. Morrow should only miss one start from this, but I'll be curious to see how he pitches in rehab work.

One of the things I love about baseball is that no matter how many games you've watched, you'll always see something that makes you go, "Wow, I've never seen that before!" I've done over a thousand UTKs, but I've never seen this one before. Pence will miss a couple of spring games after needing a tetanus shot. The details of how this happened are a bit murky, but Pence ended up with a cut on his shin, necessitating the shot. Overall, this shouldn't affect Pence's Opening Day in any way, as manager Brad Mills saying that Pence could have played this week if needed. Once Pence gets back on the field, we can safely ignore this incident, assuming that lockjaw doesn't set in.

It's not as bad as hurting your knee on a pie trick, but calling a shoulder setback a "hiccup" isn't exactly the height of medical transparency for Coghlan. Coghlan is still feeling tightness and some pain in hard throwing, a problem with his planned shift to CF for the Marlins. Every 3B coach in the league is loading up on Coghlan, knowing they'll test him early. The Mets, Nats and Astros all have some speed, so look to see if they're going first to third. It's a reach for a fantasy play, but there could be some extra runs and RBIs in those games, though predicting which players is tough and the gain will be fractional. For Coghlan, he's going to have to prove that he can handle the position, not expose his team defensively, and show that his shoulder will hold up over the course of a season without more "hiccups." The easy solution here would be shifting Coghlan to LF, but that would create a roster cascade that might be worse than just suffering with Coghlan's weak arm.

Both Webb and Wang succeeded with a pitch that's popularly called a sinker. This 2009 blog post about Wang shows the PitchFX views of the pitch, which doesn't really "sink" as most think of it. It moves in (assuming RHB/RHP) and goes down slightly, more like a screwball than a splitter. (By the way, most fans confuse "sink" and "ride" with "drop," which is what a splitter does. Scouts really have their own language.) To make the ball "sink", the pitcher pronates at release, turning the thumb down. Go ahead, try it at home -- gently. You'll notice that as you turn the thumb down in a "pour the can" motion, the head of the shoulder also moves in the joint. That rotation, done hard enough, is what seems to be hurting players like Webb and Wang, leading to labrum, cuff and capsule issues. The shoulder is very difficult to repair, as the rehab times of these two show. The progress is slow for both, though they moved in opposite ways this week. Webb had a mild setback, which is going to keep him out past May 1, the optimistic goal the Rangers had for him. Wang is going to throw live BP this weekend, which is another step toward his eventual return. Both ERDs are the optimistic case for Webb and Wang, but I don't have a ton of confidence in that happening on schedule.

Maybe no news is good news. With Utley, it's not bad news, but the radio silence from Philly also tells us there's no progress. There's very little in the way of leaks or anyone going off-message here, so there's really no new information, and therefore, no changes to our estimates on Utley's return. We have to assume that something's happening, but that he's not yet ready to get back on the field in any manner. We can assume he's keeping up his cardio and likely taking swings, perhaps seated instead of standing, just to keep his eyes used to recognizing pitches. Until we got some new information, some new Area 51-type sighting of Utley, we'll have to just keep pushing the clock back slowly. Right now, the timeframe looks like the end of April or beginning of May, but calling it fluid doesn't do it justice. For an example of how this might go, we need look no further than Guillen. His arthritic knees have bothered him for years, forcing a lot of maintenance, a couple position changes off 2B, and finally, a modified microfracture procedure this offseason. Guillen's was much less extensive than the procedure done on Grady Sizemore, but the struggles he's had along the way show both the upside and downsides of the issue. Guillen's not back on the field yet and will start the season on the DL, ceding 2B to Will Rhymes.

Things are looking positive for Jake Peavy, though the tendinitis and rehab will cost him at least the first half of April ... There's late word that Brad Lidge will start the season on the DL. Ryan Madson moves up boards on this news ... Tommy Hunter left his start with a groin strain, just after being named to the Rangers rotation. There are off-days, so they may not need an SP6, but even if they do, it won't be Neftali Feliz, who's locked into the closer slot ... The Mets are going to make "big decisions" on Carlos Beltran by the start of next week, a source tells me, based on his physical performance this weekend. The knee "isn't progressing as hoped" ... Don't mistake the situation with Brian Wilson for a setback. Wilson merely got his reins pulled by the medical staff. That's a positive, not a negative ... Cody Ross has a significant strain of his calf and is headed to the DL. The playoff hero could miss as much as a month with this Grade II strain. The Giants will have to shuffle the roster a bit, potentially keeping Brandon Belt from a trip to Fresno ... Jair Jurrjens had another issue with his side. The Braves say it's not a recurrence of his oblique, but some suggest it could be related to his weight loss. That seems odd to me ... Casey McGehee came away lucky after what looked like a severe knee injury. He's day-to-day as the Brewers see how his knee responds over the weekend ... James McDonald could miss only one start if his next session goes well. He's the titular Pirates ace, but check the Pirates Team Health Report -- there are big workload concerns here ... I know some are saying that Matt Kemp is more focused post-Rihanna, but seriously, do you think the guy is short of distractions now? ... If you're going to be at the SABR Convention this summer, I hope to see you there. I was honored to be asked to moderate a panel on sports medicine that will happen on the opening night of the convention (just after Scott Boras' keynote.) The panel will include Dr. Neil ElAttrache, Kevin Wilk and Ned Bergert. That's one of the top sports docs, one of the top sports therapists and the former trainer for the Angels, talking about sports medicine and taking questions. Yeah, that's going to be awesome. I'm also looking forward to getting out on the road, and when possible, I like to get together with readers. We've had great events in the past and I can only imagine that things will get bigger and better this season. I'll have more info. soon on those, but I can tell you that the first one will be in Cincinnati.

Will Carroll writes about sports injuries. You can email him or follow him on Twitter (@injuryexpert). He is a member of the BBWAA and PFWA.