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 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.
Hughes’ knee again became bothersome to the point that the Cubs placed him on the 15-day IL on Saturday, retroactive to Thursday. This latest situation began after the series against the Los Angeles Dodgers on April 20-23 at Wrigley Field.
“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 and two walks and striking out nine in 5? 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 the IL (stints).
“It’s been frustrating. But 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 of 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 knee feeling good.
Manager David Ross said the process will involve some trial and error to break the cycle and get Hughes back as one of the Cubs’ high-leverage weapons.
“When you get off that back side, the mechanics suffer and then the pitch efficiency suffers, the effectiveness — it’s 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 every day.”
Ross and the Cubs got a taste of how to best utilize the bullpen without Hughes in high-leverage, late-inning situations the first two weeks of the season. 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 40-man roster Sunday to replace the optioned Caleb Kilian, giving them a lefty in the pen. Borucki had a looming upward-mobility clause in his minor-league deal.
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 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.”
