Who Manages Diamondbacks Player Load and Return-to-Play Protocols?

Injury prevention and managing return-to-play from injury is the holy grail for MLB organizations. No matter how strong a roster a GM puts together, or how good a manager is in getting the most out of his players, nothing can derail a team faster than critical injuries at the wrong times to the wrong players.

Every organization handles this aspect of managing a team's efforts to keep players healthy differently. In the case of the Arizona Diamondbacks, their media guide Sports Medicine & Performance page shows no fewer than 22 personnel responsible for this area. It is this group that constitutes what is frequently referenced as "the Medical Team."

That includes Director of Sports Medicine and Performance Ken Crenshaw, Head Athletic Trainer Ryan DiPanfilo, and numerous other strength and coordinating trainers and therapists.

They also have an in-house Sr. Sports Medicine Analyst, as well as designated team physicians and specialists they rely on heavily. Baseball operations staff also provide support, and there is even a head of Mental Performance and Development coach.

Arizona Diamondbacks Sports Medicine and Performance | Arizona Diamondbacks Media Guide

This group produces volumes of information that determines player usage and load management. Whether it's day-to-day bullpen management, days off for position players, or managing a player's "return-to-play" protocol, it all goes through this group of professionals first, and then to manager Torey Lovullo's desk.

Lovullo even made an interesting choice of words when describing Ketel Marte's return to play protocol last week. "Once a prescription hits my desk, I'm going to follow that pretty closely," he said.

In few areas does the manager come under more criticism then how he uses his bullpen, and which pitchers he deploys and when. Likewise, giving position players time "off their feet" often results in fans, pundits, and even some local media ripping into the manager for being soft or "coddling" the players.

The fact is, however, Lovullo's hands are often tied. He receives detailed guidelines for which pitchers to stay away from and which are considered completely "down." When the medical guidelines indicate a position player is due for time off, it's then up to Lovullo to find that day, assuming the specific day is not provided to him.

I asked Lovullo how strictly he adhered to the guidelines that he's presented with. His answer was both straightforward and even somewhat startling. Words such as "negotiation" and "bartering" were used to describe the discussions about which players he can use when they are redlined in a report.

"100% of the time I follow the medical team's guidelines. I don't want to put anybody in a situation. Now September rolls around, all bets are off. You feel good, you're going to throw. We've used that through the course of the first five months of the season. It's been very successful. We haven't had a lot of arm injuries here," Lovullo said.

Lovullo often emphasizes that he is not a medical expert, and so he defers to their expertise. But he is not above trying to negotiate when he is especially shorthanded. An example of that took place in the case of Shelby Miller recently. He had worked on back-to-back days, and was designated as a "down" pitcher to stay away from.

"I kind of negotiated to get him to close only," said Lovullo. "He should have been down and most circumstances would have been down, but we were up against it a little bit. And I thought, 'okay, well, let me barter,' because he was kind of in that gray area.

"I said if it's a close-only situation, could we use him? And that's the agreement. So once you make the agreement, you've got to stick with it. And once I get the information, a hard no for me is a no."

Despite all this, the team has suffered a spate of recent arm and shoulder injuries, including A.J. Puk, (elbow) along with Justin Martinez and Corbin Burnes (shoulders). Lovullo admitted he is at a loss to understand why this has happened.

"That's what's so puzzling about what's going on for these early injuries is that we have followed the guidelines. And I didn't even get close to the red line. I kind of stayed a little bit below it," Lovullo said.

Lovullo has to answer questions every day about injured players, giving updates to reporters hungry for the latest information and timelines. Make no mistake, he is a company man. He works within the system, and does not color outside the lines when it comes to presenting information.

The organization is very guarded with the players' private medical information, and will only reveal what is absolutely necessary according to MLB guidelines.

Sometimes Lovullo will say that there were reasons other than workload concerns when explaining a move. Competitive advantage is a factor there as well. There is no need to tip off the other team.

"I can't always tell you [the media] why, but I usually say it's my decision because I felt like there was a better matchup sitting elsewhere."

Some of these explanations don't always make sense, due to his desire not to reveal the deepest inner workings of player load management. And the bottom line is the buck stops with Lovullo when it comes to in-game decisions.

Another key area Lovullo must manage is the player's willingness to disclose how he is feeling. It's not uncommon for a player to be hesitant to have that discussion, and discerning whether the player is being forthcoming or not is as much art as it is science.

"It's probably one of the harder parts of my job because they're going to tell me one thing, and then tell somebody that isn't their manager and making decisions on their career, or might think that they are not this tough major league baseball player the truth."

Lovullo spends a lot of time trying to break down barriers with the players so that the trust is there and they're free to speak their mind, and let him and the coaching staff know what is really going on.

"Mental toughness is telling somebody the truth even when it hurts to tell them the truth in both directions. So when I ask if you're doing okay and you're not, I expect you to tell me the truth," Lovullo said.

Lovullo said that it's probably more common for a young player to be more hesitant, especially one that is fighting to keep a roster spot, as opposed to a veteran that is secure in both his contract and his place on the team's roster.

Baseball players get injured. As hard as they might try, no medical staff or manager is going to be able to stop that from happening. It often seems like luck of the draw. All teams battle injuries. Pitching injuries are epidemic in MLB. Some years the Diamondbacks enjoy better health than others. The holy grail remains well hidden and protected.