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Under The Knife: Infections an increasing risk in locker rooms

I spent Saturday morning out at the Colts complex here in Indianapolis. The hundreds of kids there weren't watching baseball, obviously, but were getting their helmets fitted while their parents were hearing about concussions. USA Football is doing a pilot program that is trying to get the right kind of information out, but a day of football reminded me that it's this time of year where lots of people -- maybe you -- make a mental shift. I know my colleague Eric Mack has started that shift, but I say resist. Baseball deserves more and has given you so much over the last few months. I'm not saying don't get ready for football season, since I'm already doing that. What I'm saying is that you can do both and do them both well. Maybe it means you sleep a little less. Maybe you find a way to read the latest UTK while you're on the treadmill. Maybe you watch one less episode of Real Housewives of Mountain Brook. Maybe you get smarter, more efficient, less wasteful; what you don't do is abandon your team, your friends and your fun. Baseball is just getting good, and no matter where you are, there's still plenty to learn, plenty of ways to win and enough time to play fantasy football and baseball, and to have a life as well.

Powered by knowing that Ron Santo is finally in Cooperstown, on to the injuries:

Infections are flat scary. We've seen that over and over in sports medicine over the last decade. Whether it's Ryan Howard being pushed back two months by an infection that required actual muscle to be carved away or Peyton Manning's knee nearly costing him time in an MVP season, the scourge of infection is a reality. It's worse in locker rooms, where no matter how much effort is expended on cleaning, something will get dirty. Sharing facilities is just not sterile. It gets worse when you consider some of the things that go on in there. (Please, don't.) Ramirez has an infection on his hand that started with him punching a fan. That punch cost him a cut and a couple stitches, which is where the infection came in. At this point, Ramirez's hand is inflamed and just can't be used in a game. Worse, Joe Capozzi found out that Ramirez has forgotten to take his medicine on occasion. Ramirez is likely out to mid-week, costing him an important series against the Braves that might be used by the front office as a "buy" or "sell" signal.

The Mets have watched Santana hobble through a couple starts dating back to just before the All-Star break. There were some worries that his mechanics were adjusting due to the ankle. With his repaired shoulder, being conservative, yet proactive, is the smart play. There's nothing tricky here; it's a simple sprained ankle that should heal with rest and treatment. In the meantime, the Mets get a chance to take a look at top prospect Matt Harvey, which they hope will minimize any dropoff without putting too much expectation on the young pitcher. Santana will be back at the minimum, and the short break will help keep Santana's innings down in his first season back from shoulder surgery as well. The Mets would be happy if he ended the season around 175 IP.

Garza scared the Cubs (and the several teams scouting him) when he came out of his Saturday start with an arm injury. The problem was said to be a simple cramp in his triceps, though you can be sure that if Garza is dealt, treatment records will get a close look to see if there's any indication that something more is going on. Sources tell me that Garza was in pain as he came off the field, but was "pretty good" shortly after. With the heat, cramping is possible and certainly seems the most likely scenario. The Cubs will see if Garza does well with his normal throw day before they'll commit to him making his next start. They'll also closely monitor his fluid intake in the coming days to see if they can prevent this from happening again. (Quick question -- how many teams have a nutritionist on staff? I only know of three and none of those are with a team on a regular basis. Several players have personal nutritionists or chefs.) I don't expect this to cost Garza any time. At worst, the Cubs will push his next start back a couple days.

There's no question about three things in regards to Harper. He is amazingly talented, he plays the game very hard and he has a terrible haircut. It's that middle one that the Nats have to worry about a bit. He's going to beat himself up a little bit. It wasn't a hard play but simple bad luck that cost Harper some time this weekend. He fouled a ball off his ankle and it was painful enough (and he's valuable enough) that the Nats took him for X-rays. Harper's ankle had nothing more than a bruise, and with a very short bench, having Harper play on Sunday was big for the Nats. Davey Johnson is going with an eight-man pen and lost Rick Ankiel and Xavier Nady. Harper didn't seem to be having any issues, but I'll ask again -- why isn't Harper wearing any kind of protection? He not only didn't have on a guard on Saturday, he didn't appear to have one on when he returned on Sunday! There are few more valuable assets in baseball, so the Nats don't have any excuses for asking Harper -- someone who's already using Evoshield products -- to wear something.

The Nats are getting closer to getting Werth back. His injury kept Harper in the majors, so having both will be a nice boost to their offense. Werth started his rehab on Saturday and did well. He hasn't shown much power yet, though it's early. Look for any sign that he's got his power back -- long fly balls and doubles to the gap are almost as good as homers in determining that. Werth isn't expected to be on rehab long and could be back as quickly as next weekend if his wrist handles the at-bats.

Maybe luck balances. If so, Chamberlain is getting a little of that and teaching us about the Tommy John recovery process. Chamberlain's preseason trampoline accident could have been career ending, according to some reports, but not only did he make it back from that, it didn't slow his rehab process significantly. One of the most interesting facts about the rehab is that for those young pitchers who have the procedure, it acts as if the pitcher had a normal season in terms of innings progression. The theory is that the workload of the rehab process mimics the workload of pitching closely enough without being destructive so that, along with additional physical maturity, the expected loss vanishes. (This might also hold a lesson for Stephen Strasburg's current innings situation.) Chamberlain is just over the one-year mark now and should be back shortly. He's been dominant in his minor league outings and likely will slot into a set-up role once he's back in the Bronx.

While everyone has been talking about trades for big-name pitchers, let's look back at the deal for Ubaldo Jimenez. While it's easy to say that Jimenez hasn't been the ace that the Indians thought they were dealing for, it's hard to say that Pomeranz has been what the Rockies thought he'd be either. He's cheaper and younger, but young pitchers with injury issues don't sell the "younger" argument as a big positive. Pomeranz will miss his next start due to "arm stiffness." I'm told this is a shoulder issue, though the Rockies are being vague. Pomeranz has been a part of the four-man experiment, but hasn't pitched on three days rest during the time it's been used. His innings and pitches have been limited, but Pomeranz is still, at best, fatigued. I've been strongly against this no-data approach to a four-man rotation since the beginning and I worry that this is just the start of the consequences, along with the poor performance. The DL is a possibility, especially if he can't do a side session on Monday.

The first outing for Neftali Feliz didn't go that well. He was wild in a start at Frisco (AA) and will need to show increased control and perhaps stamina, as his role is as TBD as his return date ... Roy Oswalt was scratched from his Monday start with back stiffness. Scott Feldman will take the spot start ... Rehab is going well for Giancarlo Stanton. He's hitting off a tee and could be ready for a rehab assignment by this time next week ... Erick Aybar fouled a ball off his toe and could be headed to the DL. The Angels haven't made a final decision, but they did call up SS prospect Jean Segura from Arkansas (AA) as insurance ... Shaun Marcum had a good session on flat ground, with no problem in recovery. He'll be on a mound soon and the Brewers think he'll be back in mid-August. Some teams are watching to see if Marcum would be available post-deadline given his salary and risk ... Turf toe is painful, despite the name. Mike Aviles played on Sunday despite dealing with the condition. With the two remaining turf surfaces in the AL East (and having been in Tampa recently), it's worth noting for the versatile Aviles ... Ian Desmond heads to the DL with his oblique strain. He could miss as much as a month and force Mike Rizzo to make a deal for help ... Andy Pettitte threw off flat ground and is making progress. The Yankees are focused on a Sept. 1 return, but Pettitte's rehab seems to be just ahead of that ... Jeff Niemann threw a pen on Saturday and did well. Yankees fans should watch Niemann's return as a comp for Pettitte ... Alex Cobb got hit in the shin and of course, was wearing no padding on the leg. He was luckier than Pettitte and Niemann, coming away with just a painful bruise. His next start on Friday is in question but a decision won't be made until mid-week ... Brett Anderson went two innings in his first rehab start. It's been almost exactly a year since his Tommy John, so he's slightly behind the expected schedule, but it's hardly problematic. He'll be back in Oakland in a month, after taking much if not all of his 30-day rehab clock ... Wilin Rosario thinks he could be back in the lineup by Monday after a minor ankle sprain kept him out this weekend ... With Rosario down and Ramon Hernandez so bruised up that Jim Tracy said he looked like a "California grape" (?) the Rockies started emergency C Jordan Pacheco. I can't remember anyone ever starting the emergency catcher, though I'm sure it's happened ... Todd Helton is playing at Grand Junction (Rookie) and says he'll be back when eligible on Tuesday despite being sore after his first game. The Rockies seem in less of a rush, targeting Friday ... Jose Valverde wasn't available Sunday due to a tight back. He's not expected significant time, but watch this early in the week ... After Jon Lester's start over the weekend, many think the vultures are circling pitching coach Bob McClure.

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