101 replies to this topic

[trekfan55]

Seems Crawford had his elbow checked out in Boston, again.

Then returned to Florida.

Call me crazy, but 2 trips to Boston already for elbow soreness seems bit suspect. Bears watching, for sure. So much for May 1 projections.

Edes

[SoxScout]

I don't understand the media here... they all seem to be wetting their pants over this... but a few days ago they all told us this return trip was happening.

[trekfan55]

What I still don't get is why hasn't he started a rehab stint.

[SoxScout]

What I still don't get is why hasn't he started a rehab stint.

Because they told him not to throw. So he has been hitting, and doing well, in the XST games. It sounded like this was a planned trip to get clearance to throw and move on to Salem or wherever.

[trekfan55]

Well, there's more to it than a routine test.

In a potentially ominous development, Carl Crawford has decided to get a 2nd opinion on his sore left elbow. #RedSoxTalk

Sean Mcadam

Others have it too.

[Yazdog8]

Multiple twitter accounts (Cafardo, McAdam) have reported that CC is now going for a 2nd opinion on his elbow. I would say that doesn't sound too promising on the rehab front.

Edit:Trek beat me to it.

Edited by Yazdog8, 24 April 2012 - 11:24 PM.

[NDame616]

FYI, he isn't just getting ANY second opinion....

Sean McAdam ‏@Sean_McAdam

Carl Crawford, still experiencing soreness in left elbow, will visit Dr. James Andrews soon. Exact date not known. #RedSoxTalk

[Buzzkill Pauley]

Carl Crawford, still experiencing soreness in left elbow, will visit Dr. James Andrews soon. Exact date not known.

Well, that's certainly not good news.

[yecul]

Phew, no need to worry about the outfield roster crunch anymore! Guess there's a reason they acquired Byrd.

Done for the year.

[Carl Everetts Therapist]

Any utterance of the phrase "Tommy John surgery?"

[Ed Hillel]

How the hell did we get from a wrist injury/surgery to what looks like an inspection for Tommy John? Am I missing something?

[Hyde Park Factor]

How the hell did we get from a wrist injury/surgery to what looks like an inspection for Tommy John? Am I missing something?

Probably just a little subterfuge on the part of the Sox and Crawford so they wouldn't get bent over if / when they needed to make a move for an outfielder. At least I hope it's that and not that their medical people had no real idea how serious it was.

[StuckOnYouk]

If you were to think of a worst case scenario with the Crawford contract/performance, this would pretty much be it, right?

[Steve Dillard]

Hopefully Theo thought ahead enough to put a roll-over clause, so that this gets us another year of Crawford on the back-end.

[Buzzkill Pauley]

If you were to think of a worst case scenario with the Crawford contract/performance, this would pretty much be it, right?

Yep. If he's really lost till next season due to TJS, and he's not just going to see Dr. Andrews for peace of mind.

Most of us thought it was an overpay, but this signing is looking as bad or worse than Zito, Wells, and Hampton.

[glennhoffmania]

Yep. If he's really lost till next season due to TJS, and he's not just going to see Dr. Andrews for peace of mind.

Most of us thought it was an overpay, but this signing is looking as bad or worse than Zito, Wells, and Hampton.

If he has TJ surgery in May he may not even be back until the middle of next season. It could be over $50m in wasted money, assuming one counts 2011 as a complete waste of money.

[Bowlerman9]

If he has TJ surgery in May he may not even be back until the middle of next season. It could be over $50m in wasted money, assuming one counts 2011 as a complete waste of money.

Hitters have a much quicker recovery time than pitchers. Tony Womack had the surgery in October 2003 and was back for opening day 2004. If Crawford has the surgery now, he should be 100% by next spring. Not like he ever threw a ball 90 MPH before the surgery.

[Buzzkill Pauley]

If he has TJ surgery in May he may not even be back until the middle of next season. It could be over $50m in wasted money, assuming one counts 2011 as a complete waste of money.

Nah, he's not a pitcher, so he wouldn't have to gain as much command -- 10 months or less is the norm for position players these days.

Aviles was back at the start of May '10 after having TJS the previous July. If Crawford were to get surgery before about May 15, I'd think opening day would be a perfectly reasonable return date.

Though it would still be ~$34MM wasted on 0.0 WAR over two years, accounting for his backloaded contract. Probably still not as bad as the Howard extension, but really close.

[Al Zarilla]

Because they told him not to throw. So he has been hitting, and doing well, in the XST games. It sounded like this was a planned trip to get clearance to throw and move on to Salem or wherever.

So what's the problem, let him DH, Papi at first and bench Gonzo.

[glennhoffmania]

Hitters have a much quicker recovery time than pitchers. Tony Womack had the surgery in October 2003 and was back for opening day 2004. If Crawford has the surgery now, he should be 100% by next spring. Not like he ever threw a ball 90 MPH before the surgery.

Nah, he's not a pitcher, so he wouldn't have to gain as much command -- 10 months or less is the norm for position players these days.

Aviles was back at the start of May '10 after having TJS the previous July. If Crawford were to get surgery before about May 15, I'd think opening day would be a perfectly reasonable return date.

Though it would still be ~$34MM wasted on 0.0 WAR over two years, accounting for his backloaded contract. Probably still not as bad as the Howard extension, but really close.

Right, brain cramp on my part. Carry on.

[sachilles]

The injury that Tommy John corrects, is it the type that gets progressively worse if left untreated? If Lackey was able to pitch, albeit poorly while injured, could we expect Crawford to play through it(getting surgery in the off season if needed). Or would it make sense to tackle Tommy John while the wrist still isn't 100%, allowing it more time to heal as well?

[Bowlerman9]

The injury that Tommy John corrects, is it the type that gets progressively worse if left untreated? If Lackey was able to pitch, albeit poorly while injured, could we expect Crawford to play through it(getting surgery in the off season if needed). Or would it make sense to tackle Tommy John while the wrist still isn't 100%, allowing it more time to heal as well?

If Option A is to have him play through 2012 while hurt and then miss a part of 2013 and Option B is to have the surgery now and hopefully be 100% in 2013, why would anyone take Option A?

[sachilles]

If Option A is to have him play through 2012 while hurt and then miss a part of 2013 and Option B is to have the surgery now and hopefully be 100% in 2013, why would anyone take Option A?

Assuming less than 100% performance, it's still going to be around 100+ available games of service, where the alternative is one of the group Byrd, McDonald, Ross or Sweeney. While you'd lose him for games in early 2013, it still nets out to more games in service.

[Judge Mental13]

[Plympton91]

Assuming less than 100% performance, it's still going to be around 100+ available games of service, where the alternative is one of the group Byrd, McDonald, Ross or Sweeney. While you'd lose him for games in early 2013, it still nets out to more games in service.

Yeah, I'm thinking, even if he can't throw, Crawford in leftfield against righthanded pitching with a defensive replacement in the late innings is better than McDonald or Byrd out there. It's not like his arm was an asset anyway; and in Fenway's left field having the cutoff man go 15 further out isn't really much of a burden. I suppose there'd be more wall-ball doubles than we're used to. They can quantify that and make a decision.

Other reasons to prefer option A: As someone else said, there's precedent for a position player to have the surgery in October and be back by opening day. Also, they'd know that they need a quality starting leftfielder for April-June 2013, whereas right now they don't have one.

However, Is there a precedent for an outfielder playing the majority of the season while needing Tommy John surgery?

[Savin Hillbilly]

Assuming less than 100% performance, it's still going to be around 100+ available games of service, where the alternative is one of the group Byrd, McDonald, Ross or Sweeney. While you'd lose him for games in early 2013, it still nets out to more games in service.

Aren't you forgetting this guy?



Granted, he won't be back till at least June, and we don't know what we'll be getting from him then, but he could certainly be an important part of the mix in the second half.

Assuming that Ellsbury will be back by early June, and Kalish by July, we'd be looking at the following if Crawford is shut down:

Now-early June:

starting OF: Ross/Byrd/Sweeney
bench: McDonald/Anderson

June:

starting OF: Ross/Ellsbury/Sweeney
bench: McDonald/Byrd

2nd half:

starting OF: Ross/Ellsbury/Sweeney
bench: Kalish/Byrd or McDonald

It's not exactly Rice/Lynn/Evans, but it's a decent outfield with better-than-decent depth.

If you want to ask Crawford to play through the pain until Ellsbury is back, I guess that's OK. But I'm not sure what we gain by that, really. Is 75% of Crawford really that much better than 100% of Marlon Byrd?

[luckysox]

I'm not sure that Carl Crawford and his agents would necessarily want to play while needing TJS.

[Smiling Joe Hesketh]

I'm not sure that Carl Crawford and his agents would necessarily want to play while needing TJS.

He's already got the big contract. Not sure if they'd care about that as much as they would if this was a contract year.

[Dogman2]

Assuming that Ellsbury will be back by early June, and Kalish by July,

A lot of people have been assuming that CC would be back around May 1. I think this thread is more than enough evidence to stop assuming when players will return.

[sachilles]

Ellsbury is not forgotten. He isn't likely to move over to Left field(nor is Crawford going to Center).

Additional concern is losing a full year of service and how that might timing in regards to hitting. Though you can also argue that hitting while injured could create bad habits if the body is compensating for the injury.

[Gene Conleys Plane Ticket]

Considering that we've got Crawford for 5 more years after this one and preumably we want those years to be useful, I wonder if missing his a season might not be the best thing for everyone at this point. I'm thinking that last season, his slump did not appear the direct result of injury but if bad habits -- a bad psychological pattern if you will. He also showed a very low level of ability to "snap out" of his bad patterns. Perhaps taking a whole year off during which he's thinking mainly about simply getting back to full health and not about hitting might actually break that pattern for him -- clean his psychological slate, so to speak. Then when he's healthy he comes back in 2013 able to go back to the form that got him the massive contract in the first place.

Pop psychology, I guess, but maybe there's something to it.

[Savin Hillbilly]

A lot of people have been assuming that CC would be back around May 1. I think this thread is more than enough evidence to stop assuming when players will return.

I was using "assuming" in the "positing what looks like the most probable outcome for the sake of argument" sense, not in the "take this to the bank" sense. Of course we don't know for certain when any injured player will come back. Nor do we know for certain that players who are healthy won't get injured tomorrow. We can't "assume", in your sense, that any given player will be available even for tonight's game. But we still can make projections based on what seem like relatively likely outcomes.

[OnWisc]

Whew. It's probably only likely that there's potentially a major issue.

Cherington says "likely" Crawford to see Dr James Andrews. Elbow "improving but still sore"

http://twitter.com/#...176629503406080

After putting together a modest win streak last night, I figured we were due for some bad news. My money was on a Byrd-Padilla altercation, but I guess Crawford setback fits that bill.

Edited by OnWisc, 25 April 2012 - 10:57 AM.

[glennhoffmania]

If TJ was a possibility, wouldn't something have shown up on an MRI by now? Improving but still sore doesn't seem like a reason to consider TJ unless something in the test suggested it might be the problem.

[sachilles]

"Assume" Tommy John surgery is required. If playing at a reduced level is acceptable to Crawford, why not let him play at least a little, knowing you can still shut him down in enough time to have the surgery and be ready for 2013?

[tims4wins]

So each of Theo's last 2 major FA signings may end up with TJ surgery and missing entire seasons... awesome.

[TomRicardo]

Uploaded with ImageShack.us

[Stitch01]

At least his legs will be fresh for 2014.

[wade boggs chicken dinner]

After putting together a modest win streak last night, I figured we were due for some bad news. My money was on a Byrd-Padilla altercation, but I guess Crawford setback fits that bill.

My how things have changed. Three months ago, if you had posted on this board that CC would be out for the year with surgery, people would have had a parade.

[Rasputin]

Do you think Dr. Andrews knows we'd rather our players see Dr. Kevorkian than him?

[reggiecleveland]

Signing him was a bad idea based on his on base skills and likley poor performance as he aged. These injuries just add bad luck to a bad desision.

[Carl Everetts Therapist]

AS much as I've been reading around the different papers/sites it seems like this isn't going to require TJ surgery. What it sounds like is that a test/MRI showed no structural damage , but Crawford was saying it was still very sore. I think he feels that with the amount of soreness that's occuring there has to be something going on in the elbow and feels he needs a second opinion on the test results. I think the Org. is going along with this for the sake of caution. I can't remember anyone ever going to see Andrews and coming back with positive results , but let's hope that this is typical soreness caused by some kind of compensation during workouts rehabbing the wrist.

It's possibly minor, but with this team/player's luck it's a blown out elbow.

Edited by Carl Everetts Therapist, 25 April 2012 - 11:45 AM.

[wutang112878]

If TJ was a possibility, wouldn't something have shown up on an MRI by now? Improving but still sore doesn't seem like a reason to consider TJ unless something in the test suggested it might be the problem.

Maybe, lets compare to the Lackey situation. The RedSox obviously saw something that indicated that he might need it in the future, most likely because the MRI showed some ligament issues. Unless the ligament is torn I believe its difficult to look at an MRI and say its fine or its 'going to pop', because if that was the case they probably would have stopped Lackey from pitching much earlier than they did.

To put this in perspective I will never forget this quote from Andrews "If you want an excuse to operate on a pitcher’s throwing shoulder, just get an MRI", and I think this article helps to put the diagnostic value of MRIs in perspective:

Dr. James Andrews, a widely known sports medicine orthopedist in Gulf Breeze, Fla., wanted to test his suspicion that M.R.I.’s, the scans given to almost every injured athlete or casual exerciser, might be a bit misleading. So he scanned the shoulders of 31 perfectly healthy professional baseball pitchers.

The pitchers were not injured and had no pain. But the M.R.I.’s found abnormal shoulder cartilage in 90 percent of them and abnormal rotator cuff tendons in 87 percent.

M.R.I.’s can be invaluable in certain situations — finding serious problems like tumors or helping distinguish between competing diagnoses that fit a patient’s history and symptoms. They also can make money for doctors who own their own machines. And they can please sports medicine patients, who often expect a scan.
But scans are easily misinterpreted and can result in misdiagnoses leading to unnecessary or even harmful treatments.
......
“An M.R.I. is unlike any other imaging tool we use,” Dr. Sangeorzan said. “It is a very sensitive tool, but it is not very specific. That’s the problem.” And scans almost always find something abnormal, although most abnormalities are of no consequence.

[opes]

2 years of worthlessness.

[Carl Everetts Therapist]

Maybe, lets compare to the Lackey situation. The RedSox obviously saw something that indicated that he might need it in the future, most likely because the MRI showed some ligament issues. Unless the ligament is torn I believe its difficult to look at an MRI and say its fine or its 'going to pop', because if that was the case they probably would have stopped Lackey from pitching much earlier than they did.

To put this in perspective I will never forget this quote from Andrews "If you want an excuse to operate on a pitcher’s throwing shoulder, just get an MRI", and I think this article helps to put the diagnostic value of MRIs in perspective:

But MRI's on non-pitcher's might be more accurate, pitcher's usually have ungodly looking scans from both the elbow and the shoulder, because of incredible amounts of overuse, built up scar tissue etc.

On a non-pitcher who has a lot less wear and tear it would be more benefitial especially in showing a player if they are experiencing pain because of normal inflamation/strain or structural damage. In otherwords it's as useful for what it doesn't show as much as for what it shows. Re-assuring a player that they have a clean bill of health might be very important in this case.

[Smiling Joe Hesketh]

Hey fellas, enough with the wasted of space one liners. We just killed off a couple of threads that had devolved into chat-room talk, let's avoid that here.

[Harry Hooper]

I think the Org. is going along with this for the sake of caution. I can't remember anyone ever going to see Andrews and coming back with positive results , but let's hope that this is typical soreness caused by some kind of compensation during workouts rehabbing the wrist.

It's possibly minor, but with this team/player's luck it's a blown out elbow.

Beckett did just that a couple of years ago?

[Plympton91]

But MRI's on non-pitcher's might be more accurate, pitcher's usually have ungodly looking scans from both the elbow and the shoulder, because of incredible amounts of overuse, built up scar tissue etc.

It almost suggests that pitchers should have a "baseline" scan every so often, even if they're healthy. Say, after their rookie year, and then the year before you plan to give them a big free agent contract. If you could compare an MRI given when the pitcher has pain to the MRI given when they were not experiencing pain, wouldn't that improve the diagnostics? Plus, you're only talking about doing this for a couple pitchers each year; the cost can't be that prohibitive for a major league club.

[radsoxfan]

To partially address the MRI discussion....

For diagnosing UCL tears in the elbow, according to one study, plain MRI sensitivity is 57% and specificity is 100%, while MR arthrography is 92% sensitive and 100% specific. So its pretty good (especially with dye), but not perfect. At the same time, I think much of the data is close to 10 years old, if not more. There are better magnets and imaging techniques now, especially at high powered academic places.

The shoulder is an entirely different topic, and I actually tend to agree more monitoring or baseline imaging should be done for pitchers (maybe this happens and I just don't know about it?). Clearly it's not cost effective for non-professional athletes. But it probably would help with treatment decisions for MLB pitchers. In a vacuum, unless blatantly abnormal, some of these MRIs are very difficult to interpret. There is also probably a place for MRI in injury prevention or workload modification as well (as an adjunct to the strength type testing I think teams currently do), but as far as I know that has not been fully studied or utilized.

Edited by radsoxfan, 25 April 2012 - 01:43 PM.

[drtooth]

From Rob Bradford

https://twitter.com/#!/bradfo/status/195221544933396480

Valentine on @WEEI re second opinion for Crawford - just wants to know what the story is with elbow when he starts to throw