When the Doctor says Oops

What happens when the Doctor Says "Oops?"

You become a Cub.

Lookie here. The Cubs get an early holiday present under their tree in 31 year old starting pitcher Scott Baker. In typical Cub fashion, the wrapping paper is a bit discheveled and the bow on the gift is a little off kilter. Scott Baker toiled on the mound for the Twins from 2005-2011 including his best year in 2009 with 33 starts, 200 IP, a 15-9 record and a WHIP of 1.190. He had Tommy John/Ulnar collateral ligament (UCL) reconstructive surgery on his elbow last April, missing the entire 2012 season. Fitting Jedstein's Modus Operandi, it's a one year deal at $5.5M with $1.5M in incentives. According to XM Radio's Jim Bowden, the Cubs have made an offer to lefty Francisco Liriano, so maybe they are just going after ex-Twins. Matt Garza should soon be tweeting: "Collect em all."

Baker was supposed to have the (quicker to recover) flexor-pronator muscle attachment repaired in his right pitching elbow (compared to Tommy John ligament reconstruction) , but there was a change of plans decided intraoperatively...

In looking up the history on Scott Baker, I saw some pre-surgery articles in April that said his elbow injury was diagnosed as a tear of the flexor-pronator muscle attachement but when his surgeon, reknown Dr. David Altchek from Hospital for Special Surgery in New York (who did former Twin, Joe Nathan's TJ surgery) opened the elbow up it was clear that Baker needed his UCL reconstructed. The flexor-pronator recovery is usually 6 months whereas the Tommy John surgery is typically felt to be longer at 12-18 months for recovery. 

An MRI taken late in spring training showed that the ulnar collateral ligament - the one that is replaced during Tommy John surgery - was sound. But Twins spokesperson Dustin Morse said that when surgeon Dr. David Altchek opened up the elbow and took a look, he decided to repair the ligament.

...and going into the April surgery, the Twins GM Terry Ryan said in  a press conference that Baker's flexor-pronator attachment surgery would just be a simple "cleanup"

Baker said this preoperatively:

"He (Dr. Altchek) said this is something that’s not going to repair itself. It’s not going to cure itself. It’s something that needs to be taken care of. Fortunately, he said the (UCL) ligament looked great, so I guess in a way, as bad as this is, the flexor pronator tendon is what needs to be repaired. Nobody hates this more than me. So it’s tough.”

When asked about his Ulnar Collateral/Tommy John ligament, Baker said:

“Yeah, he said there’s no need to mess with that. I haven’t had any discomfort there, which is a good thing. But at the same time, what’s going on right now, I just know two things: It’s painful and it’s affecting my ability to be effective in a major league baseball game. What do you do when that’s the case? You have to get it taken care of."

A Simple Twist of Fate

Of course, the anatomy of the flexor-pronator tendon attachment and the ulnar collateral ligament attachment are so close together it's not unusual for an MRI or physical exam to be misleading. It is common practice to include in the surgical consent permission to do both procedures "just in case" this scenerio plays out. According to the Star Tribune article, if Baker had the cleanup elbow surgery with a 6 month recovery estimate, they probably would have picked up his $9.25M option on his contract and he'd still be a Twin. Then again, that's a lot of $$ for any pitcher coming off of any elbow surgery unless you're under 30 or your initials are SS (or both).

Biomechanics 101

The forearm flexors are really responsible for controlling wrist flexion but they originate just above the elbow which gives them maximal leverage. The forearm pronator muscles are responsible for forearm rotation, in the direction of going from palm up to palm down, clearly needed to put spin on the ball. The reverse direction of pronation is supination where you move the forearm to a "palm up" position. The Ulnar collateral ligament is a bit deeper but in the same general attachment area and is responsible for keeping the elbow joint on the medial or inside from opening up. The elbow joint is a complex hinge where the forearm bones (radius and ulna) and the radius bone rotates around the ulna to produce forearm rotation (pronation and supination). The hinge component involves the ulna (olecranon) and distal humerus (medial condyle) on the inside (medial) and the radius (radial head) and lateral condyle or capitellum of the humerus on the outside (lateral).


  Ulnar Collateral Ligament Origin:                               Flexor-Pronator Muscle Origin:                                  

Tommy John LigamentPronator-Flexor Origin

Star-Tribune author, La Velle E. Neal III, so generously offered the link to a comparable case, former Giant pitcher Russ Ortiz. Ortiz at age 32, who in 2007, went in thinking flexor-pronator and wound up with Tommy John surgery. Ortiz came back to pitch in 2009-10 but lasted only 90 innings before retiring.

There is an in-house comp. We've seen Tommy John surgery work well in Ryan Dempster. Dempster was younger at age 26 when he had the surgery in August 2003. The Reds didn't pick up his contract in November 2003 and the Cubs signed him in January 2004. Demp missed most of the 2004 season with a brief 20 inning bullpen comeback in September. He remained a Cub closer/reliever for 3 seasons and finally went back to the starting rotation in 2008. 

People as saying there is not much risk paying a starter at $5-6M. Upside: See Paul Maholm. Downside: See Russ Ortiz or Good ol' duct tape himself, Chad Fox. Nuff said.


Recent comments

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  • To be fair to Emery and Trestman the foreshadowing of last year started happening well before them with the failure or mismanaging of multiple draft classes forcing the team to overspend in a free agency market that is even worse than baseball. Kyle Long seems like a good pick but they traded away another good one in Olson because of Martz's stupidity and inability to change his offense to fit the team talent.

  • HAGSAG: I think Domonic Brown does fit the criteria of a reclamation project, but unless he is willing to accept a minor league contract with an NRI to Spring Training, I don't think the Cubs would be interested given where the Cubs are right now. A couple of years ago? Yes. But probably not now.

    Brown would be better-off going to a club that is rebuilding and re-establish his value there, like Chris Coghlan did with the Cubs. And if he can re-establish his value, he could get traded to a contender at the trade deadline and take it from there.  

  • "they just fade away"

    (Except in the cases of no-fade lefties like Moyer, Orosco and Rich Hill.)

  • Amazing to me how quickly it fell apart under Trestman. Year 1, they were a Chris Conte brain fart away from making the playoffs. Year 2 -- coach, staff and GM all fired.

  • I am sure Jonathon Mota will be signed next.

  • AZ Phil, what is your thoughts on Domonic Brown as a reclamation project?

  • He also played LF in deference to Curtis Granderson.

    Meh... other moves to make...hope to see a move or two soon.

  • I haven't seen much Bears football this year - difficult to watch the games out here, but the game I saw the week before I was watching in shock as I saw them actually make tackles. And Cutler has looked really good, too.

    I guess people can quibble about play calling, but the team I saw is way more than 50% better coached (my only very minor disagreement with your comment).

    Under Trestman, the team didn't do anything right. This team played like a well coached team when I saw them play the Rams.

  • "What is sometimes overlooked about Vogelbach because of his "bad body" and because he has struggled so much defensively is that he is a hard worker, has a great attitude, loves to play the game, and is very well-liked by his teammates, and while that may not seem important, teams do actually value stuff like that. "

    As well they should. Replace a word here and there and you are describing any worker someone would hire.

  • Hak-Ju Lee signs a minor league contract with SF Giants.

    Some closure on the 6 degrees of Separation for Matt Garza/Chris Archer

  • Hahahahaha

  • -0.3 WAR in 7.1ip last year...

    -3 WAR projected over the course of a season.

    the cubs just added an all-star reliever's worth of work by losing b.schlitter.


  • Rockies sign Brian Schlitter to a minor league contract. Good luck in Coors Field. Enough said.

  • i'll take him over frandy since it's unlikely he'll progress as a SS (and 2nd isn't looking much better).

    i hope patton's delivery deception skills play well in the bigs over time. cubs need pitching options that are MLB-ready and dude fits the bill for a MLB/AAA mix...both needed.

  • I'm not saying he's great, but can we agree on the word "decent"? Became a pro at 23, called up at 26; nothing wrong with that trajectory, he hasn't been knocking around. Even in the majors his SO9 is 9.7. In the minors it's 12.2, so he's always missed bats, and without being a wild man: his walks are low. He cost the Cubs an unheralded A-ball middle infielder and a roster spot.

  • he's a righty (a 27 year old one that's going to be 28 before spring training starts) that throws low 90s with a low-80s slider. that's as ordinary as it gets for a righty reliever.