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February 20, 2012

Collateral Damage

The DL Kings: Nick Johnson

by Corey Dawkins and Ben Lindbergh

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One of the most difficult aspects of injury projection is deciding how to deal with acute injuries. Athletes often acquire a “bad luck” label that follows them over the course of a season or a career, even if their injuries haven’t followed a predictable pattern. It isn’t much of a surprise that out of all the hitters in the last decade, one such injury-prone player, Nick Johnson, has missed the most days on the disabled list and the third-most of any player.

The New York Yankees drafted Johnson in the third round of the 1996 draft. Like all of the other players on the DL Kings list, when Johnson has been healthy, he’s been a productive player. In his first season in the Sally League, he displayed power, speed, and a good eye, only to improve over the next two years. He also got his first taste of the injury bug in 1998 when he dove for a ball, tore his labrum, and underwent surgery. He missed six weeks.

In 1999, Johnson cemented his top-prospect reputation with an OBP over .500 for Double-A Norwich. Prior to the 2000 season, he was ranked the fifth-best prospect in baseball by Baseball America. However, his momentum was soon halted. During spring training, he strained a muscle in his hand while taking a swing. Traditional therapy was unable to reduce the pain and inflammation, and it wasn’t until the medical staff put him in a cast for six weeks that his pain finally decreased. Unfortunately, that didn’t happen until the end of the season. Johnson wouldn’t play in another game at any level until 2001.

Johnson’s 2000 season ended because of a bad swing, but 2001 was the season when his high rate of getting hit by pitches—he took one for the team 37 times in 1999—finally caught up with him. He played in 110 games for Triple-A Columbus, but he hit the disabled list for a bruised hand after being plunked by a pitch. When he was active, he continued to get on base at an impressive rate (if not as often as he had two years earlier), and he was called up to the majors in August. Like most rookies, he struggled in his initial at-bats, but he was able to stay healthy.

By 2002, injuries were already being mentioned in the same breath as Johnson. To that point, though, none of the injuries appeared to be anything that could have been prevented, which made the DL stints all the more frustrating. Baseball Prospectus 2002 describes Johnson as possessing a “Max Bishop/Ricky Henderson batting eye and a very quick stroke; and plays a pretty good defense, too. There aren’t too many players with exactly the same skill set.” Armed with that skill set, he broke camp with the Yankees and managed to stay healthy through most of 2002, though he did end up on the disabled list in August with a bruised left wrist. He didn’t show the same kind of initial success in the majors as he had in the minors, but he did demonstrate that he could be a productive major leaguer when he was at full strength.

In 2003, Johnson started to put things together for the Yankees only after suffering through multiple injuries in spring training and the first half of the season. In camp, he dealt with two issues that likely forced him to change his mechanics just enough to cause problems later on. The issues began in 2002, when he bruised his left wrist while diving for a line drive at first base. After being activated that season, he did not have the same pop in his bat and managed only three extra-base hits. His condition improved to an extent in the offseason, but in January, he experienced sharp pains when turning the wheel while driving. As he made his way to spring training, the wrist still wasn’t right.

After trying rest and anti-inflammatory medications, he underwent an MRI, a CT arthrogram, and bone scans, all of which were reportedly negative. After undergoing additional treatment, including specialized taping and a pad on his wrist, his pain started to dissipate to the point where he could play. About a week later, he sprained his thumb, which shut him down for 10 days.

Once he recovered from the thumb sprain, Johnson made his time count until he returned to the disabled list in May, this time with a stress fracture in his right hand. He first felt pain on May 14th, when he fouled back a ball in the ninth inning. At the time, he was leading the league in walks and showing decent pop. Further testing revealed a stress fracture, and he was given a timeline for recovery of about six weeks. Six weeks proved optimistic, as Johnson didn’t make it back for 70 days.

Even though his injury was diagnosed as a stress fracture, it behaved more like a combination of a stress fracture and a true fracture in that he became more symptomatic after one particular incident. The bone could have had a stress reaction as a compensatory result of the injuries sustained in spring training. Once Johnson made it back from the stress fracture, he continued to get on base over 40 percent of the time, but his power slipped, and he hit only 18 extra-base hits in 60 games compared to 15 in his first 36 games.

Johnson was part of a player package that the Yankees sent to Montreal in December 2003 for Javier Vazquez. It was clear heading into 2004 that Johnson had trouble staying healthy, and playing on Olympic Stadium’s artificial turf probably wasn’t the best thing for him. Before stepping onto the field as an Expo, he’d torn his labrum diving for a ball, strained his hand/wrist after a swing, sprained his wrist, suffered a deep bone bruise after diving for another ball, and sustained a stress fracture that became problematic only after an acute episode.

Once again, he wasn’t able to make it out of spring training on the active roster. This time he strained his back and was on the disabled list for 52 days, and that was before the turf monster got him. On August 20th, Royce Clayton hit a hard grounder that took an odd bounce and smashed into his face, breaking his right cheekbone. That put him on the shelf for the rest of the year and cost him another 44 days.

By this point, Johnson had been on the disabled list in every season since 2000, and the trend continued through 2005. His talent didn’t disappear, but any ability he might have had to stay healthy did. Baseball Prospectus 2005 noted:

The ball jumps off his bat. He has amazing control of the strike zone. He’s potentially one of the best hitters in baseball. He plays first well enough that when he can be penciled into a lineup card, he can be a huge asset to his team. But Johnson can’t stay healthy.

On June 25th, Johnson was creative in how he was injured, as he bruised his heel while scoring standing up. Most bruises are day-to-day, but Johnson landed with his leg straight in the process of avoiding catcher Greg Zaun, jamming his foot and ankle in the process. Initially thought to be sidelined for only a few days, he missed almost a full month: 29 days, to be exact. The heel flared up on him periodically down the stretch, but never to the point where he had to be placed on the disabled list again.

Numbers alone don’t always tell the entire story, and 2006 was another example of this. Johnson stayed off the disabled list in ’06, but on September 23rd, David Wright hit a blooper into shallow right field. Austin Kearns came racing in while Johnson went racing out. They collided so violently that Johnson broke his femur and was immediately taken to the hospital via ambulance. He underwent surgery shortly thereafter. There were only seven days left in the regular season, so the Nationals didn’t bother to place him on the disabled list, but Johnson still kept his consecutive years injured streak going.

Fractured femurs are severe injuries and rare among baseball players. Bones heal predictably, however, and Johnson’s femur itself healed well. The soft tissues around it did not heal as well and became a major issue when he was trying to recover in 2007. When bones heal, they form a callous around the fracture site and look very similar to a swollen knuckle after it’s been jammed. Over time, that bone gets reabsorbed, and the contour becomes very close to normal again. During the time before the bony callous gets reabsorbed, the player’s biomechanics are thrown off. Johnson’s tendons, bursa, and scar tissue all were inflamed during 2007, and he had two cortisone injections into the area that helped, but that was not enough, in part because of continued weakness in the area. In August, he went through a second surgery to remove the rod that ended his season. The femur injury from the end of 2006 cost him 186 days in 2007.

Trying to put the broken femur behind him, Johnson started his 2008 season with Washington healthy but still could not avoid the disabled list. In his last at-bat on May 13th, Johnson injured his wrist and was diagnosed with a torn tendon sheath after an MRI. Placed into a cast, Johnson expected to miss about six weeks, a serious blow but not a season-ending one. As the estimated recovery date came and went, Dr. Richard Berger, a wrist specialist at the Mayo Clinic, evaluated the troublesome wrist. Further tests revealed that the root cause of Johnson’s pain was a split tear in a ligament that required surgery. He finally had the surgery in late June, but it ended his season, and the injury added 137 days to his already-impressive days lost total.

After turning the page on the calendar, Johnson looked like he might finally be able to put everything behind him. In the first half of the 2009 season, he missed only one day because of an injury, and that was nothing more serious than a HBP-induced bruised toe. He produced a .282 TAv before being traded to Florida, where he hit at a .315 TAv clip, proving that he still had something left. He suffered one injury that resulted in a trip to the disabled list, and that was just a strained hamstring, which kept him out for only 17 days.

Fresh off that successful season, Johnson signed with the Yankees for the 2010 season. The Bombers saw someone who could spend most of his time in the DH slot, take pitches, get on base, and fill in for Mark Teixeira when he needed a day off. They didn’t foresee the right wrist becoming an issue again, but the foundations were laid for further problems. Scar tissue formed around the tendon sheath and torn ligament that had been repaired in 2008, causing inflammation. Cortisone shots could not relieve the pain, so Johnson had surgery to clean up the scar tissue on May 18th.

As usual, it took him much longer to recover than expected: Johnson's problem isn't just getting hurt, but not being able to return quickly when he does. Scar tissue develops after every surgery. That’s how the body heals itself. After Johnson’s first surgery, new tissue formed around the tendon, and the tendon sheath continued to be inflamed. Johnson faced a choice: have another surgery that could improve his condition or give up any shot of being pain-free while hitting. That wasn’t much of a choice, so Johnson underwent the second surgery on his right wrist in less than a year in late August and hoped to be ready for the 2011 season.

That wasn’t to be. Injuries haven’t released their hold on him, and he hasn’t played in the major leagues since. The Yankees were clearly over their experiment with him after he missed 166 days between the 2010 regular season and postseason and did not re-sign him for 2011. However, the Indians were interested and hoped to get at least some production at a low price before he broke down again. They waited until March 7th to sign him, knowing full well that he’d recently had his fourth wrist surgery in three years. This time Dr. Thomas Graham at the Cleveland Clinic removed the tendon that had given him so much trouble.

Could that be all that Johnson needed to return to playing at a productive level? Could the real Nick Johnson stand up after 733 days missed since the start of the 2002 season? That didn’t happen last year, which Johnson spent hitting just .201/.326/.328 in 225 minor-league plate appearances, most of them coming in Triple-A. The Baltimore Orioles recently signed him to a minor-league deal, so we might find out whether anything’s changed for him this spring. Odds are that he’ll be injured again. That’s the safest expectation when a player has failed to finish the year healthy in five out of the last seven seasons and has been injured every year for over a decade. Johnson still has a .401 career OBP in the majors, but he can’t get on base when he’s on the DL, and he’s on the DL much too often.

Corey Dawkins is an author of Baseball Prospectus. 
Click here to see Corey's other articles. You can contact Corey by clicking here
Ben Lindbergh is an author of Baseball Prospectus. 
Click here to see Ben's other articles. You can contact Ben by clicking here

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