Under The Knife: Wilson becomes latest closer to fall early in season

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It's no particular type, but it highlights the fact that we don't have any tools to monitor relievers' fatigue. Even the oversimplified pitch count doesn't help. There's no PAP, no innings limit, no real data on usage and recovery. Teams are left asking, "Can you go?" and most do nothing more technical than that.

As the game has evolved and the closer has become more and more specialized, pitchers have adjusted. There's no discernible reason that they should all be getting hurt right now and no pattern to follow here. There's no real difference in the usage patterns early in the season between closers and the designated eighth inning guy, so why are those guys not breaking down?

It's a problem in the short term, but over the course of the year, we may see a hit to the modern closer myth. If we lose this many "top level" closers and teams end up with as many saves and one-run wins, there's going to be more fuel for those pushing for a more logical bullpen management algorithm.

Powered by In-N-Out's "Secret Menu", on to the injuries:

Wilson isn't just heading to see Jim Andrews to have Tommy John surgery. Wilson is heading to Andrews and at least one other doctor (probably David Altchek, who does a slightly different technique) as well as consulting with the Giants ortho, Ken Akizuki.

Sources tell me that Wilson has an incomplete sprain of the UCL, a tearing that is at or near the threshold for repair. Wilson had Tommy John surgery in college, so like several others, this will be a repeat.

Tim Kremchek, who has done a number of repeats on athletes like Scott Williamson, Chad Fox and Jose Rijo, doesn't believe that a repeat is significantly different or has a lower chance of success. In fact, one top therapist that I spoke with in regards to Joakim Soria believes there may be an advantage, in that the athlete knows the rehab process and succeeded at least once before.

Wilson had problems with his elbow at the end of last season and even getting his heart rate up to 410 couldn't help. The probability is that Wilson is done for the season, but with a guy like that, you just never know.

Knowing that Ellsbury had a shoulder subluxation is something, but it doesn't tell us much. A subluxation is like a "dislocation lite" -- the head of the humerus comes out of its normal position, then pops back in. That's the mechanism, but the real problem is what happened during the trip.

Think about Martin Riggs in Lethal Weapon 2. The Mel Gibson character would pop his shoulder out of place and then knock it back in. Riggs didn't do any damage to the shoulder because, it was said, he'd done the damage in the past. The network of ligaments, tendons, muscles and the surrounding capsule are all at risk for Ellsbury (and Riggs, I guess.) How much or little those structures are damaged will determine how long he'll be out and what the effect will be.

The mechanism -- having a large SS land on an outstretched arm -- makes it difficult to get a good comparable. Function will be the key, so when we see Ellsbury running, throwing and swinging, it shouldn't be long after that we'll see him back on the field.

The Sox won't rush Crawford because of the injury to Ellsbury. They can't given that when he started gearing up from his wrist surgery, he immediately strained his elbow. A flexor strain isn't as serious for Crawford as it is for someone like Scott Baker, but it's not good. That a cascade injury happened so quickly is a big worry, but the Sox will understand this. The elbow won't be a huge problem for Crawford at home since LF is so short, but watch for teams to test him early. Crawford should play in games shortly. They'll wait to see him hit since confidence will be an issue. The Sox know Crawford doesn't need to go through another slow start.

Wright came back on Saturday and immediately hit a home run. That's good. It means he can grip a bat and that he and the team made a good decision keeping him off the DL. Wright's finger looked good in X-rays, and while not healed, it is healing. As good as the homer was, the 3-for-5 was better since grip-strength issues can show up in fine bat control more than in power. The road ahead looks good for Wright, or as good as it can be with a broken finger. The Mets need to be careful, but the medical staff seems to have handled this one perfectly.

Burnett is scheduled to make a rehab start for Indianapolis (AAA) on Monday evening, though rain is in the forecast. Burnett is coming back from a fractured orbital and is well ahead of the conservative schedule. His first outing at Bradenton (A) was solid, but Triple A will be more of a test.

Assuming Burnett can get through six innings and his reported 85-pitch limit, it's likely that he'd be activated for his next start. It's unclear when that would be, more for reasons of the rotation than anything. Monday is scheduled to be Erik Bedard, but there's an off-day Thursday. That could make Charlie Morton's slot the likely place for Burnett, though the Pirates would need to juggle and may just slot Burnett in, giving everyone else an extra day's rest.

Hudson will make the short trip over to Gwinnett (AAA) next Wednesday. He's not starting off easily, wanting to go 90 pitches. He's been working in extra spring training and has had no issues with his back post-surgery, but it's still an aggressive plan.

Hudson won't make more than two rehab starts if it goes to plan, meaning he'd be back right at the end of the month. The Braves have the depth, even after dealing Derek Lowe, to be more conservative with Hudson, but in what might be the last year of his career, it'll hard to hold him back.

The Twins took one big hit this week, losing Scott Baker for the season. Losing a second pitcher might break their already small playoff chances. Blackburn left his last start with what was reported as a posterior strain, but an MRI showed "no structural damage" (don't get me started ...), and the Twins say Blackburn could make his next start.

We have to assume that Blackburn doesn't have significant swelling or weakness in the shoulder a couple of days after the problem. The Twins don't seem to be looking for a backup plan here, which is either confident or stupid. We'll find out soon which it is.

Chipper Jones had some fluid drained from the knee he just had scoped. That's a bad sign, though he was back in the lineup Sunday. I'm lowering my expectations for how many games he'll play. The Braves need to focus on how to best utilize him, not trying to hope he stays healthy ... David Freese had a minor finger injury ... Brandon Phillips was back in the lineup for Sunday. With Miguel Cairo hurt as well, Phillips was forced back a bit early to keep from pushing Cairo to the DL. Both should be fine, but bear watching ...

B.J. Upton has looked solid in his minor league outings at Port Charlotte (A). He could be back as soon as this week ... The Twins have played Joe Mauer in every one of their nine games. One-third have been at 1B, but with Justin Morneau healthy, I'm curious if that ratio will hold ... Carlos Gonzalez missed Sunday's game with a case of strep throat. That meant he missed the hail that hit Coors Field ... Freddy Sanchez should start a rehab assignment at Fresno (AAA) sometime this week ... Mark Prior worked out for the Red Sox. Yes, really ... I'm in favor of celebrating Jackie Robinson, but everyone wearing 42? It's lost any impact and is just confusing. There has to be a better way. Tell me your ideas on Twitter.