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Wednesday, July 20, 2011
When will Josh Johnson, Santana return?


It's that time of the week where your mailbag questions drive the blog. This week there seems to be one player on everyone's minds (hint: an NL East pitching ace who has not been seen in two months). But first, several players returned to the lineup Tuesday night and it's worth noting how they fared:

Jose Reyes, SS, New York Mets: He gets the prize for biggest impact upon return. Reyes had been out with a Grade 1 left hamstring strain, which originally was expected to keep him out beyond the 15-day minimum. As it turned out, he came back on his first eligible day and delivered as much on the defensive side of the ball as he did at the plate in the Mets' victory over the St. Louis Cardinals. Perhaps most importantly he showcased explosiveness at short and brought a spark to his team. The key will be no setback over the next few weeks.

Shane Victorino, OF, Philadelphia Phillies: While Victorino did not provide any fireworks in Tuesday's victory over the Chicago Cubs, he did have four at-bats and emerged apparently no worse for the wear. It appears he will be able to play on with his still-healing thumb.

Ryan Braun, OF, Milwaukee Brewers: On Tuesday I outlined the concerns that surround an athlete trying to play through injury, particularly when he is specifically trying to protect the involved body part. Braun, who has been in and out of the lineup with a calf strain, was back in Tuesday and went 1-for-3 with a two-run home run, but he was in the game for only five innings. Apparently this was planned as a means of easing him back into action. The Milwaukee Journal-Sentinel reported Tuesday that manager Ron Roenicke indicated before the game that Braun would not go the distance. "We're going to try to get him back where there are no setbacks," said Roenicke. It should be interesting to see if this strategy works.

From the mailbag

The most recent three questions in the mailbag are all about Josh Johnson. Clearly he is the hot topic.

Ryan (Brookings, S.D.): The last I heard regarding Josh Johnson was there was no structural damage to his shoulder, but he was going to rest for 10 days. That was on June 29. Are there any updates regarding my No. 1 pitching pick?
Evan (New York): I was wondering if you think that Josh Johnson will pitch again this year and/or if you feel that this injury could linger into next season?
Aariano (Flushing, N.Y.): What is the deal with Josh Johnson? He was only supposed to be out a week or two when the injury originally occurred. It has been two months now and still no actual word on what the actual problem is or if he is even alive.

So let me start by stating for Aariano that I do believe Johnson is, indeed, alive, although his shoulder may not be fully cooperating with his plan. According to a report on the Florida Marlins' website shortly after Johnson consulted with Dr. James Andrews, while he was instructed to rest his right shoulder for at least 10-14 days following a cortisone injection, the timetable to return was not hard and fast. "[Andrews] said however long it takes to get to where you don't feel it at all," Johnson said. "Where you can do everything, all the stretches. He said take however many days you need. I felt a lot better [during recent throwing sessions], but it wasn't always 100 percent." Johnson indicated that he was hopeful to return in August.

It has now been three weeks since Johnson saw Andrews, nearly four weeks since his last throwing session and two months since he first went on the DL with inflammation in his throwing shoulder. On Monday, the South Florida Sun-Sentinel reported that Johnson was still not throwing, but rather just continuing with a strengthening program. Consider that a return to throwing program requires a progression, however variable timewise, from playing catch to bullpens to facing live hitters to rehab games. And consider that Johnson's previous attempts through a similar progression have resulted in roadblocks. At some point the expectation (read: hope) is that the combination of rest and rehabilitation will allow Johnson to work his way back to competition; the problem is that no one can say for sure how long this will take and whether he will definitively pitch again this season.

Sorry gang, but welcome to the abyss that is the thrower's shoulder. There are typically more unknowns than knowns and the range for recovery is all over the map. The longer it takes, the more concerned we become but it does not necessarily change the regimen in a significant way. Time, as they say, is everything.

Cap (Fontana, Calif.): How much longer is Johan Santana going to be out of action? What is taking him so much time to heal and get back to playing baseball games?

Santana underwent a major reconstructive surgery of his shoulder (anterior capsule repair) last September, which involves a very lengthy rehab. The surgery is done to create stability, but it then takes a long time to restore adequate motion to function as a pitcher, not to mention the necessary strength in the shoulder to protect it going forward. There is not a long list of pitchers who have returned from this procedure, although Chien-Ming Wang is just now appearing in rehab games (with the possibility of joining the Washington Nationals late this month) after undergoing a similar procedure in July 2009. Wang's recovery was projected to take at least a year, but as is often the case with complex procedures, particularly in a thrower's shoulder, the pace was ultimately dictated by his shoulder's response to activity.

Santana's recovery will not necessarily take as long -- and there are signs that he could be throwing to live hitters soon -- but that does not mean his return timetable is definitive. ESPN New York reports that even if Santana is technically able to pitch this season, Mets general manager Sandy Alderson says that "we're not looking for Johan to ride in here and be a major factor in this season." More recently Alderson told the New York Post, "We're more concerned about him pitching this season so we get past that question going into spring training next year." In other words, if Santana can demonstrate the ability to throw at a high level this fall, the confidence the team and the pitcher would have heading into next season would be high. That appears to be the bigger goal -- and a wiser one long-term -- as opposed to counting on Santana to deliver in a late or postseason situation for 2011.