Under The Knife: Knee injury could bring end to career for Berkman

We all know Moneyball. Let's call this Money-where-your-mouth-is-ball. The season is underway, but there's another part of baseball that's just getting ready. The independent leagues, those last bastions of Wild West baseball, where dreamers and hangers-on mingle in front of sparse crowds, are getting ready to go. Minor league baseball has become big business, with multi-million dollar stadiums in big cities taking over. It's still a great show and fun for the whole family, but if you'd like to maybe own one of these teams, I hope you hit the MegaMillions. Independent ball? Not cheap, but "reasonable." At least we wouldn't need to ask for government handouts.

So with a million sabermetric geniuses out there trying to be the next Bill James, Eddie Epstein or Dan Fox, I'm betting one of them could buy into an independent league team. Billy Beane once famously said that his bleep didn't work in the playoffs, but it should work in the bus leagues, right? A league that will have a pig as a batboy or get a big bump in sales from cowboy monkeys would have to love the idea of finding an advantage and bringing a winning style of baseball. So who's up for it? I know there are some big names and big dollars that are fans of Fangraphs and the like. Maybe Brooks Robinson would be a bit too old school for this, but the promotional value has to be better than just another bobblehead.

Powered by Kickstarter, on to the injuries:

Berkman popped his right ACL back in November '05 playing in a flag football game. He came back very quickly, and it showed in his batting line, defensive range and pretty much everything else. He's shown no real problems since then, and it's long enough ago that it's hard to associate it with any of his other leg problems. In this latest incident, Berkman was able to walk off the field. The video shows that he extended the knee forward and it gave. There was no apparent lateral stress, unless he did it prior to the extension while he was running to cover. His immediate reaction is pretty clear; he looks both pained and resigned, as if he's done this before. Sources tell me that manual testing at the time of injury indicated a torn ACL. Late Monday came word that while Berkman may have avoided the ACL, a torn meniscus may be in play, but that was shaping up as the best-case scenario. The swelling was significant enough that the team will wait for an MRI. The results there could determine Berkman's season and perhaps his career.

This article on Strasburg's sore shoulder has a lot of great information, so kudos to Barry Bloom. For those who think access used properly doesn't help, I'll point to this article for why it does. Strasburg's issue appears to be in the elbow, not the shoulder. The biceps goes to both, of course, so "biceps tightness" can mean a lot of things. This fact is key because any injury to the shoulder after elbow surgery tends to be a major problem, signifying a breakdown that's traveling down the kinetic chain. Strasburg reportedly was working on an arm flexor machine -- flex is "curl" -- in trying to work out this tightness. I can't get inside Strasburg's head, but why would a curl help loosen up a muscle? I asked two strength and conditioning coaches inside baseball and they said it was likely just a reaction by Strasburg to work the muscle through a full range of motion. He was likely feeling that tightness at the external rotation. By what Davey Johnson said, it appears as if Strasburg didn't consult with trainers or coaches before doing this, which isn't a good sign.

There's also the strict 160-inning limit. the Nats have set for him. With as good as Strasburg has been for a contending Nats franchise, I don't see how they'll keep him to this limit. Do the playoffs count? Managing those innings, whether limited or not, is going to be key for Steve McCatty and Johnson. If Strasburg has even a minor elbow injury, this could be a good time to skip a start or two, pushing those innings a bit deeper into the season. This doesn't appear to be a major injury, but as Kerry Wood's retirement reminds us, nothing comes automatic to even the most talented of pitchers. That even Strasburg is being treated with best guesses and arbitrary guidelines reminds us just how far there is to go.

Jackson is dealing with an abdominal strain. It's a minor strain -- minor being severity, not pain or loss of function. The severity is tipped by the team's response. The Tigers are allowing him to do activities to tolerance, and keeping a retro DL move possible. The specific location of the strain doesn't help, since the timeline for any core muscle tends to be similar. If Jackson isn't ready to go by mid-week, the Tigers will push him to the DL and give him time to heal.

Valverde is in the same situation with his back spasms. The team held him out all weekend and with a planned off-day on Monday, the Tigers think he could be back on Tuesday. They'll be careful with him over the next week, so he could miss some saves if they occur on back to back days or similar. Valverde will be watched closely but sources tell me that they think this episode will serve him well. "It's been a wake up call for him," I was told. Many players take a more serious back injury to get that same sort of affect.

As much as McCarthy might credit advanced analytics for his plus season and model wife, he might be better off listening to Billy Beane. McCarthy has always been talented. He has seldom been healthy. That's happening again, as his shoulder is acting up and pushing him to the DL. With the injury history on that shoulder, one has to immediately wonder if there's any other damage in there that has built up. He held up well last year, but look at his stats -- normal or advanced -- and you'll see that last year's run of good health was the fluke. Beane wasn't wrong to give McCarthy a big raise after last year's success, but the lack of a long-term contract shows that he was watching the health as well. Expect McCarthy to be out a bit longer than the minimum as the medical staff works to get the shoulder as healthy and stable as they can over the next few weeks.

Lost in Wood's perfect moment -- a strikeout, a tip of the cap to both the crowd and Ron Santo, and his son hugging him at the top step -- and the sweep at the hands of their crosstown rivals, the Cubs did get a bit of good news. Marmol will head to Iowa (AAA) for some rehab. There was a bit of drama about whether Marmol would accept the assignment, but it appears to be a non-issue. Marmol won't work until Friday and then could take much longer than normal as they both do the traditional rehab work and then use the rehab clock to buy him some confidence and workload. That said, Marmol has indicated he believes he won't need much work to be ready. Let's assume it works out somewhere in the middle and watch to see how Marmol's results are in the minors.

The Angels found themselves a bit shorthanded on Sunday, forcing Mike Scioscia to go a bit Tony La Russa on us. Albert Pujols was at 3B for a bit, which makes those in the one-game eligibility leagues happy (though they should be ashamed for playing with that ridiculous rule.) Scioscia was forced into this by injuries to Wells and Langerhans. Wells injured his thumb after catching himself on a slide. The initial reports are mixed, so "sprained thumb" could change to a strain or a fracture. Langerhans, who was up covering for Torii Hunter's absence, bounced off the wall and ended up with an injured shoulder. Both players were in protective gear after the game and are likely headed for the DL. Langerhans' timeline is tough to read since he was likely a short-timer anyway. Wells' injury might force Scioscia to make some adjustments, but Wells was hitting well over the past couple weeks. We'll have to wait on further tests before figuring out just how long Wells will be out.

Jeff Stotts points out an interesting article on the involvement of cortisone on Ryan Howard's Achilles injury. As I've pointed out here, the generic term "cortisone" is being superceded by the increased use of Toradol in baseball, in part because of these kinds of issues. Howard remains on track in his rehab, though the trolls will continue to factlessly troll ... Chase Utley is taking grounders and could be sent for a rehab assignment at any point. That said, there's no timetable for doing so ... Tim Lincecum said he injured his non-pitching thumb in a home plate collision. No word at deadline on severity ... Emilio Bonifacio can't steal bases while on the DL. He'll be there while his sprained thumb heals. It's going to be a couple weeks at least before he's back on the bases ... Mark Ellis had surgery that was reported to be done to "relieve pressure on his leg." That sounds like acute compartment syndrome, which is very serious. You might remember it with Kyle Lohse or Noah Lowry, but this is in Ellis' leg. He's out at least six weeks ... Paul Konerko took a nasty pitch to his eye. It's still swollen shut, as of Sunday's day game at Wrigley, but the team think he could go on Tuesday. They expect his vision to be fine once it opens up ... Brett Gardner will have another MRI before trying to bat again. The elbow remains problematic and the Yankees are getting worried ... Daisuke Matsuzaka has developed some soreness in his shoulder. This is common, but very problematic, after Tommy John surgery ... The Indians, Phillies, Reds and White Sox are monitoring Kevin Youkilis during his rehab assignment. His back has responded well ... Josh Beckett had a second consecutive solid start, which makes me think there was something to the idea that he was tipping pitches ... Sergio Santos is throwing again, but he's at least two weeks and a rehab assignment from a return to the Jays ... Salvador Perez is getting ready to head to XST. This is slightly ahead of the expected timeline, but not ahead of the normal timeline for the kind of surgery he had ... Most no-hitters and near no-hitters come with additional stress, something one MLB AT has termed the "adrenaline cost." Justin Verlander appears to be immune to that, though he did use more breaking balls than normal in this last effort ... Congratulations to Petr Cech, Didier Drogba, and the rest of the champions at Chelsea.