ptatc

QUOTE (caulfield12 @ May 21, 2014 -> 10:49 AM) With Putnam, his career record suggests you just have to ride him while he's hot in the 7th and 8th, mostly. There's always going to be that unique situation (Jason Grilli last year, Politte and Cotts in 2005, etc.) where someone just catches fire for almost the entire season, but it's pretty rare, indeed. Petricka's pitched all over the place, from the 5th-9th, same with Webb. But Ventura, after quickly losing faith in Cleto, definitely has been favoring Putnam and Belisario, and for good reason too, statistically. To call Petricka or Webb elite...well, let's just say we have no idea right now exactly what they are...although I'd love to see if they have the ability to close out an elite team on the road in front of 40,000+ screaming fans, we just don't know yet. There are always relievers who catch fire. However, these also occur with diefine roles like politte and cotts did in 2005. They were the set up guys in the 7th and 8th depnding on if lh or rh were comoing up. They knew what was coming. Ventura is settling in to defined roles as you said and it's changing only due to injury.

QUOTE (caulfield12 @ May 21, 2014 -> 10:35 AM) The big thing is mixing enough curveballs at lower velocities to go with his slider/cutter/fastball/sinker combination. Because he has a tendency to throw a lot of pitches at roughly the same speed, he needs to have at least one pitch that makes his usual high 80's stuff (and he did throw a few four seamers at 93) look even faster. Seems he has a tendency to either fall in love with his curve or go away from it completely for stretches. The curve is a feel pitch. There are going to be games and times in games he doesn't have it. Those are his bad outings for exactly the reasons you said.

QUOTE (Buehrle>Wood @ May 21, 2014 -> 09:51 AM) Well agree to disagree then. Maybe one of the worst is too harsh, but hes not one of the best either. Belisario, Putnam, and Petrika are all pitching at an elite level. Webb has the experience in the minors, nice potential, and has been mostly better than Lindstrom this year anyways. I'd rather see any of those guys close. Or get rid of the role all together but we know that's likely not to happen, even if they won't officially name one now. The problem with this is you can say that putnam and petricka are pitching are currently pitching at an elite level. There is no track record for them. Are you going to move them around based on only how they are currently pitching? If they have a couple of bad outings do you move them? Pitchers like routine. They will respond better if they know about what their job is. If you continually switch everything around based on their last or last two outings you will lose the bullpen.

QUOTE (bmags @ May 20, 2014 -> 03:15 PM) this is actually pretty awesome: http://www.vikings.com/stadium/new-stadium/images.html That does look awesome. do you know if the roof retractable or is it a clear plexiglass or similar substance.

QUOTE (witesoxfan @ May 20, 2014 -> 03:09 PM) I was thinking it was outdoors for some reason. It's just exposed slightly to the elements, but it'll be fine otherwise. I thought it was going to be an outdoor stadium as well. Too bad it was alot of fun going to the games at old Met stadium.

QUOTE (Eminor3rd @ May 20, 2014 -> 01:33 PM) Obviously if "he keeps hitting like he has" he'll be great, but the whole point of this was to analyze whether or not it looks like he actually can. Elite hitters with his K and BB rates are rare, the analysis is totally justified. I was commenting on the defensive skill increasing his value not some much the K and BB rates. I consider that part of his "value as a hitter"

QUOTE (HickoryHuskers @ May 20, 2014 -> 01:01 PM) Now official, from Sox FB page: That's a different injury for a pitcher. I've seen it in high jumpers who routinely take off from one plant foot perpendicular to the pit. This is one that may require surgery if the decreased inflammation and coordination cannot hold the tendons behind the lateral malleolus. He must have had a partial tear of the retinaculum on the outside of the ankle. The White sox pitchers have been coming up with some really odd injuries.

QUOTE (Rowand44 @ May 20, 2014 -> 12:01 PM) I see what you're saying but this value DOES increase if he's a better defensive 1b. Yes, his main job here is to hit the baseball out of the park but if he's a better 1b, he's a better baseball player. So if he's a better baseball player, he's more valuable. I don't see the problem in saying that. No there's no problem with it. However, I think it's such a small point and it really wouldn't play a factor, for a trade or signing. I don't think he would command more money or more players in a trade if he were a better defensive first baseman. The points in the article should focus on his hitting with a bare mention of the defense.

I'm sorry but this is another time when analysis is leading to paralysis. When looking at a first baseman especially this one, it hasn't once occurred to me "gee he would be more valuable if his defense was a little better." Of course his value is tied to his hitting. If he keeps hitting like he has he will be worth mentioning in the HOF category like Pujols. If he doesn't he will most likely still be a valuable piece to a team's offense.

QUOTE (caulfield12 @ May 19, 2014 -> 04:49 PM) Hahn and Ventura should be thankful there was no tear. Or Schneider/Thomas. Can you imagine if that were the case? Talk about a promising season deteriorating into ashes in the blink of an eye. They would have known if there was. The medical staff knew already. THe MRI is just a CYA thing because of the contract. Anyone else besides a professional athlete would not have had the MRI with the insurance crackdowns. I know it may be picky but don't put Schneider and Thomas together with injuries. One is trained in evaluation/diagnosis/treatment of musculoskeletal dysfunctions, the other is not. Schneider is part of the medical staff.

QUOTE (RockRaines @ May 19, 2014 -> 03:19 PM) Yes. He had ankle pain prior to signing with the Sox. It appears to be chronic. It makes even more sense why they tried to stretch it out then. He will always battle the problem. I've worked with runners who he battled it for 30 years. It can be managed but there will be times when he will need to rest it. edit; the key will be to not allow the tendon to degenerate to the point where a debridement surgery may be required.

QUOTE (Dick Allen @ May 19, 2014 -> 12:59 PM) The thing is, this isn't probably going away. They actually probably maximized his playing time doing it this way, and he did help win a couple games banged up. If they rested him a few games, every amatuer doctor would have been happy, but while it might have felt a little better and he might not have limped around as severely, maybe comes right back in a couple of games anyway. Assuming the injury is what the Sox say it is and he's out 15 days, I really don't think playing him ultimately made it worse overall. Maybe it caused him more pain, but in terms of numbers of games missed, at worst, it cost them a game or two, but might have got them 5 or 6 or more with him in the line up. It will be interesting to see how this is handled going forward. It has obviously been a problem before he was even here. He's never played more than 89 games in a year. Hopefully they figure out something that keeps it in check. Did he have a problem prior to spring training? If so, then this problems moves into the chronic category and it will be a problem that he needs to manage a little differently. It's one that will never totally go away. The practice of orthotics and activity modification will be a constant throughout his career.

QUOTE (raBBit @ May 19, 2014 -> 10:38 AM) How serious of a recovery process would the surgery require? I only ask because if the recuperation isn't significant, he could get the surgery in say, October, and then be ready for ST. Of course this is dependent on the actual recovery process, which I am not mindful of, but if that could alleviate the stress after this year. At face value, that would seem like the optimal strategy. There are a variety of surgical options depending on the actual problem. All of the options would require at least 3-9 months of rehab. As stated earlier, surgery is only an option for a very few of the problems.

QUOTE (caulfield12 @ May 19, 2014 -> 09:45 AM) It seems there's one thought that weight loss (a bit) could help alleviate some of the problem....and I'm not even sure what "natural gait" means, that there's some predisposition to this problem genetically simply because of the way he walks or runs? Runners get shin splints from too much wear and tear...but this is slightly different. Somehow I never got that despite being a distance runner and soccer player. All I know is that the most painful things I've ever had to deal with personally are plantar fasciitis (see Carlos Quentin, another big dude), a herniated disk, an oblique and kidney stones. Not really. Natural gait in this case refers to the foots natural path of starting in supination (on the outside of the foot) at heel strike, then progressing to pronation (arch lowering and weight on the inside of the foot) and mid stance (body over the foot, then progrssing to supination again before the toes leave the ground. These problems arise when the person's foot either gets to the pronation too quickly or stays too long. If the foot does this naturally, orthotics are used to mitigate this different motion to take the stress off the muscles. I'm sure the process of the last week was an attempt to modify the orthotics to see if it could take away enough of the pain.

QUOTE (Jake @ May 19, 2014 -> 12:43 PM) He acts like that's something new. Yeah, they are going to keep taking a look at it to make sure it's okay. Yeah, when he arrives in Chicago he's going to see the doctors again. Yeah, when the only way to heal the injury is to keep you off your foot, he's going to wear a walking boot. And then the strengthening and orthotics afterwards.

QUOTE (fathom @ May 19, 2014 -> 08:58 AM) Would they be better off shutting him down for the rest of the year instead of risking a possibly more career-impacting injury? Probably not. Tendonopathy is a problem that can be managed and the off season rest is really the thing to help it. It could be a chronic problem but they will be able to tell it by the way he responds to treatment.

QUOTE (southsider2k5 @ May 19, 2014 -> 07:46 AM) Out of curiosity, how much does losing weight alleviate a problem like this? The weight really won't cause the problem. most of the people I see with this a runners without weight issues. It's just that the bigger you are the more weight there is on the arch and this tendon. Weight loss will not be a treatment for this but getting better support in his shoes will.

QUOTE (caulfield12 @ May 19, 2014 -> 12:17 AM) http://espn.go.com/video/clip?id=10951020 Let's see if ptac agrees with ESPN "injury expert" Stephanie Bell whoever that is. I would mostly agree. I think that not only running will bother him but also planting the foot when he swings a bat is also an issue. They tried just DH but it still didn't help enough. I also think that the 15 days won't be enough to fully resolve the problem but it will help to manage it.

QUOTE (jamesdiego @ May 18, 2014 -> 02:43 PM) Way to early to even think of surgery. That should be a last resort. They were stupid to try and play him and rehab at the same time. He would probably be pain free shortly with the proper treatment and rest. Strengthening and stretching program afterwards I imagine. And hope he doesn't re-injure it again This probably something that will bother him all year. That's why they tried it this way. It wouldn't surprise me if he needs the DL again later. The off season is the only thing that wil lreally help.

QUOTE (Quinarvy @ May 18, 2014 -> 09:30 PM) What would you say the "time to jump off the cliff" level is, on a scale of 1-10 so far based off what we know? 3 it's not aserious problem for a non speed guy. It will bother him but it can be managed as long as there is nothing structural involved. By the way they were treating it, I doubt there is anything else going on.

QUOTE (Jake @ May 18, 2014 -> 03:05 PM) Rock, can you explain the thought process behind "planned" DL trip? It would make perfect sense if they anticipated it but were keeping him out there in hopes that it might resolve itself. Simply pre-planning it would have to have some kind of personnel-related reasoning...ie, wanting to wait for Eaton's return or something I'm sure they planned it because they knew he would need to rest eventually. This isn't something that would resolve itself without rest.

QUOTE (caulfield12 @ May 18, 2014 -> 09:33 PM) So likelihood of surgery is probably 5-10% at best? With someone his size, you worry about the wear and tear over time...just like a Frank Thomas or Yao Ming in basketball. That said, rest is the only effective treatment at this point, along with support/orthotics. Pretty much. Frank Thomas was different as he had a fracture of the navicular that they tried to piecetogether with screws. Tendonopathy was theleast of his worries. This isthetendon that Mitchell tore a couple of years ago.

QUOTE (chitownsportsfan @ May 18, 2014 -> 03:30 PM) There was no "pre planned" DL trip. The Sox had no handle on the injury at all. Now Jose needs an MRI. In Rock's world I'm sure they planned the MRI as well, like 2 weeks ago. It's ludicrous. Actually, it does make some sense. This tendonopathy is thetype of problem that they will need to manage like a plantar fasciitis. Hewill need 4 to 6 weeks of rest for it to really heal. They can manage well enough during the season but need some rest. An MRI will do nothing except confirm theinflammation which theyalready know. This tendon is very superficial and can be felt around the ankle.

QUOTE (caulfield12 @ May 18, 2014 -> 01:05 PM) Let's just hope that the DL stint clears things up. Along with Sale TJ surgery, this doesn't look like the greatest injury in the world for someone of Jose's size to be dealing with from a medical perspective. Surgical Treatment Surgery should only be done if the pain does not get better after 6 months of appropriate treatment. The type of surgery depends on where tendonitis is located and how much the tendon is damaged. Surgical reconstruction can be extremely complex. The following is a list of the more commonly used operations. Additional procedures may also be required. Gastrocnemius Recession or Lengthening of the Achilles Tendon This is a surgical lengthening of the calf muscles. It is useful in patients who have limited ability to move the ankle up. This surgery can help prevent flatfoot from returning, but does create some weakness with pushing off and climbing stairs. Complication rates are low but can include nerve damage and weakness. This surgery is typically performed together with other techniques for treating flatfoot. Tenosynovectomy (Cleaning the Tendon) This surgery is used when there is very mild disease, the shape of the foot has not changed, and there is pain and swelling over the tendon. The surgeon will clean away and remove the inflamed tissue (synovium) surrounding the tendon. This can be performed alone or in addition to other procedures. The main risk of this surgery is that the tendon may continue to degenerate and the pain may return. Tendon Transfer Tendon transfer can be done in flexible flatfoot to recreate the function of the damaged posterior tibial tendon. In this procedure, the diseased posterior tibial tendon is removed and replaced with another tendon from the foot, or, if the disease is not too significant in the posterior tibial tendon, the transferred tendon is attached to the preserved (not removed) posterior tibial tendon. One of two possible tendons are commonly used to replace the posterior tibial tendon. One tendon helps the big toe point down and the other one helps the little toes move down. After the transfer, the toes will still be able to move and most patients will not notice a change in how they walk. Although the transferred tendon can substitute for the posterior tibial tendon, the foot still is not normal. Some people may not be able to run or return to competitive sports after surgery. Patients who need tendon transfer surgery are typically not able to participate in many sports activities before surgery because of pain and tendon disease. Osteotomy (Cutting and Shifting Bones) An osteotomy can change the shape of a flexible flatfoot to recreate a more "normal" arch shape. One or two bone cuts may be required, typically of the heel bone (calcaneus). If flatfoot is severe, a bone graft may be needed. The bone graft will lengthen the outside of the foot. Other bones in the middle of the foot also may be involved. They may be cut or fused to help support the arch and prevent the flatfoot from returning. Screws or plates hold the bones in places while they heal. X-ray of a foot as viewed from the side in a patient with a more severe deformity. This patient required fusion of the middle of the foot in addition to a tendon transfer and cut in the heel bone. Fusion Sometimes flatfoot is stiff or there is also arthritis in the back of the foot. In these cases, the foot will not be flexible enough to be treated successfully with bone cuts and tendon transfers. Fusion (arthrodesis) of a joint or joints in the back of the foot is used to realign the foot and make it more "normal" shaped and remove any arthritis. Fusion involves removing any remaining cartilage in the joint. Over time, this lets the body "glue" the joints together so that they become one large bone without a joint, which eliminates joint pain. Screws or plates hold the bones in places while they heal. This x-ray shows a very stiff flatfoot deformity. A fusion of the three joints in the back of the foot is required and can successfully recreate the arch and allow restoration of function. Side-to-side motion is lost after this operation. Patients who typically need this surgery do not have a lot of motion and will see an improvement in the way they walk. The pain they may experience on the outside of the ankle joint will be gone due to permanent realignment of the foot. The up and down motion of the ankle is not greatly affected. With any fusion, the body may fail to "glue" the bones together. This may require another operation. Complications The most common complication is that pain is not completely relieved. Nonunion (failure of the body to "glue" the bones together) can be a complication with both osteotomies and fusions. Wound infection is a possible complication, as well. Surgical Outcome Most patients have good results from surgery. The main factors that determine surgical outcome are the amount of motion possible before surgery and the severity of the flatfoot. The more severe the problem, the longer the recovery time and the less likely a patient will be able to return to sports. In many patients, it may be 12 months before there is any great improvement in pain. Top of page Last reviewed: December 2011 AAOS does not endorse any treatments, procedures, products, or physicians referenced herein. This information is provided as an educational service and is not intended to serve as medical advice. Anyone seeking specific orthopaedic advice or assistance should consult his or her orthopaedic surgeon, or locate one in your area through the AAOS "Find an Orthopaedist" program on this website. http://orthoinfo.aaos.org/topic.cfm?topic=a00166 These are all very rare and for more serious problems than a tendonopathy. It usually comes from a bony deformity of flat foot not just a tendonopathy

QUOTE (KyYlE23 @ May 18, 2014 -> 10:14 AM) The ptatc bat signal has been turned on Surgery is rare for this problem. It is commonly treated with rest and othotics. It is a very tricky problem with a man his size. The posterior tib is connected to the navicular bone. This bone is important because it is the keystone bone for the medial arch. The poterior tib helps to hold upthe arch. Sowhen he puts his foot down and the arch lowers the tendonopathy will hurt. So eachtime he steps the tendon will hurt. For treatment it is rest to decrease the inflammation then orthtics to support the arch to decreasethestresson thetendon. The only surgery they could do is a tarsal tunnel release. Just like carpal tunnel in the wrist tendons around the ankle can swell and cause compression. So they cut through the retinaculum on the inside of theankle to relieve this pressure. I've seen it in runners but it's fairly rare.