Hughes And Everything You Wanted To Know About TOS...

The good news is that Phil Hughes may finally have a definitive diagnosis as to why he's got no pop on his fastball. The bad news is that for the moment local specialists believe Hughes is suffering from Thoracic Outlet Syndrome (TOS).

According to the National Institute of Health, TOS "is a rare condition that involves pain in the neck and shoulder, numbness of the fingers, and a weak grip. The thoracic outlet is the area between the rib cage and collar bone."

"Blood vessels and nerves coming from the spine or major blood vessels of the body pass through a narrow space near the shoulder and collarbone on their way to the arms. As they pass by or through the collarbone (clavicle) and upper ribs, they may not have enough space.Pressure (compression) on these blood vessels or nerves can cause symptoms in the arms or hands.

Problems with the nerves cause almost all cases of thoracic outlet syndrome.Compression can be caused by an extra cervical rib (above the first rib) or an abnormal tight band connecting the spinal vertebra to the rib. Patients often have injured the area in the past or overused the shoulder.People with long necks and droopy shoulders may be more likely to develop this condition because of extra pressure on the nerves and blood vessels."

Hughes will be visiting the "go-to-guy", Dr. Robert William Thompson in St. Louis, to have the diagnosis confirmed or ruled out. A time table had not been set as of last night. Hughes had undergone several hours of tests before it was determined that TOS was the likeliest scenario.

Physical therapy is the first order of business in such a case to strengthen the outlying areas and improve range of motion. Meds may be added, such as a blood thinner. If symptoms don't improve than surgery is performed. Here's the "not-so-great" part. Surgery is successful in 50%-80% of patients. Not exactly a "sure thing" and disconcerting for a pitcher. Also some patients experienced weakened muscles. 5% of patients experience a recurrence.

The surgery may involve removing an extra rib and cutting certain muscles; removing part of the first rib; bypass surgery performed to reroute around the compression or remove the area causing the issues.

Texas Rangers pitcher Matt Harrison, Colorado Rockies hurler Aaron Cook, and Boston Red Sox catcher Jarrod Saltalamacchia are among those who have undergone the surgery. (The Texas Rangers in particular seem to have a problem with TOS; Saltalamacchia was with the Rangers at the time. Kenny Rogers, Hank Blalock, and John Rheinecker have all undergone the procedure as well. Blalock was the only non pitcher/catcher).

On the bright side when Rogers had his surgery he returned with an extra 4-5 mph on his fastball. Either way the recovery time can vary. But this is indeed a delicate condition to be dealt with.

The Daily Yankeeland - 3/6

We said Joba Chamberlain was awful yesterday, and we stick by that. But he feels good, which is important. After walking four and allowing a hit without retiring a batter, Joba shrugged his performance off as one of those spring days when the mechanics are off. More importantly, he felt good physically. Joe Girardi isn't concerned about Joba yet, but will be if he throws the same way his next time out.

Hideki Matsui participated in his first game, going 0-2 in the exhibition game with Team Canada. Le Canada won 6-0.

Both Mariano Rivera and Edwar Ramirez threw off a mound yesterday. It was the first time this year for Mo and the first time since experiencing shoulder discomfort for Ramirez.

The beat writers for various teams around the country are already looking at who their team can deal to the Yankees if A-Rod is out. The Dallas Morning News would like to move the injury prone Hank Blalock and his $6.25 million annual salary. One of the bay area papers (sorry, we lost the link) suggested the even more injury prone Bobby Crosby, who is not even a third baseman. A's GM Billy Beane has said, for now, he does not intend to trade Crosby despite the acquisitions of Orlando Cabrera and Nomar Garciaparra.

Joe Sherman of the Post reported today that Brian Cashman recommended that the Yankees let A-Rod walk if he opted out of his contract prior to the 2008 season. Perhaps the Steinbrenners should have listened.

MLB.com's Jonathan Mayo takes a look at 10 Yankees prospects to watch.

Former Yankees pitching coach/mentor Billy Connors has established a fund to help Schenectady, NY students.

Around the Horn - 7/11

The Diamondbacks are looking into the possibility of bringing back their former 1st baseman Tony Clark. The Arizona Republic reported that the Dbacks are one of several teams to have contacted the Padres about the 6'7" 1st baseman. We recommend they get a 3rd baseman too. Mark Reynold's lack of defense is killing them.

Dbacks GM Josh Byrnes and company have decided not to pursue Barry Bonds, and according to the East Valley Tribune, have denied having any interest in Milton Bradley, as had been reported on a radio broadcast.

According to the Dallas Morning News, Hank Blalock is set to start a rehab assignment and may soon finally return to the Rangers lineup.

Fausto Carmona threw a 50-pitch simulated game and, according to the Akron Beacon Journal, hopes to begin a rehab assignment soon.

Pitcher Josh Johnson made his return to the Florida Marlins after Tommy John surgery. He allowed 3 runs in 5 innings.

The Associated Press reported that the Mariners have acquired 1st baseman Craig Wilson from the Pirates for a player to be named.

Blue Jays outfielder Vernon Wells is out 4-6 weeks with a Grade 2 hamstring strain.

Around the Horn - 7/11

The Diamondbacks are looking into the possibility of bringing back their former 1st baseman Tony Clark. The Arizona Republic reported that the Dbacks are one of several teams to have contacted the Padres about the 6'7" 1st baseman. We recommend they get a 3rd baseman too. Mark Reynold's lack of defense is killing them.

Dbacks GM Josh Byrnes and company have decided not to pursue Barry Bonds, and according to the East Valley Tribune, have denied having any interest in Milton Bradley, as had been reported on a radio broadcast.

According to the Dallas Morning News, Hank Blalock is set to start a rehab assignment and may soon finally return to the Rangers lineup.

Fausto Carmona threw a 50-pitch simulated game and, according to the Akron Beacon Journal, hopes to begin a rehab assignment soon.

Pitcher Josh Johnson made his return to the Florida Marlins after Tommy John surgery. He allowed 3 runs in 5 innings.

The Associated Press reported that the Mariners have acquired 1st baseman Craig Wilson from the Pirates for a player to be named.

Blue Jays outfielder Vernon Wells is out 4-6 weeks with a Grade 2 hamstring strain.