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March 8, 2010

Team Health Reports

Minnesota Twins

by Will Carroll

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Team Health Reports 

The Summary: The training room is not a meritocracy. While all are welcome, athletic trainers are waking up to the reality that their valuable and finite time is better spent on certain players. In Minnesota, that's Joe Mauer. His comeback from a potentially devastating back injury is singular. From the first game back in the minors to begin his rehabilitation assignment, he exhibited power without losing his vaunted contact. The Twins continue to insist Mauer is a long-term catcher, rather than looking for ways to save his legs and back. Then again, maybe that's someone else's problem if the Twins can't sign the hometown hero. There's been less luck keeping pitchers healthy. The loss of relievers such as Jesse Crain and Pat Neshek are balanced by the health of the starting staff. The relatively new medical staff in Minnesota under Rick McWane is noted more for reaction to initial injury than prevention but, as the results show, they're very good at that.

The Facts
Days Lost:
638
Dollars Lost: $3,855,027.17
Injury Cost: $6,094,166.67

The Cost: The Twins were one of the best teams in baseball in regards to dollars lost in 2009, losing only $3.9 million. The 2009 season was a continuance of keeping the dollars lost to injury down. Minnesota has lost $14.8 million over the last three seasons, which was just slightly over the league average for just 2009. Mauer took up a large majority of those dollars lost in 2009, spending 26 days on the DL for a loss of $1.5 million. Minnesota had about $10 million that they saved on injuries compared to the rest of the league, and it appears that they used those savings to upgrade. The Twins spent north of $13 million to bring back Carl Pavano and bring in Orlando Hudson and Jim Thome as free agents. Minnesota also brought in J.J. Hardy through trade and will be paying him $5.1 million this season. The Twins look like a team that spent their savings and spent it to considerably upgrade at positions that tended to be weak in 2009.

The Big Risk: Hardy has really had only two healthy seasons. In those, he was phenomenal. In all the others, he's been injury-prone. It has mostly been a shoulder problem that started young and hasn't gotten better despite surgery and a designed strengthening program. A lot of people will point out that he's "just 27." Sure, but being injury-prone doesn't care about age, and chronic injuries get worse with every tick of the clock. The Twins understand the risks that Hardy has and were willing to take that on for the promised upside. Here's a very simple equation: in six of the last eight years, Hardy hasn't been able to stay healthy. If "25-percent health" isn't a big risk to you, well, this isn't the column for you.

The Comeback: "Fractured vertebrae" is one that doesn't come up in the database very much, thankfully. Justin Morneau watched from the bench for the last two months of the season after lower back pain proved to be a stress fracture. It's something that should heal well, but note that Morneau and his former roomie, Mauer, both had lower back problems. That alone would cause some level of concern, but going from the turf to grass with the opening of Target Field next month is thought to help this. We see that turf players with knee and back problems can come back well, but there's usually a long-term cost as well. Morneau's injury was at the L5 level, which has a ton of long-term implications. As a known injury, the Twins staff will need to watch this closely. Morneau's 10-year projections might trend downward, but in 2010, he's got a great chance to come all the way back.

The Trend:
One thing we know is that medical staffs have done well during the Selig-era building boom. In most cases, a brand new training room is designed inside new stadiums with much better facilities and new toys. Modern-era stadiums have pools with treadmills, giant weight rooms, modalities most people couldn't identify on sight like cold lasers and chiropractic "tappers." It's not quite the NFL with MRIs on site, but the difference between old and new is stark. With better facilities normally come better results, though they've often been a bit disguised under the noise a normal season caused. Good facilities don't outweigh one Tommy John surgery or a broken wrist. The Twins have been on a bit of an upswing the past few seasons, but pitching injuries have dragged them down from what sometimes appear to be solid results.

The Ratings

Red light SP Kevin Slowey: Slowey has some screws in his wrist and has made some comments that not only doesn't it feel like it did, it probably never will. Whether he can keep pitching effectively with those changes remains to be seen, though early results are positive.
Red light SP Carl Pavano: Do I have to say more than "Carl Pavano"? Yes, after last year, I probably do. Pavano showed that maybe he's just allergic to pinstripes and big contracts. He put up 200 innings and great control last season, but he defines risk.
Yellow light C Joe Mauer: Mauer missed a month last season, but his final line sure doesn't look like it. Still, back and leg injuries are all that stands between him and Cooperstown. Playing catcher makes it tougher and tougher to think his career will be both long and productive. Yes, I know I said that in the summary, but we should say this over and over until someone in Minnesota gets the message.
Yellow light 1B Justin Morneau: See The Comeback.
Yellow light 2B Orlando Hudson: Hudson's late-season swoon and benching last season with the Dodgers was coincident to another wrist problem. There's no evidence that they're related, but PIPP doesn't believe in coincidences. He's in a similar situation to last year, where a manager's pet player could cost him playing time.
Yellow light 3B Matt Tolbert: Tolbert has simply never had a full season of work, so while he's a low-risk yellow, it's also a bit telling that he started having muscular problems late in the '09 campaign. That's fatigue, Holmes.
Yellow light SS J.J. Hardy: See The Big Risk.
Yellow light LF Delmon Young: Young would be red except that he's expected to lose some work due to Jason Kubel needing to play in the field. He's come in to camp lighter, which is good, though there's no evidence to support the "best shape of his life" trope. Young's risk is probably a bit overrated. His benchings look like injury to PIPP, as we saw above with Hudson.
Yellow light CF Denard Span: Span played well enough to push Carlos Gomez off the field and out of Minnesota. Whether Target Field ends up a plus or minus for Span remains to be seen, but the increased workload has PIPP a bit worried. Span's backup is really Ben Revere, a great prospect with the odd combination of great speed and chronic knee issues. Span's health in 2010 could determine whether he's a Twin long term or just a placeholder for Revere.
Yellow light RF Michael Cuddyer: Cuddyer was as solid in 2009 as he was fragile in 2008. Which one will see in 2010? If we accept the underlying principle of the THR—that risk is measureable and that injuries are not completely random—then we have to accept that Cuddyer is risky while understanding that the more recent year has to be weighted more heavily.
Yellow light DH Jason Kubel: Kubel has been able to come back from devastating leg problems and succeed as the DH, but the presence of Thome (who's red) appears to be pushing him out to the field more often. A 50/50 split between DH and OF would have Kubel solidly in the red.
Yellow light SP Scott Baker: Baker's not young, had a perfect run up to going 200 innings in 2009, and is about as low risk as you'll see. Yet he's yellow because so many pitchers bounce off the 200-inning mark. I'll take that chance on this good, not great, pitcher.
Green light SP Nick Blackburn
Green light SP Francisco Liriano: Yes, really. His physical problems should be behind him, leaving it up to Liriano and the field staff to figure out how to harness the talent that's still there.
Green light CL Joe Nathan: News that Nathan is having problems with his elbow early in camp remind us that even the easiest of elbow operations isn't a good thing. If all it is for Nathan is some scar breaking loose, this green should hold. If it's more, well, few closers last even this long.

Green light RP Matt Guerrier: Gardenhire protects Nathan well. Unfortunately, he tends to ride one set-up guy, even when signs of wearing down pop up. Guerrier need only look over at Neshek and Crain for a reminder that he'd better watch his own arm.  


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