Miles Mikolas injury

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  • #122862
    AvatarBob Reed
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    “Cabrera is such a wild card, what are your thoughts on him? Not much offseason info that I can find…. he has the stuff to be a very good SP, or the stuff to be a lights out closer, but the control to be a 5th inning guy.”

    My thoughts on Genesis Cabrera are few, and far from printable at a family website.
    Since coming to the Cardinal organization, he’s had three opportunities to impress. In 2018 in AA he posted an ERA just under 5.00. Ugh. The next year in AAA he had an ERA of nearly 6.00. Blecch. Then the front office saw fit to give him a September callup anyway, and he had an ERA out of the Redbird bullpen of nearly 5.00 again. And reasonable people think he has a shot at the 2020 Opening Day MLB roster?

    Genesis throws hard. He does not throw well. He could become a fine MLB reliever some day — almost any pitching prospect with anything close to Cabrera’s velocity can say the same thing. But he looks to me like a guy who is miles and miles from that destination. And as a starting pitching prospect, well, for me he isn’t one.

    Now, I probably speak as the world’s least optimistic “fan” of Genesis Cabrera. I mean, of course I want very badly for him to succeed with the Cards. But I believe that anyone who has him as a top 10 or 12 Cardinal prospect is kidding themselves. Excellent velocity? You betcha. But on balance he’s been something between ineffective and awful at each stop since joining the organization, and excellent velocity plus two bucks gets you a ride on the city bus.

    #122872
    AvatarCardsFanInChiTown
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    Bob, thanks for your thoughts. I couldn’t agree more, he wouldn’t be in the top 5 pitching prospects if we were ranking them right now.

    I just read an article in the PD that CMart threw yesterday to Molina, and Weiters hit against him and both thought his pitches were lively, moving, etc. He’s lost 15 pounds and “strengthened” his shoulder.

    https://www.stltoday.com/sports/columns/benjamin-hochman/hochman-carlos-martinez-s-legacy-on-the-line-as-cards/article_0a17b615-3857-5b05-9d06-b32657b0ee1e.html

    I said this a few days ago, but if CMart can get back to being the 2015-17 CMart, that is a HUGE upgrade to the rotation regardless of Mikolas. It’s not as if his stuff has been bad or completely lost his control the last couple of years, he just couldn’t handle the work load of a starter. IF he can get back to his old form, that gives the Cards a 1A and 1B SP which as we saw against Washington in the NLCS, is invaluable.

    #122874
    Brian WaltonBrian Walton
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    CFICT said:

    …he (Cabrera) wouldn’t be in the top 5 pitching prospects if we were ranking them right now.

    Well, that isn’t really a change, since with the addition of Liberatore, Cabrera is sixth among pitchers in our current rankings. (Nor should there be a change, since nothing has changed with the players themselves since last fall.)

    Liberatore
    Thompson
    Woodford
    Rondon
    Fernandez
    Cabrera

    My personal ranking has Cabrera higher, but I understand why others feel differently. The good news is we will very soon be able to see real results rather than projections.

    #122877
    BlackHillsCardBlackHillsCard
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    If the first PRP procedure and 4 months of rest didn’t solve the issue, what makes the Cardinals think another PRP procedure and 1 month of rest will fix the issue? It really seems like the Cardinals are trying to avoid an operation and in the end Mikolas will still need an operation. Furthermore, a team with the resources the Cardinals shouldn’t be using worthless pseudo medical procedures, which PRP is a pseudo medical procedure.

    Platelet-Rich Plasma (PRP) Injections: Lots of hype, no convincing evidence

    #122879
    Brian WaltonBrian Walton
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    Do you think the Cardinals are making his medical decisions? Do you think the player is bound to the treatment plan proscribed by whoever he is seeing? Would he be unable to seek additional opinions if he has concerns? Ultimately, the player decides what happens with his body. From our vantage point, we only have generic information.

    P.S. The current problem is flexor tendon, not ligament. So there is no justification for Tommy John at this time. His ligament checked out clean twice via MRI. What surgery is there for tendon soreness? I do not know.

    Some people on social media are predictably ripping the Cardinals medical staff. Not having full details is no deterrent from second guessing, because that is what people do…

    #122887
    Brian WaltonBrian Walton
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    In a quick search, I found a medical study on MLB players who had flexor injuries during the 2010-2014 period. Here is part of the summary:

    Of the players in MLB who sustained a forearm injury, subsequent injuries included 50 shoulder (37.3%), 48 elbow (35.8%), and 24 forearm (17.9%) injuries. Over the study period, 26 (19.4%) MLB and 56 minor league players (8.9%) required UCL reconstruction within 365 days of sustaining a forearm injury.

    (UCL reconstruction is Tommy John.)

    So, which could be Mikolas’ follow on problem – shoulder, elbow or forearm? Even if they know where to operate, would surgery now fix the problem? Maybe even the doctors don’t know. Surely, we don’t.

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542103/

    #122893
    AvatarCariocaCardinal
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    I still dont buy the scar tissue excuse. No tear? No surgery? How do you get scar tissue?

    #122894
    BlackHillsCardBlackHillsCard
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    Brian if you read my post again you will see where I didn’t say Tommy John surgery. I used “surgery” as a generic term because I don’t know what the exact issue with Mikolas is. And as you pointed out, Tommy John surgery is only for the UCL which isn’t damaged, so that’s why I specifically didn’t mention Tommy John surgery.

    I think the team has significant input with with players on medical procedures, which is why I don’t understand the team and player thinking PRP and rest is going to fix the issue. It’s already been done and failed. Why does Mikolas and the team think another round will solve the issue, especially when PRP is a bunk medical procedure? Doubling down on a failed procedure doesn’t seem wise.

    #122895
    Avatargscottar
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    #122938
    Avatarmudville
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    In today’s St. Louis Post-Dispatch Derrick Goold said Mikolas ‘received a platelet-rich plasma injection Tuesday to encourage the healing of a torn flexor tendon in his right arm’.

    The buzzword here is ‘torn’. His flexor tendon is torn. It didn’t heal over the offseason, and in fact, Goold reports that the medical staff said that it doesn’t look different than it did at the end of 2019 season. I don’t know how long it’s supposed to take for a flexor tendon to heal, but I’m guessing that Mikolas will not be pitching again in a month from now.

    #122947
    BlackHillsCardBlackHillsCard
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    What the hell? So its went from a sore tendon now to a torn tendon? And they still think another PRP injection and rest will fix it after it didn’t fix it the first time? This gives me Forest Whitaker eye.

    #122948
    Euro DandyEuro Dandy
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    A torn tendon is a sore tendon.

    #122949
    RatsbuddyRatsbuddy
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    Torn? Or dislocated? Can a tendon dislocate?

    #123014
    Avatar1982 willie
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    While I obviously don’t know, im thinking mikolas wont pitch this season. hope im wrong though.

    #123020
    AvatarCariocaCardinal
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    Well, if it is torn that is consistent with the scar tissue I have been ranting about

    #123024
    Brian WaltonBrian Walton
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    The questions then might be:

    What surgical options are there for a torn tendon?
    What are the recovery times?

    Just for illustration, let’s say there is a procedure, but it takes nine months to recover. He would miss the season anyway, so nothing is lost by trying another injection before throwing in the towel on the year.

    (To be clear, I did not investigate my questions above.)

    #123110
    Avatar1982 willie
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    I don’t really think its a question of what to do now. the question was why they sat on this at the end of the season. Maybe it wouldn’t have mattered in the long run but we will never know.

    #123119
    Brian WaltonBrian Walton
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    They did not sit on it at the end of the season. They tried a treatment approach that with the benefit of hindsight did not work. Don’t you think if they knew it would fail, they wouldn’t have tried it? It is not as if any team wants to sabotage their own players.

    #123125
    AvatarCariocaCardinal
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    Isn’t what they tried in the off season was rest? Aren’t what they are trying now is rest?

    #123126
    BlackHillsCardBlackHillsCard
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    They did not sit on it at the end of the season. They tried a treatment approach that with the benefit of hindsight did not work. Don’t you think if they knew it would fail, they wouldn’t have tried it? It is not as if any team wants to sabotage their own players.

    Brian, there have been studies about PRP being a worthless procedure that accomplishes nothing, which was what my original post in this thread was about. I’m not exactly blaming the team 100% but I believe Mik and team deserve the blame because they went with a pseudo-medical procedure and it looks like it failed and will probably fail again.

    #123133
    Brian WaltonBrian Walton
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    BHC, I understand that your research indicates PRP is no good. Clearly, that view is not universally accepted by the medical community. Not sure what else can be said about that.

    #123190
    Avatar1982 willie
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    well I don’t believe rest is a treatment approach. for a short time sure. but in my eyes three months isn’t really a short time. one month is closer to it. But I know how medical stuff goes. I went to the doctor for a pain running through my arm and shoulder. while he wasnt totally on board with it, basically he legally had to send me to rehab which was a joke cause I work at a job where I use my arms and shoulders everyday. Since rehab costs me a lot of out of pocket money, I just canceled that and just dealt with it on my own.

    #123220
    Avatarmudville
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    I’m thinking that Mikolas’ flexor tendon tear did heal over the offseason. It just didn’t heal completely. Give it another month or so, and maybe it will be fine. Just speculating. No one knows for sure, even the doctors.

    #123223
    Euro DandyEuro Dandy
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    I’ve wondered the same thing, mud. Soft tissue injuries can take many months to heal. Surgery doesn’t necessarily produce a faster healing result. “Who knows” is right — it’s an inexact science.

    #123251
    Avatarbccran
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    We have a guy who hits near 100 mph on the gun, has solid secondary pitches, has a 2.95 ERA at the major league level, and has a starter’s presence on the mound. Was mainly a starter coming through the system. Has been stretched out and is ready to step in. Probably more gifted than Gant, Ponce, Gomber, Woodford, Cabrera, Etc.
    I’d really like to see how he’d do in our rotation.

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