December 4, 2013
And here's the full roster.
Get It Now!Hardball Times Annual is now available. It's got 300 pages of articles, commentary and even a crossword puzzle. You can buy the Annual at Amazon, for your Kindle or on our own page (which helps us the most financially). However you buy it, enjoy!
Or you can search by:
THT E-bookThird Base: The Crossroads is THT's e-book, available for $3.99 from the Kindle store. The good news is that anyone can read a Kindle book, even on a PC. So enjoy the best from THT in a new format.
our CafePress store. We've got baseball caps, t-shirts, coffee mugs and even wall clocks with the classy THT logo prominently displayed. Also, check out the THT Bookstore. Please support your favorite baseball site by purchasing something today.
All content on this site (including text, graphs, and any other original works), unless otherwise noted, is licensed under a Creative Commons License.
Following are the one hundred most recent articles for the category Injuries .
11/14/2013: Let’s discuss the THT Annualby Dave Studeman
11/12/2013: It’s The Hardball Times Annual 2014by Dave Studeman
12/04/2013: Cataloging the non-tendered playersby Brad Johnson
12/04/2013: Alone on the pedestalby Jason Linden
12/03/2013: Mascot fight!by Greg Simons
12/03/2013: Why is a sinker “heavy?”by David Kagan
12/03/2013: The role of fall leaguesby Jeff Moore
12/02/2013: Nationals make great deal for Fisterby Matt Filippi
12/02/2013: The Twins go holiday shopping, but to what end?by Brad Johnson
12/02/2013: The end of the benchby Chris Jaffe
11/29/2013: Card Corner: 1973 Topps: Danny Waltonby Bruce Markusen
11/29/2013: The best rookies of the ‘30sby Chad Dotson
11/27/2013: Towards an award prediction systemby Shane Tourtellotte
11/26/2013: MLB’s coffers are overflowingby Greg Simons
11/26/2013: The role of prospects in tradesby Jeff Moore
11/25/2013: Stepping up to the plateby Frank Jackson
11/25/2013: 10 things I didn’t know about player birthdaysby Chris Jaffe
11/22/2013: The end of the road for Chris Carpenterby Chad Dotson
11/21/2013: All the news that’s fit to inventby Azure Texan
11/20/2013: Marcus Stroman, the mythbusting machineby Kyle Boddy
11/20/2013: Welcome to the birthplace of… someone elseby Jason Linden
11/19/2013: 2013 THT awards reviewby Greg Simons
11/18/2013: THT Fantasy has moved to Rotographsby Dave Studeman
11/18/2013: Atlanta gets burned againby Frank Jackson
11/18/2013: The 2014 Hall of Fame VC ballotby Chris Jaffe
11/18/2013: Must See MLB.TV 2013by Dave Studeman
11/15/2013: The best rookies of the ‘40sby Chad Dotson
11/15/2013: Card Corner: Wayne Granger: 1973 Toppsby Bruce Markusen
11/14/2013: 10th anniversary: the A.J. Pierzynski tradeby Chris Jaffe
11/14/2013: The Screwball: The face of championship baseballby Azure Texan
11/14/2013: Player-A-Day: Casey Fienby Brad Johnson
11/13/2013: Player-A-Day: Tim Lincecumby Brad Johnson
11/13/2013: Pitcher performance after batting successby Shane Tourtellotte
11/13/2013: 25th anniversary: Rob Neyer writes a letterby Chris Jaffe
11/13/2013: Houston hoodoo ‘62by Frank Jackson
11/12/2013: Player-A-Day: Joe Mauerby Brad Johnson
11/11/2013: Fastball velocity by game stateby Jon Roegele
11/11/2013: The rise of the middle-aged managerby Chris Jaffe
11/08/2013: Player-A-Day: Josmil Pintoby Brad Johnson
11/08/2013: Hall monitor: The case for Andruw Jonesby Chad Dotson
11/07/2013: Big leaguers, bit partsby Azure Texan
11/07/2013: Player-A-Day: Nathan Eovaldiby Brad Johnson
11/06/2013: If he’d only gotten another shotby Jason Linden
11/06/2013: Player-A-Day: David DeJesusby Brad Johnson
11/05/2013: Player-A-Day: David Ortizby Brad Johnson
11/04/2013: Player-A-Day: Jose Dariel Abreuby Brad Johnson
11/04/2013: The Boston (Braves) Marathon of 1928by Frank Jackson
11/04/2013: 10 things I didn’t know about birthdays in 2013by Chris Jaffe
11/01/2013: Taking the close pitch with two strikesby James Gentile
11/01/2013: Card Corner: 1973 Topps: Don Baylorby Bruce Markusen
11/01/2013: The best rookies of the ‘50sby Chad Dotson
10/31/2013: The Screwball: Celebrate good times, come on!by Azure Texan
10/31/2013: Player-A-Day: Leonys Martinby Brad Johnson
10/30/2013: Player-A-Day: Jon Lesterby Brad Johnson
10/30/2013: Forecasting the major 2013 awardsby Shane Tourtellotte
10/30/2013: The effect of seeing pitchesby Jon Roegele
10/29/2013: Putting the knock on pitching changesby Joe Distelheim
10/29/2013: Player-A-Day: Ryan Howardby Brad Johnson
10/29/2013: Losing momentum in the sixth gameby Dave Studeman
10/29/2013: Previewing the fall Stars gameby Jeff Moore
10/28/2013: Player-A-Day: Travis Woodby Brad Johnson
10/28/2013: Marquis Grissom: Mr. October Jr.by Frank Jackson
10/25/2013: The blackballing of Dick Dietzby Bruce Markusen
10/24/2013: Player-A-Day: Xander Bogaertsby Brad Johnson
10/24/2013: The Screwball: Put it in neutral?by Azure Texan
10/24/2013: The all-decade team: the ‘00sby Richard Barbieri
10/24/2013: Player-A-Day: Michael Wachaby Brad Johnson
10/23/2013: Earn money watching baseballby Dave Studeman
10/23/2013: Player-A-Day: Jose Iglesiasby Brad Johnson
10/23/2013: 20th anniversary: The Joe Carter gameby Chris Jaffe
10/23/2013: Giants take a risk with Lincecum’s two-year dealby Matt Filippi
10/23/2013: BOB: Nolan Ryan retires…for nowby Brian Borawski
10/22/2013: Where does David Price fit?by Jeff Moore
10/22/2013: Survey says?!?!?by Greg Simons
10/22/2013: ALCS post-mortem: The Fielder playby Shane Tourtellotte
10/21/2013: The best rivalries of 2013by Chris Jaffe
10/21/2013: World Series workhorsesby Frank Jackson
10/20/2013: WPS recap: ALCS, 10/19/2013by Shane Tourtellotte
10/19/2013: WPS Recap: NLCS, 10/18/2013by Shane Tourtellotte
10/18/2013: WPS recap: ALCS, 10/17/2013by Shane Tourtellotte
10/18/2013: Card Corner: 1973 Topps: Bob Baileyby Bruce Markusen
10/18/2013: The 2013 Atlanta Braves and core WARby James Gentile
10/18/2013: The best rookies of the ‘60sby Chad Dotson
10/17/2013: The Screwball: What about Bob Lemon?by Azure Texan
10/17/2013: WPS Recap: LCS, 10/16/2013by Shane Tourtellotte
10/16/2013: WPS recap: LCS, 10/15/2013by Shane Tourtellotte
10/16/2013: How much do we know about pitcher value?by Jason Linden
10/16/2013: 10th anniversary: the Aaron Boone Gameby Chris Jaffe
10/16/2013: BOB: Attendance and ratingsby Brian Borawski
10/16/2013: The most exciting games of 2013, part twoby Shane Tourtellotte
<< Click here to return to the category list.
June 26, 2013
Does elbow rehab ever work?Jonny Venters, Jason Motte, and now Dylan Bundy are those who have had major setbacks after receiving platelet-rich plasma injections in their elbow, combined with a rehab program intended to avoid replacing the ulnar collateral ligament (UCL, Tommy John surgery).
Bundy had discomfort in his pitching forearm/elbow on Monday after his rehab for 2013 had been progressing reasonably well, and so he will go see the dreaded Dr. James Andrews to further evaluate his rehabilitation plan for the remainder of the year.
Many have a dismal view on trying to rehab the elbow instead of just having surgery. Keith Law had this to say about Gavin Floyd:
Jeff Sullivan (formerly of Lookout Landing fame) and I had this conversation via Twitter:
My thoughts were mostly summed up in the exchange Jeff and I had. It's really easy to point fingers and say "rehab doesn't work, just go under the knife already," but this ignores the fact that TJS doesn't exactly have a 100 percent success rate.
For every Tommy John or Stephen Strasburg, there is a professional pitcher who has a story similar to this: Drafted in the first round, throwing 94-97 mph, and was cut because his TJS rehab didn't go well. He now throws 86-90 mph and is struggling to figure out where it all went wrong. (An actual person and client of mine.)
Assuming that a conservative plan for elbow rehabilitation takes six weeks (unlike the long plan of Dylan Bundy, which is way more rare) and TJS recovery takes 14 months, it's not hard to see that from a classic risk-reward analysis, elbow rehab doesn't have to succeed very often at all to be worth it.
There is also the very ugly side of arm injuries: pitchers who have had arm injuries (especially at the lower levels of the minors) are seen as damaged goods. You can find any number of anecdotal stories of players being released because they think an organization is trying to reduce the number of arm injuries in its system, because as Russell Carleton pointed out, the best predictor of future injury is a past injury.
So, I find tweets like Keith Law's to be very insensitive. While a long-term research project is needed to test the efficacy of rehabilitation methods like PRP, simply dismissing it out of hand and saying "get cut open" isn't the answer.
Posted by: Kyle Boddy
March 27, 2013
Tough time for NL third sackersMaybe there's something going around, but National League third basemen seem to be getting more than their fair share of injuries of late. Fans and fantasy owners probably are a bit panicked right now as this plague spreads.
Click for more...
Posted by: Greg Simons
September 10, 2012
Protecting the pitcher: The lesson of Brandon McCarthyI’ve always been reluctant to make it mandatory for pitchers to wear protective headgear, especially helmets, which are clunky and might not stay properly in place due to the violent nature of the pitching motion. But now, after the Brandon McCarthy situation, I’m ready to change my mind, at least partially.
McCarthy, a talented right-hander who has been part of Oakland’s surprising starting rotation, is now in stable condition after undergoing brain surgery to relieve an epidural hemorrhage, a brain contusion, and a skull fracture. Yet, he remains in a potentially life-threatening situation several days after being hit in the head with a line drive off the bat of the Angels’ Erick Aybar. Given the seriousness of his injuries, it is time for Major League Baseball to seriously consider protective headgear for pitchers.
Pitchers are fewer than 60 feet, six inches away from home upon delivery of the ball; the reaction time is incredibly small, even for elite athletes like major league pitchers. Based on a sampling of opinion from other writers at The Hardball Times, the average line drive comes back at the pitcher at about 80 to 85 miles per hour. The line drive that caromed off the right side of McCarthy’s head last Wednesday could have been going even faster, perhaps 90 or more mph. (The speed of a home run ball is generally 100 mph or faster.) Given that many pitchers are off balance and not in fielding position at the conclusion of their motions, it is unrealistic to expect most pitchers to be able to evade a line drive targeted for the head.
I’m still concerned about the awkward nature of a helmet, especially one that could shift during the process of winding up and throwing, and so could affect the pitcher's line of vision. Perhaps a better solution would be to fit pitchers with a protective liner worn under the cap. It’s true that the liner wouldn’t protect the face or the ears, but it would at least cover the top part of the skull.
Jackie Robinson wore a leather liner under his cloth cap during the '40s and '50s, out of fear that some headhunting pitchers had racist motivation. More recently, fiber or plastic liners were worn by a few position players in the 1970s: Bob Montgomery, Tony Taylor and Norm Cash come to mind as the last three players to bat without helmets. Though I’m not sure if any of the three were actually hit in the head with pitches during their careers, the bottom line is that all three escaped the game without serious injuries to their heads.
I think it’s time to do something before one of today’s pitchers has to endure what McCarthy is experiencing. Or worse. One of these days, we’re going to see another fatality related to an on-field happenstance, something that will be a tragic sequel to Ray Chapman in 1920. And right now, the pitchers are the most vulnerable people on the field; they are the ones that need the most help.
Posted by: Bruce Markusen
July 30, 2012
Chris Sale and “dead arm”In mid-May, I wrote about Chris Sale's faulty elbow and discussed valgus stress in the elbow as it relates to sidearm pitchers. Now there are reports that Sale will be shut down for a start or two due to "dead arm." Well, I bet many of you are asking...
What is dead arm, anyway?
Dead arm is the catch-all diagnosis for a pitcher who's losing velocity and/or command of their pitches, blaming it on fatigue. Physiologically, there's not much to this diagnosis - it's a description of symptoms rather than an actual inspection on the root causes. Chris Sale's velocity has been steadily dropping over the year:
It's also worth noting that Sale threw all of 71 innings in 2011 out of the bullpen, and in 2012 he's already at 124 innings split between the bullpen and in the rotation (predominantly in the rotation, of course).
We've talked about how sidearmers are more susceptible to valgus stress due to their mechanics, and this can play a role in the so-called "dead arm" issues that pitchers experience. As pitchers throw more and more innings at game intensities, three major physiological changes occur:
-They tend to gain external rotation range of motion around the shoulder joint and lose internal rotation at the same time
-The muscle tissues in the forearm develop adhesions as they are stressed while stabilizing the pitching elbow in the delivery
-The ulnar collateral ligament (UCL) can become stretched out while holding the bones of the arm together
The first two are all but guaranteed to happen, while the third happens if the pitcher has improper force application technique (mechanics) or other issues that can lead to a UCL sprain/rupture.
Most knowledgeable trainers will stretch their pitchers into internal rotation and provide exercises that passively engage the external rotators of the shoulder to help restore ROM in IR and strength in ER without a concomitant "bounce" that happens in the late-cocking phase of the delivery to help mitigate issues with the first physiological change.
A pitcher (me) about to exit late-cocking phase
Forearm adhesions and soreness can be treated with myofascial release using items like The Stick, foam rollers, static stretching, and manual therapy from athletic trainers.
There's not much that can be done with the last change - if your UCL is being stretched or gradually torn due to poor mechanics, that requires a mechanical change and better attention to pitching arm fitness. Performing specific exercises that improve forearm rotation near the time of ball release will help, though the only real way to know is to use high-speed video to perform a biomechanical analysis on the pitcher in question to get valgus stress levels before and after changes are made to verify things are going in the direction the coaches and trainers want.
So... what's going to happen down the road?
Only the White Sox can determine how to approach this particular case. While shutting down Sale for a few starts and getting him going again sounds like a good idea, pitching isn't an activity that is easily dropped and picked up again - even if Sale's throwing bullpens and simulated games, competing in a game is a completely different activity. Pitchers throw with more intensity and cause more stress to their arms when pitching in competitive games compared to when throwing on the side - this has been verified time and time again with results being published from various biomechanical labs.
While Keith Law isn't high on Chris Sale's mechanics from the standpoint of a starting pitcher, with a guy this good, it's hard to keep him in the bullpen if he can show this kind of dominance in the starting rotation. I'd keep him in the rotation, limit his innings this year (fat chance given the AL Central playoff race), and work on slight tweaks in the off-season to address mechanical issues and build strength in his pitching arm in hopes of mitigating issues down the line.
One thing's for certain, though: Sale's precipitous drop in velocity is a real problem and highly indicative of some sort of injury to the pitching arm. Just because he's not reporting pain doesn't mean he's not injured - plenty of pitchers throw while injured though they display no symptoms.
Posted by: Kyle Boddy
May 14, 2012
Chris Sale and his faulty elbowChris Sale has been the subject of much discussion in 2012, as he's been jerked around from the starting role to the bullpen with reports of inconsistent velocity. To compound all of this, he's had an MRI on his elbow due to tightness, though it's been reported that it's due to normal soreness and not major injury.
Keith Law is not impressed with Sale's mechanics or the idea of him in the starting rotation:
I've asked Keith on Twitter (@keithlaw if you decide to do the same) why he thinks Sale's arm action has a higher propensity for elbow injury, but he hasn't commented on the specifics of his claims.
Sale's Mechanics: Then and now
Here are two clips of Chris Sale pitching against Oakland, both in the Coliseum. These are two different years. One clip has Sale throwing a 95 mph fastball, the other a 93 mph fastball. Both came in the eighth inning. Can you tell me which one came from 2012 and which one came from 2011?
If I hadn't cut the video, I bet I wouldn't have been able to do better than simply flipping a coin and guessing, though I might choose the clip where Sale is throwing 95 mph over the one where he came in as a reliever in 2011.
I'd be wrong. Sale was throwing 95 mph in Oakland in the eighth inning as a starter on April 25.
My point is that Sale's mechanics between 2011 and 2012 have not meaningfully changed. (If you slow the clip you can see some minor differences with the glove leg and trunk flexion, though.)
But why does Law think that Sale is an injury risk? I won't speculate on his reasons; rather, I'll discuss some scientific research that might shed a light on Sale's pitching mechanics.
Sidearmers, valgus stress, and you
Generally speaking, Sale has a fairly internally rotated humerus at stride foot contact (SFC) and, combined with his high rates of pelvic and shoulder rotation, he lays his forearm back into external rotation during arm cocking quite fast. This certainly will increase the eccentric load on the shoulder, though whether or not this is specifically injurious is debatable.
However, Sale is also a sidearmer, and research does indicate that sidearm pitchers are generally at higher risk for increased elbow valgus torque. (Source: Aguinaldo et al; ignore the "conclusion" contradiction, Aguinaldo has said it's a typo/mistake in the abstract that isn't there in the full paper. Read it here if you like). Increased elbow valgus stress is highly correlated with UCL tears/sprains, especially when combined with a more-extended elbow at ball release (which Sale does have).
The theory that sidearm pitchers are at higher risk for elbow injuries seems to hold water based on previously conducted research out there, though it's worth noting most sidearm pitchers have lower ball velocity than high three-quarters and overhand pitchers (for whatever reason). Ball velocity is obviously very highly correlated with valgus stress, so the net effect may be lowered amongst all sidearmers. Of course, Sale throws very hard, so that's not applicable to him.
Whether or not Law looked at Sale's mechanics through this type of research lens is unknown, but he's probably onto something. It should be interesting to watch Sale's velocity over the rest of the year, and beyond.
Posted by: Kyle Boddy
Click here for more THT Notes.