Learning how to manage left knee inflammation is part of Chicago Cubs left-hander Brandon Hughes’ everyday reality.
The issue stems from Hughes’ 2015 surgery to repair the meniscus in his left knee. Since then, his left knee has no cartilage and is essentially bone-on-bone, Hughes explained, constantly leading to inflammation. It flared up in spring training, causing him to open the season on the injured list. His knee again became bothersome to the point that the Cubs placed him on the 15-day IL Saturday, retroactive to Thursday.
Hughes’ latest situation began after the series against the Los Angeles Dodgers at Wrigley Field last weekend.
“It always will flare up a little bit after each (outing),” Hughes said Sunday, “and then it’s just a point of, like, how much it fills with (fluid), I guess.”
Hughes, 27, appeared in five games between IL stints, allowing two runs, two walks and tallying nine strikeouts in 5⅔ innings. He took a blown save loss in his last outing Wednesday against the San Diego Padres.
“In the past I’ve been able to just handle it and keep pitching,” Hughes said. “It feels like it’s taking me out of who I am as a pitcher and that’s why we’re seeing in the IL (stints).
“It’s been frustrating. But I think we’re going to put in a routine that’s going to hopefully help in the long run.”
Hughes’ knee was drained Friday. The swelling he kept experiencing limited his muscle usage, so part of his rehab plan will involve strengthening the muscles and improving stability.
“When it swells up a little bit, it’s a little bit more unstable and that has me guessing where the pain is,” Hughes said. “When it’s not swollen, I know where the pain is. When it’s swollen, it gets a little bit iffy.”
The Cubs are approaching Hughes’ 15-day IL stint with the hope it will be a minimum stay. Much of that optimism involves getting Hughes on a good routine and seeing how his knee feels after throwing a couple bullpens.
The Cubs want Hughes to wear his bulky knee brace during the day to help keep stress off his knee. Figuring out the appropriate recovery time between outings, such as how much Hughes plays catch pregame, will be a factor in determining the right balance to keep his left knee feeling good. Manager David Ross said the process will involve some trial and error, trying to break the cycle and get Hughes back as one of the Cubs’ high-leverage weapons.
“When you get off that backside, the mechanics suffer and then the pitch efficiency suffers, the effectiveness, it’s just kind of a snowball effect,” Ross said. “Just get him back on a nice routine of working with trainers and having a process to get ready to pitch everyday.”
Ross and the Cubs got a taste of how to best utilize the bullpen in high-leverage, late-inning situations the first two weeks of the season without Hughes. Expect to see right-hander Mark Leiter Jr. and his nasty splitter continue to get key opportunities against left-handed hitters. Left-hander Ryan Borucki was added to the Cubs’ 40-man roster Sunday to replace the optioned Caleb Kilian, ensuring they have a lefty in the ‘pen.
Jeremiah Estrada will get more looks, too, and veteran Brad Boxberger could close some games. Ross wants to keep Keegan Thompson healthy and not overextend his usage. Adbert Alzolay has pitched well, striking out seven and walking only one batter with one run allowed in his last six appearances. Getting Michael Fulmer on track in non-save opportunities also has him trending in the right direction.
Relievers’ roles might change a little with Hughes back on the IL as Ross tries to find the ideal late-inning combinations.
“We’re not always going to get the perfect matchup that we want sometimes,” Ross said, “but I don’t know that anybody does.”
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