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Under The Knife: Wright, Ramirez leave training staffs scrambling


It wasn't long ago that Pete Sampras was the king of tennis. He broke the longstanding record of Rod Laver by winning more major tourneys than anyone. While we'd just seen runs by Bjorn Borg and John McEnroe, people dropped the "once in a generation" and "best of all time" tags on Sampras without a second thought. I'm not saying they were wrong, but now we have Roger Federer.

Federer broke all of Sampras' records and was perhaps more dominant than Sampras ever was in his time. Federer couldn't beat Rafael Nadal on clay Sunday, but the fact that he was in the French final again is pretty impressive. Sampras retired at age 31, so the fact that Federer will celebrate his 30th birthday this summer has to make everyone wonder if this is the end or whether Federer can stun us once again.

So what does this have to do with baseball? Tennis is such an individual sport with clear rankings, upsets and career arcs that it's much easier to judge players to other players. While equipment and training has changed the game, it's still easy to make era-to-era comparisons. It's harder to do that with baseball, but thinking that we're seeing the "best ever" is probably right. The game moves in one direction. What hasn't changed is the ability to avoid injury. While players are bigger, stronger, faster, and in better physical condition, the seemingly random nature of traumatic injuries is the one thing that can derail any career. It's hardly a Gaussian distribution, which wouldn't allow for outliers. The funnel of talent and work can only be derailed by distraction and injury, it seems, so over the next 20 years, we're likely to see an increased focus on determining the true pattern of injuries and yet another "best of all time."

Powered by Monday's Rule 4 draft, which will feature two of my favorite people, Peter Gammons and Jonathan Mayo, on the MLB Network coverage, on to the injuries, ending with a handful if likely draft picks:

The return of Wright went from "days" to "weeks" with one exam. A re-check of his back showed that a couple weeks off weren't enough to allow healing, as many had expected. Go back and take a look at what I said in this column, quoting some of the best in the business in orthopedics, and the consensus was "10 days to two weeks" would be enough rest. It's impossible to say from the outside why it wasn't. Maybe Wright didn't really rest; some guys think "rest" means hit the gym or the club. Maybe this was a bit more serious of a dysjunction than the MRI showed. This is less a misdiagnosis than a clarification. In fact, calling it a misdiagnosis (as some have) is dangerously close to professional misconduct. Wright will take the next three weeks off from almost all activity and then hope to restart the return. GM Sandy Alderson joked that Wright would be back for Johan Santana's first start, but I'd expect Wright to be back well ahead of Santana, even if it's at the All Star break. I'm a bit tentative here, going on the long side of expectations.

"The worst pain" of his career. That's how Ramirez is describing the back problem he's experiencing. There's no question that there's an issue, but there have been a lot of extrapolations (or outright guesses) without much basis in fact. While Ramirez does have some "tingling" in his leg, he has not exhibited symptoms of what one orthopaedist who specializes in back injuries called "true sciatica." Think of this as '"sciatica-like symptoms," if that makes it easier for you. The type of inflammation and impingement he has could well be disc-related, but could also be the result of a simple nerve entrapment, a muscle spasm or a combination of the three. The key here, both positive and negative, is that the pain is intermittent. That makes it difficult to pin it down and will leave the medical staff chasing symptoms, looking for patterns, and "shotgunning" treatment, doing as many things as possible to try to break the pain/spasm cycle and then distilling it over time. The key here is figuring out what works and then working to maintain him in a productive situation. A decision on the DL comes early this week, but if you can't wait, it's reasonable to bench him this week as he's very unlikely to play before the weekend series regardless.

The Rays are a cautious organization medically. We saw that as they brought Longoria back from the strained oblique that cost him the first month of the season and we'll see it again after he felt a "twinge" in the same side. While the team insists this is a minor injury that will only cost him a few days, they're also conservative enough to keep him out more than a few days or even a run a DL stint if they feel it will ensure Longoria is healthy. It's a difficult equation trying to figure out how much risk versus reward there is with a player like Longoria, especially when you have to factor in the AL East competition, the need for ticket sales in a fading market, and the questions about how this team's construction will or won't change over the next month. Longoria's injury isn't that serious, but if it goes past Tuesday without him back on the field, the conservatism might hurt fantasy players. (Late word is that he intends to play Monday.)

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The latest problem appears to be going down his left arm. While the team won't clarify whether or not Morneau's latest injury, a problem with his wrist, is in any way related to his shoulder/neck issue that he's been dealing with all season, it's reasonable to think that this is, at worst, a cascade injury. Sources tell me that the wrist is problematic, but that it's more a sign that things are breaking down around him, not unlike the situation with Joe Mauer. As Morneau tries to fight through his injuries, he's more likely to cause more problems, ones that will make it more difficult for him to be productive. The team seems to be hoping that they can keep Morneau going until Mauer gets back, but the occasional days off he's needed might prove that the plan isn't going any better than anything else for the Twins this season.

I decided several years ago that it simply wasn't possible to cover the minors in anything but a superficial manner. There's the occasional big-time prospect who will have a clear injury that I'll mention, but getting quality information is difficult. Trying to track minor league injuries as a whole is simply impossible at this point. That makes the draft prospects a level beyond, though teams take a hard look at the available medical files of the top players.

Rendon, the Rice infielder that could go as high as No. 1 Monday night. The only issue with Rendon is his ankle, which is post-surgical and has shown some chronic problems. While it's enough of a worry to probably have the top few teams pass on him, it's not thought to be a major problem. Rendon is seen as a 3B by most organizations, and the ankle shouldn't cause much of an issue with range. He's shown solid power before and after the ankle surgery, but wasn't a big speed player, so that's not a concern. The real concern is that there's also an ongoing issue with his shoulder that has some worried that he won't be able to stick at 3B. If it wasn't for the ankle, teams seem mixed on whether he could stick at 2B, but none want to chance it with the ankle.

The easy comparison for any big-time hitter from Rice is Lance Berkman, but most scouts say it's not just easy, but correct. "If he's not an infielder, maybe he is Berkman. Berkman was a better OF, even a legit CF, during his career, and the bat plays anywhere," said one scout from a team with a top-10 pick. The injury risk -- and the reticence that Rendon and his advisors have had regarding his medical -- will drop him in the draft, but not too far. There are enough teams willing to take the risk in order to own his upside.

These two pitchers -- one an Oklahoma prep and the other perhaps the most effective college arm in the draft -- are raising questions due to their insistence that they not change their long toss programs. Bundy was said to be telling teams he would pass on signing unless the team that took him would commit to not altering his workout. If you think that went over well with teams, well, just look at how the Red Sox dealt with Daisuke Matsuzaka after spending big bucks on him. They immediately changed his workouts and repertoire. The key here is to define the kind of long toss. Most, if not all, pitchers use a form of it. Most use it as a warm up or off-day routine and focus on throwing the ball more or less on a line, up to a distance of about 120 feet. The work is done to tax the arm without changing the mechanics significantly. Roy Halladay's pre-game workout shown here is a good example of what I'll call "medium toss" for clarity. Contrast that to what Alan Jaeger uses, a 300 or more foot throwing program that looks nothing like the mechanics used on the mound. I'm not saying Jaeger and other long toss proponents are right or wrong. Actually, I'd love to see ASMI or one of the other places with motion capture test one of the long tossers and see if the same muscles are being activated. That's my major question about this, whether or not long toss is training the right muscles. Jaeger's had some good results with his program, but there's no team in baseball that's fully on board with this kind of long toss. Both pitchers will go high, especially Bauer, but we'll have to see whether or not a team is willing to sign on in order to sign one of them up. (By the way, the kid that Bauer struck out in the video I linked to is Mike Gallego's son. There are a ton of sons in this year's draft and yes, that makes me feel very old.)

Purke got caught up in the Rangers bankruptcy a couple years ago, seeing his draft offer drop and then vanish the same way that Tom Hicks' cash flow did. Purke passed on the lower offer and headed a bit west of Arlington, to TCU. As a lefty with high-90s stuff, the decision didn't look to cost him any money, and comparisons to David Price popped up all over. Unfortunately, Purke's shoulder came up sore halfway through the college season and he ended up heading to see Dr. James Andrews. While Dr. Andrews cleared him to pitch, Purke has teams doubting him. "It's a red flag," said one scout. "It's not that I don't like him," said another, "because I love his stuff. I just can't say he's worth $7 million."

Purke has the ability to return to TCU as a draft-eligible sophomore, and teams think the injury this season has to have him worried about next year. "Once he gets past the [supplemental picks], reality is going to set in for him. Then some team is going to call his bluff a bit. They'll end up over slot, but much closer to their number than his." Several teams think Purke is being targeted by the Red Sox, who had a similar situation last season with their pick, Anthony Ranaudo.

Jake Peavy left his start with a groin strain. We won't know until Monday how serious it is, so plan conservatively in what would be a one-start week anyway. (See, I learn from working with Eric Mack!) ... Phil Hughes is headed back to Tampa and seems on track for a rehab assignment in the next two weeks. It's unclear where that might start, but word from team sources is that they're still very concerned about him getting up on a mound and throwing at game velocities. "He's got a lot to prove to everyone," the source told me, which means the rehab could start low and go long ... Edinson Volquez will start for the Reds on Tuesday. We'll know early if his control is any better. If I had him on my fantasy team, I'd be hard pressed to start him that first time out ... Aroldis Chapman is still working on mechanics (not recovery), so he won't get to Louisville before late this week. There's no timeline for his return ... Homer Bailey's shoulder issue has turned out to be relatively minor, but it's certainly recurring. He won't be back in Cincy this week or next, but it's probable that he'll get a rehab start somewhere ... Carlos Beltran leaving after fouling one off his shin is just precaution. The chance of a cascade injury if the shin bruise made him limp makes this the smart play by the Mets ... Remember what I said about Chase Utley being unlikely to run much? He's 3-for-3 on steals since returning ... I've said all along that Buster Posey's positioning (and inexperience) was a major issue, but Johnny Bench is Johnny Bench. I hope some will listen to him ... Joe Mauer will shift his rehab from Florida to an upper level -- perhaps Triple-A since they're thin at C there -- in the next 10 days. The Twins insist that Mauer will only catch, with an occasional day at DH ... Denard Span got banged up on a play at the plate as he was trying for an inside the park HR. ... Francisco Liriano should be back in the rotation as of Tuesday. The Cubs get Matt Garza back on Monday or Tuesday as well ... Jimmy Rollins will miss a couple days with a simple bruise on his kneecap ... Brad Lidge is about a week away from re-starting his rehab. He's still on track for a mid-to-late June return ... Matt Harrison not only had a blister, he was dealing with a kidney stone. It's still unclear whether he'll be ready next time his turn comes up for the Rangers ... If you're interested in my next book project, you can read about it here. It's a ways off from the point you can read it, though there will be plenty of updates here, starting with the actual surgery this week.