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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

July 20, 2012

Ron Santo career highlights

Better late than never. This weekend, at the annual Hall of Fame Cooperstown induction ceremony, the late former Cubs third baseman Ron Santo will gain his plaque.

When a player has a such a high honor for his career, it’s nice to look back on his playing days. I did something like this for Barry Larkin back in January when the BBWAA voted him in. Now let’s do it for Ron Santo.

Below is a list of his career highlights. They are his personal bests and worsts, milestones achieved, great games he appeared in. And just because I find it interesting, I'll throw in some odd or bizarre games Santo happened to be on hand for. Here they are, in chronological order:
Click for more...

Posted by: Chris Jaffe

May 31, 2012

Magglio Ordonez career highlights

The news broke earlier this week. Longtime White Sox and Tigers right fielder Magglio Ordonez decided to call it a career. He suffered an ankle injury in last year’s postseason and had gone unsigned by any team since then, so it makes sense that he’s decided to retire.

Now that his career is officially over, it makes sense to look back at his career. Below is a list of his career highlights. They are his personal bests and worsts, the most memorable and greatest contests he appeared in, his milestone moments, and various other oddities and notable moments he was on hand for.

Here it is, in chronological order.
Click for more...

Posted by: Chris Jaffe

May 14, 2012

Chris Sale and his faulty elbow

Chris 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

April 23, 2012

Run Ryan, run

The last out of Philip Humber’s perfect game brought some controversy as an umpire’s call was questioned. The last pitch was on 3-2 count involving a called third strike on a checked swing.

The problem, though, was missed. The controversy should not be about the call itself, but Brendan Ryan’s reaction. Down to your last out in a 4-0 game, instead of attempting to get on base, you argue the call instead of running to first base?!? I think Ryan, if he would have run, probably would have been safe at first.

Yes, Ryan could have ended a perfect game by being safe and also the 27th out, since Humber would have been credited for the strikeout. In fact, if Ryan would have run, the discussion of Brian Runge’s call on the checked swing would have been muted immediately.

The real problem was Ryan’s lack of hustle.

Given that, I still want to take a look at Runge’s call. Interesting enough, it was one of the Fox national games, opposite the Red Sox and Yankees. Significantly, this means the game’s camera coverage was increased a bit.

We—at least, I—have not yet seen a first-base angle replay of the check swing. This leads some people to speculate that MLB is just trying to hide the fact that Runge’s call was incorrect. Most likely the reason for a lack of replay is less sinister.

The center field camera was used to record the pitch, and a normal set of cameras was prepared to cover the live action. Any remaining cameras available to record the batter and different angles probably were used to record the reaction of the White Sox’s dugout, Humber, etc.

Since checked swings are not a reviewable call, the production team has the option not to record it at every angle. Watching a replay of the last pitch and the events surrounding it, it is pretty clear the Fox production team was scrambling a bit. It was a fairly unique circumstance.

But here lies the problem with a fan’s expectation of replays and the reality of the production of a televised baseball game. If something is not reviewable, the production team is under little obligation be able to produce replay material for it. As I believe happened in Humber’s perfect game, Fox used extra cameras for entertainment value.*

*This is why, in a previous post about instant replay, I included uniform standards across games and stadiums for instant replay specifically so something like this could not happen on a reviewable call.

Like most people, Fox did not anticipate a called third strike on a checked swing where the catcher missed the ball and the batter argued before running to first.

Thus, we circle back to the real problem: Brendan Ryan didn’t run.
Posted by: Mat Kovach


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