Under The Knife: Young pitchers facing drops in workloads soon

Michael Pineda and Jeremy Hellickson stand out, but Pineda might not be in as much danger as it looks. ZIPS, a prediction system created by Dan Szymborski, predicts only another 84 innings for Pineda. I'm not sure if Szymborski is factoring in a slow-down factor, but it's hard to see Pineda ending short of 175 without the intervention of GM Jack Zduriencik. The same is true for Hellickson, though the Rays have long done some interesting work about the nature of innings jumps, which could give them a bit of an advantage. Zach Britton is more the classic case, a pitcher who jumped to the bigs from "out of nowhere" with a big spring, holding onto a roster spot with good results, but carrying a lot of innings to do so. Several names above were limited due to injury, such as Jordan Zimmermann, who was coming off Tommy John rehab, and Derek Holland, who couldn't seem to stay healthy at the end of last season. Mike Leake is a nice case study, since he hit a wall and was shut down by the Reds, but that smart move has led to a potential big innings jump in Season 2. The same is true for Jamie Garcia, though, like Zimmermann, he's a bit different in that he was coming back from Tommy John, a situation that seems to require different calculations.

Fantasy players should be aware that any of these players could begin to fade the way Leake did last year, or that even the best of pitchers, like Pineda or Kyle Drabek, could be shut down because of innings limits, a team falling out of contention or, worse, injury. All should be considered risky in the second half, so have your Plan B ready. In non-keeper leagues, consider selling high on one of these youngsters for something more stable and durable.

Now, onto the injuries.

Before you start blaming -- or worse, slandering -- the Mets medical staff, let's look at the facts: We've heard a lot about bone bruises over the past couple of years. It's not because there suddenly are more, but now, with new MRI technology, doctors are able to actually see them. X-rays and arthroscopes don't see the internal bruising and damage that one of these specific types of MRIs can see. Given that his symptoms didn't call for the type of specialized test that would have shown team doctors the real problem, it's hard to blame the Mets for this.

(The Mets problem is one of perception. The willingness of some parts of the Mets front office to talk to the press, leaking out info or sharing things that are early process, seems to always work against them. It's as much about the setting of expectations as their ability to keep players healthy that's the problem in Queens.)

Davis could be facing surgery, one option for which would be microfracture. There are almost no sports comparables, let alone baseball comparables, so if Davis is forced down this route, it will be a complete unknown. The team will continue to try and be conservative, with a decision to be made within the next three weeks if there's no further progress. At this stage, it's hard to imagine him coming back, but there are enough unknowns here to have a very broad range on his possible return. Doctors estimate a recovery at three to six months, but since we have nothing in baseball to compare, and because it's been so hard to come back from microfracture on the knee, I'd lean toward the long end of that range. Even so, Davis would be ready for the start of spring training.

That Mauer was out of the lineup for a day-after-night game isn't a big deal, but MLB.com's Rhett Bolinger dropped the bomb that Mauer was out of the lineup due to back soreness as much as scheduling or some plan of action. Mauer's soreness was downplayed, but sources tell me he once again is having issues at the SI joint. That's sacroiliac, not Sports Illustrated, and is located where the pelvis meets the spine. This is the same area Mauer already has had issues with and the reason he was having a "checkup" in Baltimore with one of the world's leading SI specialists.

The Twins insist Mauer won't miss any time and expect him back in the lineup Friday, but signs this is an ongoing issue could see a repeat of last season, when Mauer fought to carry the load when Justin Morneau was out with a concussion. The trainer's room is fuller this season, so who knows what pressure Mauer will put on himself to play through. The Twins are still trying to sell that his early-season issues weren't related to his previous back problems, but I simply don't believe that to be the case.

Oswalt's been battling a bad back for most of the season, leaving the team at one point to give it some rest. It's not working, as he left his last outing on Thursday after just two ineffective innings. Oswalt's delivery is out of whack, and scouts are talking about how he's "pushing" the ball. Oswalt's velocity wasn't bad, living at 91 and showing 92, which is about where he's been this season, though down from an average of 93 last season. Oswalt will be treated as normal, but if the back is tightening up in games and leaving him struggling to get to normal, the Phillies are going to have to make a decision soon on how to go forward. This is a conservative medical staff and a deep pitching staff; the combo leads me to believe that Oswalt's headed for some time off, perhaps through the All-Star break.

There was more bad news for Rich Dubee's pitching staff, with Contreras heading back to the DL with the same elbow symptoms that had him there earlier. "He just can't recover between outings," a source told me, citing symptoms that would indicate some kind of irritation, which matches with the low-grade strain of the flexor tendon. That inflammation would cause irritation, which puts Contreras into the kind of vicious cycle that the medical staff will now have to try and break. The recurrence of the symptoms isn't a good thing, given that what they did then didn't hold up and keep Contreras healthy. They'll have to be more conservative with the timeline, so Contreras could end up missing as much as six weeks.

The Astros aren't saying much about what's going on with Lyon, but what they are saying isn't good. Lyon met with both Lewis Yocum and James Andrews, electing to let Dr. Andrews perform the surgery on his biceps. Much of the focus had been on Lyon's elbow, but this is a shoulder injury, and a bad one. Lyon has a strained biceps, torn cuff and damage to his labrum, on top of the recurrent cyst issue that cost him time in '10. Lyon's going to have a very difficult time returning from this given his age, the extent of the damage, and the way he pitched. Lyon never relied on velocity, but losing any will make it tougher for him to get batters out. Lyon's big three-year contract is looking like an almost total loss at this stage.

The Red Sox skipped Beckett on his last start, with my sources tipping me that this was going to be more than a simple thing. The Sox could have just pushed Beckett back a couple days if he was going to be ready, but the expectation was that he'd slot back into his normal place in the rotation, leaving Alfredo Aceves to do nothing more than spot him. Instead, the Sox will have Beckett come back next Tuesday, not over the weekend, which might mean that Terry Francona is looking to re-set the rotation as well as giving Beckett more time. They won't need to do much, however, as with Clay Buchholz on the DL, they were already adjusting. All indications are that Beckett should be fine by next week and as a two-start guy, should probably be active in most formats.

Torii Hunter hit the wall and the wall won. Hunter has bruised ribs and is day to day ... Denard Span is making some progress after his concussion, though his return is not imminent. The Twins are hoping he's back after the All Star break ... Fernando Rodney's not ready to make his return to the Angels bullpen. He's at least a week away and when he does, he'll be behind several other options for saves ... Brandon Beachy came off the DL blazing. I'll remind you that on six weeks rest, most pitchers are going to feel good. Let's see how Beachy does on five ... Darwin Barney is coming back soon, but he'll need a knee brace to stabilize his injured leg. The key now will be how much that brace costs him in lateral quickness ... Josh Willingham hits the DL with a recurrence of his Achilles strain. Willingham thinks it will be a minimum stay ... Brett Lawrie's still having grip problems and his return to Vegas, let alone Toronto, could be pushed back to August ... Why is everyone so surprised that Pablo Sandoval is struggling since coming back from wrist surgery? I told you to expect a power drought, but hadn't expected the lack of bat control as well.