Jim Hendry's Plan #44
Before I get to what's going on with Aaron Heilman's knee, I've got a few odds and ends to mention.
I've figured out what the heck Cubs GM, Jim Hendry, is up to this offseason. In a nutshell, in an attempt to beef up the middle of the lineup he wanted to add one of the all time great sluggers to the Cub lineup. Unfortunately Hank Aaron is just about to turn 75 years old. So this great idea came to him in a dream...swap out Hanks (Blanco, Williamson) and accumulate Aarons (Miles, Heilman). Voilà, plan #44!
The newest acquisition (Aaron Heilman) grew up as a Cub fan. It seems that this is the first directive from Tom Ricketts, all new organizational members must be diehard fans.
On to Aaron Heilman's medical issues. I've not been able to find a precise diagnosis to his 2008 left knee ailment other than it being labeled tendonitis. This LINK goes to an article from Sept 12th, 2008 discussing what problems Heilman was dealing with last year.
Last night on WGN radio, David Kaplan interviewed Aaron Heilman and specifically asked him about his knee problems. All we got was "athlete speak." It does seem that they have a therapy treatment plan that was worked out for him to address his issues this offseason.
Kaplan: In terms of your knee. I'm reading an article on ESPN today, it said knee pain played a role in your 2008 struggles. Would you agree that your knee was a problem and how is it today?
AH: Right now it's great. I feel healthy, everything feels good. I struggled a bit early on in the season trying to figure out a routine that would work best for me. By the end of the year I had figured that out. It certainly took a lot longer than I thought it would and that I hoped it would. It certainly wasn't 'the' factor that caused me to have a year I wasn't particularly pleased with. When you are going through something like that, you're trying to figure it out, you're trying to do different things every day, you don't really quite have a routine because you're not sure how you're going to feel the next day, that can play a role into it. We've got all those issues hammered out. I'm looking forward to staying with a good program, staying healthy all year and just going out there and competing.
Tendonitis refers to inflammation of a tendon and there are several tendons around the knee. The largest two are the quadriceps tendon (which inserts into the patella/kneecap) and the patellar tendon (which goes from the patella to the tibia below the knee). Tendonitis of either one is common. There are also hamstrings (medial or lateral) and even the gastrocnemius which is more of a calf muscle but the tendons go behind and above the knee attaching to the femur.
My guess is it was a patellar tendonitis (aka Jumper's knee) as it's probably the most common of these conditions. In a pitcher, this would a significant problem for both push off or landing from a mound. Heilman played through it most of the season, meaning it was nagging but not incapacitating . It wasn't disclosed to the press until the 2nd week in September where there are multiple articles (see the link above for one of these) explaining why they hadn't used him as much in early September. Of course blowing 5 of 8 save opportunities might just be a better excuse to skip calling him from the pen.
I'm sure they had MRI imaging on him as that would be useful to rule additional conditions inside the knee that might make the tendonitis a secondary problem (like a torn meniscus). The treatment is the usual rest and non-steroidal anti-inflammatory medications, better shock absorption in shoes. Therapy includes stretching and controlled exercises also various heat modalities to the inflammed area. In a pitcher it's unlikely to resolve until enough rest can occur, which means the off-season.
He didn't have this in 2007 so I'd expect him to be OK in 2009. I saw that he did have right (his pitching elbow) tennis elbow surgery immediately after the season on 10-23-06. Tennis elbow (aka lateral epicondylitis) is an inflammation of the tendons responsible for wrist extension and originate just above the outside/lateral aspect of the elbow. It develops from repetitive resistance to wrist extension activities hence it's nickname, tennis elbow came from the added resistance of using a tennis racquet. Dr. David Altchek (he's quite a famous NYC Sports Orthopod, who did similar surgery on Carlos Delgado that same week) performed the surgery and although it's obviously unrelated to his knee issues, it is an example of a chronic tendonitis that rarely needs surgery but ultimately he needed it (and presumably got better from the surgery). His stats in 2006 (74 games, 3.62 ERA, 1.16 WHIP) were better than 2008 (78G, 5.21 ERA, 1.59 WHIP) so I guess it was the same nagging thing but he put up with it pretty well. He probably had a bunch of therapy, ultrasound/deep heat rxs and a few cortisone shots for it before the elbow surgery.
Patellar tendonitis can be chronic (which isn't all that common) and then the tendon can be surgically explored or consideration is occaisionally given to (ESWT) extracorporeal (ultrasonic) shockwave treatment, which is more often used to treat resistant plantar fascitis (arch inflammation). ESWT is not like ultrasound in a physical therapy center which is mostly a way of delivering deep heat to tissues. ESWT is more like what they use to break up kidney stones (lithotripsy). It actually traumatizes the tendon collagen and brings in new blood supply which then promotes healing of the damaged tissue.
Update: based on a nice pickup from reader ankeith15, it looks like Heilman did undergo ESWT treatment. This LINK from a mets.com archive on November 20th confirms his diagnosis was patellar tendonitis and goes on to say:
After a loss in September, Manuel disclosed that Heilman had pitched much of the season troubled by patellar tendinitis, a malady that affected his landing leg, restricted his conditioning and non-game throwing, and reduced the sharpness of his pitches. Heilman since has undergone a noninvasive ultrasound treatment that has reduced the pain in his knee.
ESWT was used off-label on Magglio Ordonez during his free agent year when he was diagnosed with avascular necrosis of the femoral condyle (dying bone in the knee due to damaged local blood supply). I think Mags had to go to Vienna, Austria to get that treatment as ESWT wasn't being used like that in the US then. Ordonez knee did recover apparently enough to hit .298 with 24 HR's and be the ALCS MVP with a memorable walk off 3 run homer to end that series.
A variant on such an example of surgical treatment of a chronic tendonitis was the chronic achilles tendonitis in Cliff Floyd who had surgery (also at the same hospital/same week that Heilman had surgery, but a different surgeon) on it the offseason before he signed with the Cubs.
Of course if you have HMO insurance, they just tell you to change shoes.
Stockpiling young talent isn't only for trading for someone like Chapman though. Even with an elite closer winning the World Series is basically a crap shoot so the key is to get to the playoffs as much as possible and not just mortgage everything on one year. Once you get there an elite bullpen certainly helps but the playoffs can be won by one hitter or starting pitcher getting hot (Murphy, Molina, Baumgardner) and a closer might not be able to stop that.
I'm also not crazy about press convictions. As the police report noted, there were no marks on the lady in question. There's a TMZ link (of course) to her police pictures, as well.
I think the only way this trade goes real bad is if Cubbery intervenes and Chapman is suddenly bad for some reason.
I am right there with you closing in on 60.
I don't care that much about "mortgaging" one player who is not only blocked by two guys, but is not ready to hit the majors for at least a couple years.
There is no reason why this team, this year, can't have a real shot at something NONE of us have experienced.
Further, I don't feel that even if they fall short that they have ruined their farm system.
I have made my opinion clear here, with others, Warren was shit on the Cubs save one spot start.
Trading for Warren, Warren sucking, getting Warren back for Chapman plus 3 prospects, sounds like Revenge of The Yankees on the former Boston executive. Old rivalries never die.
I pray to the heavens above Chapman doesn't suck for some reason, or he'll be booed out of town faster than a Todd Hundley revival meeting.
I'm kind of nostalgic for the Schwarber-for-Miller rumors.
This offseason, after some ridiculous playoff run and Chapman saving every game from here until the end of the postseason striking out 27/9innings, I welcome anyone to quote this thread and call me a dummy: I hate this trade, and my hate is 2 parts Chapman makes this team less likeable and 1 part that's a ridiculous overpay for 30 regular season innings and, at tops, 10 postseason innings. Already hoping they don't extend him.
btw...Thanks AZ Phil. I'm really enjoying your take on this trade.
I'm a bit disappointed on the Warren experience. Essentially they gave Castro away for crickets (OK, well they signed Zobrist with the Castro salary dump). Otherwise one might look at it as Chapman for Castro and our #1 minors prospect (Torres) + McKinney/Crawford. Seems pricey for a 2 month rental. We will see if this price tag is that steep in a relative way based on the remaining deadline deals for relievers.
Yep. One of the great things about this team (in addition to being really good at baseball) was the "likable" factor. Feels a bit different now. Who knows...maybe Chapman will be the king of the dance parties.
Here are some possible corresponding minor league moves we might see in the aftermath of the Chapman trade:
SOUTH BEND to MYRTLE BEACH: OF Donnie Dewees and INF Bryant Flete
EUGENE to SOUTH BEND: OF Robert Garcia and INF Vimael Machin
There is really no reason to replace Billy McKinney at Tennessee because both Chris Coghlan and Jorge Soler are doing their rehab at Tennessee.
And there are plenty of pitchers at Iowa. No need to replace Warren at AAA. .
I am 70 years old. The Cubs last played in the World Series in 1945. I was born in 1946. I hate to lose a prospect like Torres, but when the opportunity is there to get that World Series ring, you go for it. This was the idea in stock piling all this young talent. I would like to see Reddick added now and the Cubbies should be done.
I would expect Richard to accept an optional assignment because based on how he's played this season, there is a decent chance that he won't find work elsewhere. Rather stay and potentially get a ring. Same goes for Coghlan since he's struggled mightily this year.
Edwards should not go down. He's pitched very well and Maddon is very impressed with him. I would expect Grimm to go down for Cahill so he can get back on track (he's pitched better in July, but he's not getting enough appearances).
chitownmvp01: Indeed Clayton Richard would seem to be odd man out once Chapman reports, but Richard might accept a minor league assignment if he is promised a return to Chicago on 9/1 when MLB Active List rosters expand (Richard has minor league ioptions left).
The only player in the deal that would cause me a second thought is Gleyber Torres.
McKinney and Crawford are decent prospects but both are redundant/replaceable in the system and Warren was really only a middle-reliever or #6 starter, so to me it's really just Torres for Chapman.
There is no Comp pick for players traded mid-season. 2+ months of Chapman is it.
to get one of the best you have to give up one/some of your best...but it's a bit painful to watch the system's best prospect walk for any 2-3 month rental, especially one that's not an everyday player.