Matt Wieters is making progress. A trade for another catcher was taken as a sign by many that Wieters might be heading for surgery, but Dan Connelly of the Baltimore Sun corrected that thought. While Wieters hasn't begun any baseball activities, the thought that he's getting closer is not only a positive, but it shows that the direction he's taken may be correct.
Wieters is doing a standard elbow rehab at this stage, focused on range of motion, stability and secondary stabilizer strength. With a damaged ulnar collateral ligament (UCL), the concern will be that the elbow will have additional laxity and that the scar tissue that's rebuilding the damage will need to be protected until the ligament is stronger.
Another big advantage that Wieters had was a platelet-rich plasma (PRP) injection delivered directly into his elbow. PRP is made by drawing blood out of the patient, spinning it in a centrifuge and then injecting it back into the patient in the joint space where the problem exists. For Wieters, that was the elbow, of course.
PRP has been used for several years, but there is no consensus on why or even if it works. The scientific studies are very vague and have mixed results. There's agreement that using the body's own product in concentration does no harm, at the least, and most surgeons say they have seen some gains in some cases. Dr. James Andrews once stated that he was going to use PRP on all elbows he saw. "If it doesn't hurt, it can't hurt to try," he explained to an audience at his ASMI conference.
PRP is also being lumped in with other therapies, such as extracting stem cells from the body or adding things to PRP, such as the Regenexx therapy that is becoming more widely used in American sports. The term "biologics" is taking hold, though it's still a very vague label. Stem cells were recently used to help CC Sabathia's knee, though it is too early to tell how well it works.
These injections may not be well understood, but they are not illegal. Some have been confused due to the use of HGH and other substances in some injections, but in a tested environment, doctors know not to use those substances. Dr. Anthony Galea was caught using some performance enhancers in his injections, but the guy was arrested for a reason.
When I wrote an article about the future of sports medicine for Popular Science a few years back, many of the doctors I spoke with pointed to biologics as one of the big possibilities. If Wieters and others can have a low percentage rehab like his aided by their use, it's a win-win proposition for everyone.
Right now, the Orioles are operating on a calendar, not a clock. They'll be as patient as they can be with Wieters in his rehab, but for every day they wait before surgery, they're taking a day off his 2015 season. They're gambling on the possibility of the biologically aided rehab working and risking some lost time in the future.
There's no indication at all that Wieters will be back to catching in the short term. The trade for Nick Hundley seems to be intent on getting more production from the position in the short term, but it may also be needed in the longer term if Wieters has to shift to DH. With Chris Davis at 1B, that's not a long-term option unless Davis moves on.
The next step for Wieters will be taking swings. He's weeks away from live batting, and again, this is not an assured step. Even a small setback could force him to undergo surgery, ending his 2014 and perhaps eating into his 2015. The Orioles hope that biologics and hard work can keep Wieters on the Albert Pujols path, avoiding surgery and maintaining production.
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