Wednesday, May 31, 2006

NIH: And this is what I come back to?

I've returned from my vacation, and it's time for NIH to wake back up again. Except...well crap, it looks like the Nationals just had a field day getting themselves injured while I was away. Eischen is likely out for the season. Guillen has been put on the 15-day. Neither of those is really a surprise, what with the bullpen abuse this team undertakes and Guillen's willingness to play injured in the apparent hope to get more injured. Sigh.

Schneider's back, that's good. Patterson I need to research. Oh god, there's just way too much to cover right now. I'm going to try to catch up with what I've missed, but now's not the time.

Thursday, May 18, 2006

NIH: Mission Statement -- and then some

I was going to do something like this back when I started the new blog imprint, but ended up getting thrown basically right into things, since there's been constant injury news to be reporting on. So, with this about to go dark for two weeks, I thought this might be a good time to talk about what I'd like to do with this blog.

NIH, for those who missed the opening post of this new imprint, is the Nationals Institute of Health, a name I wish I could take credit for. In general it exists because I wanted to be part of the best blogsphere within Major League Baseball, but had nothing to add that wasn't being covered already. So, when no one else leapt on the idea of the NIH, I basically stole it. Yup, that's me, one big ole idea theft.

The purpose of the NIH will be to pass along news of Nationals injuries, whether they be major injuries or minor ones. I'll also be tracking the recovery of DL players, as you've already seen me doing with Patterson and Guzman. Right now, most of this information comes from the Nationals Notes in the Washington Post, official team releases, and occasional trolling of Google News. In short, I'm just one guy who's assembling the available information into a single location.

So then who am I? Basically, I'm a complete neophyte. I really know almost nothing about what I'm talking about except what I read in releases, and what I research. That means that when you read posts where I'm explaining things like a SLAP Tear, I'm doing that research on the fly, and educating myself at the same time that I'm hoping to educate others. By the end of the season, I'll probably have a better idea of what I'm talking about, but ultimately there will always be injuries that pop up that I've never heard about, and will have to research.

So, what do I hope to do with this blog? Well, I hope to make it as helpful as possible to those people who chose to read it. My goal, at the time, is to assemble and pass along the information I can find. Also, I've already planned to start presenting more information about injuries that come up, treatments, and even talk about what other players have come back from the same injuries, and what shape they were in when they made that comeback.

And...I'd also like to know what you, the readers, would be interested in seeing as part of a blog focusing on Nationals injuries. I'm already finding this is a really interesting (and, unfortunately, entirely too frequent) of a subject to work with.

Upcoming entries: UCL injuries, and Tommy John surgery.

Catch y'all in two weeks. Hopefully any news that I have to catch up on will be good news. In these next two weeks there's a chance that John Patterson will finally have his rehab start, for one. Astacio should start to progress, and might actually have a timetable by the NIH comes back.

Wednesday, May 17, 2006

NIH: Guillen day-to-day

Another day, another injury to report. I'll admit, I started this imprint within the blog I wondered how much there would be to talk about. Nationals injuries, how much is there to really talk about there?


Guillen's evening was cut short on Wednesday at Wrigley when he suffered from some strain in his right hamstring. Unfortunately, that's really all the more information available right now, especially with the game still going on right now. We can hope this is a minor thing, but the last time we had someone go off with a hamstring strain, we brought him back too soon, it got worse, and he's now on the DL.

At this point right now it makes better sense to be healthy than rush recoveries. We're not in the running for anything except fourth place in the NLEast. There's also been some talk about flipping Guillen over to a contender in exchange for some fodder to start rebuilding our farm system. DL drops his trade value like hell.

Tomorrow shall be the last post before this blog goes dark for a few days. Look for the NIH Mission Statement.

Tuesday, May 16, 2006

NIH: Addendum

Wow, I am going to have to do some serious research of Drese's injury. I did a very brief preliminary search, and it seems that there is a surgical repair that is effective at fixing UCL injuries.

It's called, colloquially, "Tommy John".

Look for my next "research along with thurdl" in the next two days, I'm guessing.

NIH: Pitcher roundup

I believe this is what they call a good news/bad news situation. Burried at the bottom of the most recent Notes article at the Nationals home page were some updates.

The good: Pedro Astacio had a bullpen session without any pain. Of course, they're still not giving any kind of timeline for him. On the other hand, they are giving a timeline for John Patterson, and that just keeps sliding further and further back. It does look like he'll return to the major league club. Hopefully by the All Star Break at this point.

The bad: There's been a new diagnosis of pitcher Ryan Drese. What had originally been called flexor tendon sprain was revealed, after an MRI, to be something called a partial tear of his ulnar collateral ligament in his right elbow. a long stream of words that adds up to "it's a heck of a lot worse than we thought". Plus, I think I have my next injury to research, but not tonight. Anyway, it's going to be 2-4 weeks of rest, followed by a re-evaluation, followed by potential surgery, which would likely be season ending.

Pitcher injury woes, the theme of the 2006 season, look like they're not going to be ending anytime soon. Oh joy. At least they'll keep me busy on this blog.

Except... Except your humble blogger is going to be taking a vacation, and the NIH will thus be going dark starting Thursday night and continuing until probably the last day in May. I'm off to New England, where I will be taking in a game at Fenway, assuming it hasn't been completely washed away by then. This won't be my last post before the vacation (I've already got that one planned), and when I get back, there might be some changes in the way I conduct the Nationals Institute of Health. Stay tuned, and good health.

Monday, May 15, 2006

NIH: The SLAP tear

Normally there wouldn't be much Nats injury news on an off day, and I'm fortunately not here to say that anyone has broken an arm climbing out of bed. I think that only happens to Wake Forest football players. The only real news of the day is that Guzman has been moved over to the 60-Day DL. Not sure what purpose there was to waiting this long to do so, but it's been done.

One of the things I wanted to do with this new focus on the blog is to explore exactly what the injuries are. The whole thing is still a work in progress, I'll admit.

The SLAP tear, for the layman, based on my research. The first question I had was what the hell a SLAP is. It's always been presented in upper case, and since I was never told there was a part of the body called a slap, I figured it was an acronym. Sure enough, SLAP stands for "Superior Labrum Anterior to Posterior".

My next question was what, exactly, a Superior Labrum is. Yeah, I'm just getting into this whole anatomy of a baseball player thing (and thank god this isn't Yudachat, cause I know that Jeff Gannon would be showing up after that comment). Through a little research I've found that there isn't a Superior Labrum, just a few above average ones. The labrum in question is actually caled the glenoid labrum, which is part of the shoulder joint that runs generally from the edge of the armpit closest to the body and curls up to about the midpoint of the shoulder joint. It's a ring of cartelidge.

Superior actually refers to the tear itself. A superior tear is a tear to the labrum at the front of the body, and an anterior tear is in the back of the body. More specifically a SLAP tear tends to occur where the bicep tendon meets the labrum.

What causes it? Throwing overhand. In sports it's most common in baseball players (like Christian Guzman) or volleyballers. Compare the overhand motion of a serve with that of a throw, and you'll see some very similar motion. It's basically a form of repetitive stress injury, though it can be caused by one-time events such as lifting heavy boxes or having your arm jerked. More frequently it happens to pitchers, who put a hell of a lot more stress on their arms, but it can happen to position players as well. Or to anyone, really.

It's one of the arguments against getting kids too much into pitching at an early age. This is a slight veer fromt he topic, but as younger and younger kids are being pushed to throw more sophisticated pitches in the little league ranks, shoulder injuries are on the rise. Young arms and shoulders that are still going through puberty aren't built to sustain the kinds of stressful forces that can rip even healthy adult shoulders to pieces.

The long and short of it is Guzman suffered from the proverbial throwing his arm off.

Most pitchers who get a SLAP tear have peaked in their careers. Their velocity and stamina will be down. However, a position player is more likely to make a recovery to regular season form, just because they aren't relied upon to throw the ball 100 times a game.

The biggest name position player I can find who suffered a SLAP tear was Troy Glaus, who had his 2004 campaign cut short by what was diagnosed as a SLAP fray (some sites seem to suggest the terms are interchangable, others that there is a subtle difference that I can't fully grasp). He has not only come back, but come back strong. He's hitting better since the injury, and his fielding is showing no sign of suffering.

So the prognosis for Guzman could still be good. He's got plenty of recovery time, and the injury isn't quite the career-death sentence as it would be for a pitcher. Still, only time will tell.

Sources used while assembling this entry: article: Labrum, it nearly Killed Him. By Will Carroll
Orthopedic Center, St. Louis: Patients Guide to SLAP Tears. By Dr. Mark Miller
Various wonderful drawings I got from entering "glenoid labrum" into a Google Image search.

Saturday, May 13, 2006

NIH: Catchers play musical DL

Schneider came back the other night, but not for long. Apparently his hamstring problem is a little more severe than originally thought, and is reporting that he's been moved to the 15-Day DL.

So, that leaves us with one catcher, right? Wrong.

The slight good news is that Fick is ready to come back, so he's being recalled from his rehab assignment and the 15-Day to serve as LeCroy's backup until Schneider is ready to return (though whether it'll be starter/backup or a platoon is yet to be seen). When Schneids does return, it'll be interesting to see what happens. Will Fick stay with the big league club to act as an emergency catcher? If so, who goes down? Some of the talk is that Church might be getting an undeserved return trip to New Orleans. But that's not really injury news.

This will be Schneider's first career trip to the DL.

Friday, May 12, 2006

NIH: Playing catch

John Patterson reportedly had a pain free round of catch today, which is great. Of course, this marks the beginning of a return process that will take three weeks in the best case, but that's fine, considering the alternative would be more setbacks, and a return closer to the fourth of July than Memorial Day.

And how healthy is too healthy? Tom Boswell floated an interesting chunk of interview in his chat today. He talked to Livan Hernandez, who had surgery to repair a bum knee that was giving him problems all of last season. It's actually possible that that LACK of injury is what's giving Livan such a hard time. Last season he had to futz around with his pitching motion to put less pressure on the knee that was bothering him, and it's apparently taking him much longer than he expected to get back into his old motion.

I hope this is the case, because it means there's a potential light at the end of the tunnel for Livan's pitching woes. It could also explain his problems in first innings, as he's needed to settle down into his motion. Of course, it's also entirely possible that he's just in the middle of a massive and horrible slump, dragging the team down with him.

So it's official, folks, it looks like we've got one ace out with an injury, and one ace struggling through being injury free. Don't you just love the Nationals?

NIH: Bullpen Workout

Today was The Day, Mark 2. When Patterson's rehabs start down south in Woodbridge was rescheduled, today was supposed to be the day. However, the last reports I've seen are that Patterson's actually just going to get some bullpen work today, and his actual rehab start is going to be pushed back. Currently his return to the big league club looks like it will happen in a month starting with a 'J'. Looking at the June 2nd game against the Brewers, but there will likely be more news either later today or tomorrow based on whether he feels any soreness today.

Hopefully we'll see him back, and soon.

Wednesday, May 10, 2006

NIH: The good news

Can there possibly be good news in a game where the opening day starter still failed to get his second win, and the team went down in flames right after actually fighting back? Well...a little. Schneider was promised back tonight, and sure enough, he was behind the plate. Not only that, but his bat, which was heating up before his injury, stayed sizzling, as he pounded out two hits in four at bats, and even managed to come around and score.

Nice to have him back.

NIH: Tendinitis

From wikipedia:

Tendonitis (also tenonitis or tendinitis) is an inflammation of a tendon. For example, patellar tendonitis (jumper's knee) is an inflammation of the patellar tendon, which connects the tibia to the patella.

Chronic overuse of tendons leads to microscopic tears within the collagen matrix, which gradually weakens the tissue. Swelling in a region of microdamage or partial tear can be detected visually or by palpation. Increased water content and disorganised collagen matrix in tendon lesions may be detected by ultrasonography or magnetic resonance imaging.

Due to their highly specialised ultrastructure and slow collagen turnover, tendons and ligaments are very slow to heal if injured, and rarely regain their original strength. Partial tears heal by the rapid production of disorganised type-III collagen, which is inferior in strength to normal tendon. Recurrence of injury in the damaged region of tendon is common.

Ahh, nice to be able to get a free three paragraphs with a block quote like that. So, why am I starting out with a description of tendinitis? Quite simple: it's a word that Nationals fans might have to get used to hearing for awhile. For example, the press release about Guzman yesterday reveals that to be John Patterson's diagnosis, and it's been reported in the WaPost that Majewski might have a touch of it as well. However, in Majewski's case, it looks to be more minor, and he did see some time on the mound in last night's victory over the Reds.

Patterson? Well...this morning Barry Svrulga is reporting in his Nationals Notebook that the May 18th return date might get pushed back two more weeks, with a new date of June 1 being eyed. That's an off day for the Nationals, though, who then head to Milwaukee the next day. The article isn't clear as to whether the 6/1 target would be for a rehab start, or to rejoin the big league club. Keep tuned for more updates on JPat, and to see which National gets tendinitis next.

Tuesday, May 09, 2006

NIH: Tada!

Press release time from the Nationals concerning Guzman's surgery. Apparently it has been categorized a success, and he'll be starting rehab very soon, and the prognosis is excellent that he'll be back and ready to whiff at fastballs by Spring Training '07.

Same release also says that JP has gotten and "injection" which I've seen elsewhere described as a cortozone shot to the elbow that's giving him trouble. Right now his rehab start with the P-Nats is still scheduled for this Saturday, but I'm not going to go buying tickets tonight in hopes of seeing it.

NIH: Knife day for Guzman, Schneider back today?

Guzman's surgery, pushed back from yesterday, will be occurring today, officially ending his season. Everything that I'm reading says there's little worry that the recovery time will be long enough to keep him away from Spring Training this year, but it does mean that, barring a trade or a call up, we're looking at Clayton as the Nationals day-to-day short stop for the foreseeable future.

All hopes are that Schneider was given Sunday's game off to give him a little extra time, especially since Monday was an off game. Tonight the Nationals are taking the field agaisnt the Reds, and I've seen nothing that says that LeCroy is going to be behind the plate, which is great news. The last thing we need to do is stumble into a situation where we discover just how shallow our catching depth is.

Sunday, May 07, 2006

NIH: No news on Schneider

In today's win against the Pirates, LeCroy was behind the plate for the entire game. Which means two things: First that LeCroy was apparently not in any way seriously injured by the backswing he took to the shoulder yesterday, and the Schneider was given the day off. Whether that's to let him recover, or because his injury is actually being evalutated, I cannot find. Hopefully it is the former, and he'll be back in action sooner, rather than later. I will pass along any real news when I can get my hands on it, and I'm hoping such news will come by seeing his name in the Monday lineup card.

Saturday, May 06, 2006

NIH: Schneider day-to-day, bad pitching news

Brian Schneider was pinch hit for his third at bat during tonight's game against the Pirates. The initial indication from the broadcasters has him day-to-day with a tweaked hammy, I'll get the Nats press release up as soon as its released.

This put Matt LeCroy behind the plate tonight, where he took a bat to the shoulder during the top of the tenth inning. He was able to stay in the game, but it immediately raised the question of who would catch if the injury had forced him to the bench for the rest of the night. I don't know if that almost-disaster situation will change anything about how quickly the Nats pull the trigger on bringing an extra catch up should Schneider have to spend some time out of the lineup.

Now, that's the bad news. The worse news is that the Nationals pitching health is not going to be improving anytime soon. Both Drese and Patterson are being reported as having set backs this week. Serious suck there. Drese was found to still have inflammation of the elbow, though no structural damage, and the club is still reluctant to set a time table to when he'll be back in a Nationals uniform for a game.

Patterson's rehab start with the Potomac Nationals has also been pushed back after he experienced some pain in a bullpen session. He was hoped to start this coming Monday, but has been pushed back to at least the 13th, which means the earliest he'd be on the mound for the Nationals will either the closer at Chicago or the opener of the Orioles series.

This means the Nats continue to have three of their anticipated starters sitting on the DL. Just wonderful, eh?

Friday, May 05, 2006

NIH: Guz Gone

NIH is going to be a new occasional feature of this blog. It started with a joke on the Yuda chat that a blog needed to be started about the health of the Nats, but no one thought there'd be enough news. looks like there will be. I'll try to keep up with injuries, research and explain some of them as best I can. All in the name of the Nationals Institute of Health.

It's starting today because there's been a press release: Guzman is going to be lost for the season. There had been a lot of hopes that he'd be able to work out his SLAP tear and start a rehab assignment with the Zephyrs just as soon as they were playing in plenty of warm weather cities. Yeah, I guess the injury was cold sensitive. He's been spending time at extended Spring Training before coming up for a consultation with the Nationals medical staff.

Well, what many people thought would be inevitable has, indeed, happened. Much of the amateur medical talk when the SLAP tear happened was that surgery was inevitable. In fact, there were some fans who wanted the surgery to happen sooner rather than later. Though how much of that was a response to his 2005 numbers, it's hard to say.

So. Would Guzman have a better 2006 than 2005? Hard not to. But now we're never going to find out. Hopefully he'll be completely better for the 2007 season, and ready to put up career average numbers.