Sunday Morning Coffee with Ray Mileur

The Cardinals expect starting pitcher Chris Carpenter to begin a throwing program before the end of January. Meanwhile a recent study suggests that the Cardinals should add depth to their starting rotation rather than counting on the return of the former Cy Young Award winner.

The St. Louis Cardinals staff ace and former Cy Young Award winner, Chris Carpenter has made just four starts among five appearances since opening day 2007. He missed the entire 2007 season after his opening day start, due to injury and subsequent elbow surgeries to include; one in May to remove bone chips and Tommy John surgery in July.

The Cardinals expected Carpenter to rejoin their rotation around the All-Star break last season, just 12 months after his surgery. At the time I thought the Cardinals were a little overly optimistic about his return. I thought it would be at some point in 2009 before we would see an effective Chris Carpenter back on the mound, because it is not uncommon for a pitcher to experience some setbacks while on the comeback trail from Tommy John surgery.

Carpenter has had to deal with shoulder and elbow nerve issues throughout his 18 months of rehab, since the Tommy John surgery in 2007. Cardinals' officials have pointed out that Carpenter's shoulder has shown signs of normal healing and his strength has returned to "almost the level" he had before. The nerve relocation surgery in November in his elbow was successful, but it caused some problems in his shoulder.

This past week Carpenter underwent a nerve test on the shoulder that generated a positive report from the Cardinals vice president and general manager John Mozeliak, claiming that the nerve in Carpenter's right shoulder has shown enough growth and improvement that he should be able to begin a throwing program before the end of January.

"It was a very positive report," Mozeliak told St. Louis reporters. "The nerve is healing, healing at the normal rate. He has regained his shoulder strength almost to the level of what he had before he had this issue." The Cardinals are hoping that Carpenter will be able to be put on the same program as the rest of the team's starters next spring.

It seems like it has been forever since St. Louis signed Carpenter to a five-year, $63.5 million contract extension in December of 2006 with a $15 million club option for 2012. A recent study suggests that the Cardinals may not get much of a return for their investment.

Only 45 percent of baseball players were able to return to the game at the same or higher level after shoulder or elbow surgery, according to new research released during the 2008 American Orthopaedic Society for Sports Medicine Specialty Day at the Moscone Center in San Francisco, California.

"In an ideal world, of course, we would get 100 percent of the players back to their pre-injury level or higher," says Steven B. Cohen, MD, assistant team physician for the Philadelphia Phillies and director of Sports Medicine Research at the Rothman Institute in Philadelphia. "But the fact of the matter is at this elite level of the sport, the physical demands of throwing have much higher requirements than the regular person on the street. The average person who has shoulder or elbow surgery can return to their regular activities. Throwing a baseball at the professional level puts a significant amount of stress on the shoulder and the elbow."

Over a four-season period, Cohen and colleagues studied 44 players from one professional baseball club (major league, AAA, AA and A) who underwent 50 shoulder and elbow operations by a variety of surgeons. There were 27 shoulder surgeries performed on 26 players and 23 elbow surgeries performed on 21 players. A key finding of the study was that players returning after elbow surgery were more likely to come back to the same or higher playing level than those who had shoulder surgery. Thirty-five of the players were pitchers with 43 percent returning to the same or higher playing level.

The researchers found that overall, only 20 of the 44 players (45 percent) returned to the same or higher level of professional baseball. For ballplayers at the major league, AAA, or AA level, the study found only 4 of 22 (18 percent) were able to return to the same or higher level.

Even though it is only one study, I still found these statistics to be very disappointing and significantly lower than the 60%-80% successful recovery rate for a pitcher, that I was expecting, a range that I had come to accept as the norm.

The news out of St. Louis this week about Chris Carpenter was positive, but the Cardinals brain trust, who will be arriving in Las Vegas later today for baseball's annual winter meetings, will need to add depth to the starting rotation this week, as insurance until Carpenter can return, if he returns.

NOTES & QUOTES

--The Cardinals finally signed LHP Trever Miller, who went from a two-year deal to a one-year deal because he was found to have a slight labrum tear in his left shoulder. Miller can make $2 million with incentives. My biggest problem with Miller is, my nephew's name is Trevor with an "o", which means I'll be spelling Millers name wrong throughout the length of his contract. "I approve this deal." (Sorry, been watching too many political ads recently)

--RHP Chris Carpenter, is expected to be ready by spring training. For insurance, the Cardinals need to pick up another starter at the winter meetings.

--The Cardinals did not offer arbitration to any of their eight free agents, including rotation member Braden Looper, who worked 199 innings last season and was 12-14. RHP Jason Isringhausen, who has had elbow surgery, wasn't offered arbitration but might be back in an incentives-based contract. Others not offered arbitration included valuable relief specialist Russ Springer, LHP Ron Villone, LHP Mark Mulder, INF Felipe Lopez, SS Cesar Izturis and OF Juan Encanarcion.

The decision not to offer arbitration to this group was a no-brainer, other than perhaps Braden Looper of infielder Felipe Lopez. I wasn't interested in bringing Braden Looper back, but I'm a little surprised about how little love has been shown to Lopez, who played very well for St. Louis. Cesar Izturis, is another player who did everything that was asked and expected from him last season, only to be shown the door. Rumor has it Lopez could end up in Baltimore.

--SS Khalil Greene will be paid $6.5 million for 2009 on the back end of a contract he had with the Padres. I'm a Greene fan and expect him to quickly become a fan favorite in St. Louis. His offensive production hopefully will return to his 2007 form, when he hit 27 home runs and drove in 97. Think positive!

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