Under The Knife 6/19/24

Dear God, Padded Gloves

Tuesday night while I’m trying to catch up on The Boys - which is a disturbing task at times - my phone exploded. Aaron Judge took a ball off the hand, left the game, and headed for X-rays. So, open letter:

Misters Steinbrenner, Cashman, Boone, Jassy, and Manfred:

My name is Will Carroll and I write about baseball injuries. Some of you probably know me and my work. I’ve been doing this for twenty years. I’ve written about injuries in print, on the internet, was a member of the BBWAA, helped bring technologies to reduce injuries to MLB, and now, I’m just a guy, talking to some guys in charge, asking to help.

Mookie Betts has a broken hand. Aaron Judge could have. We’ve seen any number of players go down because a pitch gets away, inside, or a batter is a bit too inner-half, and bang - one pitch creates an injury that doesn’t have to happen. The MVP is down for six weeks, leaving the biggest teams in baseball scrambling. Miguel Vargas is no replacement and the MLB Network can’t promo a game where Alex Verdugo is the biggest star on the field.

No one wins.

It’s not just Betts and Judge. Nick Martini is out today because of the same exact thing and we’ve seen this time and time again, this year, last year, and every year that pitchers have been throwing inside, with or without intent.

I can’t solve a lot of problems in baseball. I’ve done my best but pitching injuries are here to stay. You put Statcast in and thank you, but it hasn’t reduced injuries. What you and I can do is a simple thing, something that can be put in tomorrow, using existing technologies, at every level, that would cost thousands, not millions, of dollars.

Padded. Gloves.

That’s it. Use the kind that Shohei Ohtani is using. Use the kind some others are using. Let players come up with another solution that passes a test of some kind. It might not stop every injury, but it will stop most. We’ve had this problem most of my career and I’m sure it existed before. I remember Jeff Bagwell — you know, the guy running the Houston Astros? - having a hard plastic piece on the top of his glove, something cobbled together after two injuries from the same kind of unintentional pitches. Do that, but better.

This isn’t hard. This isn’t expensive. This isn’t something that requires thought. Mookie Betts’ injury is going to cost the Dodgers six weeks of his playing and the equivalent of $7.5 million, a lot more than equipping every single player, minor leaguer, and a bunch of Little Leaguers, if you so choose. It’s really that simple.

Here’s my pitch. It’s mid-June and the All-Star Game is coming up. For that game, require every batter to use it and in the first inning have Rob Manfred and Tony Clark stand up and say “We’ve agreed that all players should do this.” No one will disagree, player or fan. The game isn’t slowed down. The best players are playing more, rather than stuck on the bench in a cast. What’s the downside, sirs? And please, consider your upside even before you consider the upside for the game itself.

Sincerely,

Will

PS. RIP Willie Mays.

YOSHINOBU YAMAMOTO, SP LAD (strained shoulder)

So much for precautionary. Yoshinobu Yamamoto had his MRI on Sunday and on Monday, the Dodgers released that they’d found a rotator cuff strain. This after he was initially placed on the IL for a triceps strain. A source tells me both are true, and the two issues are likely interrelated.

Let’s note the triceps anatomy. It goes from the elbow to the shoulder, at the back of the upper arm, so location of any strain is key. It could be “elbow” or “shoulder” in the colloquial sense and be the same muscle group. But how does that relate to the rotator cuff, which is a series of four muscles in the upper back/shoulder? Besides the anatomic closeness, there’s some overlap in action and even tendon placement.

The cuff issues likely led to a secondary action in the triceps. The body always has some redundant systems and if the cuff was able to do less work, something else took over, or worse, took an unusual load. The key here is that Yamamoto himself never complained of an issue in the shoulder/cuff area. Some of that may be cultural, some may be a language barrier, but one source I trust said Yamamoto never even suggested there was an issue beyond the triceps, so no one looked there. Hence the surprise.

The worry is that the cuff is a tough injury. As the “brakes” for the arm, we’ve seen less of these over the past decade as other shoulder and elbow injuries have taken over. Once again, the influence of Dr. Frank Jobe is seen, with his “Thrower’s Ten” exercises largely thought to be a key in reducing cuff injuries. Depending on which muscle, how severe, and the interaction with his full motion, there’s a pretty broad range for how this could go.

As before, Bobby Miller is the short term replacement for Yamamoto, with Clayton Kershaw on the horizon and pitching well per all reports. There’s just enough depth to get by, but Yamamoto is special and losing him makes the possibility of an all-aces playoff rotation a bit more distant. There’s few enough teams around MLB that have even one real #1 starter and the Dodgers have potentially four for the playoffs and yes, I’ll wait a beat while you remember that Shohei Ohtani could be available for late in the season.

MOOKIE BETTS, SS LAD (fractured hand)

There’s not a lot of new information on Mookie Betts, nor can there be. Dave Roberts said that Betts will be out the standard six to eight weeks and even with Willson Contreras returning in five from a broken arm, it’s hard to equate the two. For Betts, it comes down to the point where he can grip a bat safely. It’s not just hold it and control it, but for the still-healing bone to take the forces and vibrations. Even with all our knowledge in 2024, that’s going to be more art than science.

The other element here is protection. Wearing the padded glove before the injury would have helped, but after it will be a massive key if he’s not going to wait for full healing*, which would add weeks, even months to it. Betts came back from a rib fracture at the minimum 15 days, clearly not fully healed, but functionally a hand is impossible to bat with while a rib can be played with, knowing there’s a mild risk of collision or impact.

We still don’t know the specific bone - I’ve heard whispers it’s the third metacarpal, the bone of the hand between the wrist and middle finger - but that doesn’t matter. Any of them aside from the thumb would have the same function and issue. I won’t get overly technical as there’s no indication that there will be surgery.

*Let’s be clear about full healing. When someone returns from a broken bone, the bone itself is stable and functional, but probably not fully healed. There’s a lot of debate about the point where this happens, which is complicated by the fact that the human body is constantly reconstructing itself. Estimates are that the entire structure of bone is turned over every seven to ten years! There are differences, even within the same bone, which is why the bone and location of the fracture are important.

AARON JUDGE, OF NYY (bruised hand)
JASSON DOMINGUEZ, OF NYY (strained oblique)

Aaron Judge took a pitch off the hand, but not only did he have x-rays - which are in-stadium and near-instant in almost every park* - but he also had a CT scan. I’m not sure where, but getting one on a late Monday night in New York City probably isn’t the easiest task, though I’m sure Dr. Ahmad has someone on speed dial. All the images are negative (no fracture) and they’ll likely watch for his response and will perhaps do an as-needed followup. Mostly, it’s luck that he didn’t join Betts and others on the IL. He’ll return once the hand is back to function and less painful.

Jasson Dominguez injured himself over the weekend, straining an oblique on a check swing. He went on the IL Monday, so had Judge gone down, he wouldn’t have been the immediate call. Depending on how severe the strain is, he could miss a month or more with this, shortening the depth of the Yanks in the short term. Coming off augmented elbow reconstruction, Dominguez was expected to be a second half call up or the first up for an injury with the big club, with many wondering why wait? For now, the answer to that question is the injury.

*There are at least two that don’t have the instant digital x-rays installed and you can probably guess exactly which two. There’s about five where I don’t know for sure.

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