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Under The Knife: Elbow concerns for Sabathia, Crawford, Giolito

I think MLB's testing program is about as close to perfect as we can get in 2012. Each and every player is tested at least three times a year, plus a number of random tests that are, well, randomly conducted. Players have told me that they've been tested as many as six times in one season. Baseball should put the dates of negative tests on its player pages. I'm sure Sean Forman could put up a table pretty quickly. Letting the public know how many tests a player has undergone and when is powerful information.

I'm sure there's some wag out there saying that Giancarlo Stanton's homer binge is steroid fueled. Stanton could simply point to his negative test dates as an answer. It may not quiet the critics, but it's hardly an invasion of privacy. (I'm torn as to whether players in accelerated testing programs should have those extra tests publicized.)

Calls for an independent agency to take over testing in baseball don't convince me that a change is necesary. No other professional league has done that and there's no proof that it would lead to better testing. There's still suspicion about Olympic athletes, and with USADA wrapped up in a ridiculous battle with Lance Armstrong, it's difficult to see how it would help. So, let's not throw out the best testing system in America, the one that's not only catching athletes, but testing them more than ever. Positive (and apparently related) tests of Bartolo Colon and Melky Cabrera, plus the quick unraveling of Cabrera's coverup, tell me that things are working.

Powered by best wishes for Michael Weiner, let's move on to injuries, suspensions and a possible comeback:

Colon is the latest player to find himself caught by MLB's testing program. Testing positive for the same kind synthetic testosterone that Cabrera used, plus speculation that the two suspensions are interrelated, does lend some credence to claims that this is a bigger problem, but again, there's no evidence to suggest that it's anywhere near the 50 percent mark. One key part to note here is that Colon's suspension has nothing to do with the elbow surgery he had two years ago. That procedure, which used mesenchymal stem cells to allegedly repair his elbow, did not involve the use of any performance enhancing substances. MLB investigated the procedure and Colon's doctor, and came away without any significant questions. With Regenekine treatments in the news about Andrew Bynum and Brian Urlacher just this month, the fine line between medical treatment and performance enhancing is getting finer. Catching someone for using a banned substance is still very simple and that's all this is.

We shouldn't be surprised by anything coming out of Boston these days. It's not that Crawford needs surgery -- we've known that for a while -- but the problem of how it came out. Initial denials by the Red Sox just look silly now, or worse. Crawford will head down to Pensacola for the surgery that will be overseen by Dr. Jim Andrews. As I detailed on Monday, this schedule should make Crawford close to being ready for Opening Day next season. He'll be able to participate at some level during spring training, or at least show that he's going to be healthy if this off-season shakes him into the trade market.

The Yankees will have Sabathia back on Thursday, the date he told people he would return after the Yankees pushed him to the DL. His elbow inflammation has to be worrisome, given his contract status and workload, but Sabathia doesn't seem concerned at all. Going back to his time in Cleveland when elbow soreness led to a trip to Birmingham, Alabama for a biomechanical analysis, we have to think that this is the end result. Still, Sabathia has been durable and effective, to say the least. There are some worries about his minor issues this season signalling the start of his decline, but I'd expect it to be slow and to start from a very high point in his performance.

There has been some speculation that Chamberlain might be pushed aside when Sabathia returns. It would be easy to put him on the DL with some sort of move, and give him time to rest or work on things without pressure. It doesn't seem like Chamberlain was rushed back, though the timing is difficult to assess, given his ankle injury that threw off his normal rehab.

The Jays had expected to get Lawrie back on Tuesday . . . until he woke up on Monday morning and had significant pain in the same areas that had been bothering him. The team is going to shut down his rehab for at least a week, which bumps him up against the end of the minor league season if he's re-starting from a rehab perspective as well. There's a chance that the Jays will shut him dow altogether, and a worry that his first full season has led to a general fatigue that's showing itself in his multi-system breakdowns. I think the team will want to see Lawrie push back and prove to himself that he can close a season. It's more about confidence that anything, so if the Jays see any negatives physically, the shutdown is on. Be ready for this if you have Lawrie rostered.

The worry is not that Giolito's elbow didn't hold up. It's that the Nationals ever thought it would. They didn't red flag him in this year's draft. It would have been fine to bring Giolito in, known injury and all, the way organizations have done since Eddie Bane made a calculated gamble on an injured high schooler named Nick Adenhart. Giolito's value isn't quite as high now because of the controlled cost structure that started with this year's draft, but he was considered to be a possible No. 1 overal pick before his elbow injury. He'll have surgery and miss most if not all of 2013, his second season away from baseball. There's some evidence that Tommy John rehab can replicate a year of development and Giolito is young and talented enough to come back. The big worry here is that the Nats don't seem to understand injury risk very well and have no data on which to base better decisions.

Roger Clemens is back. It's getting to be a bit Favre-like, but this is more than just a guy who can't stay away. Clemens will start on Saturday for the Sugar Land Skeeters, but his workouts last week were observed by scouts from at least three teams. The fact that Tal Smith is involved leads many to think that the Houston Astros are looking to bring Clemens back. Clemens would be a sideshow that would sell tickets, and it's hard to say he wouldn't be as good as any pitcher the Astros have now. He was hitting the upper 80's with his pitches and showed good movement according to reports, so there's very little downside for the Astros. It would reset his Hall of Fame eligibility as well, though I think that's well down the list of why Clemens would come back. Pitching is really all he's ever done. He's not the coaching type, isn't in a position to make a Nolan Ryan-style business move, and touring the autograph circuit would be a slow death to someone as competitive as Clemens. We'll see how things go on Saturday near Houston.

Johan Santana will not make his next start. The Mets are talking more openly about shutting him down ... Justin Upton left Tuesday's game. There was no clear injury, but he was running the bases prior to his exit. Keep your eye on this ... Brett Anderson went seven strong innings in his first game back in the bigs. He could be a big boost for the A's down the stretch ... The A's might also get AJ Griffin back soon. He'll make the first of his two rehab starts at Sacramento (AAA) on Wednesday. The A's are watching his workload closely ... Yu Darvish is having some groin issues -- I mean, I don't know him that well, but that's what I'm told. He'll make his Thursday start, but the Rangers will be watching him closely ... Alejandro De Aza heads to the DL with an oblique strain. Dewayne Wise will hold CF for now ... As expected, it looks like the Rockies are going to shut down Michael Cuddyer. His oblique strain isn't any worse than they thought, but they'd rather get him ready for last year than fight for two weeks of now-meaningless season ... Madison Bumgarner outdueled Clayton Kershaw in a big game for both teams. The Giants are in this position because of young pitching. How have they been able to keep their young arms - Bumgarner, Matt Cain, Tim Lincecum -- healthy through age 25 when almost no one else has, despite big innings totals? ... Eric Young Jr and his steals hit the DL. Those desperate for steals have to hope the Reds call up Billy Hamilton for September. It's worth grabbing and stashing Hamilton now if you can spare the slot ... Denard Span couldn't finish an MRI because of claustrophobia. That's a serious issue, but open sided MRIs are available. He did take batting practice on Tuesday, which is progress ... Carl Pavano will be shut down after the discovery of a significant bruise in his pitching elbow. That's an internal issue, not an external one ... Grady Sizemore has been shut down for the season. It will be interesting to see if any team wants to take a shot on him next year -- and if Sizemore wants the shot ... Bob McClure was the latest casualty in the Red Sox drama. The Sox have a short list of candidates for the position, but will wait to hire someone until they have a better idea of who that coach will be working with. Read that as, "We'll have someone different based on whether Josh Beckett is around or not."

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