Under The Knife: Past injuries often not an indicator of future success

It might not seem like it but there's a lot of work that goes into this column. Besides what I do, I've always been lucky enough to have great people working with me and for me. My interns and assistants have gone on to work in baseball many times and I'm always humbled by how good they are. This year is certainly no different as I'm lucky enough to work with Dan Wade. He checks in with an interesting take on ADP and injuries:

It can be easy to fall into the trap of using injuries as a binary state: either a player is hurt or he's healthy. That distinction, while easy to understand, simply isn't that useful, since it glosses over the nuances that differentiate a Johan Santana from a Jake Peavy. Even with the news that Kendrys Morales is going to miss the rest of 2011, rendering the 73rd pick of most drafts according to MockDraftCentral.com virtually worthless, it would be a mistake to pull a "once bitten, twice shy" routine and swear off drafting "injured" players ever again.

It's too late now to rethink draft-day strategy, unless you're in a redraft league of course, but recall that Jacoby Ellsbury (ADP 62) and Justin Morneau (ADP 50) missed most of 2010 the way Morales did and both have come back healthy, if divergent in terms of production. Zack Greinke (ADP 56), Peavy (ADP 356), and Chase Utley (ADP 31) were all injured on draft day, but two have already come back and Utley should soon join them. While it may be possible to avoid a player with an already extant injury on draft day, doing so removes a major source of bargains, while only nominally limiting your exposure to risk. Morales may have been the first top-100 player to officially miss more than half of this season, but he's unlikely to be the last. After all, he has only played nine games fewer than Joe Mauer (ADP 20) has so far.

Powered by that knowledge, on to the injuries:

The Phillies will make a decision regarding Utley early this week, after he played all nine innings at 2B in a rehab game Sunday. The downside here is that we might not know what that is until after weekly moves are due. Even if Utley is asked to go to an upper minor affiliate for a bit more of a challenge and more at-bats, he's not far off. While the 5/15 ERD I had on him isn't dead on, it's not far off either. While I'm far from perfect, this one was a matter of having the right sources and resources to get a complete picture of how it was being handled by the Phillies. At this stage, there's nothing physical to sort out. The Phillies have the "system" down and don't anticipate any problems.

There's always the stylistic challenge of an all-out player like Utley and the theoretical issue of the "Ironman effect," which worry some. It's not really the case in the truest form, which was a pattern I noticed in regards to some older, but durable players, like Cal Ripken. Ripken was famously durable, but once he started getting injured, it was a rapid decline. Johnny Damon also has followed this pattern, though he seems to have adjusted his game to accommodate what we could call a "slower healing rate." Utley's not there, because he's not that durable. He's been able to come back and play through injuries, but that might also be wearing on him. If what we've seen is a slightly debilitated Utley for the past few seasons, that's amazing.

The M*A*S*H unit in Philly continues. As we try and discern what is luck and what is preventable, one of the things that often stands out is a "burst" pattern: Injuries come all at once, with no discernible pattern until we can step back and look at all the data. A medical staff doesn't get that kind of time. They have to deal with things in the now, like a strained hamstring for Victorino and an injured thumb for Brown, who is still returning from a hamate fracture, despite being off the DL. He was optioned to the minors, but it's reasonable to think of this as a very extended rehab stint.

So we have two injuries, piling on a long list of team injuries, but is there any connection whatsoever? The injuries were to different parts of the body, happened in different cities at different levels, and one was an acute injury while the other was acute with an association to a previous injury. There's little extra tasking for the Phillies since Brown is at AAA, nor is there a dropoff in quality. Some of the best trainers in the business are at the lower levels of the minor leagues, placed there to handle rehabs and monitor investments. Neither of these injuries seem serious, though the Phillies have been increasingly conservative over the last year.

The shutdown is over. Hughes stepped back on the field, playing catch on flat ground Friday. It doesn't sound like much, but it's something and maybe the first positive indicator for Hughes in quite a while. No, I'm not counting the negative on thoracic outlet syndrome. While that's certainly better for him in some respects, most would take the known and correctable over the unknown. The unknown is right where Hughes is, with the medical and field staff left taking baby steps to see how Hughes' shoulder responds to increasing workloads and, as important, how he recovers. Hughes likely will continue with a conservative program to bring him back, but there are those who are starting to get a feeling that the Yankees are on a plan where any setback will result in a full-season shutdown for Hughes. I'm not sure that comparisons to Chien-Ming Wang are good, but I can see why people are saying that. I still have a bit of faith in Hughes, even if I can't recommend holding him on a fantasy roster.

I hate unknowns. With Sizemore, the rest of his career is going to involve unknowns. With a procedure like microfracture and an athlete like Sizemore, it's impossible to foresee how this will all go. Just coming back to this level is something that really hasn't been done before in baseball, so the idea that something like this knee bruise setting him back several days is neither predictable nor improbable. The problem is that same old thing -- my lyin' eyes. Watching Sizemore, even after returning from surgery, is enough to make you dream. Scouts and execs I spoke with over the past months all revel and want to know more about this "miracle that Lonnie Soloff has wrought," in the words of one NL exec. Watching Sizemore or looking at his numbers distracts from the huge, incalculable risk that Sizemore is and will be. That said, he should be back from this early this week, most likely on Tuesday.

Beachy has been a find for the Braves. The Indiana native wasn't drafted as highly (or at all, actually) as Mike Minor or as touted as Julio Teheran, but it's Beachy who got there first and was pitching very well for the deep Braves. The one knock on Beachy is his stamina, not going deep enough into games to lock in a decision often. Beachy's not a small guy, but he's often described by scouts as "slight", which seems odd given his listing at 6-foot-3, 215 pounds. Beachy's strained oblique is a simple one, but will cost him about a month, giving Teheran another chance to show what he can do. Beachy has been a "sell high" candidate for a while, as he's better now than Minor or Teheran, but not likely to have the upside (or the scouting sizzle.) Honestly, he looks to me like the perfect swingman, something the Braves could easily use with a four-man skip rotation, given it's current makeup and some Diamond Mind nomenclature.

Anytime a pitcher says he feels a "pop", teams worry. When it's an ace-level pitcher like Hudson, it's even more of a worry. Hudson said he felt a pop in his hip while covering first, but after a discussion at the mound, the trainers elected to leave him in. Hudson made it a few more innings and showed no problems, but does this pop portend future problems? It's hard to say, but if Hudson didn't show any problems now and doesn't have any post-start swelling, making his side session and next start as scheduled, I won't worry too much. I'll call it a "strained hip" for lack of a better term, while setting no ERD, an anticipation of him not missing a start. I'm sure the Braves field and medical staff will be watching closely.

They're definitely watching Jones after he missed Sunday's game. Commentator Dave O'Brien said that Jones could be facing a knee surgery, which would correct a minor meniscus tear, and likely cost him a month. Knowing Jones, he'll likely try to play through it and make it worse, though his experience in coming back from a pair of ACL tears might make him a bit gun shy. Jones came back in '11 to go out on his own terms and his play has been solid. I won't suggest he'll be in play this deadline, but Jones has a bit of Brett Favre in him and could delay the retirement if he continues hitting well.

I know we went over the Colon situation on Friday, but now that we're past the more sensational parts of the story, I'd like to double back. I made a ton of calls over the weekend and no one seemed to know exactly what kind of surgery that Colon had. It's clear -- or should be, to anyone who does the research -- that the type of injections that Colon had could be done without surgery. Platelet rich therapy, prolotherapy, guided corticosteroid injections -- these are all done with large needles and some guidance, but is a far step short of surgery. This was done as an adjunct to ... something. The Yankees' insiders that knew wouldn't tell me, but it seems to be contained in a very small population. Surgery isn't something that's hidden well. There are scars and rehab/prep work that is ongoing. Guys like Vlad Guerrero and Pudge Rodriguez, years removed from back surgery, still do their stretches before every game. So what was it that Colon had done? Until we know what that was, in addition to the known timeline, we can't assess anything about this comeback.

This article should scare the hell out of you, especially if you have kids and they pitch. We have adult supervision for a reason, but it's the adults that are failing ... Albert Pujols got hit by a pitch on the hand. While the Cards think he will be OK, he'll have some images done on Monday ... Remember Michel Ynoa, the uberprospect signed by the A's? He's progressing in his return from Tommy John surgery and is still just 19 ... The Jorge Posada injury is going to be a non-story in a couple days, so I'm going to ignore it here, OK? ... Chase Headley is expected back no later than midweek after rolling his ankle this weekend ... The latest timeline on Josh Hamilton has him returning June 1, more or less ... For Mets fans thinking that Carlos Beltran will be an early trade, don't count on it. One AL exec told me "unless [the Mets are] willing to throw in cash, and no one thinks they can, it's tougher to take Beltran now. The smart play is letting the Mets carry the risk as late as possible. Biggest worry is losing his [medical] routine. I hope he's taking notes." Beltran was back in the lineup on Sunday ... Andrew Bailey passed through his side session and now heads out on a rehab assignment. When he goes back to back days, he'll be back in Oakland ... There are conflicting reports on Colby Rasmus, with the Cards insisting it's not a muscular issue. Watch closely ... Jose Contreras will start a rehab assignment mid-week and should be back with the Phillies by the start of next week. His role is TBD ... If you didn't hear Andy Zimbalist talking about the possibility of A's owner Lewis Wolff trading his team in for the Dodgers, go listen to SI Inside Fantasy right now ... Ian Desmond's sore quad might keep him out "a couple more days maybe" said an insider, "but it's no big deal" ... Casey Blake is getting close to a rehab assignment, one that shouldn't be too long ... Maybe this is the first step to getting Frank Jobe and James Andrews into the Hall of Fame.