Under The Knife: Johnson's intent with Strasburg raises concerns

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On Sept. 13, the Professional Baseball Athletic Trainers Society announced their 2011 Athletic Trainers of the Year -- 17 winners in all -- one from each league within the minor league system and one for the coordinator of the year. Somewhat surprisingly, no one team made a particularly noteworthy showing. The Reds took home twice as many wins as any other team did with, well, two: They can claim the minor league coordinator of the year in Richard Stark and the top trainer in the Cal League, Clete Sigwart. Sixteen other franchises had a single trainer recognized. Stark and three of the trainers were repeat winners from within the last five years.

It is possible the wide variety of organizations represented is a factor of a large talent pool and relatively few openings. Even if a team were looking to bring in a new staff, they're unlikely to completely liquidate their current staff of trainers. Given how important it is for prospects to stay healthy and on the field, it is curious no team seems to have made an attempt to wrap up a greater percentage of the best trainers. It's difficult to say precisely how much improvement an organization loaded top to bottom with the top medical staffs would see, but keeping a team's best players healthy isn't ever going to be a bad thing, no matter what the level.

Let's get to the injuries ...

For all the things Strasburg has going for him heading into next year, my biggest worry might be Davey Johnson. The Nats manager has had some old-school tendencies when it comes to Strasburg, but he seems to have been held in check at most points. He talked about having no pitch counts on Strasburg when he returned, but we've seen that Strasburg has been kept on very conservative counts. Now, when most expected Strasburg would be making one final start, Johnson's talking about bringing him back on short rest for the final game. While I've long been an advocate of Strasburg pitching during this last month, if only for his confidence, this kind of move is simply pointless and makes me wonder if Johnson is the right man to manage this pitching staff going forward. With Strasburg, Jordan Zimmermann and some other young but fragile pitchers likely in the mix for the '12 and '13 rotations, the Nats might need to consider whether Steve McCatty is a strong enough voice or whether Johnson is going to need hard and fast rules on pitcher usage.

The Cards are chasing the Braves (trailing by two games in the wild card with six to play) and doing it with the kind of team Tony La Russa seems to excel with. They are missing their best pitcher, a key offensive cog, and has a bullpen that's ... quick, who's the closer? La Russa loves and even creates this kind of "us against the world" situations, which come off as a lot more believable than Mariano Rivera saying "no one gave us a chance" after the Yankees clinched. Holliday would be a nice addition to the offense, but his finger is still painful any time he tries to grab something, which would include a bat. He is technically available off the bench, but the Cards can't just worry about making the playoffs. They have to make sure that Holliday doesn't exacerbate the injury. He's "close to returning," said a source, but another doesn't think he'll be back this weekend. Much depends on how the rest of the Cards play in Holliday's absence.

Jumper's knee sounds pretty innocuous, which is why I try to avoid those kinds of descriptions. Then again, patellar tendinitis doesn't tell us much either, even if we get a lot more specific and a lot more technical. I won't bore you with the details or show off my medical vocabulary. Instead, let's just stick to what this means for Pence and the Phillies -- not much. Pence has dealt with this problem on and off for a while, with some reports going back a few years. Pence could play through it, though he's sore. Instead, the Phillies are taking this last week to do the last-minute maintenance they should be doing. Pence will be back this weekend and is expected to play normally through the playoffs. It's a maintenance issue in the short- and long-term, but not something that should affect Pence's value on the field or in next year's fantasy drafts.

The Yankees are very worried about Hughes' availability for the playoffs after his chronic back issue flared up at just the wrong time. Hughes has disc problems that go all the way back to '04, but this was bad enough to get him in for an epidural injection quickly. He's out for the rest of the regular season and his reaction to the injection is going to determine whether or not he's available at all this postseason. It's going to be tough for the Yankees to get a good read on Hughes before rosters are due. That leaves Joe Girardi with CC Sabathia and ...

I feel like I might be underestimating what got the Yankees here, because they've gotten here easily, but in terms of what we know wins playoff games, the Yankees look to be light in the rotation. Speaking of Yankees pitchers, they'll have Chamberlain back at some point next year and it could be as soon as Opening Day. Chamberlain is already throwing lightly and will be at the 10-month mark at that point. They'll likely start him out in the minors, probably Tampa, due to weather, and have him back in May or June

The Sox could be forgiven if they went against what they know and pushed Buchholz to start. Then again, they also could be a bit more creative and use Buchholz in a tandem or even a trio set-up rather than clinging to some idea of "starter." There's no team better prepared to buck convention than the Sox and no team with a bigger potential payoff right now. Given the expanded roster, the Sox could conceivably go with nine pitchers going an inning each for the next few days and not overtax anyone. Buchholz doesn't have stamina, but reports from his simulated games say that he does have enough stuff to get batters out. How the Sox use him and his fellow pitchers could make the difference between making it to the playoffs and being the next addition to this list.

A fractured middle finger ended Lawrie's rookie season, leaving him fourth among rookie hitters despite playing only 43 games. Yes, he's been more valuable (according to WAR) than Mark Trumbo, Eric Hosmer and Desmond Jennings and behind only Dustin Ackley among AL rookies. It's not likely to be enough to get him the award, but it does illustrate just how good Lawrie has been. The finger won't be a long-term problem, but it did put him on the DL. The DL -- at this time of year? Yes, the Jays have decided to be consistent with their use of the DL despite expanded rosters. I can't say I fully understand this, but everything else Alex Anthopolous has done so far has worked, so I'll be keeping my eye on this as well. Lawrie will be a top pick in many leagues, especially if he retains middle infield status.

Some are calling this a "lost season" for Arroyo, but looking at his stats, I don't see it. Sure, he's 9-12 but I think we can all agree that wins and losses don't tell us much about an individual pitcher, especially one that has been pitching through mono the entire season. Arroyo is likely to end his streak of 200-plus innings this year, but just barely. (My research indicates that the real "wall" for pitchers is the 190-inning mark, but it's not as round a number.) To me, this looks like his '08 season, but at 34, I'm not sure if we're seeing age or some of the effects of the mono. While expecting some big bounce-back next year may be a lot to ask, I do think he's undervalued. There are a class of pitchers we've labeled "innings sponges" and with the right deal, those pitchers are immensely valuable. My pal Matthew Leach from MLB.com said recently having a chance to win every night counts for something. Guys like Arroyo take the ball every fifth day, save the pen some work, and give their team a chance.

AndrewBaggarly had some great notes on BrianWilson's first save. I won't be surprised if Wilson needs minor surgery after the season ... There's also a great note in there on how random urine tests are conducted, featuring TimLincecum ... DanHaren took a comebacker off his wrist in his last start. He'll have a bruise but won't miss his next start, which will come against the Rangers ... 11 K's? That's a nice first start for MattMoore, right when the Rays needed it ... MarkLowe left Wednesday's game with a hamstring strain. This is a big loss as the Grade II strain will keep him out through at least the ALCS ... JaysonWerth is expected back in the lineup Friday after dealing with elbow inflammation ... JasonIsringhausen wont make it to the mound in St. Louis, but he does think his back problems won't keep him out through the end of the season. Isringhausen does intend to come back in '12 ... JasonBay is sick and the team's not sure when he'll be ready to play again. They're not rushing him ... MichaelPineda was not sharp and his big innings jump looks more and more worrisome. He's bound to be a red flag next year, though the M's have done well with a very similar situation and pitcher in FelixHernandez ... Looks like ToddHelton is done for the season, but he won't need surgery. Downside here is that this situation with his back is likely to recur and he has two more years left on his deal with the Rockies ... BudNorris will miss his last start with biceps tendinitis. That's not a great sign for a guy who had a big jump in innings ... CCSabathia has been shut down for the regular season. It's not an injury -- the Yankees are just setting up their playoff rotation ... The final UTK of the season comes on Monday.