January 30, 2012
Rounding Up the Usual Suspects: Grand Finale
Spring training seems like it is right around the corner, although from where I’m writing from, winter still hasn’t arrived (we’ve only had about three inches of snow in Boston this season). One of the great things about spring training is that you never have to worry about snow. On the other hand, injuries will happen regardless of the weather outside.
Over the last few months we have talked about the ”usual suspects,” that is, the kind of injuries we see over and over. How common are they? To answer that question (and hopefully not bore everyone to death), I brought a bunch of graphs. There are also doughnuts for everyone at the back of the room. In the first graph, we have the breakdown of usual suspects disabled list injuries, with the data collected for the years 2002-2011. There is some overlap between a few of the categories, (most notably with fractures). It probably won’t surprise you that pitchers make up a large part of the shoulder and elbow injury categories (such as rotator cuff, labrum, or Tommy John surgeries). Abdominal strains are more spread out; understandable when you consider that the number of swings a hitter takes during the season is often more than the number of pitches a pitcher throws throughout the year. Other injuries, however, are less discerning in their targets: Knee injuries, hip injuries, and fractures are all equal opportunity disablers, with only the DH managing to miss out on the party.
Another way to look at it is to see how the different types of injuries make up the whole of all baseball injuries. Out of these usual suspects, almost one-third concern the shoulder while another 24 percent involve the abdomen or the elbow.
To give you an idea of the discrepancy between injury rates for pitchers and position players, take a look at the graph below. Over half of all the DL stints are for pitchers (when I wrote this, an Eddie Murphy Raw quote came to mind: “Half. I’ll take half his…”). A key point to consider is how relief pitchers have gotten hurt at a greater rate than starters, dampening the theory that pitching injuries are solely related to high pitch counts. Outfielders rank third, but this is misleading since there are three of them on the field. When we take all of that into account, every other non-pitcher on the field stands roughly the same chance of ending up on the disabled list.
It would be nice if all of the days missed due to injury averaged evenly, but this is only wishful thinking. The discrepancy actually worsens here, to the point that 60 percent of all disabled list days are missed by pitchers. All other positions average around five percent.
So, we have the basics, but that’s not all the information we need. Preventability is what separates players who last in the majors and the ones who don’t. Knowing how to prevent injuries is how team medical staffs can make the biggest impact on the field, and consequently on the bottom line. There will always be inherent risk for some injuries, like fractures, concussions, and dislocations, but you might be surprised to see how poorly some positions do.
Injuries like sprains, fractures, dislocations, concussions, ACL tears, meniscus injuries, and contusions are, for the most part, not preventable. One can argue that the chance of any injury can be lessened through improved balance training or reaction time, but with these particular problems the best we can do is moderate the degree of injury, not avoid it altogether. On the other hand, we have shoulder inflammation, rotator cuff tears, labrum tears, Tommy John surgery, elbow inflammation, disc problems, and many types of strains that are more preventable. Clean-out surgeries were included in this section because of the pathomechanics associated with these conditions, while sports hernias are also included because of their chronicity.
As the graph below shows, preventable injuries are much more common than non-preventable ones. All position players, except for DH, have non-preventable rates of at least 40 percent. On the other hand, pitchers come in rock bottom, around 12 to 13 percent each. This means that over 85 percent of all pitching injuries have a large component of preventability, a staggering number... but not as staggering as what is coming next.
Here’s what will blow you away: 10 percent or less of all days lost due to pitching injuries were due to injuries that were unpreventable. In this ten-year period, over 100,000 days lost to injury for pitchers had some level of preventability. That’s over 273 calendar years. Shoulder inflammation, abdominal strains, and Tommy John surgery are all taking their toll, but to some degree these were avoidable injuries.
We will never be able to avoid all injuries, but think about what could happen if we were able to cut that number in half. Your favorite players would stay on the field longer, and general managers would not have to waste money on injured players. The quality of play would improve, leading to more parity across the league. This has been possible for some time; teams just need to invest as much in their medical staffs as they do in filling out their roster