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Under The Knife: Chamberlain's loss stresses need for analysis


UTK arrived in New York for a couple days of baseball and Broadway, just as it became the center of the baseball injury universe. I'll have more on Derek Jeter below, but much of the recent focus has been on Joba Chamberlain. His upcoming Tommy John surgery has many going back to put a backwards-facing microscope on how they handled him. It's impossible to know, even in hindsight, what broke Chamberlain.

All we can really say is what didn't work. Switching between starting and relief seems to be the popular suspect, but if so, we have plenty of people, both historical and current, that have done that without consequence. Even the closest possible comparable, Phil Hughes, came up with a different injury despite similar usage patterns.

What it comes down to is that we just don't know. No one has any idea how much force Chamberlain puts on his elbow with each pitch or how that elbow responds to starting or relieving. I like to think that trainer Gene Monahan has some clue, but it's art, not science, that too many teams are relying on to keep their players healthy.

Allen Barra had a nice piece in the Atlantic about Chamberlain, saying that the only way to fix bad mechanics is Tommy John surgery. That's not exactly correct. If we knew more about the forces, we could fix more things. I can understand at some level why teams don't do biomechanical analysis on every pitcher, but I have no clue why pitchers don't have that analysis done as a matter of course during their rehab. That goes double for pitchers who have their surgery in Birmingham, since it's a short walk over to ASMI's facility there.

The other key suspect getting a lot of scrutiny is the so-called "Inverted W," where a pitcher has both elbows up above the shoulder line as he is striding forward. While this pattern does appear to be a sign of poor timing, there are as many counterexamples as there are examples, leaving this as ... well, no one really knows if, what, or how much it means for a pitcher.

In my progression as someone who watches and coaches pitchers, I've gone from a "one true way" advocate to a "do no harm" advocate. Instead of tinkering to get a pitcher to what we currently believe to be best practice, I would only change what's causing problems and then only as much as necessary. Pitching is neither unnatural nor unsurvivable for anyone with enough natural talent to make it to the pros. The failures of pitchers from Chamberlain down to Kyle Cotcamp are on us for not doing more, for not funding the research, and for not fighting against the one thing we do know -- how we're doing it now is not working.

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Powered by Mesa Grill, on to the injuries:

Give Jeter credit for hustle. Then again, that hustle has cost him a chance at getting to 3,000 hits while on this current homestand. I had hoped to be in New York for that history, but as Joe Posnanski showed, that doesn't always happen at home nor should it. A hit is a hit, and the Yankees need all of them as they fight for the AL East, so if it comes in Cincinnati, so be it. Jeter's strained calf is not a serious injury, but it's enough to keep him on the bench for a couple games to make sure that there's no further damage. Jeter might miss more time if Joe Girardi decides to keep him out during the road trip to get that historical hit at home. (Someone like Maury Brown is going to have to tell me whether that has a business value to the Yankees.) Expect the Yankees to be cautious, but not to hide Jeter. That's going to mean a week, more or less, but the Yanks have made the decision to put him on the DL. It's a tough move, but the smart one.

On a related note, I'm curious why the Yankees don't shift Alex Rodriguez over to SS. It's not really that long ago that I saw him make one of the most amazing throws I've ever seen. The Rangers were playing at Wrigley Field and Rodriguez came forward on a bounding ball toward the SS-3B gap, barehanded it, and threw a pea to first. Joe Girardi probably remembers the play, since he was a Cub at the time.

The Yankees don't just have Jeter to worry about. Martin's back pain is becoming an issue, with speculation that he'll need to head to the DL. The team seems inclined to wait, but with Jeter putting the team a man down for a few weeks, the Yankees may be forced to get some reinforcements via Martin. The Yanks have enough catching depth, especially if they're willing to use Jorge Posada on more than an emergency basis, and they have Jesus Montero past the Super Two date if they want to go that route in the short-term. Martin's back doesn't appear to be more serious than it did a couple days ago, but given his recent history with his hip and the demands of the position, the cautious route seems smart.

As I was leaving Indy, Heyward was stopping by. He started his rehab assignment with the AAA Gwinnett Braves on Monday and showed no issues, going 1-for-3 with a double. He was going against Brad Lincoln, so this is a decent indicator of bat speed and strength. Lincoln's not far off an SP5 for most teams and still has some upside. Heyward reportedly looked normal in all respects from the multiple observers I had in the park. Announcer Scott McCauley says that Heyward was clearly the best player on the diamond. "His timing looked a little off," McCauley said, "but he did extend his arms taking an outside fastball to right. Two pinpoint throws from RF wowed the crowd." Heyward was back in the Gwinnett lineup Tuesday and should be back in the Atlanta lineup by the weekend.

The Marlins activated Ramirez on Monday night after he showed that he didn't need any more time on a rehab assignment. Ramirez went 5-for-8 and showed "great rotation and bat speed," according to one observer. The key is not how he comes back, but whether or not Ramirez keeps working on his back, making sure that this type of problem doesn't creep up on him again and cost him more time. I'm also curious whether all of his early season troubles can be blamed on the back, and if so, it's another knock on the Marlins medical staff. If players like Ramirez and Josh Johnson can't feel comfortable telling them when they're sore, that's a major issue going forward.

Kazmir has one last chance to prove he can still pitch. Through four starts at Triple-A, he's shown next to nothing. He's 0-4 with an ERA over 15.00. Worse, his K/BB is only 17/13, showing that his control hasn't come back, though the fastball appears to still be there. Angels GM Tony Reagins is supposed to be there with the scouting braintrust, and there are strong rumors that the Angels may be ready to make a drastic move. Releasing Kazmir and eating the contract makes sense at some level, given no interest in taking on even a reduced amount of his current contract. One source said that the Angels would likely put Kazmir in the pen as a last gasp, making him essentially a one-pitch guy and the highest-paid LOOGY in history.

Josh Johnson was pushed to the 60-day DL, meaning he won't be back until after the All-Star break. No word on what changed ... Ryan Zimmerman was activated by the Nats on Tuesday and should be added back in all formats ... The Twins had Justin Morneau out of the lineup again on Tuesday. The DL remains a possibility, but the Twins seem to be holding out hope that they'll be able to avoid it or at least wait for Joe Mauer to take the slot ... Cole Hamels left his start with a sore back, but word is that he should have no issues making his next start ... Travis Hafner started a rehab assignment at AA Akron. He could be back by the start of next week ... Rubby De La Rosa is set for his next start. He left his last outing with cramps in his forearm ... Scott Cousins went on the DL with a lower back strain. Let's hope that the death threats he received in the wake of the Buster Posey incident have nothing to do with this ... For those asking, Chris Hayes is doing very well a week post-surgery. His physical therapy is going well and he's showing better than expected range of motion ... There's still time to RSVP for Friday's get together at Foley's NY. E-mail me for details and to say you'll be there.