Baseball Injury Report on Pujols and Glaus

Injury expert Rick Wilton sounds a warning regarding Albert Pujols' need for a cortisone shot in his elbow and remains concerned that Troy Glaus' power may be absent until the second half of the season.

In my writings, I generally try to give the doubt in gray areas to the Cardinals as I respect the hard-working and knowledgeable professionals who run the organization for a living. So do most all of the writers that cover the team daily, generally leaving the mud-flinging to the columnists who might pass through on their way to other sporting events, appearances on talk radio and the like.

Joe Strauss is the St. Louis Post-Dispatch's lead beat reporter covering the Cardinals. I certainly include him among the fair reporters on the club, yet that doesn't mean he is a pushover. Last May, what was likely several years of pent-up frustration erupted when the writer blasted the Cardinals medical staff and specifically, their pattern of reporting of player injury information.

While the information presented could not be proven, a long list of circumstantial evidence was offered to support Strauss' concern that Cardinals head team physician and medical director Dr. George Paletta worked with the front office on suspect press releases regarding player medical information - suspect in both in terms of description of injuries and suggested timing of recoveries.

If one is a "glass half full" kind of person, one might call the Cardinals actions ambiguous. If one is a "glass half empty" type, as many Cardinals fans were with regard to injuries even prior to the Strauss article, then one might label the team reports as misleading.

I am not going to get into theories on the many potential motivations of any of the parties involved other than to say that as a result of Strauss' case presented, I admit that I now treat Cardinals injury reports with a greater dose of skepticism than ever before.



With that long introduction aside, yesterday I spoke for some time with Rick Wilton of Baseball Injury Report. The subject was a pair of recent medical reports on the Cardinals corner infielders, first baseman Albert Pujols and third baseman Troy Glaus.

Somewhat buried in a recent Strauss article about the reasons for Pujols' withdrawal from the World Baseball Classic was news that the first sacker was forced to cut back his rehab from off-season elbow surgery last month due to discomfort associated with bone spurs in the elbow.

The elbow was not directly offered as the reason for Pujols to remain in Cardinals camp instead of competing for the Dominican Republic in the WBC. Instead, that was attributed to a lack of disability insurance coverage related to that off-season surgery. Oddly, half a dozen other players on the Dominican team, including Boston's David Ortiz were in the same boat, yet apparently plan to play.

What we do know for sure is that Pujols' January problem was bad enough that the reigning National League Most Valuable Player required a cortisone shot. As one might expect, Pujols is now saying his elbow is fine. Yet when I hear of the need for shots of any kind in the off-season, a red flag goes up.

Now I will remind readers that I was not among those in a panic last winter and spring when Pujols' elbow was seemingly in the headlines every day. Not wanting to overreact here either, my question to Wilton was a simple one.

As an outsider with medical training and a job focused on baseball-related injuries, what is his take on the latest Pujols news?

What follows in quotes is Rick's assessment.

Albert Pujols (1B, STL)

"When we first reported a while back that Pujols' surgically repaired elbow was ok and he was making a solid recovery from nerve transposition surgery, we did not have all the needed information to make an accurate projection if he could come back before the start of the regular season. At the time we felt he did.

"Now we are not sure. Pujols also had a sprained ulnar collateral ligament last fall that we did not get the whole story on until just recently. In addition, Pujols has bone spurs in his throwing elbow. The team surgeon must not have felt the spurs would be an issue because they were not removed during his off season surgery.

"Now as we just get started with spring training, we learned that Pujols had cut back on his workouts. He needed a cortisone injection in the elbow in January to quiet down the inflammation, no doubt caused by the bone spurs.

"Should we be worried about the spurs in his right elbow? It depends on where the spurs are located. If they are in a location close to the ulnar collateral ligament or a spot where they will constantly irritate the soft tissue, then Pujols will be playing at less than 100% all season long.

"Since the surgeon was in the elbow joint in January, we must assume he took a look around and determined the spurs would not be a big issue in 2009. If that is the case, then the odds are Pujols will make it through the entire season without any problems.

"When will we know? If Pujols can make it through the entire slate of spring games without an elbow setback or cortisone injections then the odds are they spurs will not be an issue this season. If they do cause irritation this spring, then be ready for a bumpy ride in 2009."



In the case of Glaus, the same fears Strauss put in the headlines last spring resurfaced when the third baseman, suffering with a shoulder problem since late last season, apparently surprised even the Cardinals with January news that surgery had been recommended and scheduled.

The Cardinals Winter Warm-Up fan event was underway while this unfolded, yet neither club nor player acknowledged anything was up. Yet, just a couple of days later, a press release appeared announcing Glaus' surgery.

Its timing brought up a lot of the old second-guessing as to the flow of information as well as the treatment last season, the rehab plans over the winter and the decision for surgery so late that some part of Glaus' 2009 regular season would be lost.

Glaus' explanation was that the medical opinion last fall was rest, not surgery but the problem flared up as he began to prepare for the season. Since it wasn't getting better, he had it checked out and the decision was made.

Again, my primary interest is in when we can expect the player back on the field and when he should be 100%.

Wilton's view remains considerably more guarded than the published reports coming from the team.

Troy Glaus (3B, STL)

"Now that major league teams are in camp along with the beat writers that follow them, we are getting more injury information. In Glaus' case, we received a more detailed report on his shoulder injury Wednesday.

"Glaus had a moderate tear of the subscapularis muscle, one of the four muscles that help make up the rotator cuff in the front of the shoulder. One of its main functions is to provide stability to the anterior (front) portion of the shoulder capsule. It is important enough that the Cardinals will make sure he has sufficient strength in all his shoulder muscles before activating him from the DL.

"His treatment late in the year and up until his surgery date in late January did not help heal the tear. Now we are about a month post operative and Glaus has not received the green light to resume workouts including lifting weights yet.

"One medical advisor to the Baseball Injury Report stated this type of tear and the muscle in question could keep him off the field until June if he struggles to recover. The Cardinals believe this DL stint will be a lot shorter than a return in June.

"If Glaus does not start lifting weights and begin baseball-related drills until late March or early April, then yes, Glaus may not be back until sometime in June. If he suffers any kind of significant setback, he could miss the first half of the 2009 season.

"The other issue is how soon his power will come back. We should not be surprised if Glaus needs at least a half of season's worth of at-bats before his normal power stroke returns."

Draw your own conclusions from the information presented. For now at least, my view is "show me".



To get the rest of the story on injuries all over baseball, check out The Baseball Injury Report at Baseball-Injury-Report.com.

The Baseball Injury Report is published by Rick Wilton, fantasy baseball's most experienced injury analyst. Rick, with background in radiology, pharmacology and physical therapy, has been a contributor to STATS Inc., Sports Weekly Hot Sheet, BaseballHQ.com and ESPN.com.



Brian Walton can be reached via email at brian@thecardinalnation.com. Catch his Cardinals commentary daily at his blog, The Cardinal Nation.

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