Under The Knife: Preventing injuries a matter of smart and will

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"The best is the enemy of the better." It's a phrase I learned from Aaron Schatz at Football Outsiders. Things are never going to be perfect in baseball. Trainers and doctors are never going to be able to just kick back, their training rooms empty and their tape sitting in boxes. The DL is never going to be empty. But there just has to be more and better we can do than what we have now. I realize that I'm more sensitive to it than most since I'm embedded in the day-to-day injuries, but yes, injuries are up. Yes, it seems to be happening to bigger stars and the marquee teams. Yes, the pace seems to be accelerating.

The time is here, again, for a change in the way players are cared for. The naive question needs to be asked over and over: If we hadn't been doing things this way, would this be the way we'd choose to do them? We need to find those 1 percent reductions -- better protective gear, noninvasive monitoring like a Fitbit or Nike Fuel, a focus on nutrition. No one's ever mistaken Bud Selig for Steve Jobs, but at what point does someone actually do something?

Powered by Bird Rock Coffee Roasters, on to the injuries:

The Yankees placed Sabathia on the DL, as much as a precaution as for a real problem with his mildly strained groin. Hours later, Pettitte took a shot off the leg and is out for six weeks. Pettitte's injury is reminiscent of the one to Roy Halladay a few years back. All it would take to prevent this is a small, light soccer shin guard like this one. I'm sure there are cheaper shin guards out there, and Pettitte -- and every pitcher -- has the right to choose, just as they've all chosen to be exposed to this kind of injury.

In the NFL, players are fighting the league mandate that they wear thigh guards, a position that reeks of ignorance and an abdication of their role in the overall football landscape. Baseball pitchers are doing the same thing. I accept that they have the right to accept this risk, but in doing so, they should also accept some of the downside.

The Yankees will be scrambling for a pitcher, all while paying Pettitte's full salary. The location of the fracture will be key to Pettitte's return. However, the Yankees' roster crunch necessitated a move to the 60-day DL. Pettitte should be ready before then, but can make some minor league starts and should be full-go when first eligible to be activated. This is not a fracture of the ankle, but the fibula, one of the two bones of the lower leg and the one that takes much less of the body weight. NFL fans might remember Reggie Bush, the "star" RB missing five weeks with a similar, but more severe, fracture. (The difference was in the location.) Further indication of this is that Pettitte won't need to be casted and will remain in a walking boot for the first few weeks. As for Sabathia, he'll be out the minimum, returning just after the All-Star break to his slot at the top of the rotation.

One of the keys for Utley is power. That he had a homer in his very first at-bat after returning to the Phillies is a good sign. He had no problems in the field and felt good afterward, according to several reports. Utley was out on Thursday, which was more a function of a day-after-night game than any regression; the Phillies have a plan for resting Utley. Charlie Manuel told the press that Utley was going to get a day off once every three games. Some tried to parse Ol' Cholly's pronouncement, but there's not much to figure out. Scheduled off-days help with this, so if you have Utley in a daily league, you'll have to keep an eye on rosters. So far, all signs are positive for Utley.

Ethier left Wednesday's game with an apparent oblique injury. With a slight uptick in muscular injuries, we have to wonder whether the heat has made dehydration an issue. With all the Gatorade, sports drinks and plain ol' water available to players at all stages of the game, dehydration is tough to understand, but it's a reality of the game. It's very difficult for anyone to monitor the intake of a player in game, and downright impossible to monitor their outflow. Dehydration leads to all sorts of issues, but one of the biggest is muscle cramping. At that stage, the dehydration gets down to an interstitial level and can lead to tearing of the fibers. Ethier is day-to-day as the Dodgers assess his progress, but the call-up of Scott Van Slyke might be a tip that he's more likely to end up on the DL.

Kemp is going to start a rehab assignment before the All-Star break, but the Dodgers are a bit dodgy on him playing in the All-Star game, let alone actually participating in the Home Run Derby. Kemp's going to have to convince them he's fully healthy, and even then, the re-injury makes me think the Dodgers will very strongly suggest he stay safe.

Braun took a nasty HBP, right off the elbow. Bronson Arroyo isn't a fully-caffeinated Aroldis Chapman, but the swelling cost him some flexibility. The Brewers held him out on Wednesday, knowing that pairing that with the scheduled off-day would give trainer Dan Wright the chance to make sure Braun's arm is ready. Indications are that he'll be back in the lineup on Friday, but double-check if you're in a daily league. Braun has been dealing with dings all season. Still, he's putting up the kind of numbers that will answer some of the questions that his overturned suspension caused. Braun can play through minor injuries like this or his sore heel when he's engaged, so watch this kind of thing if the Brewers start selling or fall further out of the NL Central race.

Hudson got the bad news on Wednesday afternoon. He has a torn UCL and is likely headed for Tommy John surgery. He'd left a game with what looked like an elbow injury in his last start, and the scans confirmed what many had suspected. Hudson will have the standard second opinion before making a decision on surgery. The rehab will take 9-12 months and he should return without much issue after that.

The D'backs do have some pitching depth with Pat Corbin and Josh Collmenter coming up. And of course, there is Trevor Bauer, whop made his MLB debut Thursday night. He was hardly dominant, but showed signs of why he's so well regarded. Beyond that, the D'backs have Joe Saunders coming back (though he's not yet throwing), so results will determine who gets the slot over the second half. Hudson made a huge leap in innings, going from 92 MLB innings to over 220 last year. That's risky and the D'backs knew it, but at 16-2 and pitching the team to the playoffs, it's hard to say they should have handled things differently.

The Rangers have gone from very healthy to very thin in their rotation in a matter of weeks. Feliz is in the midst of a throwing program that should have him back in August. He's not on a mound yet, and the Rangers won't get that until the All-Star break, but it's progress. They haven't determined yet what his role will be, so it's impossible to say when he'll be back. There's been some discussion about making him a long man or perhaps pairing him with Robbie Ross or Scott Feldman in his first couple of starts, the way the team did with Ogando. If Feliz is going to be a starter -- and some of that will be decided by how Martin Perez pitches in the next couple starts he makes -- it's more likely he'll get a couple rehab starts and be back in late July. I'm using that as the ERD right now, but it could change quickly.

It's a bit clearer for Holland. His shoulder fatigue seems to have been directly related to his illness and now that one is cleared up, the other seems to be clear as well. Holland threw three innings at Round Rock (AAA) Wednesday. He'll make one more start on Monday and then should be back to Texas' rotation. That would fall right in the All-Star break, so he'll likely return just after (or make one more start at Round Rock to stay on schedule.)

Ogando is also making progress from his groin strain. He's scheduled for a side session early next week and depending on how everything else falls and his role is set, he might head right back to the pen.

Pettite's injury was bad, but top Pirates prospect Gerrit Cole's comebacker could have been a lot worse ... Chris Carpenter was back on the mound Wednesday after what he called a setback over the weekend. Despite this, he went to see a specialist on Thursday to check for thoracic outlet syndrome ... That injection really seemed to work for Ryan Zimmerman. The question now is how long it will continue to work. The other question is whether it was cortisone, which can't be used safely over and over, or whether the Nats could/are using something like Toradol ... The Yankees problems aren't just pitching. Russell Martin remains out with a back problem that just won't let go. With the All-Star break upcoming, they may have to DL him ... Brandon Phillips took a forearm to the head Wednesday, then was scratched on Thursday. The concussion guidelines are in effect for him ... Kyle Farnsworth is expected to be activated. His role is still in question, but we'll find out more once he gets back to Tampa this weekend. My guess is that Fernando Rodney will keep the job and Farnsworth will get the high leverage situations, a win-win for Joe Maddon ... I'm curious to see how Andrew Cashner works as a starter. The Pads sent him to San Antonio (AA) to stretch out. He's been whipsawed for a while and had seemed to find himself as a fireballing setup guy, but the Pads need starters desperately. His first start was great, but his issue starting has always been stamina ... Things like this are going to make further delays of replay worse ... With the Rangers scouting Zack Greinke, you have to wonder what they might have to give up. My guess is the price starts with Jurickson Profar, who could immediately start for the Brewers.