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July 20, 2010

Under The Knife

A Case for Encyclopedia Brown

by Will Carroll

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Sometimes, things hide in plain sight. Do you remember those Encyclopedia Brown stories from about fourth grade? The brainy kid would solve the mystery inside of 10 pages, always in some sharp way. Put on your Encyclopedia Brown hat, because you're going to solve a mystery. Last week, a major study was published at the annual conference of the American Orthopaedic Society for Sports Medicine that got quite a bit of publicity. The money line from the study is that "pitchers are 34 percent more likely to be injured than fielders" and that "77 percent of all injuries to pitchers happen before the All-Star Game." The first seems like common sense, especially in this era. The second, the 77 percent, is wrong. It's correct, yes, but there's a very apparent reason. Think about it and I'll give you the answer in just a bit.

Brandon Inge (fractured hand, ERD 9/5)
At some point, someone will suggest that everyone wear a protective glove. Until then, we'll keep having unnecessary injuries like what will cost Inge six weeks. In the AL Central, a seemingly small thing like this could tip the playoff balance since even small losses or gains could be the difference. While broken hands from an inside pitch are a small percentage of injuries and a smaller percentage of at-bat outcomes, it doesn't diminish the cost when it does happen. As with batting helmets—and I should mention the new, smaller but better helmets we saw in the All-Star Game—there's no real cost, no adjustment to more protective gloves. Inge's fracture is non-displaced and he should be able to come back, but will he have a race to come back to?

Scott Kazmir (shoulder fatigue, ERD 8/2)
It should surprise exactly no one that Kazmir is back on the DL. The Angels starter is on the shelf with what's being described as shoulder fatigue. Sources tell me there's a strength imbalance laterally more than there's any sort of weakness. His average fastball is down 0.5 mph, but the average is based on an erratic series of ups and downs, so it isn't terribly instructive in this case. Since Kazmir was helped before by heading to see Rick Peterson, there's been some thought that he'd need to do the same, but Peterson isn't a free agent this time around and it doesn't look like Milwaukee is going to take on any part of Kazmir's risk. No, the Angels are going to have to figure this one out. The shoulder fatigue gives them a little time, but he's very close to being pushed to the LOOGY role in Mike Scioscia's bullpen, or maybe the Oliver Perez role. Kazmir is expected to be out until August, which gives Tony Reagins two weeks to figure out Plan B.

Justin Morneau (concussion, ERD 7/25)
Morneau is being treated very carefully by the Twins. He's headed to see a specialist regarding his concussion, but sources tell me this is more about clearance than any sort of treatment. Morneau is still having some symptoms—headaches, a bit of nausea with activity—but the Twins think he should be back soon. The problem with concussions is that they can linger and have no discernible time frame. That's what the specialist is about, using some advanced tests to provide a bit of guidance and some confidence for Morneau. He's eligible to return on Friday, but that's 50/50 now, though it's unlikely he'll need a rehab assignment.

Scott Rolen (strained hamstring, ERD 8/1)
Rolen is having a bad week. After a solid comeback year, one that makes Walt Jocketty look really smart, Rolen is down with a hamstring strain that's very likely to push him to the DL. On top of the strain, Rolen is also dealing with flu that had him dehydrated, perhaps exacerbating the symptoms of the strain. The Reds' medical staff is holding off on a final decision until they're at least looking at just the one problem, but all signs point to a DL stint coming for Rolen, a big blow to the lineup. Rolen's long history of back problems do come into play here. Back injuries and hamstring problems are often anatomically connected—check the Carroll Guide to Sports Injuries for more info on that, if you're interested—so the Reds will have to be careful to not exacerbate existing problems while they're trying to get Rolen back in the lineup. In a tight NL Central race with Jocketty's former club, the Cardinals, this could be a tipping point. Rolen's noted "toughness" is playing into the ERD; he's likely to push hard to be back at the minimum, but the medical staff is going to have to make sure he doesn't push too hard.

Ryan Sweeney (patellar tendinitis, ERD 10/4)
Sweeney has been dealing with an ongoing knee problem, but finally, he's done trying to fight through it. There had been some question about whether the surgery he's headed for was needed now. However, Sweeney consulted with several doctors, including Richard Steadman, and decided to have the surgery now. I was on the A's pre-game show Monday night and tried to make it clear that injuries might not seem like much, but can really sap the ability of a player to stay productive. If Sweeney felt he couldn't play on it, the fact is he probably couldn't, physically or mentally. He'll have one surgery and possibly have two, on both knees, if it's determined that it's needed. The procedure he's going to have is a patellar tendon decompression. It's an involved procedure, but one that shouldn't have long-term consequences. The normal recovery time according to my best sources is between 8-10 weeks, so Sweeney's season is effectively over. 

Andrew McCutchen (sprained shoulder)
McCutchen might not be part of "The Cavalry", the nickname for the group of prospects pushed up to the Pirates this year, but he might as well be their general. (Christina Kahrl is probably twitching right now, wanting to remind us that pirates didn't have horse-born forces and that the proper term is dragoon, given the context, unless of course you bring up Eylau ... ). Pirates fans can only hope that a shoulder injury doesn't turn McCutchen and The Cavalry into a baseball equivalent of the Seventh Cavalry. McCutchen has a mild sprain of his AC (acromioclavicular) joint, where the collarbone meets the shoulder. It's painful and can linger, but doesn't tend to have serious consequences when the sprain is mild. McCutchen was available Monday night but unused and is likely to get a couple more games of rest and treatment, but won't need a trip to the DL.

Brian Roberts (herniated disc, ERD 7/26)
Roberts is up at Double-A after proving that the Rookie Leagues couldn't contain him. Even rehabbing, that shouldn't surprise anyone. Roberts is looking like the back problems that have kept him sidelined are, at least for now, under control. He's hitting, fielding, and running well, so this stint in Bowie could be a relatively short one. The O's could use the bump he'd give the team and the psychic lift. The problem is that, as before, it might not take much to push Roberts back. It was a slide last time, reminding everyone how fragile the work the medical staff has done on Roberts really is. He's going to be like that the rest of his career, so the team is going to have to be careful about his usage while Roberts is going to have to dial it back a bit on the diving and sliding. This could affect his steals total, if that's why you like him. If Roberts is activated quickly, don't believe the rumors that he's being showcased.

Chase Utley (sprained thumb, ERD 8/20)
Matt S writes: "Hey Will, I had a question for you about UCL tears in thumbs.  I tore mine in 2005 playing football with friends, and it was 5 months before I was free of casts, and I still didn’t have much strength in my hand for another couple months after that.  When I saw Chase Utley’s hand bend on the slide into second base when he tore his, I immediately thought it was a UCL tear because of how his hand bent and concluded he was done for the year.  He is supposedly coming back in a couple months apparently, though, and I have no idea how that’s possible.  I saw on TV that he’s wearing a cast that I wasn’t wearing until maybe 2.5 months later, and it’s been only 3 weeks.  I know that mine could easily have been a worse tear just because the orthopedist needed maybe 10 seconds to realize I needed surgery and Utley needed three opinions, but I just don’t understand how Utley is healing so quickly.  Is he very fast at healing, was I just incredibly slow, or are there a lot of flavors of right thumb UCLs?  Is Utley going to struggle after he gets back with power?  Because I didn’t have strength in my hand for a while afterwards, and I can’t imagine gripping a wooden bat and hitting a ball 400 feet even six months after the surgery.  Maybe I’m just a crappy healer, though?  I was curious if you had any explanation for me on this.  Thanks."

Thanks yourself, Matt. There's a simple answer here. I'm guessing you didn't have three trainers, two doctors, specialists, 24/7 care, and a million dollar incentive to get back. Utley won't be 100 percent when he does return, just functional, which is what the Phillies need. That could be enough or he could look terrible, one of the risks that you didn't have to take on because there was no ticking clock or Braves to chase down with your injury. The other thing to keep in mind is that athletes often take on risks that will cause problems down the line, things that no doctor would ask a 'normal' patient to take on. Fast forward 20 years and you might see Utley struggle a bit with signing autographs at Phan Phest or similar. But it's not unusual—more reminder that major-league players just look like normal people. Utley's time frame is normal for an athlete, not for you and me.

Ubaldo Jimenez
Sometimes I have conversations with some really smart and interesting people inside the game. I was talking with someone who must sadly stay anonymous (though you'd know the name) when Jimenez came up. He wasn't looking as sharp Monday night and this person started musing on the idea that the All-Star startshurt both Jimenez and David Price. We laughed it off, but he came back to it, wondering if Jimenez's better results might not be more fatiguing. "Sure, he's gone over that age you like to see. He went 220 last year (actually 218) and he's rocking the NL. But what if whatever changed was just a little more tiring? What if he's throwing just a little harder, working a bit longer, putting a bit more force on the Pedro-body of his?" I'm not sure if there's anything to this, but it was interesting enough that I thought I'd share. There's a lot we don't know about pitching and this is just one of them.

Quick Cuts: The Rockies are planning on Troy Tulowitzki starting his rehab assignment tonight. The plan would have him back in Rockies purple the following week. ... Jose Reyes was back in the lineup for the Mets, as expected. He looked healthy, though he did have a couple of errors. Those didn't seem to have anything to do with his mild oblique strain. ... Roy Oswalt scared the Astros with a bit of an ankle sprain last time out. He thinks he'll be able to go without issue on his next turn, which could end up his last as an Astro. A source reminded me that Oswalt's contract makes him very likely to clear waivers and be tradeable in August. ... Kevin Millwood will start tomorrow, a return exactly on the minimum from his arm issues. ... Look at Daisuke Matsuzaka's 2010 numbers. Now look at Ben Sheets' numbers. Why is Matsuzaka considered a "failure" while Sheets is a trade target? I don't get it, especially after their matchup last night. ... Rocco Baldelli left his "special assistant" slot and is trying a comeback. We'll see how that works out, though he can hardly be expected to be a real addition to the Rays' lineup, nor can we blame him for trying. ... Speaking of comebacks, Jason Isringhausen is going to work out for the Reds and Jocketty, his former boss. There's some hope he could be a long-roster bullpen addition in September. ... Kyle Lohse is making some progress in his return from forearm surgery. We should know by the end of July if he'll be able to return to the Cardinals this season. ... Dustin Nippert was hit in the head by a comebacker, but doesn't appear to have any serious injuries. He's lucky, as is baseball. If he goes to the DL, Tanner Scheppers is a possibility for the roster slot.

Answer: This one took me a while to figure out, but it was such a strange number that it simply couldn't be "right." (There's a difference between correct and useful. When something's not useful or that there's a major logical error that leads to a result, I feel comfortable calling it wrong.) The answer here is that the date of the All-Star Game throws things off. It's a mid-July game, so there's always three months before it. This year, there were about 100 days of the season prior to the All-Star Game. That leaves 80 or so days after in this example. Here's the problem—teams stop using the DL on September 1 when rosters expand. That means there are actually only 50 days where a pitcher could get injured after the ASG. The big difference in the size of the buckets changes everything and makes that 77 percent very explainable and not very useful. Like knowing that Encyclopedia Brown's real first name was Leroy. Yeah, Leroy. (Thanks to Bil Burke and Joe DeFrancisco for discussion and thoughts on this.)

36 comments have been left for this article. (Click to hide comments)

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TADontAsk

Would that 77% also include spring training injuries? That would provide further context to your answer since it would expand the 100 day window prior to the AS Game.

Jul 20, 2010 07:34 AM
rating: 2
 
BP staff member Will Carroll
BP staff

Good point!

Jul 20, 2010 07:47 AM
 
eeyore
(885)

If it's measured by the DL, don't all the injuries that happen during the off-season get credited to happening in March and April, when teams finalize their rosters?

Jul 20, 2010 08:22 AM
rating: 1
 
OTSgamer
Other readers have rated this comment below the viewing threshold. Click here to view anyway.

What ERD do you have for Brandon Webb?

Jul 20, 2010 07:38 AM
rating: -6
 
SaberTJ

Did they focus on DL days only? Lots of injuries after the roster expansion aren't recorded like they are prior.

Jul 20, 2010 07:59 AM
rating: 0
 
BP staff member Will Carroll
BP staff

Umm, that's what I said.

Jul 20, 2010 08:01 AM
 
SaberTJ

See below. Didn't realize you type the answer in the column.

Jul 20, 2010 08:06 AM
rating: 0
 
Dan W.

Kazmir's still a 26-year old lefty with a track record of success in the not-too-distant past (2005-08, more or less). Milwaukee needs pitching. Even if Peterson weren't there, wouldn't Kazmir be an attractive/logical trade target for them? (Also, I can think of a 1B they could ship to Anaheim in return for a Kazmir-plus package.)

Jul 20, 2010 07:59 AM
rating: 0
 
BP staff member Will Carroll
BP staff

That's a lot of plus. A lot.

Jul 20, 2010 08:02 AM
 
SaberTJ

Sorry, thought you were giving the answer in the comments. I had only read the first paragraph before guessing the reason behind the inaccuracy of the study.

Jul 20, 2010 08:06 AM
rating: 0
 
lonechicken

Speaking of comebacks (some more): Wily Mo Pena's back as well on the same day as Rocco Baldelli.

Jul 20, 2010 08:28 AM
rating: 0
 
tommybones

"Hey Brown, why don't you make like a tree and split!"

Man, I loved those books as a kid.

Jul 20, 2010 09:12 AM
rating: 1
 
jgrinnell

Bugs Meany is nodding his head in agreement.

Jul 21, 2010 13:13 PM
rating: 1
 
tommybones

Choose Your Own Adventure Books were better, though....

Jul 20, 2010 09:13 AM
rating: 5
 
JoshC77

I'd give you a +10 on that if I could!

Jul 21, 2010 04:14 AM
rating: 1
 
flyingdutchman

"Why is Matsuzaka considered a 'failure'"...

Because his team paid over $51 million for exclusive negotiating rights with him.

"...while Sheets is a trade target?"

Because Matsuzaka is set to make $10 per year through 2012 and Sheets a prorated $10 for the rest of this year only?

Jul 20, 2010 09:47 AM
rating: 2
 
OTSgamer

I think you're hitting on part of the reason. I see two big reasons why Sheets is more of an attractive trade candidate than Matsuzaka:

(1) Sheets is a free agent at the end of the year, while Matsuzaka has about 20 million guaranteed coming the next two years (and more in incentives if he pitches well).

(2) Matsuzaka has a full no-trade clause in his contract. Given that he is already with a top team, I doubt he's going to be willing to accept too many trade offers.

Jul 20, 2010 10:27 AM
rating: 2
 
BP staff member Will Carroll
BP staff

Good point. My original point is obscured by the trade implication. There's obvious reasons why Sheets is a target and Matsuzaka isn't. What I was trying to say is that Matsuzaka, this year, is better than Sheets, this year. By "trade target" I meant to imply success, but instead just confused the issue.

Jul 20, 2010 10:32 AM
 
ScottyB

Will, could it also be that pitchers injured in the 1st half aren't around to get injured again in the second half?

Jul 20, 2010 10:17 AM
rating: 2
 
ScottyB

as an analogy...if someone told me 77% of the times that high school kids got sent home happened before lunch, I would conclude that the bad kids got sent home early and weren't around to cause trouble later...

Jul 20, 2010 10:19 AM
rating: 2
 
BP staff member Will Carroll
BP staff

Also a good point.

Jul 20, 2010 10:31 AM
 
wilykat

not quite the same... when a high school kid gets sent home, they don't have an 8th grader come to high school for the rest of the day.

(unless the study only tracks people who were in the majors as of opening day, that isn't a relevant factor, I don't think.)

Jul 20, 2010 10:49 AM
rating: 0
 
dalbano

At the same time, the 8th grader wants to stay in high school and is going to act like a good kid so he doesn't get sent back, even if he is a bad kid after school is over.

Jul 20, 2010 13:16 PM
rating: 0
 
irussma

Well, minor-league pitchers get hurt too. So the ones that get called up are guys who, just like the big-league guys, have already passed through previous parts of the season unscathed and are thus probably pretty durable. Plus, minor-league fill-in guys tend to get rotated in and out, and the lower workload tends to reduce injury risk.

With all that said, this is still probably a pretty small factor. But I'm guessing it matters a bit.

Jul 20, 2010 14:35 PM
rating: 0
 
ScottyB

This is true, but I guess the injury-prone would get injured first, replaced by replacement-level-injury players, who are less likely than the first group to be injured. of course, the non-injury-prone can play the entire year.

Jul 21, 2010 11:19 AM
rating: 0
 
TangoTiger

Number of DL trips, all players, 2002-09, by month:

1 0
2 0
3 419
4 784
5 634
6 562
7 490
8 531
9 93
10 1
11 0
12 0

So, yeah, you have a definite bias in DL assignments. July has about 10-15% fewer games (because of the All-Star game), and so, it's no surprise that DL assignments in July is about 10-15% less than June and August.

The average of March/April is 600, and that's in-line with May/June.

All-in-all, nothing there.



Jul 20, 2010 12:24 PM
rating: 3
 
jake726

Doesn't it make intuitive sense that you would have fewer injuries in March? Lumping March, as spring training, in with April, the regular season doesn't make a whole lot of sense.

At the same time, it would be interesting to see a breakdown for the April injuries by week. Some of the injuries credited to April are going to be a result of players who were already hurt actually getting placed on the DL. But, depending on the size of this number, there might still be a noticeable trend of players getting hurt more in the early months of the regular season. This wouldn't be that strange. The early parts of a season, as your body has to readjust to the grind of professional baseball, do seem likely to be more dangerous than the later months when your body is accustomed to what it is being asked to do.

Jul 20, 2010 14:10 PM
rating: 0
 
BP staff member Will Carroll
BP staff

I'll have more numbers in the next column.

Jul 20, 2010 14:21 PM
 
John Carter

Roughly 20% more injuries in April over an 8 year period . . . could be significant.

Is it possible the high April number is from teams waiting for the end of spring training to decide whether they really have to put their pitchers on the DL?

Perhaps, pitchers are injured more often in colder weather

. . . or before they are used to pitching a full schedule. If that is the case, teams might try to have their starters pitch fewer innings in April. I wonder how those stats break down between starters and relievers.

Jul 20, 2010 14:23 PM
rating: 0
 
BP staff member Steph Bee
BP staff

That's certainly possible, and it's also possible that the massive influx of injuries in April come from people who had off-season surgeries or injuries that they are still nursing and aren't ready for Opening Day. My guess is that the first week of April has a pretty high concentration of players headed to the DL as they continue to rehab from their various maladies.

Jul 20, 2010 15:14 PM
 
BP staff member Will Carroll
BP staff

You're right, Steph. More numbers in next column.

Jul 20, 2010 15:17 PM
 
sandriola

Is there any chance that the gloves Scott Sizemore was wearing when he was up with the Tigers would have prevented the broken bone in Inge's hand?

Jul 20, 2010 15:17 PM
rating: 0
 
BP staff member Will Carroll
BP staff

Couldn't have hurt.

Jul 20, 2010 18:22 PM
 
FLeghorn

I can't help but wonder if the Masked Stranger's comments about Ubaldo have some real validity to them. The last month he has been really lousy. The pattern is generally that he starts off strong, but by the fifth or sixth he reverts back to rookie Ubaldo; constantly wild, seems to have no idea where the ball is going, and inevitably throws a straight pitch that any major leaguer can take over the wall. I know that a lot of his early success was 'luck', but it's not as though he's not a very good pitcher. He was worked really hard in the first half of the season, so I do wonder if fatigue is becoming a factor. He's a big fellow, and he can tend to labor a bit. I'm starting to think that, not only is the Cy Young talk going by the wayside, I'm not certain he'll even win 20 games. He's been that bad.

Jul 20, 2010 15:49 PM
rating: 1
 
datacooker

An analysis of 1989 - 2010 DL data will be presented @ the annual meeting of the american statistical association on August 2nd. Shows that more players on DL is not as important as the patterns over the season in terms of post-season performance.

Jul 21, 2010 07:14 AM
rating: 0
 
BP staff member Will Carroll
BP staff

I'd be curious to see this. Data from the DL is rife with collection issues, so that's going to be the first big problem.

Jul 21, 2010 10:22 AM
 
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