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Under The Knife: Surgery to sideline Tulowitzki for most of season

When I wrote Saving The Pitcher in 2003 -- it was published in the spring of '04 -- one of the things I felt was "unfinished" was the section on velocity loss. It was easy enough to grab a radar gun at that point and get relatively accurate measurements. Scouts and teams would share some data, but there was certainly nothing like the wealth of data that PitchF/X affords researchers now. At the time, I was able to figure out that a drop in fastball velocity was a solid enough measure of fatigue that it was usable, but I also found at the time that a radar gun wasn't even necessary. It wasn't just Earl Weaver's axiom that the hitters would tell him when his pitcher was tired. No, I did a quick and dirty study that showed almost anyone, including Little League moms, could visually determine a velocity drop.

Bill Petti has been doing some great work on velocity loss of late, using the modern tools to try to tease out information. Petti'slatest piece talks about the predictive factor of even a small loss of velocity when it comes to attrition. It looks like a usable, informative list. There's more to look at here, including the relationship to age and workload. In essence, we may have a more modern version of the Verducci Effect. If this line of research holds up, I can imagine we'll have "velocity watch lists" pop up on Rotowire. You can be ahead of the trend now.

Powered by Wookiee The Chew, on to the injuries:

Tulowitzki was expected to need surgery to repair a sports hernia. (Yes, it says strained groin. There's really just a semantic difference.) Instead, Dr. William Meyers went in and cleaned out scar tissue that was irritating a nerve. There's no defined timetable for the return from this surgery, but with the demands of the SS position and the lateral motion, expect Tulowitzki to be on the long end of any range. The Injury Database says that range for a sports hernia is anywhere from 26 days in a non-surgical case (Ian Kinsler) to 95 days for Trot Nixon's surgical fix. The median is about 50 days for a sports hernia, but it's not the best guidance for this procedure. Part of his return will depend on what the Rockies do with him out. If they're way out of even the wild card, the Rockies are likely to shut down Tulowitzki to make sure he's ready for next season. Right now, I'm setting the ERD optimistically, just a bit above the median.

Gonzalez's issue was originally cited as a hamstring problem. It became a "strained knee," which is an unusual diagnosis, especially given Gonzalez's mechanism of injury. It turns out that both are right. Gonzalez has an injury to one of the hamstring tendons located at the back of the knee joint. Anatomically, it's not exactly a knee issue, but if I pointed to it, most people would say "knee." The severity is a big question, with the DL debated on Monday and then Gonzalez reportedly available to pinch hit on Tuesday. The New York Posts's Joel Sherman tried to make the case for a Gonzalez trade, but I'm not buying in there. The Rockies have to have a healthy Gonzalez to win, now and in the near-term.

Scans of Beachy's elbow did not come back how he expected. He told the press he didn't feel a pop, that he thought it was a bone spur acting up again. (Again? Yes, apparently this has been going on awhile.) An MRI showed a partial tear of the UCL, though the Braves and other sources didn't acknowledge how significant the tear is. Beachy is headed to Dr. James Andrews for his opinion, but Dave O'Brien has it right -- a partial tear for a young pitcher usually means elbow reconstruction. If surgery is necessary, he'll be done for the season and much of next. There are going to be questions about when Beachy first had the sprain, but that lack of pop is going to be the key. The Braves didn't hurt Beachy more by sending him out there last time, though we'll never know exactly when the damage was done the way we did with Michael Pineda. Beachy's second opinion came back as expected. He'll undergo Tommy John surgery on Thursday and is done for the season.

The worry with Pedroia's original strain was that he would re-injure it. The medical staff put together some sort of plastic brace that apparently reduced the issue while batting, but on a broken bat pop up, it might not have helped. Pedroia left Tuesday's game and was replaced while Pedroia headed for the clubhouse accompanied by Mike Reinold. While there were few details at deadline, the worry is that Pedroia will now need to take time off to let the adductor heal up. This could be more like what Kevin Youkilis dealt with a couple seasons ago, which necessitated surgery, though that hasn't been addressed as much of a possibility so far. We'll know more soon, but in the short term, it looks like Pedroia will be back on the bench and perhaps on the DL.

Things were going so well for Longoria. He was a bit ahead of schedule. He had started a rehab assignment. He had even played in a game without incident. It was that second game, on Monday night, where he felt the hamstring "grab" again. The hope is that Longoria feeling it, pulling himself and telling the medical staff, will keep the damage on the low side, but we're also at that point in the season where the All-Star break becomes a factor. Unless this is the mildest of setbacks, Longoria's rehab is going to be pushed into early July and at that point, some teams start saying "Well, why don't we just give him the extra week and bring him back after the break?" The Rays tend to be conservative, but they're also one of few teams that understands the value of each game, especially for a player as productive as Longoria and in a race as tight as the AL East. I'm putting the ERD back just after the break to indicate I think Longoria will need some time off, but don't lock that date in; if Longoria can return early, the Rays will be smart enough to let him.

If you're one of those half-full glass people, then Mauer's strained quad is also giving his strained hamstring some time to heal up. If you're more half-empty, like most Twins fans these days, then Mauer's legs are shot and seeing this kind of serial (not cascade) injury is an indication that Mauer won't hold up. The truth is likely somewhere in between. Terry Ryan told the media that he doesn't believe Mauer will be out long. In fact, Mauer was available as a pinch-hitter on Tuesday. Mauer has a lot of say in that and is becoming the Twins' version of Chipper Jones. Mauer pushes his way back into the lineup, sometimes against the better instincts of the medical staff, and often ends up hurting himself more. There have been indications for years that the Twins were taking some of the heat for Mauer's insistence on staying at catcher. It's time for the Twins to protect Mauer from himself.

Strained latissimus dorsi injuries are piling up these days. It could be that there is more specificity in the description of injuries, rather than "shoulder" or "back" or "upper body." It could be that we're seeing a new weak link in the kinetic chain after a decade- long focus on the elbow and shoulder. Dempster has reportedly been dealing with this for the past couple weeks, but he's been very solid during that same period of time. Moving Dempster to the DL now makes sure that the strain heals up well and Dempster's value is maximized heading toward the deadline. A player can be moved while on the DL, but it's unusual. Dempster should be back just after the All-Star break.

It's not just North Siders having issues. Danks has found his way to the DL with a subscapularis strain. This is one of the muscles that makes up the rotator cuff, so don't let the unusual specificity confuse you. This is a mild, Grade I strain, one that Dr. Lew Yocum says will not require surgery. This diagnosis is actually good news, relatively. The worry had been that there was a significant rotator cuff tear, labrum damage or both. That the damage is confined, treatable and healing is certainly a positive. Danks is going to have to undergo a strengthening program before starting a throwing program, so even an early August return is a bit optimistic. When Danks is throwing again, we can revisit the ERD.

The Phillies were going to be without Galvis anyway, as he's done for the season with a spinal fracture. It turns out, they'd be without him anyway -- and one of few remaining loopholes in the drug policy is exposed. Galvis tested positive for clostebol, a variant of testosterone that was a favorite of the East German Olympic program. It's unusual in nature and the German origin recalls THG ("the clear"), but there's no apparent connection between Galvis and the creators of THG. Galvis will be suspended for 50 games, which will now be served while he's on the DL. He will lose his salary during the suspension, so it is a six- figure penalty. Galvis' declaration that it was a "trace amount -- 80 parts in a trillion" suggests that MLB is now testing using the more advanced and costly testing, rather than ratio triggers.

Kyle Drabek had Tommy John surgery on Tuesday with Dr. Andrews. He'll be back this time next year ... Roy Halladay has begun playing catch. He's a ways off from anything resembling a game, perhaps more than we thought ... Jered Weaver's bullpen session went so well that he'll start on Wednesday. The Angels will push everyone back a day, so it's a nice win-win situation ... Jose Valverde was passed over for a save chance, with some speculation about a wrist problem. Daily leagues will need to watch this closely ... Derek Holland's shoulder has passed the tests the Rangers have set for him. He'll have a side session on Wednesday, the first real step toward returning to the rotation. At least one rehab start is likely ... Matt Cain took a Mike Trout comebacker off his forearm. He's fine -- just a bruise -- but it was close to being a lot worse ... This is great analysis of why Tim Lincecum is so confounding ... Matt Capps will miss a couple days with a sore shoulder, but it's not considered serious. Why I keep mixing up Capps and Mike Fetters in my mind is a bit more serious and inexplicable ... Matt Joyce left Tuesday's game with an apparent back injury. This one bears watching ... Bartolo Colon will head to the DL with his core issue ... Mark Prior got a save for Pawtucket (AAA). He's throwing in the low 90s and is using his curveball regularly. This report makes it sound like Prior could be in Boston soon. ... Remember last week when the Red Sox said they weren't trading Kevin Youkilis? ... One-hitters are the new black.

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