Saturday, February 9, 2013

Spring storylines: Returning from injury

USA Today Sports Images
Danny Espinosa will attempt to play with a torn left rotator cuff.
With the countdown to spring training in its final stages, we're counting down the five biggest storylines facing the Nationals in Viera. We continue today with spring storyline No. 3: The lingering injury issue for several key players...

Injuries are part of baseball, and no team is going to navigate its way through an entire season without seeing at least a couple important players land on the disabled list. But you always prefer to have your entire roster report for spring training with no major health questions, and unfortunately the Nationals can't quite say that.

Three key lineup regulars are returning from injuries suffered last season -- Danny Espinosa, Wilson Ramos and Ryan Zimmerman -- and all three must prove they have fully healed and will be able to proceed without any lingering problems.

Espinosa is the biggest concern of the three. He hurt his left shoulder late last season, was told by team orthopedist Wiemi Douoguih he had sustained only a bone bruise (not a tear) and received a cortisone shot to relieve the pain. The 25-year-old second baseman struggled mightily down the stretch, though, hitting .157 (14-for-89) with 34 strikeouts after initially hurting himself Sept. 7 diving for a ball.

A follow-up exam with Southern California orthopedist Lewis Yocum revealed the injury to be far more serious than initially suspected: Espinosa had a torn rotator cuff.

Perhaps the bigger surprise was the consensus decision not to have Espinosa undergo surgery to repair the tear but instead build up the muscles around the damaged cuff and play through the injury. Surgery, even had it been performed in November, would have sidelined Espinosa through at least the season's first two months. Not wanting to miss that much time, and recognizing the injury wouldn't affect him in the field because it's to his non-throwing shoulder, Espinosa expressed confidence two weeks ago he'll be good to go in 2013.

"As long as I just keep up with my maintenance on my other muscles around the shoulder, I should be fine," he insisted.

But it would be foolish to just assume Espinosa will be fine, and the Nationals will monitor him closely, understanding the injury may be too much to play through. The organization does rest easier knowing it has a more-than-capable backup second baseman in Steve Lombardozzi, though team officials also have been hopeful a healthy Espinosa could enjoy a breakthrough season at the plate much like shortstop Ian Desmond experienced a year ago.

Ramos' injury -- a torn ACL and MCL in his right knee -- did require surgery, but the catcher has had nine months to recover, and the Nationals are optimistic he'll be cleared for full participation when camp opens next week.

Ramos worked hard throughout the summer, fall and winter to rehab the knee, and general manager Mike Rizzo (upon seeing his young catcher a couple weeks ago) was encouraged by his progress.

That said, the Nationals will take things slowly with Ramos, letting him ease his way back over the course of the spring. He'll not only need to prove he's 100 percent healthy again but also that he is back in top baseball shape.

The club doesn't feel the need to rush Ramos because of the presence of Kurt Suzuki (who stepped up late last season) behind the plate, not to mention plenty of depth at the position in the form of Jhonatan Solano, Sandy Leon and just-signed veteran Chris Snyder.

Zimmerman's return from minor right shoulder surgery seems to be the least of the Nationals' worries right now. The star third baseman dealt with an AC joint sprain most of the season, receiving several cortisone shots that allowed him to remain on the field and produce MVP-caliber numbers after the All-Star break, before having the shoulder cleaned up in late-October.

Recovery time from that procedure was tabbed at six weeks, so Zimmerman is fully rehabbed and ready to join the rest of his teammates for the start of spring training. But the Nationals will also watch him closely, especially in the field, where he had to alter his throwing motion because of the pain.

The Nationals believe most of Zimmerman's throwing woes last season were a direct result of the injury. But until he proves he can throw in a more conventional manner and hit his target with more regularity, there will be some lingering questions.


Don said...

Dr. D might not be the go-to person on shoulders.

NCNatsie said...

Interesting that Mark throws "team orthopedist Wiemi Douoguih" under the bus by name. Not something I think he would do unless he had a reason.

Speculation aside, if the surgery had been done in September, the referenced six-month recovery would make him good to go by the start of the regular season.

And what would the Nats lost during the stretch drive last fall? A guy who hit .157 (14-for-89) with 34 strikeouts.

original Nats Fan said...

I'm most concerned about Espi's shoulder. I'm afraid I foresee surgery sooner, rather than later. Wilson won't be rushed and I hope he can get back to what he was. We'll just have to wait and see. [not easy for NI folks] We should get a read on Zim's shoulder and throwing issues early in ST. I hope he's fully recovered, because he's a joy to watch play 3B.

Faraz Shaikh said...

I still hold the same view that he should got it treated as soon as they had found out. Worst case scenario, Lombo will be manning 2B regularly for a while. That should make some Insiders happy I suppose.

original Nats Fan said...

NCN, Mark may feel that Espi should have had the enhanced MRI early and not have waited for Dr. Yokum to do it.

Doc said...

Concerning Espi, still think that missing the 1st two months with an operation in November past would have been the way to go.

Now if this so-called 'rehabbing of muscles around the RC' doesn't work, or he reinjures it diving for a ball, then he is out for the season.

The good news is that the Nats had 4 starters miss significant time playing and still won 98 games!

rogieshan said...

While I admire Espinosa's toughness to play through pain, I fear this is one story arc that is not likely to have a happy ending. Even if his defense won't suffer because of this injury, his offense will. As a fan, it will be difficult not to speculate his condition or second-guess his judgment each time he goes through a hitting slump.

Anthony Zammichieli said...

the best thing that could happen for this team is Espi not getting surgery now he will get hurt and u they will be able to play the best 2nd baseman on the team LOMBO. Espi strikes out far to often and its now been a year and a half since he hit with any kind of purpose where lombo might not be flashy but a switch hitter who makes contact and does all the little things is better then a guy that looks great on the highlight real 40 times a year and terrible the rest of the season

Sec. 3, My Sofa said...

Gee, if Danny had only had that shoulder done, the Nats might have finished in first place. and the pitching staff might not have blown a six-run lead, at home.

sjm308 said...

I am obviously not a professional ball player and never played one on TV or stayed in a Holiday Inn Express, but I wonder about the sentence in this article, that this injury will not affect him in the field because its his non-throwing shoulder?? How many times have we seen Espinosa lay out for a grounder in the hole or up the middle? Are you telling me this will not affect an injured shoulder? I have my doubts on that. Also, I can't remember but I am guessing like most current players he slides head first. Are you telling me that putting his shoulder in jeopardy on each slide isn't a concern? And while it is a rare play, what about the collision at the plate. His shoulder is in play much more then just swinging a bat. I am joining others here in wishing he had the operation. I also wonder how much faith the players will now have in our good doctor?

Go Nats!!

Tony said...

The rotator cuff is already torn through, so it can't tear any more. It's his non-throwing shoulder and apparently doesn't affect his swing. The only issue will be pain, and just like with Zimmerman that may be manageable with a shot or two of cortisone. Putting off the surgery is a gamble worth taking.

sjm308 said...

Sec 3 - of course we had a great season but you have to look at what he did during that last month and it was pretty dismal. No one on this post so far has blamed Danny for that game 5 loss but this is a whole new season and he is starting out with what I feel are major health concerns. This can't be fixed with cortisone shots. If it tears, he is lost from that time until the next season. It is just not how I would have liked to have seen it played out. Hoping he will prove me wrong.

Tony said...

It's already torn completely through. That was determined from the enhanced MRI. Once something tears completely through, it can't tear any more. So the only risk is that another muscle or tendon might tear because he's compensating for the loss of the one that's completely torn through. If it was his throwing shoulder, that would be a possibility. But it's not.

sjm308 said...

Tony: again, I am not a doctor but if this was a complete tear of the rotator cuff (any one of those 4 tendons) I don't think he would have been given an option. I might be wrong but I am thinking its a partial tear. You are correct that the cortisone will mask the pain but it will not help the healing process. If he gets through this he is one tough cookie.

sjm308 said...

Silly to argue about this but, I have had 100s of swimmers with rotator cuff injuries. The two that had full tears were operated on, the others used probably the same exercises Espinosa is using to build up muscles strength around the shoulder. Again, totally different type of situation. Swimmers abuse their shoulders thousands of times each practice in a repetitive manner that is basically unnatural. Danny will have single bursts in using his shoulder. If he has completly torn all 4 tendons and is still playing I salute him.

ExposFanSince69 said...

I just had rotator cuff surgery last September - I have played baseball for close to 35 years (now its softball for an old geezer of 53 y) and ice hockey on a regular basis and can relate entirely with Espinosa's injury.

1. You simply cannot throw, which fortunately will not be an issue in Espinosa's case.
2. If he does not re-injure it, yes I think by building up the muscles around the shoulder he should be ok. I was able to swing a bat no problem before surgery, and that was with a biceps tear as well.
3. Espinosa will have NO range to his left. If he dives for a ball, he will re-injure it. Whether it is completely torn or partially torn, it will cause, at a minimum, swelling and inflammation. sjm308 is 100% correct here.

I think its crazy not having the surgery and am very surprised at the decision on the part of the Nats medical staff. Mine was repaired by one of the top orthopedists in the country and I am sure she would concur 100%. The 'fixability' rate for a NON-Throwing shoulder is close to 100% if you are not throwing a ball.

Sec. 3, My Sofa said...

Speaking of surgery, the videos and countdown clock (TWO DAYS!!!) finally got me to force-feed Flash Player to my android phone. So if you're having similar issues with a droid not playing Flash content, it's because they stopped supporting that plugin, but you can hack it in. FYI.

Unknown said...

I am worried about the upcoming season. Not that the Nationals won't do well (anything above 90 wins is a successful season)but rather regardless of how good they may be, nothing is as good as that first good season.

Of all those wonderful Redskins' seasons, the best remains for me 1971, when George Allen took over for Bill Austin (following Vince Lombardi's death) and won 9 games and got the team into the playoffs. I still have an SI cover from the (I think) second or third game of the year showing Larry Brown running against the Giants with the title, "The Redskins are for real!"

Going from a perennial loser to a winner. Wow.

In 1969, the moribund Senators hired Ted Williams and went 86-76, finishing just one game out of the upper division of their league (a big thing back then).

Dick Bosman came out of nowhere to go 14-5 and Mike Epstein hit 30 homers and had an OBP that would have made Nick Johnson proud.

Eddie Brinkman went from embarrassment to a .266 hitter and though it didn't last, it was a wonderful year.

Maryland basketball was terrible before "Lefty" Driesell came to town from Davidson. With guys named "Sparky" and "H" and "Bodell," he made the Terps competitive until his vaunted freshman class was ready (back then frosh couldn't play on the varisty), led by Tom McMillian and Len Elmore they went undefeated and finished #1 in the Nation, ahead of UCLA's Bill Walton team.

That team matured as sophomores and went 27-5 and won the NIT, a big deal back then as only 32 teams were in the NCAA tournament and the two championships were considered equal by many.

Though the Terps won 20 or more games seven years in a row after that, it was that first year that really was special (having my high school classmate Jim O'Brien from JEB Stuart certainly made it more special).

And of course, the 2012 Nationals fit perfectly with these other teams. Terrible teams who fairly quickly became good teams, some of them championship caliber.

I have no doubt the Nats will do well in 2013. How well could they do? I think if they remain healthy, this is a very possible:

CF-Denard Span: .292-8-58, 25 steals
LF-Bryce Harper: .300-30-87, 25 steals
3B-Ryan Zimmerman: .290-28-105
1B-Adam LaRoche: .265-26-100
RF-Jayson Werth: .275-20-80
SS-Ian Desmond: .288-26-80, 24 steals
2B-Danny Espinosa: .250-23-68, 23 steals
C-Suzuki/Ramos; .265-20-57


Strasburg: 19-4, 2.33
Gonzalez: 17-8, 3.20
Zimmermann: 16-10, 3.03
Dan Harren: 13-8, 3.33
Ross Detwiler: 12-10, 3.23

Back end of bullpen:

7th--Clippard: 7-3, 2.82
8th--Storen: 6-4, 2.44, 10 saves
9th--Soriano: 5,3, 2.10, 37 saves

That's a 103 win team, maybe more. And they could go to the World Series.

But last season, at least for me, will be far more special, because it was unexpected.

Good luck Nationals.

Farid @ Idaho

SCNatsFan said...

I was under the impression the rotator cuff had a tear but was not completely torn; this came up in a thread about a month ago and no one really had a link to how large the tear is, so if someone does please post it.

TimDz said...

Maybe it is the case that management feels Rendon can be plugged in at second base if Espinosa ends up needing surgery before the season ends...

realdealnats said...

Would love to see everything you list but Espi's SBs. I fear for his shoulder with him stealing. Like RGIII running taking a hit to gain 3 yards: not worth it.

Tony said...

As Espinosa himself said to Mark Zuckerman, "As of now, it's almost completely torn. So it's not that it can be affected any more. It's already gone, basically. So with me rehabbing, I do feel strong." One would have to assume that Espinosa did not come to this diagnosis on his own, so it must have come from Dr. Weimi "Doogie" Howser MD, or some other doctor. One would also have to assume that those guys know what they're talking about, or they wouldn't have an MD after their names.

JayB said...

This is one of the second of two issues that I have been waiting for Mark to address. Gio and PED was the first. Danny and Nats broken Medical/Management philosophy is what I had hoped Mark would address here.

Dr. D for years has been misdiagnosing injuries. For years the Nats failed to do extensive testing of these types of injuries. It really is well documented how players have been missed diagnosed and how players lied about injuries and hurt their team, but who cares when you have Acta and 100 loses.

Well now it is time to care. Nats need to clean house. All new Medical and training staff is long over due.

Now is also the time to change the Davey "my guys always play not matter what" approach. If you are batting like .080 with 80% K rate you Management needs to pull you.

What I really would like is if players could put team ahead of self in October but if like Danny they can't then Davey must.

SCNatsFan said...

Thanks Tony I had not seen that

Teddy Rochlis said...

i don't know about the rest of you but i want this team to win 108 or more, because we will be the first franchise to win at least 10 more games then the previous seasons for 4 seasons in a row

JayB said...

Dr. Weimi "Doogie" Howser MD, or some other doctor. One would also have to assume that those guys know what they're talking about, or they wouldn't have an MD after their names.

Too much data out there to assume MD after their names mean anything. Dr Doogie and the Nats have botched more cases than they got right. Second and third opinions often contradict Nats Medical findings. Time to get better doctors doing better work the first time. Cost is too high with a team ready to win.

NatsLady said...

Gio is going to pitch in the WBC.

MicheleS said...

Bright side of GIO in WBC. Do you really think that Bud or Joe Torre would have GIO in WBC IF they were about to suspend him?

Gonat said...

sjm308 said...
MicheleS - you are the best! thanks for the headsup on promotions. Just went through it and we have 13 promotions on our 20 game package including two bobbleheads and two concerts. Can't complain but it looks like I miss out on the $5 beer & peanut dates.

I 2nd that! We have some awesome people here.

NatsLady said...

Maybe Rizzo and Gio struck a bargain w/ MLB. I know my interest in the WBC just went WAY UP.

Gonat said...

MicheleS said...
Bright side of GIO in WBC. Do you really think that Bud or Joe Torre would have GIO in WBC IF they were about to suspend him?

February 09, 2013 3:38 PM

I think after the NYT article they all exhaled. So did Keith Law as he was very happy he stuck to his journalistic integrity and didn't disclose the big name as I think many were suspect of even Braun's name, Peralta and Valencia which is why the Miami New Times didn't put their names in there.

The whole thing just stinks.

Section 222 said...

Not surprisingly, I associate myself completely with JayB on this topic. No need to repeat my rants about the failures of the Nats medical staff, or argue with Tony/Feel, again. I doubt Espi makes it to the All Star break before ending up on the DL.

Then again, I didn't think ALR could come back from his shoulder injury either. So I can't even play an MD on TV, or in a Holiday Inn Express commericial. :-)

NatsLady said...

Have to feel his offense was either minor or unprovable if he will be representing.

NatsLady said...

LaRoche and Soriano get a suite on the road--it's in their contract.

Gonat said...

Sect222, in 2007 Ryan Zimmerman had a SLAP tear and Espi has been lucky enough to have enough time to rest it to let it heal and rehab it. Its a common injury and he should be fine.

The problem I have is why it wasn't disclosed in Sept 2012 and why he was even playing in the playoffs.

MicheleS said...

SJM.. are you on the Teddy Plan Still?

Gonat said...

NatsLady said...
LaRoche and Soriano get a suite on the road--it's in their contract.

February 09, 2013 3:51 PM

I remember in the Kevin Costner movie For Love The Game he got these huge suites. I thought it used to be the Manager and GM only got suites.

The price the teams pay for "extras" is just incredible. No wonder staff people get paid so little.

Mark Lerner was just talking about the hit the Nats took being removed from the revenue sharing and how they have had to find alternative revenue sources. Clearly the team needs to get this MASN SNAFU resolved.

MicheleS said...

As far as Espi goes.. Lombo can be a replacement if needed, I expect that Mr Rendon will be taking grounders at 2b during practice at AA (kind of like Machado was doing at 3b). And if Davey thinks Espi is hurting the team, then boom, he will be on the DL (or Rizzo will do it for him).

MicheleS said...

MLB NETWORK ALERT! Australian Baseball is on!!!

Ghost Of Steve M. said...

Michele/Gonat, I suffered the SLAP tear before their were MRIs. I was given Tylenol and a Cortisone shot.

Zim never had another problem with a minor shoulder tear since his original SLAP. It really is as simple as power training to build up the deltoid muscles and that keeps the shoulder healthy after that injury.

Its that awkward fall where you extend your arm to break the fall that causes that tear.

As for your 2nd and 3rd options for Espi (Lombo/Rendon), I fear that's more if the April/May/June 2012 Espi returns.

Tony said...

"NatsLady said...
LaRoche and Soriano get a suite on the road--it's in their contract."

Wow. First Clippard and Storen get married. Now this. Doesn't LaRoche already have a wife? Is this Fritz Peterson and Mike Kekich all over again?

sjm308 said...

MicheleS - yes (see you at Justins!)

Tony - thanks for digging that up and while I would rather have a Doctor's report than a quote from the athlete, I read it several times looking for the words "complete tear" and did not find them. Athlete is saying its "almost completely torn" Is that 50%/60% he has no clue. My point is, it was not completely torn.

I am also on the team (jayB,222) that highly questions our medical staff at this time. Whether its a full tear or partial he was still misdiagnosed!! There is a huge difference between a bone bruise and a torn tendon (or muscle). These are athletes worth millions of dollars and you can't be making errors like this.

My guess is we all hold our breath every time Danny dives for a ball or steals a base (unless I am wrong and he goes in feet first).

Tony said...

Yeah, maybe the Nats should fire Dr. Weimi "Doogie" Howser MD and get that guy in the hat with the fuzzy ball on top who saved RG3.

NatsLady said...

Well they are sharing the suite with about 3 guys on other teams who have the same deal, so the logistics are gonna be interesting. ;)

Tcostant said...

Gio is headed to WBC. Stay clean:-)

sjm308 said...

Natslady: Suites are not uncommon at all. Lots of players have them in their deals. Cal often stayed in a separate hotel from the team. Of course what Tony is alluding to just might be cutting edge.

Tcostant said...

Espi reminds me a lot of LaRoche 2 years ago, mistake to play though?

Section 222 said...

Again, I don't even play a doctor on TV, but it's worth pointing out so the confusion doesn't gain a life of its own that a SLAP tear is not the same injury as a torn rotator cuff. Obviously, the severity of every injury varies, and surgery is not necessary in every case. But just as obviously, just because one player has recovered from one injury without surgery doesn't mean another player can recover from a different injury without surgery.

All I know is that I wouldn't want to rely on the advice of Doogie Howser or any other doctor on what to do about my injury if he had misdiagnosed it initially.

I certainly hope for the best with Espi. But the chances of him having a Desi-like breakout season this year sure seem slim.

Jim Webster said...

I am a skeptic on Espinosa situation. I had a torn rotator cuff some years back and it took several weeks of therapy and a cortisone shot to get where I could easily put on a jacket without discomfort.

sm13 said...

I'm just plain worried about Danny. It's gonna be like a ticking time bomb -- one hard dive on the shoulder or one hard swing-and-a-miss and he's going to go under the knife and be lost for the season.

And, now, I'm worried about GIO gettin hurt in the WBC. Although, MicheleS raised my spirits with her theory that letting him on the team means a suspension is not in his immediate future. That makes a lot of sense. Thanks MicheleS!

MicheleS said...

new post

NatsJim said...

I'm taking the optimistic approach to Danny's injury - maybe it will force him to shorten his stroke and he'll strike out less... too much to hope?

peric said...

Espinosa's injury is definitely a concern. Same deal with LaRoche in 2011 in the non-throwing shoulder. He couldn't swing for power and wasn't hitting.

So, Espinosa may not make into the lineup and might find his way to the surgeon's in southern Cal before they get too far into the season.

JamesFan said...

I'm comfortable with Lombo at 2d.

Section 222 said...

ALR had a different injury, and his injury was in his throwing shoulder. But yes, Espi's injury is a big concern.

Rabbit34 said...

I hope they will all be well soon. But it always seems in sports, the "least of the worries" turns out to be the "most of the worries". Without Espi or Ramos, we should be fine. Without Zim, we should get along ok.

JSLSais said...

Espi is a far better def player than Lomba, so unless Lomba improves his fielding, Espi will be missed defensively. Offensively, Lomba has proven to be a better hitter--more patient and doesn't try to be something he is not (power hitter). In a good season, I don't see Espi hitting above .260--consistently. Espi, even when healthy, tends to be a very streaky hitter. If Espi goes down and Lomba slumps at the bat, we have a problem. Best case scenario: Espi stays healthy and we hide him maybe at 8th or 9th and 9th might be an option cuz the other pitchers (exlcuding Det) can probably hit better--certainly Strasburg can. Other option is to give Lomba a lot of playing time in ST cuz even though some of Espi's def skills are innate, I do think that Lomba can improve his fielding.

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