Under The Knife: Reds may be forced to turn page on Rolen era

Not a game goes by when pitch counts aren't mentioned. In general, they have come to represent an important marker of fatigue, of dangers that lie ahead in a particular game or one down the road. But Dan Wade, who helps me with research, in addition to his work at Fangraphs, recently came across an intriguing study about the topic.

"While pitch counts are still common consideration in baseball -- and a favorite of announcers trying to explain why a pitcher's efficacy is waning -- the research arguing against their worth is beginning to pile up," says Dan.

"This month, Baseball-Reference's Sean Forman and J.C. Bradbury, Chair of the Health, Physical Education, and Sport Science department at Kennesaw State University, have published their findings on the subject in the Journal of Strength and Conditioning Research with a study of pitchers from 1988-2009. While their research did find a very slight negative correlation between ERA and pitches thrown in previous games, the effect was so small that their ultimate conclusion adds them to the growing chorus of voices that are clamoring for a way to measure pitcher fatigue that actually has some relation to reality.

"At the American Sports Medicine Institute's course on injuries in baseball last January, Will Carroll and I presented research from the last decade arguing that there was virtually no correlation between average pitch counts and days lost to injury for pitchers. Other speakers touched on similar ideas, noting that once a pitcher's arm is fully developed, pitch counts were no longer a good way of measuring fatigue.

"Pitcher decisions (wins/losses) and RBI have declined in importance since with the wider acceptance of sabermetrics. With any luck, pitch counts will be one of the next numbers teams stop caring about so much."

There's another study I learned about this weekend that I'll share with you on Wednesday. Powered by more studies and direct measures, on to the injuries:

The Reds were already looking to find Rolen a backup, despite Todd Frazier's solid work so far. Rolen's trip to the DL might accelerate that. Rolen had offseason surgery on his left shoulder, a Mumford procedure that relieved some of the impingement that had led to pain and inflammation. It didn't last long, and Rolen could be on the DL for an extended period. It affects him at the plate more than in the field, though there's more chance of doing more damage in the field. Frazier will get the short-term starts, with Mike Costanzo backing him up, but expect the rumors to start. Hometown boy Kevin Youkilis has been mentioned as a possible addition, as well as several lesser names. At this stage, it looks like Rolen will be out about a month, but the situation is very fluid. Even when he's back, there's a question of function and how long that function will last.

The White Sox got an MRI for Sale after his agent, BB Abbott, requested it. It's not an uncommon request, though it's usually paired with a second opinion. The scan came back "crystal clear" and the Sox ... well, they put Sale back in the rotation. The confusing week of events gets weirder when we focus on the medical issue. Sale's elbow was sore enough that the team felt it was necessary to shift him to the pen, where he hadn't had problems with recovery in previous seasons. A source with knowledge of the team's decision process told me that it was based less on current information than on the fact that he'd relieved before without issue. "It worked before, so the assumption was it would work again. He wasn't the closer, but [Sox officials] and trainer Herm [Schneider] don't see anything different about the usage he had in the past and what they anticipate he'd get as a closer," I was told. Sale started Saturday and had a terrible first inning. He ended up going five inefficient innings. We'll have to watch how this turns out, but at this stage, I'm as confused as everyone else. Like sands through the hourglass ...

The Rays don't have much choice when it comes to turf. Grass isn't growing inside of the Trop and they've done what they can to make that stadium as good as it can be. A couple years back, I was down on the field for their Fan Fest, signing books, and when I walked off the field, my back was stiff. It's not the same thing, but standing on turf -- and running, and diving -- is not the same as grass no matter what people try to sell you. The only two teams with turf left in baseball are both in the AL East, which complicates things a bit in that division. It definitely complicates the return of Jennings. It was thought that being on the road would help Jennings' knee, but he's not back and a trip to Toronto starts Monday. A retro move to the DL is possible, but the lack of progress is worrisome. Again, the Rays tend to be conservative with injuries and have a more flexible than normal roster. This has gone from "soreness" to "bruised" to "sprained" over the course of a week, which is just new information coming out as this has extended. The Rays will make a decision on the DL Monday, which I expect to be to list him.

The Red Sox have had a rough season so far, but they're not out of it. The pitching has been an issue, but if they get Bailey and Matsuzaka back at level, some of the biggest issues will go away. Bailey is further away, but key to the team's confidence if nothing else. Bailey could be cleared to throw this week after a quick consult with his surgeon. Bailey has said that his thumb feels normal. He should come back pretty quickly since the thumb isn't key to a normal pitching delivery. He won't need a ton of stamina either, given his role. I'm shifting his ERD up a bit on the assumption he'll be cleared. Matsuzaka made another rehab start, and while he's fine with stamina, his off-speed command still isn't there. Proprioception is one of the last things to return, so this isn't a huge negative. Matsuzaka's rehab clock runs out on May 23, so he should be able to get a couple more starts in if needed. (For those curious if Tommy John surgery works, check out the stats of Anthony Montefusco, who was referenced in the linked article.)

I'd been talking to a baseball insider about the velocity increase seen this season by Duffy. It's a real increase but no one seemed to have any clue why. He didn't look different, according to scouts. He wasn't throwing a different pitch. There wasn't any reported change to his workouts that I could find. Instead, he just showed up with a couple extra mph. Assuming everything stayed the same -- which is not a good assumption -- then Duffy was simply getting more force. It could be that he increased his energy efficiency, transferring more into the ball, or he was increasing the overall energy, which could also tax the kinetic chain. That latter is the big worry after he came out in the first inning of his latest start. The Royals called it "medial elbow pain" and will send him for an MRI. It's easy to jump to the worst case scenarios here, so having Plan B in place is a must.

I don't have any injury history on Cespedes. I'm assuming that the A's did their due diligence on this prior to their surprise signing. A source with the team said they were both comfortable and complete when it came to checking Cespedes out before the signing. Cespedes' injury is minor, a strained muscle in the back of his hand that should heal up well with rest and rehab. That kind of injury is odd, but not unheard of, especially given the force of his swing. The move is a retro one back to May 7, so he should be back in a bit over a week. There is some concern about re-injury, so the A's will be watching him closely. Head trainer Nick Paparesta has held onto his Rays' tendencies and is very conservative with return-to-play timelines.

Matt Kemp left Sunday with a hamstring strain. He's headed for an MRI, but not much is known at this stage. With a new medical staff on the field with the Dodgers, it's tough to get a read on how they'll play this ... Sixty-day DL moves are seldom anything more than roster adjustments. The moves with Mariano Rivera and Jacoby Ellsbury don't change their expected returns at all ... Wilson Ramos has become the latest to tear his ACL. He turned to chase a passed ball and twisted his knee. He's done for the season, which gives the starting job to oft-injured Jesus Flores ... Lance Berkman came off the DL and was put right into the lineup for the Cardinals. He should start in all formats ... Kevin Youkilis hasn't begun hitting yet. He's at least a week away ... Josh Thole will shift to the 15-day DL. Testing found he's suffered from a series of concussions and will need more time to recover ... Sean Rodriguez was out Sunday with a sore pectoral. He was available off the bench, so this doesn't look to be too serious... Erik Bedard will start Wednesday rather than Monday. His back doesn't seem to be an issue, but it bears watching ... Derek Holland was skipped this week as he worked with the Maddux brothers on some mechanical issues. He'll be back in the rotation on Saturday ... Saying that forearm tightness in the midst of a rehab is "normal" is a bit of a misnomer. It's common, but it's not what you want. The Rockies don't think it will set Jorge De La Rosa back much ... Jemile Weeks has a minor ankle sprain. He'll miss a couple games ... Carl Pavano is going to try to pitch through a capsule strain in his pitching shoulder. I don't think that's going to end well ... Is there a more must read weekly column than Nick Cafardo's Boston Globe "Notes"?