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:

• In July 2007, Oriole closer Chris Ray was placed on the 15-day DL with bone spurs. Not long after that, Ray had surgery to remove the spur and Dr James Andrews noticed a minor tear in his UCL and repaired it. The following month with pain still continuing, Ray decided to undergo Tommy John surgery.
• In the same year, Cardinals’ ace, Chris Carpenter encountered arm pain that was sourced to bone spurs in his elbow in April. In May, Carpenter had those spurs removed. Two months later, Carpenter underwent Tommy John.
• In September 2008, reliever David Riske had some bone spurs removed from his elbow. The following April, Riske landed on the 60-day DL and needed Tommy John that June.
• In 2009, it was discovered that JJ Putz had bone spurs and had them removed in June. During his rehab, an MRI revealed further damage to his UCL and necessitated him sitting out the remainder of the season.
• The same year, Rockies reliever Manny Corpas was diagnosed with bone spurs and had them removed in July. In August 2010, Corpas once again hit the DL, this time requiring Tommy John.

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.