Under The Knife: Blue Jays finding pitchers hard to keep healthy

I deal with pain every day. I hear the stories of woe. Being the "injury guy" makes me feel like the grim reaper sometimes when I'd much rather be a chaos muppet. Radio and TV stations call to ask why when things go wrong, but so seldom want to talk about the great things going on in sports. People e-mail to kill the messenger more often than they thank me for warning them. I'm OK with all that. What I'm not OK with is that cancer continues to cause so much pain. It's touched me all too personally and far too many of you as well. We don't need more "awareness;" we need a cure. There's great work being done across the country, from researchers working on cellular level cancer fighters to hospice workers making things a bit more comfortable for those that will be gone before the cure comes. Baseball does it's part, with pink bats and the Father's Day prostate fundraiser. Alex Paluka is doing more and doing it with baseball. His organization is trying to use something that we all love to beat something we all hate. This world needs more people like Alex, and the rest of us need to help them. Powered by a dream of a world without cancer, on to the injuries:

Things looked positive for Drabek late last week, despite the description of a "pop" in his pitching elbow. By Monday, things have gone negative. Drabek has a significant tear of his rebuilt UCL, according to reports, though it's not clear when (or even if) he had a scan of the elbow. Drabek is headed to see Dr. James Andrews, who performed his first ligament reconstruction in 2007. The result is likely to be a re-do, a second Tommy John surgery, which would end Drabek's season and put him back about this time next season. There's conflicting evidence about whether repeat Tommy John surgeries are more or less complicated, but the return rate appears to be only slightly lower, and not for medical reasons. The Jays are once again showing that keeping pitchers healthy isn't something they do well, despite the presence of John Farrell and the watchful eye of GM Alex Anthopolous' front office.

It's kind of fitting that Beckett broke down just as he's about to face Theo Epstein's new team. Beckett's shoulder strain isn't serious, but the inflammation is enough that if he tries to pitch through it, he could develop something that is serious. The concern is that Beckett isn't recovering well in the normal period, missing side work and needing extra care in between starts. Beckett's DL move is retroactive to June 12, but how Beckett's shoulder responds to the rest will determine a lot of things going forward. Beckett may require extra rest between starts, which could force the team to make some future roster moves in order to make sure it happens. One interesting possibility is that John Lackey could return in a very limited, but starting role later this season in order to spot out Beckett. With two big-dollar years left on his deal with the Sox, they'll have to do what they can to keep him available and productive.

The Kokomo Kid has been a nice story this season for the Braves, leading the league in ERA and doing as well in most advanced measures. All that's held him back is a bit of a sore elbow. He was cleared to start over the weekend after some extra rest, but after three innings, soreness had become pain and Beachy appears headed to the DL. He'll have scans early this week with the early word being negative. Beachy had no major control issues on Saturday, giving up only one walk, so there's not the kind of loss of control that so often functions as an early warning sign or even a smoking gun. Beachy has been relatively healthy throughout his career, so it's hard to get a read on this. We'll know more this week, but it's likely that even with good news, Beach will head to the DL. If there's one thing we know here, it's that a couple days extra rest didn't help.

Perhaps Hamilton's only weakness is a bit of fragility. Even so, he tends to come back from these absences with the same talents. Hamilton was most recently sidelined by an intestinal virus that weakened him enough that he required hospitalization. Dehydration due to illness was once a leading cause of death, but that's no longer the case. Hamilton will be fine and may be back on the field as soon as Monday. Hamilton's recent slump can't all be blamed on this illness, however, since it has only been going on about a week. There's reason for worry, but Hamilton's always been streaky. The bigger concern is the lack of communication that allowed this to go down the way it did. It's something teams will have to consider before handing him a huge deal.

Mauer had a tough weekend, but the Twins should understand that this is what their centerpiece gets if he's going to remain at catcher full time. Mauer missed Saturday's game with a sore hamstring, then was back -- at catcher -- on Sunday, when a collision with Rickie Weeks left him limping off the field. Mauer's value behind the plate (and his preference to stay there) is questionable. No one's arguing that Ryan Doumit is a great catch-and-throw guy, but he's got the same percentage (3 percent) of passed balls as Mauer and is actually throwing out a higher percentage of runners. Catcher ERA has been disproved by Keith Woolner and others, so don't try that. If there's an argument for Mauer staying at catcher full time, it's that he has an OPS almost 200 points higher, but I think there's something to be said for adjusting to DH and being in the flow of the game. Mauer will be re-evaluated Monday and Tuesday, but there's a chance he misses more time.

Ruiz came away from a strikeout grimacing and holding his left side. The worry was that he had a strained oblique, but before he was back in the lineup on Sunday, the Phillies said it was "just a cramp." Hitting is hard, but it's hardly entering the "stitch in the side" area. The Phillies checked closely to make sure there wasn't more going on - or that "Chooch" wasn't hiding something -- before letting him back out there. It certainly bears watching, especially given Ruiz's tendency to play through injuries. It's what makes him a favorite in Philly, but is risky for the Phillies.

Bay dove toward the wall for a ball and ended up hitting his head in the "gutter," where the padding ends about eight inches above the ground. No one's ever given me a good answer for why this gutter is necessary. The best answer I've received is that this precludes a ball from getting stuck in the padding, but a couple odd ground-rule plays would be better than losing a week or more to the DL. Bay was clearly woozy after the play and was taken off the field quickly. The Mets will follow all the concussion guidelines established by MLB in Bay's recovery. Bay has had issues before, so he'll be watched even more closely. The concussion DL works like the regular DL aside from the day limit. Bay doesn't have to be transferred to the normal DL, which means he could return at a point before the 15-day mark if able. Right now, the Mets aren't putting any sort of expectation on that return. The ERD is set at two weeks based on a norm, which is, in part, based on a time before the seven-day DL was available.

The Rockies can breathe again. Carlos Gonzalez had his scans come back with good news. He's still day to day with a strained knee. That word -- strain - is the key here ... Matt Holliday left Sunday's game with a problem the Cardinals called "leg related." We're about a half-step shy of saying lower body ... No word at deadline on exactly why Bartolo Colon left his start after two innings, but it looked like a core issue ... Stephen Strasburg has a small cut on his finger. It's not serious but could push back his next start ... Bud Norris was shifted to the DL as expected with his knee sprain ... Evan Longoria played at Durham (AAA) on Saturday but rested on Sunday. He'll get re-examined on Tuesday, which will lock down when he'll return to the Rays lineup ... Bobby Valentine told the media that he thinks Carl Crawford is close to playing in games. The Sox still don't have a timetable for any return ... Scott Rolen is expected back on Monday. How his shoulder holds up over the next couple weeks could help decide how the Reds will move at the deadline. He homered at Louisville (AAA) over the weekend, a definite positive sign ... I never thought I'd see Oliver Perez back in the big leagues. Amazing that he's still just 30 years old ... Bobby Wilson is expected to be activated. His defensive work has Mike Scioscia pushing for his return ... To clarify, I did not intend to imply that Matt Cain used any kind of PED or other illegal advantage in his perfect game or at any other time. I was attempting to make a point that pitchers' feats don't seem subject to the same scrutinies as hitters.