Timetable for Johnson, Oswalt still iffy

June, 29, 2011
6/29/11
3:02
PM ET


Your mailbag and Twitter questions drive the blog today. Thanks to all for your thoughts, ideas, musings and perspectives. I read and enjoy them all, even though we only have space for some. And if you don't see your question answered here, it might be that I'm saving it for later, or even for the 06010 Fantasy Focus podcast, so stay tuned.

Jason Jeffrey (Fort Lauderdale, Fla.): Is there any update on Josh Johnson?

[+] EnlargeJohnson
Steve Mitchell/US PresswireJosh Johnson is definitely no stranger to Dr. James Andrews.
Wednesday could be a big day for Johnson as he is visiting Dr. James Andrews. Johnson, who has been on the DL since the third week of May with inflammation in his throwing shoulder, finally progressed to throwing from a mound in mid-June but apparently was not completely rid of his symptoms. According to the Palm Beach Post, Marlins president of baseball operations Larry Beinfest issued this statement regarding Johnson: "JJ says shoulder does not feel 100 percent and is going to see Andrews tomorrow before proceeding further with throwing program."



The fact that Johnson has made it as far as throwing from a mound suggests there likely won't be any catastrophic news. Dr. Andrews is certainly familiar with Johnson, having performed his elbow (Tommy John) surgery in 2007, and this may be primarily a case of seeking reassurance that he is on the right track. But if Johnson is in fact still experiencing stiffness in his shoulder, his throwing program may be slowed or even halted for a time, depending on how serious the concerns are about what is causing his current discomfort.

Johnson was originally placed on the 15-day DL but was slow to progress and was eventually transferred to the 60-day DL. The Marlins were hoping he could pitch for them again shortly after his eligible return date in mid-July, but that now appears to be in question. Given that no timetable has held up for Johnson thus far, it continues to be a wait-and-see scenario.

@digitalbear11: What's going on with Carl Crawford?

Crawford is definitely demonstrating improvement from his left-hamstring strain. He began swinging a bat Monday. On Tuesday, he performed some light running according to the team's website, running several 90-foot intervals at half-speed. The encouraging news with Crawford is that his recovery has progressed well and he has not had any setbacks. Naturally, the team wants to be as confident as possible that when he returns to game action he will be at minimal risk of re-injury.

As ESPN Boston's Gordon Edes reported, manager Terry Francona has all but ruled out Crawford for this weekend's series against the Houston Astros (although Crawford is eligible to return Sunday and Houston is his hometown). As of now it seems more likely Crawford will return Monday, July 4, when the Boston Red Sox begin a homestand.

@bobthemule: Can Shaun Marcum really avoid going on the DL or are he and the Brewers just postponing the inevitable?

@peacechex Should I trust him [Marcum]?

We may have the answer to that very soon. Marcum is scheduled to pitch a full workload against the New York Yankees on Wednesday, so we will see how he holds up. His original injury (left hip flexor strain) was in mid-June, but Marcum made his next start, although he was limited to just three innings. He later said he felt his hip not while pitching, but during an at-bat in that game. The Brewers said they had planned to limit his innings in that game all along, staying clear of calling it any kind of a setback. For his part, Marcum told reporters Friday that his hip was a "non-issue" and expected a regular outing Wednesday. He does benefit from the scheduling that afforded him a couple of extra days rest but until he goes the distance, we won't know how his hip responds. The red-hot Yankees, who traditionally have done well against Marcum, might present a challenge, but if he is able to get through the game without incident, it will help alleviate concerns about a DL stint. And then we will have a better idea as to whether we can trust him.

@teeceli: Any word on Brett Anderson?

@PutonSwole: Will he be effective this season?

[+] EnlargeBrett Anderson
Ezra Shaw/Getty ImagesBrett Anderson is avoiding surgery for now, but his return is still up in the air.
There's not much to report at this early stage. To recap, Anderson had discomfort in his elbow in early June which sent him back to the A's team physician for evaluation. He subsequently had a consultation with Dr. Andrews in Alabama, and many feared the season was over for Anderson, especially given he was on the DL twice in 2010 for issues with the elbow. The decision, however, was not for Anderson to undergo surgery, but rather to try an extended course of rehab and attempt to return to play. Anderson then received a PRP (platelet-rich-plasma) injection into the elbow, which required a follow-up immobilization period for his elbow and forearm. Anderson visited his teammates in the clubhouse on June 19 sporting his splint and tried to focus on the positive. According to the team's website, Anderson said, "The shot wasn't much fun, but it's better than having surgery."



Anderson knows however that there are no guarantees. This is his second such injection (he had one last year), and often times these extended rehab trials are performed when there is not clear and distinct evidence that surgery is required. The hope is that the athlete will be able to return and pitch effectively and perhaps go on indefinitely without additional problems. The alternate possibility, however, is that the rehab effort will not succeed, something which may not become evident until a pitcher returns to full-scale throwing. In other words, every step along the way is a notch on the measuring stick. After each success in a rehab and return to a throwing program, the pitcher is progressed to the next level of activity. Unfortunately, success at one level is not necessarily predictive of continued success, meaning we won't know whether Anderson can return and be effective until he actually arrives at that point. His history certainly gives us reason to be concerned. Then again, there are pitchers currently pitching who have defied similar odds.



For those who might be inclined to think that Anderson should just go ahead and have surgery proactively, the response is this: The best surgeons will remind us that the decision to operate is arrived at when the indications are clear that surgery is the best option, a decision mutually agreed upon by the surgeon and the athlete. The rehab process following Tommy John surgery is lengthy and difficult and is not undertaken lightly. If there are any doubts as to whether surgery is absolutely necessary, then all other treatment options must be tried first. And that seems to be exactly what Anderson is doing.

@kristinereese: A Phillies fan wants to know about Roy Oswalt ...

The Philadelphia Inquirer reports that Oswalt is scheduled to consult with Dr. Drew Dossett in Dallas on Friday, after which we hope to learn more about his scheduled rehab. The Inquirer noted that a recent MRI showed mild disc bulging in his lower back. It's worth mentioning that many people have mild disc bulges, often without any symptoms at all, so this was not an alarming finding on its own. Phillies team physician Michael Ciccotti also indicated that Oswalt has thickening of a joint capsule in the spine, which may be contributing to his symptoms. In essence, though, the reported findings aren't devastating and don't add much to what we've known for some time, which is, simply, that Oswalt has a chronic back condition.



The issues aren't so much what's present in the pictures but how the symptoms Oswalt is experiencing are impacting his ability to perform. After Oswalt's Friday appointment, the medical personnel will discuss the rehab plan and move forward from there. Although there seems to be some debate as to how long he will be sidelined, the fact is that nobody really knows. The chronic nature of back pain and the degree to which it has limited Oswalt over the past few years are not encouraging factors. Oswalt's dejection after he was forced to leave his last start early is typical of all patients who are frustrated by the severity and frequency of recurring back (and leg) pain. After a period of rest and another round of rehabilitation, he may again be optimistic about being able to return and contribute. Unfortunately for all involved, there is no way to definitively predict just how long that could take ... and whether it will ultimately work.

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