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April 21, 2008

Under The Knife

Fallen Aces

by Will Carroll

Ben Sheets (20 DXL)
If he were alive today, Franklin Adams might add to baseball's lexicon the ominous term "when healthy." Prior to Harden to Sheets doesn't have the same poetic tone or even make any logical sense, but in their own way, these three pitchers have come to symbolize this era of pitching as much as any. While pitch counts, innings limits, and mechanics have become as much a part of the discussion around baseball as wins and losses, Sheets and the others are in one of two states: dominating or broken. The frustrating part is that we're seemingly learning nothing from them regarding the process of how a pitcher stays healthy and/or breaks down. With each of them, some failure happens with little or no known cause, that symptom is worked on, and then they're returned to the rotation. With Harden, he'd made significant changes, but ended up with the same short-term result. It's a moving target, one injury after another in various locations, and it's that which might be the problem. Focusing on one part of the kinetic chain, ignores the holistic issue of how a pitcher delivers and distributes force. Those forces will find the weakest link, and if the body can't handle the repetitive stress, it will break. Sheets' latest injury, a triceps strain near the shoulder, is even more frustrating for an organization who is ahead of the curve in the use of advanced motion analysis and in possession of one of the best medical staffs around. Sheets could be headed to the DL as a conservative move while the Brewers continue trying to figure out how to keep him healthy. In the meantime, Yovani Gallardo will slide into the rotation, with Dave Bush at the ready if Sheets can't make his next start, scheduled for Wednesday.

C.C. Sabathia (0 DXL)
With poor results through three starts, it shouldn't surprise anyone that there's a suggestion that Sabathia is hurt; in one unfounded rumor, Sabathia isn't throwing sliders due to a UCL problem. Not only is this wrong, it's factually incorrect. I asked a doctor I trust about the idea that Sabathia's pitch selection has anything to do with the health of his arm. He explained the structure of the arm to me saying, "the flexor pollicis longus originates on the radius, unlike the other major ligaments that originate on the ulna. Origins are proximal (closer to the body) and attachments are distal (further from the body). The UCL originates on the medial condyle of the humerus and attaches to the coronoid process. Comparing origins and attachments is like comparing apples to oranges. All these muscles have in common are their actions (flexing) and the fact that they originate at or near the elbow. There's no medical or functional reason that a slider would be more or less affected by this than a fastball." In fact, the stress of a slider is less on the important are of concern here, Sabathia's middle finger, than it would be on a fastball. Moreover, a 1987 study by Dr. Frank Jobe and a team of biomechanists showed that there is not a significant difference between the flexor-pronator muscular forces used in a fastball and a curveball. This matches with Dr. Glenn Fleisig's 2005 study that showed there were not significant differences in kinematics for fastballs, changeups, and breaking balls, including the slider.

David Weathers (15 DXL)
Like Joe Borowski, Weathers is one of those guys that confounds fantasy players and insiders alike while proving that it doesn't always take dominant stuff—or even good stuff—to succeed as a closer. As a set-up man in front of Francisco Cordero, his fantasy value is down, and there are plenty of other options for Dusty Baker to turn to in light of the command issues that Weathers has had, problems that we can now attribute to his elbow problem. Weathers heads to the DL with ulnar nerve irritation, a more common ailment than the one Matt Garza is dealing with. It's not a serious case, but the Reds tend to be conservative managing their pitching injuries and were facing some roster choices anyway, making this both an easy and productive move. Weathers shouldn't be out much beyond the minimum, assuming that the rest and treatment clears up the irritation as it normally does. There's no need to rush, so don't be surprised to see the Reds let this one drag out beyond the expectation. I include Weathers here because his elbow problem shows that pitch selection doesn't go hand in hand with injury.

Noah Lowry (45 DXL)
The six-man rotation that the Giants are discussing is a big deal in that it could look like a shift. The thing is, the distribution of starts probably won't significantly change. As you can see on BP's depth chart for the Giants, the team is already spreading 162 starts among an expected seven pitchers. That they'd do this in what amounts to a six-man rotation really doesn't do much. The rotation and much of the reason that BP has suggested using a four-man rotation in the past is that there's no evidence that throwing in this type of rotation protects the arm while putting more starts in the hands of what should be the lesser starters, and reducing the opportunities for the No. 1 and 2 starters. The fifth starter or the least effective pitcher—is always on the bubble, either to be skipped or to be replaced. However, the Giants don't have as big a separation between the top and the bottom, though when you take what amounts to four starts from Tim Lincecum and Matt Cain and hand them over to Kevin Correia or Pat Misch without any guarantee that there will be any uptick in health, it's a questionable choice. The Giants already had some of the best results in the bigs for keeping players healthy, so this decision runs counter to the one strength the Giants have left. Lowry's return from forearm surgery has him on track to start a rehab assignment around the calendar flip, then back in the rotation in mid-May.

The other thing to keep in mind is that a smart modern four-man would limit a pitcher to around the same or slightly lower levels as used today. Six or seven innings would be the norm; let's use 6 1/3 as the "average" here, though that's probably not far off today's average. In a six-man (27 starts), a pitcher could be expected to go 170 innings, roughly. In a five-man, the normal 32 starts get that pitcher to 202, a mark only 18 pitchers hit last season. In a four-man, the average would get someone to 240 innings. It's a leap, but not an insurmountable one, and certainly not one unheard of in the modern pitching world. Dave Sheinin also takes a look at the factors in his recent article at the Washington Post.