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December 2, 2004

Under The Knife

All Others Must Have Data

by Will Carroll

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Perhaps my favorite line from Moneyball didn't make it into the book. In my interview with Michael Lewis on Baseball Prospectus Radio, he said that "the real lesson of Moneyball might be not to trust what you think you know." Rick Peterson has a mantra of "In God we trust; all others need data." You'd think that hanging around this bunch of baseball geniuses would rub off, but I found myself falling into the trap of perception backed up by my own lyin' eyes.

It started with a quick news item on the indispensable Rotowire. Jaret Wright was thinking of signing with the Mariners, coincidentally the new employer of his former manager, Mike Hargrove. Hargrove has something of a reputation as a pitching woodchipper, with Wright often presented as an example of his carelessness. Wright's long struggle with a variety of arm problems surely calls into question the load placed on him as a 21- and 22-year-old, right in the danger zone noted by Nate Silver's "Injury Nexus" research.

I'd thought that Wright had been used too much in that brief, shining moment he had in 1997 and perhaps in the afterglow of '98. While he went over 200 innings in both seasons (including the minors in '97), he really wasn't significantly overused. PAP numbers and even pitch counts aren't handy, but the historical BP comments at the bottom of his PECOTA card give us plenty of information.

Wright wasn't overused during his stay in the minors due to the pitcher's friend, the non-arm injury. He got cracked with a bat, breaking his jaw in mid-'96, preventing him from throwing the innings that might have put his workload across a threshold of concern. In '97, he went all the way to Game Seven of the World Series, but the postseason actually didn't add much to his workload. He had a disastrous ALCS outing, lasting less than an inning, and pitched fewer than 25 innings over five games. Discounting that poor outing, he still averaged just six innings per start. His control gave some indication of fatigue, but the postseason calls for rough usage. Flags fly forever, while arms can lie limp at a pitcher's side for just as long.

Wright was often compared to the other young stud in the Tribe rotation, Bartolo Colon. Their numbers don't match up well--Colon is better in nearly every category and clearly "got it." We know now that Colon is a "coaster," easing off in non-pressure situations, building relative strength as the game goes on. Wright lacked a credible breaking ball, forcing him to bring the heat more and more despite any fatigue. Add in a motion that, according to an AL executive I spoke with, was "inconsistent to the nth degree. He was constantly tinkering, changing, and if I didn't know better, I'd say overthinking."

Wright's original pitching coach, Mark Wiley, left after the '98 campaign. He was followed by Phil Regan, then Dick Pole. During this time, Wright's shoulder was breaking down. When it finally gave way, no amount of mechanical tinkering was going to help. For nearly five years, it seemed like the best medical tinkering wasn't going to be enough either. Rotator cuff surgery, labrum surgery, and even a Modified Mumford--a shaving of the clavicle to cease a shoulder impingement--did little or nothing to help. Wright soldiered along through a couple organizations that remembered those fastballs he threw in the World Series, but showed nothing resembing the phenom of '97.

When Wright was given a chance in Atlanta, though, it was another case of Mazzone magic. Was it Leo Mazzone or just time that healed Wright? We'll probably never know, but Wright came back, throwing in 2004 like he'd done in October of 1997. The gap, those lost years that everyone thinks Wright was entitled to, were not lost to any gross misconduct by Hargrove or the Indians. Wright was simply on the wrong side of the coin. Data shows that nearly half of all pitchers will end up on the DL in any given three-year period. Young pitchers have it even worse. Wright is only different in that he came back.

If Wright ends up in Seattle, the story might be written of the reunion and some might have the same misperception I did. The Mariners have certainly had their share of injury problems with young pitchers, adding to the tension of the fans and followers. We'll know quickly which writers did their homework by which ones fall into the trap I almost fell into.

  • Bad news for Jason Giambi and his defenders. Leaks from the government hit the San Francisco Chronicle, detailing Giambi's use of several performance-enhancing drugs. Giambi, in grand jury testimony from a year ago, admitted not only the use of the BALCO-provided "cream" and "clear," but several other drugs, including HGH and readily available anabolic steroids. The "cream"--a testosterone gel--and the "clear"--the now-known THG, a non-injected sublingual anabolic steroid--have also been connected with other high-profile baseball stars, as well as athletes from track, football and other sports.

    The admission, under oath and with a grant of immunity from prosecution, is the first "smoking gun" in the BALCO case. Giambi's public denial of steroid usage flies in the face of the Chronicle-obtained testimony. Use of unregulated steroids, hormones, and even off-label usage of prescription drugs like Serophene (a testosterone-enhancer often used in fertility treatments) calls into question not only Giambi's performance during his peak, but his rapid decline over the past two seasons. Giambi's tumor, reported to be in the pituitary, may also be related to some of the substances he uses.

    It remains to be seen what the consequences will be for Giambi and his brother, Jeremy, also implicated in the testimony. In the absence of any positive test, any punishment may have to fall under the "best interests of baseball" power of the Commissioner.

    As the case against BALCO heads to trial, there are sure to be more revelations, more big names implicated, and more public relations damage to baseball. For now, UTK can only remind everyone that there is no study extant that indicates there is any advantage to be gained by use of anabolic steroids in baseball. Is it cheating? Yes, but it may not actually enhance performance.

  • I hate answering a question with a baseball koan. For some injuries, even the best informed insiders don't have any more clue than the drunkest fan does about the status of a player. Last offseason, no one, save a few tight-lipped souls in Oakland, knew how Mark Mulder would come back from a broken hip. The answer was quite well, thank you. Mulder powered through the first half of the season before hitting some wall, either an injury or simple fatigue. I "red-lighted" Mulder in the spring, having done that Team Health Report early, knowing that I simply didn't know, leaving the risk level extremely high. We knew all we needed to know with his first spring-training game.

    It's like that this offseason with a handful of players. I get regular inquiries from fans and writers asking me for the scoop on Magglio Ordonez, Brad Penny, and Chris Carpenter. None are in a situation where I can say much more than "we'll know when we know." With Andy Pettitte, I can point out that his surgery was very similar to and performed earlier than Jason Schmidt's in 2003. Schmidt came back and, using his timetable, Pettitte should be back about when the Astros believe he will, at the midpoint of spring training.

    We don't have that to go on with Ordonez, Penny and Carpenter, so a little more detective work is necessary. Penny and Carpenter have similar conditions, Penny's being by far the more serious. Both had nerve damage in their pitching-side biceps, a condition that hasn't been seen. They have little in common besides pitching and some history of shoulder problems. There are some guesses that swelling in the shoulder entrapped the nerve at some point, leading to the problem, but there's no evidence available publicly to support this.

    Carpenter is said to have been nearly ready to pitch in the World Series. Another week or two of treatment and strengthening could have put him back on the mound. Again, this suggests that there was something controllable, like an inflammation, activating the problem. Since there is some information that Carpenter was close--he was seen throwing in the bullpen before games--we can use that to extrapolate that he'll likely be ready for spring training. There is nothing, however, to show that the problem will not recur. Carpenter is a risk and that makes Penny, someone who showed just how painful this injury could be, even more of a risk.

    The nature of risk is that it is a possibility of an adverse outcome, not a certainty. We're performing as baseball actuaries, assessing the risk, just as any team would. Given a lack of information, the risk is likely to be overassessed from the coin-flip state in which most pitchers exist. Baseball has been historically risk-averse, leading to the preference for veterans and an aversion to science in any aspect of the game. Both these pitchers are risky. Both these pitchers have a significant chance of injury recurrence and long DL stints. However, both pitchers also have upside, as evidenced by their performance when healthy in 2004. Watch closely, have a backup plan, but these pitchers shouldn't be written out of the plan by the Cardinals, the Dodgers, or even your fantasy team.

  • Ordonez is another story. Knee surgery led to a bone marrow edema, an injury not often seen, let alone seen in baseball players. A second surgery, performed in Austria, has reportedly cleared up the problem. Knee surgery is nearly routine now, so any complication such as the edema is rare. Ordonez was unable to return and now faces questions about his ability to return to his previous performance level. That makes teams reluctant to sign big checks.

    Ordonez is reported to have a workout planned for teams during the winter meetings. If he can perform normal baseball activities, there's little reason to believe he won't return to his previous levels. Even if he's not fully healed now, he still has months to go before he needs to be on the field. Add in that Ordonez was not a speed player or rangy outfielder prior to the injury, and the effect is minimal. While knee injuries do have a tendency to recur and need occasional maintenance, there's no reason to believe that, even if surgery became necessary, the edema or other complications would arise again. A team would be smart to get Ordonez in a room prior to the workouts; if he can walk normally now, sign him. Sometimes you don't need all the information, just enough to make an informed decision.

  • Is there a worse fate than being a free-agent pitcher and undergoing surgery for a labrum problem? Sure, there's plenty of worse fates, but not for pitchers. Matt Morris underwent a "routine" procedure to repair fraying on his labrum. Fraying is a nice word for "small tears, caught early" and there's some track record that the earlier these are caught, the better the result. I'm told that Morris injury is very similar to that seen in Darryl Kile a few years ago, and Kile was able to come back and pitch well before his untimely death. Morris' timing is pretty bad for him, though the opposite is true for the Cardinals. Morris will likely re-sign with the team on a one-year, incentive-laden deal. His PECOTA comparables run the gamut, with the name Mark Gubicza standing out to me. I don't mind Morris on that one-year deal, but you couldn't pay me to go longer.

  • Quick Cuts: If Gary Sheffield has a torn labrum, as sources tell me he does, he may miss some of the upcoming season. We'll know more soon Teams that were worried about Carlos Delgado having bad knees shouldn't worry so much. Two sources tell me that his medical records show normal wear and tear. Getting on real grass should help some More bad luck for Twins outfielders: Michael Restovich broke his collarbone in a fall. He's expected to be fine for spring training, and has a shot once Jacque Jones gets dealt off to a team that loses a free-agent outfielder Brendan Donnelly had more surgery on his nose, broken by a fly ball during spring training Tim Salmon had shoulder surgery to fix rotator-cuff damage. It's unlikely he'll return for 2004. Think Rusty Greer with this What can Washington offer for Sammy Sosa? I'm not sure, but therehave been talks. Sosa is drawing interest from the Mets, Rockies, and at least one other team in addition to the Nationals Richie Sexson is a massive risk at any position other than first base. The numbers for players changing positions from infield to outfield look bad, and Sexson's injury is already one with a significant recurrence risk Reports that flamethrower Bobby Jenks will be ready for spring training are...well, they're a joke. Not a funny one, but one of those where you shake your head and wonder.

I'll be in Anaheim next week covering the winter meetings. Joe Sheehan tells me I have to write about them this year. It should be an interesting four days to be sure, and BP will bring you great coverage all weekend long.

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