Under The Knife: Kemp's athletic gifts effort make for injury risks
On Monday, my research colleague, Dan Wade, described a new study that showed little correlation between pitch count and performance. Let's stick another fork in pitch counts; this time with a study led by Dr. Glenn Fleisig of ASMI, from 2007.
While this is another nail in the coffin for context-independent pitch counts at the professional levels, counts still offer a good-enough measure of workload for lower levels, up to and including high school. Earl Weaver said that "the batters will tell me when the pitcher is done," and this is now being objectively shown to be the right tack. Pitch counts without context don't give us enough information about what we're actually trying to measure, which is fatigue. Managers should no longer be falling back on "100" as a magic number. Whether it's one pitch or 150, the batters will let them know. Instead of counting pitches, we should be looking for direct measures of fatigue that will give predictive input to pitching decisions by the manager and pitching coach.
No studies like these have been done with major league players. The reasons are relatively simple. First, it's difficult to do studies on million-dollar players being asked to perform in season. Second, there's a great amount of resistance from the MLBPA. Even on seemingly simple studies, the union has resisted the inclusion of even data from 40-man roster players. I'm seldom one to call the union obstructionist, but in this case, their position needs to change and change quickly.
Kemp isn't going to catch Cal Ripken, but his consecutive games streak does tell us something about Kemp. He's durable, heals quickly and generally doesn't have to go "max effort," taxing the muscles and joints. He's one heck of an athlete and that reserve of talent keeps him from having to work too hard. This isn't meant, though it's occasionally seen as a lack of effort. He's just so good that things come naturally and easily. The same things happen to engines as they do ballplayers. The closer to 100 percent they run, the quicker they break down. Kemp's hamstring strain is serious enough that it's not going to be a only a week. They'll use the time to make sure he's fully healed from this Grade I+ strain. He should be fine once he returns. In the meantime, the Dodgers will use Bobby Abreu and Jerry Sands.
The Yankees kept Robertson's oblique strain quiet for a couple days. Some say they were just giving Robertson some cover while others suggest that the Yankees were checking the market for relievers. It's an odd situation for Robertson, who was kind of hung out and made to look like he'd lost his job quickly. The oblique strain is on the left side, but both sides are involved in the pitching motion, so one is not "better" than another. He'll miss roughly four weeks.
Corey Wade will get some more action in later innings with Rafael Soriano getting the save chances. It' seems as if Joe Girardi is
The worst case scenario was also the most likely scenario once Duffy was diagnosed with "medial elbow pain." That's where the ulnar collateral ligament is located. The testing done by Nick Kenney and his staff likely pinpointed that there was a deficit and tenderness on palpation.
I wanted to get an expert opinion on this and went to Dr. Orr Limpisvasti, one of the top orthos at Kerlan-Jobe Clinic in Los Angeles. I asked him when he orders an MRI on an athlete? "MRIs help diagnose many conditions that are not clearly apparent using other diagnostic means (history, examination, plain radiographs, ultrasounds, etc. ...)," said Dr. Limpivasti. "In joint pathology, the following conditions often require MRI scans: soft-tissue conditions (meniscus, articular cartilage, tendon, ligament, labrum, etc.), bone contusions, stress fractures, loose bodies and many more. It is simply a better study for many injuries in sports medicine.
"The clinical scenario truly dictates the necessity for an MRI. In sports medicine, educating the athlete thoroughly on the diagnosis, prognosis, natural history and treatment options often requires an MRI scan. Often it depends upon how involved the patient, family and, possibly agent are involved in the nuances of treatment and decision-making. MRIs can also assist in this process beyond the pure structural diagnosis."
In other words, it depends entirely on the situation. An MRI is a tool, but not always the most appropriate tool. Be aware that the medical professionals who treat and diagnose athletes have a lot of tools in their toolbox before they start ordering up MRIs. In this case, the MRI only confirmed what they knew -- Duffy will have Tommy John surgery and miss the rest of the season.
I often talk about simple solutions reducing injuries. How simple? Two injuries in baseball could have been prevented by a
The Yankees had a similar situation. Nova took a comebacker off his ankle, but was able to continue. On a later fielding play, he seemed to roll his ankle and has a sprain. His next start is in doubt, but for now he's day-to-day. It's time for players to stop resisting protection or for teams to start demanding it.
A sharp foul that comes at the dugout is a scary thing that can be very serious, but normally, it just scatters players, spills drinks and makes for some laughs after everyone comes out OK. We used to call balls like this "ugly finders." The worst case scenario is something like what happened to Juan Encarnacion a couple years ago. Tulowitzki just got a nasty bruise on his lower leg. He really had no chance to react. This happens so infrequently that I'm hard pressed to say that something should be changed. He was back in the lineup Tuesday night for a late game. He shouldn't have more issue than a bruise that matches his uniform.