Edinson Volquez Goes Under the Knife
A huge blow was hit to the Reds this week as Edinson Volquez underwent Tommy John surgery today and it was reported that his UCL ligament was “almost completely torn”. Given the timing of the surgery, Volquez should be able to return in some form next season, but beyond just the immediate return, it is not unusual for pitchers to need more time to fully regain their velocity and command to pre-injury levels. Thus, Volquez’s ability to meaningfully contribute to the 2010 Reds season is in serious doubt now.
Volquez was a four win pitcher last season, but struggled mightily with his command this season. Whereas he had previously hung around 48 to 49% of his pitches inside the strike zone, this year that fell to just 41%, a massive drop and a level not conducive to any kind of sustained success. That was the primary culprit behind Volquez’s increase in walk rate, to nearly six per nine.
If Volquez is able to return to the command he displayed in 2007 he could come back to being a big piece of the Reds’ playoff hopes, but that is not going to happen in 2010. How does the Scott Rolen trade look now to the front office?
The diagnosis and surgery came about two months after Volquez was placed on the disabled list with soreness in his elbow. He was cleared to throw twice and had even made it through bullpen sessions to the point of a simulated game before being shut down for good. Given the reported extent of the tear, one has to wonder if an MRI done initially in June would not have revealed the tear in a more minor state and saved the Reds at least a couple months of rehab time, if not many more.
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Two words: Bill Bavasi
DUSTY! DUSTY! DUSTY! DUSTY!
Saw this news already elsewhere, and most people have been using the meme:
“Dusty Baker strikes again”
And while I’m no fan of Baker and his “management style”, is it soley due to Baker and the pitch counts he let Volquez accumulate, or did that just exacerbate an already existing problem?
I only ask because he’s not the first pitcher to come out of the Rangers’ system who’s required Tommy John surgery(or some other major form of arm surgery.)
Hard to know if it’s solely because of Baker, but it’s hard to deny the trend. Cueto’s pitching like he’s hurt, too.
Do we know that an MRI wasn’t done in June?
It’s my understanding that an MRI can’t determine whether there was a tear. They didn’t know he was going to need TJ surgery until they actually went in there today. Do you seriously think the organization didn’t consider these things?
It is my understanding that they certainly can.
“MRI is invaluable in these patients, as it allows differentiation of the many causes of elbow pain in the young thrower. Treatment options and the post-treatment assessment are often guided by the MRI findings in these patients.”
http://www.radsource.us/clinic/0505
“On T1W MRIs, findings include increased signal intensity suggesting heterotopic bone formation near the medial epicondyle, epicondylar avulsion, formation of traction osteophytes or subchondral cysts, or sclerosis in capitellum due to lateral injury. On T2W images, findings include increased signal intensity in the anterior band of the MCL, hyperintensity or hypertrophy of the ulnar insertion site (called a sublime tubercle) with or without a full-thickness tear and retraction.”
http://emedicine.medscape.com/article/401161-overview
“Following a thorough examination and assessment of patient history and manner in which the injury occurred, an imaging scan is performed.”
http://www.davidhildrethmd.com/sports_med_injcnd.html
Not the elbow, but should still apply: “An MRI scan can clearly show a posterior cruciate ligament tear and determine if other knee ligaments or cartilage also are injured.”
http://www.mayoclinic.com/health/posterior-cruciate-ligament/DS00928/DSECTION=tests-and-diagnosis
And so on.
I am not saying a MRI will catch a tear 100% of the time. I am not a medical professional. But the available literature out there suggests that a MRI can be extremely useful and to rope in Rich’s question above, I assume that if an MRI was done, it would have been reported as they almost always are.
It wouldn’t surprise me if the Reds were too cheap to pay for the MRI before they felt it was absolutely necessary.
Except there were reports in June that they did do an MRI.
http://www.redreporter.com/2009/6/25/924743/red-reposter-6-25-09
And still, they didn’t know whether it was going to be Tommy John surgery until they actually did the procedure.
Well, I missed that. It was not listed among the news archive on Rotoworld and the article is no longer active at Cincinnati.com so I cannot verify.
And that in no way contradicts my contradiction of your characterization of an MRI’s ability to reveal tears in elbow ligaments.
Well, they did an MRI and did not detect a tear, only inflammation. They didn’t know the extent of the problem until they went in there. My understanding about MRIs and tears may not have been 100% right, but it wasn’t 100% wrong in that they aren’t completely foolproof, at the very least.
But you wrote this…
“Given the reported extent of the tear, one has to wonder if an MRI done initially in June would not have revealed the tear in a more minor state and saved the Reds at least a couple months of rehab time, if not many more.”
…and the answer is pretty clearly a “no.”
This is somehow Dave Cameron’s fault.
Another one bites the Dusty.
I imagine the Rolen trade looks just as good to the Reds FO now as it did before Kremcheck got to work.
Dusty is always fun to blame, but Volquez had violent mechanics that were likely to cause problems even he’d had Bobby Cox pushing the buttons.
Yep. Thats why the Rangers changed thembut he went back to them when he went to the Reds.
I heard the Padres released Mark Prior… the Reds just might pick him up and let Dusty finish him off…
That hasn’t happened already?
Prior’s going to need an arm brace by age 35 so that he won’t tear his shoulder muscles from swinging his arm.
Yeah probably. I also heard that the line-drive that hit Matt Clement’s face was an ordered hit by Baker, because Clement escaped Chicago with his arm still in tact.
I doubt Volquez will return next season, for two reasons. The first is that 12 months is actually a pretty ambitious time table for a starter to return after TJ surgery. Think of Liriano as a model here: he went out in July of 2006 and didn’t return until 2008.
Actually TJ guys are almost all coming back in less than 12 months. It looks like Marcum, Westbrook, and Wagner will all be back in that time frame like Josh Johnson was last year. However, Volquez also had a ruptured flexor mass that makes the injury worse than just the UCL tear.
The tear was caught in an MRI early but, like Santana, it was thought that rest and rehab would allow the small tear to mend, and then during a rehab outing the little tear turned into a complete tear. The same thing could still happen to Santana at any time, which makes him a very risky pitcher.
Volquez is probably done until 2011.
Since I’m sure we’re all FJM reader alums, here’s Joe Morgan’s chat from today.
Boy is it a doozy:
http://espn.go.com/sportsnation/chat/_/id/27684
Ha. I knew this would happen. Suckers.
“If Volquez is able to return to the command he displayed in 2007 he could come back to being a big piece of the Reds’ playoff hopes…”
Don’t you mean 2008?
I’m reading the ripplings that the Rangers are going to get blamed for this one? Does that mean we get to blame Cincy for Hamilton’s IR stints and surgery too?