Mets keep getting hurt; surgery updates

A number of players went under the knife during this past week, with most of them hoping to return next season. We mentioned Chien-Ming Wang (shoulder) and Kevin Slowey (wrist) last week. Slowey had a bone chip removed, and his rehab is expected to take anywhere from two to four months, giving him plenty of time to be ready for spring training. Wang's future is less certain, both in terms of timetable and location. His surgeon, Dr. James Andrews, indicated that following surgery (reportedly to address a tear in the shoulder capsule, the fibrous tissue that surrounds the joint), Wang might require a year before he can return to pitching in the majors, according to the Journal News. Whether he will return as a Yankee remains to be seen.

This week, we add Cincinnati Reds pitcher Edinson Volquez, who struggled with back spasms earlier in the season before developing numbness in his throwing hand. It turns out the numbness was foreboding of what was to come. Back in June, when the numbness in Volquez's fourth and fifth fingers first appeared, we discussed that these ulnar nerve symptoms can be reflective of instability at the elbow, associated with ulnar collateral ligament problems. Volquez rehabbed to the point of a simulated game but then had to abort the effort because of elbow pain. The next step was indeed ulnar collateral ligament reconstruction (Tommy John surgery), along with a repair of the flexor tendon. Volquez likely won't return until late next season. This serves as a good reminder that imaging studies are not perfect, since Volquez underwent two MRIs during his injury stint, neither of which showed the tears. In fact, according to the Reds' Web site, the decision as to what specifically would be required in surgery was not made until the team's medical director, Dr. Tim Kremchek, actually looked inside the elbow.

And then there's Arizona Diamondbacks ace Brandon Webb. Webb, who made an abbreviated Opening Day appearance and then was never seen on the mound again, underwent what the team termed "minor" shoulder surgery this week. According to the Diamondbacks' Web site, Webb underwent a debridement, or clean-up procedure, of the shoulder. As Webb put it, the findings in surgery were "just normal wear and tear you get from pitching. It was as good as could be expected." He is expected to begin the rehab process later this week and plans to stay in Arizona in the offseason to continue his therapy. Webb is correct in pointing out that all the strengthening he has done for his shoulder so far can only help him with his overall recovery. For those in keeper leagues, take note: Webb has no major structural damage and did about as much "prehab" as one can do. That should bode very well for his 2010 season.

Ah, but where to begin as we tour the league looking at those players hoping to return in 2009? We start with the team that has the dubious honor of most player appearances in this column.

The New York Mets: That's right. I'm just listing the whole team now. And why not? Sadly for the Mets, the list of injured players (and injured players who have suffered setbacks) continues to grow. One of the latest Mets to succumb to the injury bug is second baseman Luis Castillo. Here's how you know things really aren't going your team's way: Your middle infielder sprains his ankle -- not while rounding the bases, nor when an opponent slides into him as he tries to turn a double play, but while stumbling down the dugout steps. Castillo might not have huge fantasy impact, but another injury sends a ripple through an already-struggling team, further limiting its available options.

It got even worse Wednesday, when starting pitcher Jonathon Niese left the game in the second inning with a hamstring injury suffered while fielding his position. And Gary Sheffield (who was just activated from the disabled list Sunday) also was pulled from the game in the sixth inning with an injury.

In last week's blog, I expressed some skepticism (despite manager Jerry Manuel's optimism) about shortstop Jose Reyes' impending return: "It's understandable that the Mets want to see the glass half-full, but fantasy owners need to see the Mets' glass as balancing on a very unstable surface, one that could tip over and spill at any minute."

It appears that glass indeed might have come crashing down, as the New York Daily News reported Tuesday that Reyes returned to New York to be examined by team doctors "because of continued discomfort with his right leg." Although the outcome of that visit is not known, it doesn't take great medical insight to appreciate that this is not a good thing. Throughout this process, Reyes has never progressed to the point of being able to run the bases. His fantasy owners can't say they weren't warned, at least in this column, as Reyes has had trouble with soft tissue injuries healing slowly in the past. There's at least a possibility that he will not return this season, and even if he does, it's difficult to imagine him regaining full speed.

On the positive side, the New York Daily News reports that Carlos Delgado continues to progress, but in a truly one-day-at-a-time fashion. He pretty well summed it up by saying, "I'm going to be ready when I'm ready. If by mid-August I'm not OK, it's going to be longer." Actually, the significance here is that Delgado appears to be quite aware of the importance of not pressing to return from hip surgery too quickly, despite the fact that his team is hemorrhaging players. Delgado, who has started hitting outdoors, still has to work up to running full speed straight ahead, then base running, sliding, aggressive defensive drills and, ultimately, rehab games. Although mid-August remains possible, later in the month sounds more reasonable (insert here: assuming no further setbacks).

Meanwhile, teammate Carlos Beltran is a tougher read. Beltran, who has been out since June 22 with a bone bruise, is doing more "stuff," but still has pain, something that continues to raise flags in terms of his overall recovery picture. While Delgado was hitting balls to the outfield earlier this week, Beltran was working on his defensive outfield skills. On the one hand, Beltran seemed pleased with the result, telling the Daily News, "Today was a good day for me, honestly ... because I was able to go out and move around and that gave me confidence to continue to improve and to do a little bit more every single day." On the other hand, Beltran acknowledged that he still felt pain, although the frequency and intensity were less than what he has experienced in the past, which led him to believe he is making progress.

While Beltran's determination to return is admirable and any signs of progress are encouraging, it is worth noting that the Mets' Web site noted he still had an observable limp as recently as this past Saturday. A recent MRI confirmed the bone bruise is still present, and as the New York Post reported last week, doctors advised Beltran to continue resting, but he wanted to try to increase his activity anyway. He desperately wants to return and help his team. Fantasy owners need to be cautious here because this is a very unpredictable situation that could change daily. Even if Beltran returns (which he is hoping will happen mid-month), his condition is not likely to have healed, and we know what happened the last time he tried to play through it. It will be important to see how his knee responds as he tries to increase his running work this week.

Roy Oswalt, P, Astros: Last week, the team was calling Oswalt's injury a left-side low back strain, but we discussed the concern related to his history of disc problems. So far, his treatment and symptoms have all the sounds of a disc-related problem. Add to it the fact that this is taking (not unexpectedly) a little longer than a minor muscle strain should to heal. In fact, Oswalt confirmed to the Houston Chronicle that the disc is the source of the trouble. "I got a bad disk. It's herniated. It's sticking out and it's pressing on a nerve going around to my side. And my hip and leg tends to go to sleep some time," he said. Hmm ... sounds just like what we were surmising last week.

Oswalt received an injection to help with inflammation in the area and appears to be making progress, albeit more slowly than the team initially hoped. A DL stint has not been ruled out, but he remains hopeful that he will be able to start Saturday. According to an AP report, Oswalt's recent checkup went well and he is scheduled to throw a bullpen session Wednesday. How the bullpen goes will go a long way in determining whether Oswalt is ready to go this weekend. Bear in mind that his first effort at throwing off the mound Monday did not go as well as his flat ground sessions, so this will be a big test.

On the Mend

Seattle Mariners pitcher Erik Bedard is throwing bullpen sessions, but it does not appear he will be ready to return to the rotation when eligible Monday. The never-easy-to-read Bedard said simply, "I felt OK," after his Tuesday session, according to the Tacoma (Wash.) News-Tribune. Given Bedard's history and slow progress, this remains a sketchy situation.

Chicago Cubs catcher Geovany Soto is expected to return to the lineup Friday in Colorado, according to the Chicago Sun-Times. He has not played since early July after originally being diagnosed with a mild oblique strain that looked as if it might keep him down for only a week or so.

Houston Astros first baseman Lance Berkman, recovering from a strained calf, is eligible to come off the DL on Friday, but it doesn't appear that he will. He tried some light running Monday and paid the price Tuesday. The Astros' Web site reported that Berkman's lingering soreness led manager Cecil Cooper to hint at a delayed return from the DL. One of the clues as to the degree of recovery of a muscle strain is whether there is any lingering soreness not only during or immediately after the activity, but a day later. A legitimate concern for the Astros would be if Berkman returns too quickly; he could end up tearing the calf muscle and miss the remainder of the season. It is worth keeping a close eye on this situation, as it could change fairly quickly.

• Newest Chicago White Sox right-hander Jake Peavy, formerly of the San Diego Padres, raised a lot of eyebrows when he was dealt while still on the DL. Peavy, who continues to work his way back from a partial tear of the posterior tibialis tendon (which courses through the leg and attaches to the foot), is hopeful that he will be able to contribute later this season, but his real value is expected to be realized in 2010 and beyond. Many people have expressed surprise that a team would be willing to deal for an injured player, but while there is naturally some risk involved, it isn't all that surprising, given the nature of Peavy's injury and where he is in his rehab program.

Specifically, Peavy's injury is of lesser concern going forward since it was not to his throwing arm. A big question after any significant arm injury that requires extended downtime for a pitcher, whether it's surgical or non-surgical, is just how well the pitcher's delivery will return to pre-injury form. Will he have the velocity, command and consistency that got him to the majors in the first place? An injury to any other body part is assumed to have less of an impact, since the arm is not directly affected and a thrower can continue to work the arm to some degree.

We have seen, though, that any injury can compromise a pitcher's return to form. Exhibit A: Chien-Ming Wang, who struggled in his return from a foot injury and then suffered an arm injury. Peavy insists that his leg is feeling good and he had a pain-free throwing session Sunday in his new town. As the Chicago Sun-Times reports, he thinks it is just a matter of returning full strength to his ankle to react defensively and restoring the endurance to his throwing arm. Peavy still hopes to contribute in September and appears on track to do so as of now.

• Whew. Everyone in Atlanta is breathing a little easier knowing that it was a proximal hamstring (near the top attachment by the pelvis) strain and not a setback to Braves pitcher Tim Hudson's recently reconstructed elbow. Hudson hopes to make a rehab start soon and get back on track for a late-season return.

And finally ...

Phillies pitcher Brett Myers continues his impressive return from hip surgery in June. Myers is scheduled to pitch a simulated game Thursday and has begun light jogging, according to the Philadelphia Inquirer. Although the team insists it is not counting on him, his steady progress has to be encouraging, and there remains the possibility that he could provide some bullpen support in September and October.