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fickle finger cont'd

quoting derrick goold’s article in this morning’s post-dispatch:

Wainwright met Monday with team doctor George Paletta and also saw a hand specialist. An MRI was taken of his right middle finger. The exam, the team's release said, revealed "a sprain to the finger." At the team's request, Wainwright referred any specific medical questions back to Cardinals officials.

note the information that’s missing. the article doesn’t say definitively, "the mri revealed no ligament or tendon tears" --- and goold can’t find out whether or not that’s true, because club officials aren’t talking and the medical team (per club policy) is unavailable to talk to the press. makes you wonder. wainwright did tell the post, "surgery is not looking like something that is going to be needed" --- but it’s hard to place full stock in that statement, because it’s exactly what we heard initially when mulder hit the dl in 2006 and carpenter hit it last year. in both of those cases, the club knew from the outset that surgery might be needed, but the possibility was soft-pedaled while other, less intrusive treatments were attempted. when the injuries persisted, surgery was performed as a last resort.

you don’t have to be a conspiracy theorist to suspect that the same pattern might be unfolding here. from a medical perspective, there’s nothing at all sinister about it --- every person i’ve talked to who has any degree of medical experience (and i know a bunch of those people) tells me, "you don’t cut on a guy until you’ve exhausted the other options." pretty straightforward --- but the club has a secretive streak about injuries (you don’t suppose the sunglasses-wearing manager has anything to do with that, do you?) and, consequently, a credibility gap. attempting to fill that gap, i have consulted per about finger sprains:

Definition: Violent overstretching of one or more ligaments that hold the finger joints together. . . . . There are 3 types of sprains
  • Mild (Grade I)--Tearing of some ligament fibers. There is no loss of function.
  • Moderate (Grade II)--Rupture of a portion of the ligament, resulting in some loss of function.
  • Severe (Grade III)--Complete rupture of the ligament or complete separation of ligament from bone. There is total loss of function. A severe sprain requires surgical repair.

wainwright’s injury would seem to fall into the "moderate" category, at a minimum; he clearly has some loss of function. and we can’t rule out "severe," ie total loss of function. back to MD Advice:

The signs and symptoms of a Finger Sprain include:
  • Severe pain at the time of injury.
  • A feeling of popping or tearing inside a finger or fingers.
  • Tenderness at the injury site.
  • Swelling in the finger.
  • Bruising that appears soon after injury.

wainwright spoke of a popping sensation, but has reported no severe pain or tenderness; he specifically says there is no swelling. prognosis:

If this is a first-time injury, proper care and sufficient healing time before resuming activity should prevent permanent disability. Ligaments have a poor blood supply, and torn ligaments require as much healing time as fractures. Average healing times are:
  • Mild sprains--2 to 6 weeks.
  • Moderate sprains--6 to 8 weeks.
  • Severe sprains--8 to 10 weeks

those are average healing times; the cardinals no doubt are hoping wainwright (a professional athlete under close medical scrutiny) will heal much faster. but even if he were to heal in half the time, we’d be looking at a month-long disablement --- plus a couple of rehab starts after that to get his arm back into shape. and there’s always the chance that, like the carpenter and mulder injuries, wainwright’s finger won’t respond favorably to rest/rehab, necessitating a trip to the operating room.

from everything we can piece together, i’m gonna guess that if wainwright pitches again for the cardinals before late july, we probably should consider ourselves very fortunate. medical experts, speak up --- agree? disagree?

let’s just go with that for a moment; say he’s out for 6 weeks. it'll probably be longer, but just go w/ it. heading into the year, it was generally assumed that for the cardinals to make the playoffs, they’d have to keep themselves within striking distance until carpenter returned on or about august 1, and then try to make a late-season run once he rejoined the rotation. as of this morning, they lead the wild-card race by 2.5 games over florida and 4 over milwaukee, with houston and atlanta 5.5 back and the mets 6.5 games out. thanks to that cushion, they can afford to lose some ground in the standings to most of those teams over the next 50 games --- and let’s just prepare ourselves for that, because it very well might happen --- yet still be competitive when (we hope) one or both of carp / wainwright returns. ie, they can give back 10 games to the mets without getting hopelessly buried; they can give back 8 or 9 to the braves and still have a chance to catch up. if they lose big chunks of ground to all those teams and find themselves 5th or 6th in the wild-card race by the time carp / wainwright return, then forget it; they’re probably toast. but even if wainwright’s absent for the next 50 games, they have a reasonable chance to stay within 4 or 5 games of the wild-card lead until the rotation gets healthy. given their current bulge in the standings, that doesn’t seem to be asking the impossible.

and if wainwright needs surgery? definitely a possibility; i’ll worry about that if / when it happens. for the time being, i’m neither optimistic nor pessimistic about the cards’ playoff hopes. adjusting expectations? you betcha. but my expectations have been pretty modest all along. i’m looking forward to seeing boggs tonight; the rest will come in due time.

* * * * * * *

mgl published some UZR data, and it’s pretty consistent with john dewan’s plus/minus figures. both systems have adam kennedy as one of the top 2b glovemen in the league; both place troy glaus among the league leaders at 3b, though well behind scott rolen (who, by the way, hasn’t homered in over a month; he’s stuck on 2 for the year). and both defy the perception that chris duncan is a terrible defender in left field. bernie addressed this in a blog post not long ago, sifting through the fielding metrics to argue that duncan’s glovework is at least adequate. UZR reinforces that argument, ranking duncan as the second-best left fielder in the national league, trailing only paul mcanulty of the padres. i think it’s gotta be a sample-size blip, but it’d be difficult to argue that duncan has cost the cardinals a large number of runs w/ the glove this year --- at least so far. too much evidence to the contrary.

the other interesting note in the UZR data: edmonds rates as the worst centerfielder in baseball, and eckstein is the 2nd-worst shortstop. plus/minus doesn’t rate them quite that poorly, but they’re both about 6 plays worse than the guys who replaced them (ankiel and izturis). if you want two reasons for the improved performance of the st louis pitching staff, start with the defensive upgrades at cf and ss.