Carlos Beltran’s Mysterious Knee Surgery
In case you missed it, Carlos Beltran had knee surgery in Colorado on Wednesday. That’s about all we know for sure. He might have had “microfracture surgery”, which is pretty darn serious, or he may have had “arthroscopic surgery”, which is relatively routine. We’ve also been told by the Mets that he will be out for “12 weeks”, which makes sense for neither possibility.
Here is the exact quote from the official Mets press release:
He elected to undergo arthroscopic clean out of the arthritic area of his knee by Beltran’s personal physician Dr. Richard Steadman today in Colorado. He is anticipated to return to baseball activities in 12 weeks.
Considering the recent history of medical reports from Mets officials, it is hard to know what to believe.
If indeed it was microfracture surgery, the recovery time is at least 4 months, but could be as long as 8 — or a year, or a year and a half. There’s really no way to know for sure, as everyone is different.
On the other hand, athletes usually resume activities from a simple ’scope of the knee in 6-8 weeks — sometimes sooner.
So now you can understand why the 12-week number stated by the Mets’ press release is mysterious.
As if that weren’t enough to confuse things, microfracture surgery is something that is performed via arthroscopy. Get it? So in other words, you can have arthroscopic surgery without having microfracture surgery, but you can’t have microfracture surgery without having a ’scope. Clear as mud?
That said, if it is reported that Beltran had a ’scope, it would be correct regardless of whether the surgery was a simple cleaning or if it included the microfracture procedure. And therein lies the mystery.
Oh, and if you re-read the above quote from the Mets’ press release, you’ll see it was Dr. Richard Steadman who performed the surgery. Steadman is the man who pioneered microfracture surgery.
The 12 weeks spit out by the Mets’ crack PR team is what makes things suspicious, because it takes the blood clot formed by microfracture surgery at least 8-15 weeks to heal — and the number 12 is right in the middle of that range. Mind you, the healing of the clot is only step one of the recovery process. From the research available on the information superhighway, if indeed he had microfracture surgery, Beltran would GET OFF CRUTCHES after 8-15 weeks — I’m not sure what kind of “baseball activities” are possible immediately thereafter. Maybe it means he can start autographing baseballs or break in a new glove.
Here is a quote from Wikipedia in regard to the sensitive nature of the recovery period:
Microfracture surgery itself is relatively minor. It is an outpatient procedure and causes only small discomfort. The harder part is the restrictions that are placed on the patient during the post-operative recovery period. This can be a major challenge for many patients. For optimal re-growth of joint surface, the patients need to be very patient and also extremely cooperative. They usually need to be on crutches for four to six weeks (sometimes longer). Sometimes a brace is needed. This all depends on the size and/or location of the joint surface defect that is being repaired or regenerated. The patients are encouraged to spend approximately 6-8 hours a day on a CPM (Continuous Passive Motion) machine that helps with optimal re-growth of joint surface. Patients usually feel pretty good and think they can avoid these critically important steps, and even start running and jumping (or playing sports) before the internal aspects of the knee, and the joint surface, are ready.
Sounds pretty dangerous, no? If a determined athlete — such as Beltran — decides to push himself to recover quickly, it could have devastating consequences. Considering that Beltran is going to make $37M over the next two years regardless of whether he sets foot on the field, and that he probably has a shot at one more big payday before he retires, you’d think that agent Scott Boras will recommend insist that Beltran go the cautious route, taking all the time he needs.
Quite a conundrum.
There are already rumors flying that the Mets were not on board with Beltran’s decision to have the surgery, and that they may sue Beltran for his salary. Per Joel Sherman:
A person familiar with the situation told the Post that the Commissioners Office and the Players Association have been alerted that “the Mets are claiming this was done without clearance and that the Mets are threatening to take some form of action. There is a potential issue out there.”
That’s a whole ‘nuther can of worms.
Here’s the bottom line: if indeed Beltran had microfracture surgery — and all signs seem to be pointing that way — there’s no way he’ll be playing before June. In fact there is a very real possibility he misses the entire 2010 campaign. This isn’t panic, it’s a statement of reality — not unlike the statement I posted here last May in regard to Jose Reyes.
Mind you, I don’t point out these possibilities because I want to be right, or so I can say “I told you so” later on. Rather, I’m evaluating the situation realistically, and understanding that the Mets will need to have a solid plan in place in preparation for the worst scenario NOW, rather than scrambling later (see: Angel Berroa, Wilson Valdez, Anderson Hernandez, et al). Maybe the Mets can survive the year and compete for a postseason spot with Angel Pagan in centerfield all year. Or, maybe they need to look for an alternative, in case Pagan doesn’t work out (Rick Ankiel? Jeremy Reed? would they be crazy enough to trade for Gary Matthews, Jr. ?).
No matter which way you scope out this situation, it is not good news for the Mets.
Newsflash: Jose Reyes Has Torn Hamstring
No, this isn’t regurgitated news from months ago. This is a NEW tear in the back of his leg.
From The New York Times:
Before the game, the Mets said that Reyes, out since May, had torn the hamstring itself while working out Tuesday. He had already sustained a torn hamstring tendon, for which surgery appeared increasingly likely. The new injury further complicates the situation and raises questions about whether Reyes will be ready to participate when spring training begins in February. The Mets disclosed the new information after Reyes was examined Wednesday at the Hospital for Special Surgery in Manhattan.
If you remember, Jose Reyes was removed from a game on May 20th and listed as day-to-day. At the time I made the outlandish suggestion that Reyes could be out for the year (one person said the headline was “irresponsible”), and wondered if the Mets kept Reyes off the DL to keep the revenues flowing. Me and my crazy conspiracy theories.
Though, I must admit I thought for sure it would be his achilles tendon and not the hammy that would be Jose’s, um, achilles heel. As it turned out, the achilles was fine — it was more the complete and utter mismanagement of his recovery that did him in.
John Maine – Ready or Not?
After throwing four innings in a minor league game in Florida, John Maine has proclaimed his arm healthy. The Star-Ledger reports that Maine could soon join the rotation.
In fact, we might see him make a start this coming Sunday, against the Philadelphia Phillies. If so, it would be his first appearance in a big-league game since June 6th. But will his performance in the final weeks of this season truly give us any inkling to his health in 2010?
According to Maine: Read more
Watch Carlos Beltran on Twitter
Just a quick note… According to MetsBlog, Carlos Beltran will be playing for the Brooklyn Cyclones on Thursday night (9/3). The Cyclones are taking on the Hudson Valley Renegades at Dutchess Stadium in Fishkill, NY.
For those of you interested in seeing Beltran play, you can watch it live on Twitter. Just follow @hvrenegades and there will be a link when the broadcast starts. You will be able to see the game starting at 7pm.
While you’re at it, follow @metstoday and @smallballusa too. Thanks.
Mets Injuries: Not Bad Luck
After having his knee examined, Oliver Perez has been shut down and scheduled for season-ending surgery because of patella tendon tendinosis. No word on whether he will have his head examined.
Johan Santana will have elbow surgery.
J.J. Putz has been shut down for the season, due to new fraying in his elbow near the ulnar collateral ligament and a slight tear in his right forearm. He will NOT have surgery to correct the condition.
No word on Carlos Beltran , Carlos Delgado, John Maine, nor Jose Reyes.
There are others on the DL and/or lost for the season, but I mentioned the above for a specific reason. Can you find the common thread?
If not, I’ll make it plain and simple: in each of the above cases, the player’s original injury was misdiagnosed and/or rehab was mishandled.
In other words, all this talk about the Mets being “unlucky” because of all the major injuries suffered is a bunch of bull. Maybe some of it is luck, but at least half of it is due to incompetence.
Though, I tend not to fault the Mets’ medical staff — I have a hunch they know what they’re doing, and making the proper recommendations. In the end, the doctors and trainers have no control over whether a player goes back on the field or to the disabled list — that decision is made by the front office.
If you’ve been paying attention since spring training, you don’t need me to re-hash each individual case and point out where the team went wrong. And it goes back further than the spring — last year’s handling of Ryan Church and Billy Wagner are the most obvious examples from 2008 (you can put Maine in there as well).
In every case, a player continued to play despite an injury. Now, we know that all athletes have to learn to play with pain, and can often play through injuries without causing further damage. But over the past several years, the Mets have been grossly negligent in the evaluation and assessment of injuries.
We know this because:
- the manager, general manager, and player are rarely ever on the same page in terms of information
- the general manager cannot “remember” serious injuries to vital players
- the manager has admitted to allowing injured players to talk him into letting them on the field
- the team has admitted to hiding injuries and allowing players to continue to play through them
- the team has consistently waited too long to place players on the DL
- cortisone shots have been administered so frequently and easily it has become an industry joke
- more than one player has sought a second opinion from outside doctors, without the team’s recommendation
- Maine, Putz, Reyes, Beltran, Delgado, and Church all experienced failure in the rehab process
The only successful injury rehabilitation in the past year was Billy Wagner’s recovery from Tommy John surgery. Is it any coincidence that Wagner, for the most part, rehabbed on his own, at his home in Virginia?
Yes, there is some luck involved in a player becoming injured, and recovering from injury. But bad luck is not a valid explanation for this level of medical failure. In addition to personnel moves, the Mets need to make sweeping changes in the way they a) prepare and condition their ballplayers; b) evaluate and assess all injuries; and c) make determinations based on the recommendations of their medical staff.
** UPDATE **
David Lennon at Newsday has written a similar, more in-depth piece. Good thing to see the professional journalists are seeing things similarly to the fans and bloggers.
Oliver Perez Update
Yup … Ollie is done for the season. He’ll be undergoing season-ending surgery on his knee.
Suddenly the release of Livan Hernandez isn’t looking so smart. Can Nelson Figueroa start twice in a five-day period?
Mets Forgot About Johan Santana’s Elbow
During the team’s conference call with the press today, Ben Shpigel asked Omar Minaya if Johan Santana’s elbow issue was related in any way to the discomfort he felt back in February. Minaya was stunned by the question — he had not remembered the elbow problem, stating that “spring training was a long time ago”. Later, Minaya said that the “spring training problem” had “more to do with Santana’s knee”.
Wow … and we wonder why the Mets’ medical issues have been such a problem this year. If the team can’t remember their $137.5M investment and ace pitcher had elbow issues, how can they possibly deal with the phyical problems of “lesser” players?
Now we understand why Jose Reyes played on a bad hammy, Carlos Beltran on a bad knee, and J.J. Putz with a bad elbow (among others) — the Mets simply “forgot” those players were injured!
Another strange quote by Minaya … after being asked why Santana wasn’t shut down earlier in the season — since he hasn’t thrown in between starts since June — Minaya’s response was:
“That’s why we’re shutting him down now. … After his last start is when he brought it up.”
Um …. huh?
In any case, Johan Santana was seen by Dr. David Altcheck, and the result of the examination is that Santana has bone chips in his elbow. He will have season-ending surgery to remove the chips.
There has been no confirmation one way or the other as to whether Santana had an MRI — only that he saw Dr. Altcheck. Strange, no?
Minaya also announced that Oliver Perez would be heading back to New York to have his knee examined. No word on whether Perez would also have his head examined, unfortunately.
Further, Minaya confirmed the Billy Wagner trade, and said that both Pat Misch and Nick Evans would be activated.
Finally, J.J. Putz will NOT pitch tonight in Brooklyn as scheduled. The Mets are going to “play it safe” with Putz and have him wait a little longer before throwing in a live game.
Johan Santana To Have Elbow Examined
As if the Mets’ injury problems couldn’t get any worse, it’s been announced that Johan Santana will miss Tuesday night’s start in Miami and have his elbow checked out by physician David Altcheck.
According to Mets manager Jerry Manuel:
“He has not been throwing between starts for quite awhile,” New York manager Jerry Manuel said Monday after his team’s 6-2 loss to Philadelphia. “I would say since before the All-Star break. He has been pitching with this problem, but not with the level of discomfort he has now. … Now, it concerns him.”
Since before the All-Star break, eh? Suddenly, Santana’s inconsistent command and velocity issues are explained.
You may remember that we discussed the possibility of an elbow injury right here at MetsToday back on June 15th.
To refresh your memory:
In the case Johan, he has had both a loss of command and velocity. From what I’ve seen, he’s also been throwing more pitches, and had a different approach from previous years, in that he’s been more aggressive about getting batters to swing and miss, as opposed to “pitching to contact” on occasion. As a result, he’s been throwing more sliders, which tend to put more strain on the elbow and forearm. Again, this is what my eyes tell me …
What does it mean? My best guess is that Johan is hiding an issue with his arm. He’s too much of a competitor to use it as an excuse, and he’s too intent on fulfilling the value of his contract and filling the role of “the franchise”, to consider taking off a few starts. He has watched so many players go on the DL, he may feel obligated to pitch through pain — the old concept of the captain must go down with the ship.
You may or may not also remember that Johan had an issue with his elbow in spring training, which some people thought may have been “made up” as an excuse to miss the World Baseball Classic. (You may also remember that the Mets scheduled, and then canceled, an MRI on his elbow back in February.) Now we may wonder if indeed Santana has had an elbow problem all year. Further, I wonder if his first two months of lights-out performances were thanks to the Mets’ magic needle — a cortisone shot. With nearly every injury that’s been reported this season, the first treatment has been a shot. That said it wouldn’t be surprising if Johan received one to provide temporary relief, and put off the inevitable.
In any case, Johan will not pitch on Tuesday night, and regardless of what the doctor says, it behooves the Mets to shut down Santana for the remainder of his senseless season. After all, there are at least four more years and about $100M left on his contract.
Jeff Francoeur Has Torn Thumb
Although the x-rays proved negative for breaks, an MRI has shown that Jeff Francoeur has torn ligaments in his thumb, the result of a sliding catch made over the weekend.
However, he is not expected to miss significant time. Alex Cora played with similarly torn ligaments in his thumbs, and Francoeur is just as tough — even if his nickname is “Frenchy”.
Cavalry Updates
In the old westerns, there would be an image of the cavalry arriving from the distance. But the men on horses would be moving TOWARD the camera, not AWAY.
In the case of the Mets, it appears the cavalry is moving away from our point-of-view. Or perhaps it is an optical illusion.
Carlos Delgado, who had been “very close” to returning, has suffered a setback — a strained oblique. His hip feels great, though. Yee ha. According to the new face of the Mets John Ricco:
“The thought is possibly in a couple of weeks he could be back swinging”
Well super-duper. A “couple” weeks takes us into September. And “swinging” is not necessarily “playing”.
While Billy Wagner is pitching well and should be joining the Mets this weekend in Flushing, there is no news on John Maine nor J.J. Putz. Further, Carlos Beltran and Jose Reyes remain in New York, rather in Florida rehabbing. And we’re all on the edge of our seats wondering what’s going on with Ramon Martinez … I mean, how long does it take to heal from a dislocated pinky?
In regard to all the disabled players, and the fact there are less than 50 games left in the season, Ricco went on to provide this breaking news:
“You’re going to run out of days at some point”
Ricco may speak slightly more eloquently than Omar Minaya, but the messages are just as mixed and useless.
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