Under The Knife: Galea deal could see some stars sidelined quickly

While the world (or some small part of it) is focused on the Roger Clemens trial, there was another hearing taking place in Buffalo that could affect many more athletes, and current ones at that. Michael McCann had all the details on Dr. Anthony Galea's plea, but the next step could be investigations into the athletes he treated, which includes several baseball players, including Jose Reyes, Carlos Beltran, Huston Street and others, though the clear focus of this appears to be Alex Rodriguez. If Galea tells the prosecutors that he gave hGH or any other banned substance to an athlete, they have made it clear that the information would be shared with leagues.

Under MLB's drug policy, a player like Rodriguez who used hGH, would be subject to suspension. It is treated exactly like a positive test under a provision called "nonanalytic positive", or N.A.P. Several players have already been suspended under this policy, though there have been some inconsistencies in how it's been applied. (This is likely due to an appeals process that is not disclosed.) A doctor's declaration that he administered the substance would likely be enough to create a N.A.P., but there's one other key fact that would need to be established: the date(s) of use. If Rodriguez was given hGH, knowingly or unknowingly, anytime after 2004, he would be subject to the penalty in place at the time. ('04 penalties were of shorter duration and changed in '06.) It is unlikely that multiple uses, even over a period of years, would result in more than a single N.A,P. It's also important to note that if Rodriguez were hit with a N.A.P., it would be his first violation.

Rodriguez admitted the use of steroids and allegedly tested positive during the '03 survey testing. That admission and positive result do not count under the current drug policy. Rodriguez and other players would have almost no defense, meaning that if Galea supplies information, a suspension could be levied quickly. Losing Rodriguez for 50 games is a real worry for the Yankees, but the timing is even more key. Losing those games now would have him back by September, but baseball's policy is not clear on whether playoff games count for suspension. A player under suspension' inclusion on playoff rosters is also something that hasn't been tested. Bud Selig will be watching closely to see how this develops and hopefully acting quickly.

Powered by my iPad, wifi on the flight and the miracles of technology, on to the injuries:

Nothing really changed with Reyes, but his injury history took more priority than initially expected. The Mets decided to put Reyes on the DL to make sure that he didn't exacerbate the mild strain to his hamstring. While the MRI did show a grade I (mild) strain, the location was "in a bad spot," I was told. That likely indicates the strain is in an area where Reyes had problems before. Remember, muscle heals by the buildup of scar tissue. That scar is weaker than the original fiber and the undamaged fibers around it. That's one of the key focuses of any rehab, restoring some kind of stable balance to the injured muscle so that the player can avoid a cycle of re-injury. By shutting down Reyes for a couple weeks, the medical staff believes that he'll avoid those issues and come back ready to play at his normal levels. There's some question about how long Reyes will be out, whether the three-week rest period is the rest alone or if the rehab factors in as well. We'll get a solid signal when he begins running again. Reyes becomes a trade target if his current owner is panicking.

Lester's lat strain is a classic kinetic chain injury. On Wednesday night, I happened to have one of the world's leading experts on the kinetic chain, Kevin Wilk, handy to ask him about this type of injury. According to the noted physical therapist, the lat muscle is so big and strong that it's difficult for it to be the "weak link" in the chain, so it's usually an injury of compensation or serious trauma, such as with Jake Peavy. Lester's injury isn't trauma-related, so we have to lean to the former, making me wonder about what he's compensating. One doctor I spoke with suggested that there's usually some kind of scapular involvement before a lat strain, so that's one possibility. Wilk's protégé, Sox trainer Mike Reinold, will be watching this one closely, but as another Sox pitcher hits the DL, the team is going to have to figure this situation out quickly.

The Red Sox are also being cautious with their precious hamstring. The team is targeting July 18 for Crawford's return from the DL. That's a bit later than expected, mostly due to a bit of conservative treatment and the All-Star break's influence on his rehab schedule. The extra time isn't going to make fantasy owners any happier, but Crawford should be full go upon his return. Given some of his struggles at the plate this year, one scout from an opposing team questioned whether or not the extra rehab was also a bit of extra work. "Maybe they're worried a bit about rust on top of his poor play. He could also go back to pressing, like he was at the start of the season. The problem I see is that the Sox don't seem to be able to fix anything with him and the guy is coachable." Some of Crawford's struggles this year can be pinned on injury, but I'm not sensing any panic that the Sox bought high on Crawford just yet.

Part of Damon's legend is his durability, the kind that has let him rack up counting stats along the way. At this end stage of his career, he's still durable, but he doesn't heal quite as well. Where he previously could play through things, now he needs a couple days. What took a couple days can now mean a DL stint. That said, getting hit by a ball is mostly bad luck -- unless you're Pablo Sandoval, where pitchers are throwing at him to stop his last second step outs and Nomar-level annoyances in the batter's box. Damon's bruised hand forced a bit of lineup juggling for Joe Maddon, but the team is very flexible that way. Damon thinks he'll be back by the weekend, but it wouldn't stun me if the conservative Rays medical staff held him out through the break.

The news is a bit worse with Davis. While the strained forearm is mild, some have been reminded of last season, when Davis was a bit derailed by a mild shoulder strain. He's got everything but durability, and really, even that's not too bad. I'm not sure Davis will ever be a 200-inning starter, but at this level, he can be very useful. He'll likely only miss one start due to the break and come back without issue.

I don't seem to write about the Pirates much. That's not a bad thing in this case. As a player once told me, "I never want to see you write my name." (I have. A couple times.) That's because medhead stats are a leading indicator. The Pirates medical staff, led by Brad Henderson, won my award a couple years back and have had solid year-to-year and multiyear injury stats as well.

But no one can stop everything. Alvarez has struggled this season and his quad strain offered an easy way to get him some minor league swings. It's worked pretty well, as he's hitting like he did last time he was in Indy, giving the Pirates hopes that he'll hit like he did last time he came up for him. Then again, there have been some young players who have been crushed by a sophomore slump, and Alvarez has to show that he can make the necessary adjustments. The team is likely to give him the full 30 days of a rehab assignment unless he forces his way up.

The Pirates will also be without Cedeno for a while as he recovers from a concussion. Chase d'Arnaud will fill in as the team begins to push toward a pivotal month of baseball.

Troy Renckbrings the scoop that Carlos Gonzalez will be back on Friday and that Troy Tulowitzki is getting closer ... Scott Baker's elbow came back with a good report, but not great. He has a flexor tendon strain and will miss at least two starts ... Ryan Braun has an inflamed calf, but the Brewers hope they can keep him healthy enough to keep fighting with the Cardinals. The team hopes the All Star break is enough to help him heal up ... Peter Bourjos left Thursday's game with a hamstring strain. He's likely to rest through the All-Star break and let the Angels make a determination then. It's not a good injury for a speed player, even if it's mild ... Jim Leyland will let Austin Jackson rest his sore wrist through the weekend and the break ... So Ryan Dempster has a back issue as a result of an intestinal issue. Without speculating, there are ways this makes sense ... Roy Oswalt is back at Dr. Drew Dossett's office, trying to find some relief for his back spasms. A cortisone injection is the likely next step, though the last one didn't give lasting relief ... Tyson Ross will make one more rehab start at Sacramento as the A's try to decide whether to bring Ross back to the rotation or leave Guillermo Moscoso in place. Well, kinda. Moscoso was sent down as well, but it was because the A's wanted to keep him working through the break ... Chris Young (Arizona version) has a bruised thumb that he's playing through. The All-Star break and maybe a bit more rest on either side of it should help ... A really interesting study on shoulders coming from, of all places, China ... Nick Hundley will have his elbow scoped. What the find inside will determine how long he's out ... Rich Harden looked like he was having some recovery issues in his second start, a typical pattern. He was in Texas, which is tough ... Jason Kendall will need surgery on his shoulder after a setback during rehab. For one of the most durable catchers ever, Kendall's career will be remembered largely for his gruesome ankle injury and might end due to an injury ... Yes, this column really was largely written on my flight from Orange County to Atlanta. I did edit some and wrote two sections at home, but it's still pretty darn cool.