Tuesday, February 15, 2011

Reason for concern over Baker's setback?


As I mentioned yesterday, Scott Baker reportedly experienced some setbacks in his rehabilitation after his offseason elbow “clean-up”. While on with Sid Hartman and Mike Max this past Sunday, Ron Gardenhire included that nugget in his diatribe regarding why he doesn’t believe the Twins are looking to trade Francisco Liriano. To me, this seemed like a fairly noteworthy news tidbit yet nothing was covered in the press on Monday.

Thankfully, MLB.com’s Kelly Thesier provided an update on the extent of Baker’s situation by mid-afternoon:
“The right-hander said that it was right after TwinsFest, which took place Jan. 28-30, when he realized that perhaps he was going a little too fast with his preparation for Spring Training. Baker stressed that what he felt in his elbow after throwing a couple bullpen sessions was nothing like what he felt last season, when he needed two cortisone shots in the second half to continue to pitch. He was assured by the trainers and doctors that the discomfort he was feeling is not uncommon following surgery and Baker said he's not concerned about his elbow heading into the start of camp.
Any sort of discomfort is disconcerting – for pitchers going through rehab, no news is good news. Likewise, this close to spring training it is strikingly reminiscent of the plight of Joe Nathan in 2010.

After the 2009 season, Nathan opted to have surgery to remove bone chips in his elbow.  This past season, after some nagging injuries with his elbow, Baker decided to have surgery to remove bone spurs. Essentially, bone spurs are simply bone chips that have not fully broken off from the source yet. As I discuss last March when news regarding Nathan’s need for Tommy John broke, bone chips/bone spurs are sometimes generated by a loose UCL (the ligament that snaps and requires the TJ) and an early indicator that something is not sound within the elbow structure.  

In both cases, Twins GM Bill Smith regarded both surgeries as “clean-up”. Nathan’s, of course, parlayed into something much more significant than a simple “clean-up”.

In his rehabilitation process in the next spring, Nathan began to have issues that were initially written off a common for someone going through the same process. Following an incident in the first week of March in which he said he was experiencing pain and was being sent back to the Twin Cities for a closer inspection, Nathan relayed this to the media:
"They said with this type of operation, you're going to have days where it's not going to feel great. There's going to be tightness in there, achiness in there, and it may be scary.”  
That’s basically the exact same thing Baker was told, only in different words.

Aside from Nathan, numerous other pitchers who have had bone spurs removed often run into the dreaded Tommy John or some other UCL repair shortly thereafter:


And the list goes on.

In my opinion, Baker may be the key to having a successful year out of the rotation. With Liriano scheduled to be the number one guy and Carl Pavano as the innings-eating complement, Baker’s got the necessary skill set to be a number two starter. In the past three seasons, his high strikeout-low walk rates have led to an outstanding 3.39 K/BB (11th-best among active pitchers). His downfall had been his high flyball tendencies (45.6% fly ball%, third-highest in that time) which resulted in plenty of home runs (71 to be exact since the beginning of ’08). Fortunately, the Twins have built a ballpark that plays to his strengths (minus the outfield personnel to cover the ground, but still…) and Baker performed admirably there – posting a 3.86 ERA in the local confines.

Blessed with above average stuff, we can see how the influences of these types of lingering injuries can affect his pitching, so if he’s healthy, Baker is plenty capable of being a 15-game winner on the staff (provided the prerequisite defense and run-support). Now, it seems to be a wait-and-see game with Baker. Hopefully, the decision to ease up on the throttle will prevent any major damage to his elbow and winding up following the same path as Joe Nathan did. 

5 comments:

jbiowa said...

I share your concern over Baker and appreciate the list of pitchers in similar situations who ended up having TJ. My question would be, are there others who had bone spurs/chips removed who came back without needing additional surgery?

There must be or I can't imagine why the Twins (or any team) would downplay the seriousness of having the chips/spurs removed. Or is it just that all is well unless they start to experience "discomfort" and that is the indicator of a bigger problem?

Twins Fan c.1981 said...

My question would be, are there others who had bone spurs/chips removed who came back without needing additional surgery?

I've been trying to compile a list of pitchers who have had bone chips/spurs removed from there elbow without any added problems, and truthfully, I'm not finding a lot. Bone chips are somewhat common, no doubt. Johan Santana pitched through bone spurs in 2004 and had great success but those spurs came calling at the end of 2009 and required more surgery to remove them. The Nationals' reliever Craig Stammen had bone spurs removed in 2009 and managed to pitch 123 innings as a swing man in 2010.

There must be or I can't imagine why the Twins (or any team) would downplay the seriousness of having the chips/spurs removed. Or is it just that all is well unless they start to experience "discomfort" and that is the indicator of a bigger problem?

I think that is the larger issue. In comparison to Blackburn, Baker seemed to have much more complications related to his elbow in 2010 - requiring the cortisone shot as well. While it's possible that this flare up is indeed minor, it does makes me wonder if there isn't more issues forthcoming with his UCL - especially in light of his other elbow related problems.

OB said...

I think you're on to something here Parker. Bone spurs don't grow for no reason and pitching is hell on an arm. Time will tell how this play out, of course, but I'm happy Gibson is lookin' ready to contribute.

Twins said...

Time will tell how this play out

La Velle just reported that Baker threw a bullpen session with "no apparent problems". That is a positive sign. Still, we'll see what happens when he really begins to uncork and throwing more pitches as the games start next month.

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