Under The Knife: Rangers run of good health runs out of time

For some teams, the medical staff is closely involved in trade talks. They act as scouts, in a way, checking eBis for injury clues and calling around to friends in the business to see if there's more than the medical files show. The same is true in the off-season, but at the deadline, things move faster. Of course, I said "some teams." There are teams out there where the medical staff is barely consulted. They count on catching problems at the physical or even ignore the risks. While you often see the "our guy's better" routine factoring in on known injury risks that can be acquired at a reasonable value given that risk, it's not often factored in on pure baseball trades. We'll see this over and over, in simple situations and much more complex ones where the short-term gain has to be weighed much more strongly than any longer-term risk. Yes, flags fly forever, but so do scars.

Powered by Mountain Lion, on to the injuries:

At one point in May, the Rangers were injury free. Anyone around baseball knows that a streak doesn't last forever, so there was going to be an injury at some point. Actually, more than one, and the Rangers have gone on a streak of injuries. Their depth hasn't allowed this to be much of an issue, but losing Lewis for the season certainly doesn't help. Lewis came off the DL only to feel his arm tighten up in his first outing back. Scans revealed on Monday that he had a significant tear of the flexor tendon that will require surgery. Pitchers return from this, though there's not the precise recovery time frame that we see from Tommy John surgery. Lewis should be throwing around the time the Rangers open camp next February, but whether he's ready to pitch at that point remains to be seen.

The worry about Oswalt is that his injury history would catch up to him as he fatigued. Missing a start with back stiffness certainly brings up the worst fears from his time in Philly. He's only made nine starts between the Rangers and their affiliates this season, less than the 13 he made in Philly before his back first acted up last year. It's not a good pattern. The Rangers do have the benefit of having Oswalt's spinal surgeon, Drew Dossett, close by in Dallas, and a top-notch medical staff to try and get him to a productive point. Oswalt had a cortisone shot and is feeling better, but with the trade deadline closing in, GM Jon Daniels is going to have to take a hard look at Oswalt and decide if he can count on him going forward. He'll get one last look on Sunday, when Oswalt is scheduled to start.

I was talking to a team official when he asked me if I'd heard any update on Longoria. It turns out, Longoria had just been shifted to the 60-day DL, a roster move to free up a spot for Sam Fuld that means nothing for Longoria. "How bad was that hamstring strain?" the official asked. "Did he lose a leg or something? Is he going to come back with the spring like the guy in the Olympics?" No, Longoria won't have springs, but the hope is that this time, he'll have a hamstring that will hold up.

Longoria didn't just reinjure the hamstring during his aborted rehab, he actually made it worse. It's an atypical happening, especially for the conservative Rays medical staff. Sometimes injuries like this aren't so much a re-injury as a closely related injury. It's difficult to explain, but picture the hamstring as a rope. One big chunk torn out of the rope is bad, but two separate, distinct, but anatomically close tears is even worse. It functions as the worst of both worlds -- healing like two distinct problems, but taking function out like one long defect. Longoria seems closer to a rehab assignment, which could come as early as next week if he continues to pass the milestones that the medical staff has set up. As to the 60-day move being nothing -- remember that Longoria did not come off the DL, so the 60 days is dated back to the beginning of May. He could come off that DL at any time, so as I said, it's a meaningless roster trick.

Rodriguez took a Felix Rodriguez pitch off the hand, and from the time it cracked, it was clear that Rodriguez had a problem. I'll spare you the protective device lecture here, but its clear that Rodriguez was hit on the lower portion of his left hand. Steve Donohue, the Yankees longtime assistant Athletic Trainer who has now taken over the head position was out quickly, but Rodriguez guarded closely and indicated while still down that he didn't think he could get his batting glove off. Reports have X-rays showing a non-displaced fracture and that Rodriguez is headed back to New York to see the team doctors. While the Yankees have not confirmed it, several sources have it as a fractured fifth metacarpal, the bone on the outside of the hand -- the "karate chop" bone, if you will. It's unlikely that Rodriguez will need the bone to be plated or pinned, so the recovery time is likely around six weeks. Since it is the hand and not the wrist, a loss of power isn't the problem as much as grip, especially for batting since that hand is near the bat's knob and takes much of the force.

Batteries, recharged. Greinke came back after an 11-day layoff and faced the Phillies. Some were worried about rust, but the Phillies saw gas. Greinke had lost nothing in the way of stuff or control. He went seven strong innings with five strikeouts, but the team flopped after he was out. The time off seems to have been a good idea on all fronts. If Greinke is traded, he gets this and maybe one more start before a deal, showing that he's got good stuff and that there's no arm problem. That maximizes value. If Greinke moves, the Brewers will fill the slot with Marcum. He isn't going to be ready by the deadline, but it doesn't look like he's far beyond that. He had his first work off a mound on Tuesday with no issues. He'll do a couple more before moving out on a rehab assignment. Marcum sounds like he thinks he'll only need a short time, meaning he would be back around the second full week of August. It's impossible to gauge his stamina -- he's missed almost two months -- at this stage, so it could be longer if he needs more time to build up arm strength.

Flores has been a solid catcher when healthy. The downside is that the "when healthy" hasn't happened much. He's never played more than 110 games in any season at any level, missing a lot of time with some traumatic injuries. The back injury that cost him a couple days isn't major in and of itself, but it's a reminder that he's very risky. Flores was back in the lineup on Tuesday, but with all the furor over Stephen Strasburg's workload, one can only hope that seeing Sandy Leon for a couple days might make GM Mike Rizzo put a limit on Flores.

The immediate thought when seeing Latos roll his ankle is to think of Johan Santana. Latos' injury didn't appear as serious initially, but it's really the body's individual response to the injury that matters here. If Latos can make his side session, getting him back on the mound as scheduled next Sunday shouldn't be an issue at all. The worry is that even a minor ankle problem can cause a compensation, leading to a cascade injury. That's a bigger concern for Santana with his weakened shoulder and slighter build. Latos is a bigger guy, and while that is more weight and force it has to hold up, it's a relative issue and one that tends to be equalized by muscle and athleticism.

Don't get too encouraged by Giancarlo Stanton doing some hitting. It's a good sign after knee surgery, but his problem was running, not hitting. Once we see him doing that, he's close ... Interesting comments from Brian Cashman, calling Mariano Rivera's chiropractor "unprofessional." Cashman appears to put the kibosh on even the hope of Rivera returning in season, which is probably the smart play ... Matt Garza is getting a little extra rest for his triceps courtesy of his fourth child, who has good timing. Garza won't pitch until Monday at the earliest ... Pablo Sandoval came out of the game on Tuesday after he (accidentally) did the splits on a stretch at 1B. Yeah, ouch. He's considered day to day now ... Trevor Plouffe has been trying to play through a sore thumb, but that's often a tough thing to do. He's out of the lineup on Tuesday and may head to the DL if the team feels that's the best way to get him functional ... I don't know why, but I always confuse Francisco Cordero with Frankie Francisco. The neurons are crossed. Frankie Francisco will start a rehab assignment at Binghamton (AA) and should be back with the Mets shortly ... Placido Polanco went for an MRI on his painful lower back. No results at deadline, but keep an eye on this since it's been lingering ... Brett Gardner had his elbow surgery. He had a bone spur, which was removed ... Brett Anderson will be up to 60 pitches in his next rehab start. He could need one or two more if the A's decide to push things, but they're still publicly saying mid-August ... Jason Giambi heads to the DL with a viral infection just as Todd Helton is coming back. It's hardly a phantom move, but it is convenient for the Rockies ... If you're interested in steroids and doping, there's a new book out that I reviewed for the Wall Street Journal.