Under The Knife: Pitching injuries piling up, few solutions at hand

I don't know Eno Sarris or his Gladwellian hair. I do respect his work and enjoy reading him at Fangraphs. That said, his last piece was ... well, it was just off. Maybe I hold Fangraphs and Sarris to a higher standard. Fangraphs is the thought leader when it comes to sabermetrics, and Sarris, as I said, is a solid writer. Let's start with his premise, that the Blue Jays are being injured at a record pace. That's not the case. Forget all time record (1,378 days, by the 2006 Nationals), the Jays aren't even the most injured pitching staff this season. That mark goes to the Red Sox, year-to-date, who have a lead on them of more than a player-year (180 days.) The Jays are, at this point in the season, fourth in days lost, behind the Red Sox, Yankees and Padres.

This isn't to let the Jays off the hook. Pitching injuries for those four teams, on down to the least-injured team (the Rays, in case you were wondering), should be concerned. The Yankees may be winning despite the injuries, but they're losing millions doing it. Pitching injuries are beyond epidemic at the MLB level and yet, few teams are doing anything about it. The Red Sox have been progressive, but their results aren't showing the results. It's easy to say "yet" because it's an investment, but aside from the Royals, few teams don't focus on results.

The Jays are one of the teams best positioned to step back, assess everything they're doing as an organization, and trying to fix this issue. Alex Anthopolous and John Farrell should be able to lead this, but again, I want to measure results, not good intentions. In the post-Moneyball era, everyone's looking for the next advantage. Most will acknowledge that sports medicine could be that advantage, and at relatively cheap prices. There's no need to exaggerate to make the case.

Powered by decathlon silver medalist Trey Hardee, who had Tommy John surgery just 10 months ago, on to the injuries:

Konerko got maybe the strangest concussion I've seen in baseball. Sure, you take an elbow to the head, and a concussion is certainly a possibility, but have you ever seen this happen? It wasn't a dirty play. It was just a routine play with an odd outcome, one that makes me wonder why this doesn't happen more. The situation was enough to keep Konerko out of Wednesday's game. Sources tell me it's about 50-50 he play Friday, which makes me think the Sox will hold him out another day, but check to see how it goes.

Nathan will only pitch save situations now. He's pitched a couple of back-to-back situations, including one the other day that wasn't a save situation. It was a key game in a key series against a rival, but I guess the save stat is more important than wins at this stage. I can grasp needing to keep Nathan's usage controlled at this stage of his career and the season, but I also heard GM Jon Daniels say last week that one of the reasons Nathan was signed was his work ethic and off-season workouts. I think there's more nuance to this than what was announced, but that could lead to less usage overall for Nathan and more for the other members of the pen. We'll see how the Rangers manage this, but on the surface, it's a bit worrisome.

The Jays don't just have pitching injuries. The team had watched Lawrie over the last few days to see if his oblique injury was serious enough, but a lack of progress and the team's overall situation made the DL the smart play. The strain isn't significant, with the Jays currently thinking that Lawrie could be back at the minimum. Temper that a little bit, as there's no reason to rush the rookie back. The Jays aren't rushing Bautista back either. He's still got some pain and inflammation in the wrist, which is exacerbated by swinging a bat. Obviously, he's got to do that pain-free to come off the DL. It's better than the shutdown some were suggesting, but getting a solid timeline is tougher. Let's assume at least a couple more weeks as they try to calm the lingering inflammation and get his swing tuned back up. The best guess on an ERD is above, but note it's just a guess.

A painkiller injection helped Ortiz break through a rehab plateau. His progress continued to batting and some running, putting the Red Sox on the edge of activating him. The Sox and Ortiz have been off page for the length of this injury, but that seems to be sorted now, with both expecting him to be activated this weekend. Ortiz isn't back to 100 percent and will need to be managed, but that's one of the strengths of this medical staff. Ortiz isn't going to be hampered by a lack of speed or mobility, but he does need to generate power. His swing does tax the lower legs, so look to see whether he's generating pain-free power. Watch his face, not the bat, to see whether he'll help your team.

The Nats have shutdown the rehab that Wang was working on due to continued pain in his hip. That's not good, but there might be a bit more going on here. Wang is one of the options to take the rotation slot vacated by the shutdown of Stephen Strasburg, which we're all assuming is imminent. Since rehabs for pitchers can only go 30 days, it's possible that the Nats are just lining things up with Wang at the end of the allowable period and Strasburg still going strong. Then again, hip flexor issues like this can linger and recur. Either way, Wang is a couple weeks away at best and his history of leg and back injuries makes me wary of anything more than a cameo appearance.

One of the hardest parts of a rehab for the medical staff can be slowing things down. LBerkman knows his knees are damaged, but there's also a ticking clock in his head. He knows that the Cards need him if they're going to keep up with the Reds and Pirates. He knows that his knees aren't going to let him play much longer. Coming up sore during the early stages of rehab isn't a good sign, but it might be instructive to Berkman. He's going to have to find some patience and get some zen about his limitations once he is back. Maybe they can put Kirk Gibson's '88 homer on a loop in the training room and see what happens.

Dylan Bundy was promoted to Bowie (AA) by the Orioles, but he's very close to the planned inning limit for his '12 campaign ... Scott Rolen is having some back spasms, which is why he's been out of the lineup a couple days ... Alex Rodriguez is making progress with his fractured hand (not wrist, as some are reporting.) He could have the protective splint off next week, which would put him near the low end of the expected four to six week range ... The Rangers are watching the fatigue levels of Mike Napoli. He'll be back in the lineup this weekend after some quad soreness. If Geovany Soto can hit at all, he'll get lots of chances to play ... Brandon Morrow will have one more rehab start as he recovers from an oblique strain. His first went 51 pitches and he had no issues ... Jeff Niemann had no issues with his first rehab start. He has three more in his plan before returning to the Rays ... Francisco Cordero has turf toe. He's in a walking boot with no timetable for his return ... Brandon McCarthy will return to the rotation on Friday. His shoulder has been as balky as ever this season, but he's been solid when healthy. He's a decent streaming option ... Logan Morrison essentially has been shutdown for '12. He visited Dick Steadman in Vail again, and he's out at least another month ... Whatever the Indians saw on Travis Hafner's MRI, they didn't like it. Hafner goes to the DL and some sources are suggesting he's done for the season ... Nice story.