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Under The Knife: Uncertainty with Utley, Granderson nearing return

There's been a lot of chatter lately about how the Pitch f/x system used to track pitches could be used in injury analysis and even prevention. I'm no guru on it so I went to Eric Seidman and asked him to explain what the near-term is bringing in terms of this system:

"What would happen if the telltale signs of injuries could be quantified? Under that lens, the act of preventing injuries would take on an entirely new scientific persona, wherein specific ailments could be detected in their earliest form and before they result in an obvious physical condition. Honestly, we are not too far away from having this capability, as the Pitch f/x data set continues to evolve.

"An in-depth description of the system can be found here, but its most popular data points are the velocity, movement, and location of a pitch. The system has been around since 2007 and improves each and every year. It's utility in the form of injury detection and prevention has not yet been fully explored. I have only begun to break the surface of what is possible, but the results have been very encouraging.

"By developing a solid understanding of the specific symptoms related to certain injuries, this type of data can be used to identify warning signs in pitchers. One of the biggest issues to work around is the idea that an injury manifests itself early as fatigue, which might not be considered an injury, but which certainly leads to future issues. Rich Harden might officially leave a game with an injury on May 15, but it was on April 25 that he started to feel fatigue. Though this presents a chicken vs. egg dilemma, catching signs early allow proactive measures and could reduce the number of days a team racks up on the DL.

"Working with experts like Dr. Glenn Fleisig at [American Sports Medicine Institute] and Will Carroll, I've begun to pick up red flags as to when fatigue is setting in. Perhaps the pitcher experiences a sharp drop in his velocity around the fourth inning of a game that is sustained over the next three innings. Maybe a slider stops sliding in an inning during which the pitcher throws 25 or more pitches. I've shown before that exceeding that mark in an inning can lead to some lingering effects.

"Though pitching coaches and scouts can qualitatively evaluate these conditions, even the best eyes can only see so much. If the end result is an increased level of caution, can you really be too cautious when trying to prevent injuries to multimillion dollar players? By combining a solid understanding of the underlying symptoms of certain injuries with data that provides specific information about each pitch thrown, I am confident that we will soon have the quantitative detection of injuries down to a science."

If Eric's right -- and I think he is, since I've seen it work and perhaps prevent injuries at the major league level -- we can definitely use this information to help our fantasy teams. I'll have Eric checking in from time to time when he finds something. It's another valuable tool that might help you win your fantasy league that others just don't have. Powered by Argo Tea, on to the injuries:

"Before the All-Star break." That phrase just sent shudders through the fantasy world. What's changed in the month between Utley showing up with sore knees to perhaps missing half the season? Nothing. That's part of the problem. There has been little progress in Utley's rehab, all being done under deep cover under the watchful eye of the Phillies medical staff. In comments on Monday, Utley said that he thought the goal was to be back before the All-Star break, while team officials said they were looking at May. In that fuzzy line between what a player feels and is confident about and what the medical staff feels is appropriate, I tend to side with the medical professionals. That isn't to say that I think Utley needs to "suck it up." Eric Mack drew a Carlos Beltran comp here during the first Inside Fantasy podcast (left), but I think that's premature. (More on Beltran below.) I'm setting the ERD at mid-May, but I still don't have a good handle on how this one's going to play out or what the next step we'll see will be. That means uncertainty and I hate uncertainty.

The Yankees seem a bit more optimistic about having Granderson in the lineup soon, though Opening Day is a little shakier than opening series. There's a bit too much emphasis placed on Opening Day, first starts, and the like, but it's somewhat understandable. It's along the same line as the round number bias we have. Players want to be out there when their team first takes the field and pitchers want the "honor" of being named the ace. It's more important to maximize a player's availability, since Game 1 is worth no more and no less than Game 162. The Yankees will have to be confident that Granderson won't go out and reinjure the oblique, setting him back weeks. They'll give him a chance to play in a minor league game on Wednesday, which keeps the retro DL move in play if need be. Watch the weather closely for Granderson and any other players who are dealing with muscular issues. It's simply tougher to get muscles ready in colder conditions.

For all the knocks that the Mets medical staff has taken over the last couple years, they can really hang their hat on Beltran. Beltran's not perfect or healed, but he's playing and available. When he came back last season with that big brace on, I didn't think there was any chance he'd be able to stay healthy over the course of a few weeks, let alone a couple months. He's still going to require a lot of maintenance and is very risky, but he's been playing. Beltran made a sliding catch in the outfield, which doesn't sound like a big deal, but to one observer, it showed "he's not thinking about it as much. Every step last year looked like he was expecting it to be his last." Don't expect miracles -- or steals -- but Beltran's in a better position that most expected right now.

Here's why teams not giving injury info doesn't make much sense: It took no time at all to find out the specifics on Jason Bay. Adam Rubin of ESPN New York got there first, defining his "ribcage soreness" as a strained intercostal muscle. The Mets will make a decision Wednesday on Bay going to the DL, which makes it as much about the rest of the final 25-man roster as it is about how long Bay will be out. Intercostal strains are painful, but heal more quickly than an oblique strain, which is in the same area.

I'm hoping to have a lot more on Johnny Cueto Friday, since I'll be in Cincy for Opening Day. Cueto will be there, as will Reds personnel, but sometimes, they're not too talkative about injuries. We'll see. Right now, things are looking positive for Cueto. If Cueto is going to make it back on schedule, we'll need to see him up on a mound his next time out, which should be sometime this weekend. If so, Cueto can work a simulated game and avoid the need for a rehab start. I haven't seen definitive word that Cueto has traveled north with the team yet, but being "left behind" in Arizona wouldn't be a positive or negative. Given the cool weather forecast for the weekend, it might be better for Cueto to stay somewhere warm when he throws. Of course, if he's in Arizona, it will make him a lot harder to talk to on Thursday!

Matusz is perhaps the key part of the Orioles future rotation. There's some other good arms there, but Matusz is almost by acclimation the ace of the bunch, if not now, then soon. He took a comebacker off his arm last time out, but it doesn't seem too serious. Matusz will throw Wednesday and if all goes well, he'll make his planned start on Saturday. There's no way to protect every pitcher from every comebacker, but there's been no effort to do so aside from the new Easton pitching helmet. Something as simple as soccer shinguards could have saved Roy Halladay from a broken leg a couple years ago and there's likely a way to do something similar for forearms without being bulky or restrictive. If not a pitching helmet -- which I'm still not sure of overall -- then why not a stiffer hat? Every year, baseball should have a contest for the best idea for safety equipment to encourage innovation, if not adoption. Matusz will be fine, but who'll be next?

It's no surprise that David Aardsma is heading to the DL to start the season ... or is it? Aardsma had the type of hip surgery (a femoral-acetabular impingement of labrum, or FAIL) that we've seen in baseball and even pitchers before, with guys like Brett Myers, Alex Rodriguez, and Utley. Aardsma's slightly behind the normal schedule, but there's a very small sample size for this and very little data on how the individual response and individual athletic demands factor into a rehab. The Mariners think they'll have Aardsma back at full strength by mid-May and the evidence skews toward that date as well. Aardsma will give us plenty of looks as he rehabs to get an idea of how he should perform once he does get back. Until he does, Brandon League gets first look at the saves, though word out of M's camp is that Chris Ray impressed Eric Wedge enough that he could get some looks as well.

The Jays can exhale now. Brandon Morrow made it through a normal side session without any significant problems. It was not a full-effort side and he didn't make all of his pitches, but he showed good stamina and no problems after. Everything appears to aim toward an April 6 start for Morrow, but it's not all rainbows here. Morrow will be "severely limited" in terms of raw pitch count in his first few starts, so one bad inning could cost him the ability to get a win. The key for him will be to do what Halladay did about a decade ago -- learn to be more efficient. Halladay wanted to complete games, so the Jays told him he needed to figure out how to do it on 100 pitches. It would be a good lesson for Morrow, short and long term.

Jeff Francis is worth watching if you've got your eye on Brandon Webb or Chien-Ming Wang. Francis, like them, throws the "power sinker" that has shredded shoulders. Francis took a long time coming back with some stops and starts, but after the Rockies gave up on him, the Royals took a chance. That's paid off so far, with solid spring numbers and good reports from those that have seen him in Arizona, but one of his biggest remaining challenges will be stamina. He's unlikely to go very deep in games regardless, but if he starts fading quickly -- he'd be a perfect test case of Seidman's Pitch f/x system -- it's a big danger sign and one that Webb and Wang might not make it back well. Francis was good enough to be named the No. 2 in KC, but that says more about the Royals than it does about Francis. It does say something about their new medical staff, who made a big jump last year and hopes to continue to improve. Reducing medical losses is often a leading indicator for wins, as well.

A lot of people are missing some of the easy info when it comes to Mat Latos. He's having trouble lifting his arm, not slowing it down. That removes some concern from the rotator cuff, where some others seem focused. Combine that with some loss of velocity and movement and it sure looks like bursitis is a symptom, not the cause ... The Giants are still waiting to make a decision on Brian Wilson. He's throwing, but not full speed ... Brad Lidge had an MRI that showed a posterior rotator cuff strain. That's not good, but the strain was described as "relatively minor." Expect him to miss about a month ... Pedro Felciano is heading to the DL with "upper arm soreness." This is no long term deal for Feliciano, but get used to seeing things like this as several teams intend to give less information about injuries this season ... The M's still don't seem to know exactly what's going on with Franklin Gutierrez. Stomach/colon disorders can take a long time to get to a final diagnosis, even with lots of tests (or perhaps because of it) ... Joel Pineiro will start the season on the DL, but will miss only one start. He'll be back for the April 8 start, assuming no setback. Think I should just start saying "ANS" for these kinds of situations? ... Trevor Crowe puts more pressure on Grady Sizemore if he can't go. Crowe's headed to New York to have Dr. David Altcheck take a look at his weak shoulder ... Jake Peavy will make rehab starts on April 8 and 13, which would have him back with the Sox on the 18th. Makes me feel pretty good about the 4/20 ERD I hung on him Monday! ... I'll see some of you tomorrow in Cincinnati! Please, if you see me, say hi.

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