UTK 8/14/20

Free Friday, Cards Pitching Worries, Judge, and more

2020 is the great experiment for baseball. Everything is new and even things we know are being skewed by circumstances. The most recent “hold my beer” moment is the return of the St. Louis Cardinals after nearly two weeks of COVID pause. They’re scheduled to have a doubleheader against the White Sox, but as of Thursday night, there were no travel plans for the team and reports of a staffer testing a new positive.

Let’s focus on the two weeks off. A source near the team tells me that players, while isolated, have been trying to throw. Some have been able to do backyard catches, long toss, and even bullpens in some situations. I don’t know if this is a “Gerrit Cole’s wife” situation, or if the players live close to each other — if I’m a well-paid pitcher, I might have a catcher in Kato Kaelin position, to be honest — but I do know that two weeks with only light throwing is not enough to keep a pitcher from being deconditioned.

Studies across sports show that stopping or even ramping down activity can create a lowered capacity for activity. If a marathon runner stops training, they’re not going to suddenly go out and run a marathon. Yes, they’ll have some base and a kinematic sequence advantage over a non-runner, but they’ll be far more susceptible to injury and overuse. The same is true for pitchers.

(How universal is this? I had to take two weeks off my Peloton due to a hamstring strain last year. I am certainly no pro athlete, but my data showed that the two weeks off reduced my capacity by almost 25 percent.)

The Cardinals are a smart team with a good pitching staff and a very good medical staff. That doesn’t mean they are ready for what 2020 has wrought. The proper solution, if they do not have hard data on workload and readiness, would be to either limit all of their pitchers to less than half of their previous workload or to do a wholesale change of the staff as needed from guys from the alternate site who were able to keep their workload up.

What the Cardinals have done behind the curtain is going to become very apparent. They’ve always been known as a smart organization and John Mozeliak has come off very well during this situation, so we’ll see how everyone else looks when they do finally get back on the field.

For now, let’s get to a couple new injuries and then the Free Friday recap:

Aaron Judge OF NYY (leg fatigue)

If there’s one thing that really gets my goat across sports, it’s letting managers/coaches talk about injuries rather than allowing the medical staff to step forward. Listen to Aaron Boone talking about Aaron Judge here. (I haven’t figured out how to embed MLB.com videos yet.) Boone’s job is not to understand what’s going on with Judge, which is clear, so putting him in the position to have to talk like this is on the Yankees.

Compare that to what Rick Burkholder does for the Kansas City Chiefs:

Burkholder gives detailed but understandable medical information on a star-level player. The Chiefs won the Super Bowl, so if there’s any disadvantage to giving detailed, honest medical info, they didn’t seem to suffer any of it.

Back to Judge, Boone’s hockey-like description is interesting because he gets so close to telling you what it is. It’s a multi-system, complex situation that can be painful, but is very difficult to describe, so once again, let’s go to the video:

IT band issues can be painful, but note how Boone calls it fatigue. Not soreness, but fatigue - I think that’s a clue that they’re dealing with something that has to be managed, stretched, and treated rather than what Boone would think of with pain or soreness. I don’t have a full confirm, but people with knowledge clammed up pretty hard when I specifically asked about this.

So let Michael Schuk or Chris Ahmad or Eric Cressey come out and explain these issues and let Boone get back to better things.

Chris Sale SP BOS (post Tommy John)

Yes, there’s a story out on Chris Sale, getting ready to throw five months post Tommy John surgery. It’s been five months and yes, this is the normal rehab progression, if you like the one where Sale isn’t back until mid-season ‘21. The key here is that Sale is on schedule, but not ahead and not behind, which the articles I’ve seen soft-pedal pretty hard, but that’s true of most of these mid-rehab type stories. That’s not to say it’s bad - it’s just normal.

I’m on record, loudly, as saying this rehab protocol is outdated and unnecessary. The surgery has a 85% plus success rate at this level, but there’s really no difference in the success between one year and eighteen months. This is in part because it’s a very inexact measure. If a player is ready to come back in December, but there’s no games until April, that’s four months tacked on that’s not “real.” A better rehab plan could have players back, I believe, in about nine months as an average, with some less, some a bit more, but this would mean five months in terms of an average reduction over what we see now with no increased risk. You tell me if it’s worth it.

As for Sale, there’s not much else here to take away. It’s nice that he’s had no setbacks and that the pandemic pause didn’t push anything back in his rehab. I fully expect Sale to have a full comeback, which could end up a big addition to the Red Sox next season.

Giancarlo Stanton DH NYY (strained hamstring)

Even the Yankees have to wait for MRIs these days. The fact is, they have a very good idea how serious the hamstring strain to Giancarlo Stanton is, but the MRI will give them more info to work from as they try to get him back as soon as possible without setbacks. The Yankees have been very good at this over the last few years, which some have tipped to a modernization of their medical staff and facilities.

Stanton often gets a reputation as injury prone, but if you discount the time missed for being hit in the face, he’s not much over the average. The difference between great and really good is often availability and Stanton might not have the genes to bridge that chasm. Again, the note from most around the league is that Stanton is just too tightly wound and that these kinds of breakdowns are inevitable. The key isn’t preventing them, but limiting the time lost.

That’s the goal here with the hamstring strain. Stanton can obviously DH, but he still needs a stable base to be able to handle the kind of forces he generates with his swing. If he changes his swing or the mechanics around it, his back is going to take more of the force, so getting him healed up and back to “normal” is the far better path, even if that takes a bit longer.

Normally. There’s nothing about this season that’s normal and with the reduced schedule, missing games is equally amplified. That’s going to factor into their decisions, so much so that the Yankees med staff recently reached out to Manchester City, their soccer partner, to share notes on hamstring rehabs. We’ll see whether Stanton gets some benefit from that.

Ronald Acuna OF ATL (strained wrist)

I don’t know if Ronald Acuna is an Xbox, Playstation, or Switch guy, but sources tell me that his wrist injury is more about quarantine screen time than baseball. “We see it a lot and more so this year,” said one team AT who has not examined Acuna. “We’ve been warning guys, especially the young ones, because they’re stuck in hotels and at home.”

“Xbox Wrist” is simply a repetitive stress injury, the overuse of muscles, tendons, and ligaments in a fixed and odd position. It’s easily cured - stop playing for a while - in most cases and seldom gets chronic. The bigger worry is that it can create a muscle imbalance. We’ve seen a huge uptick in this in eSports, despite big investments in training and ergonomics.

Ozzie Albies, Acuna’s close friend, also is dealing with some soreness and if they’re playing Fortnite with a group, it wouldn’t stun me to see more of these around the team. It could certainly be a lot worse.

UPDATE: Wow, this took off after I talked about it on 92.9 The Game (as I do every week on Thursday at 9am.) Turns out, Acuna is an Xbox guy and everyone on Braves Twitter wants to believe this is a crazy conspiracy against them. Look, an RSI is not that big a deal and it could be a lot worse. The Braves did reference Albies injury as a bruise on Thursday, so it may not be related. And yes, it’s both real and serious. Check this out:

Justin Verlander SP HOU (strained flexor)

Justin Verlander isn’t patient zero for the flexor strain issue, but he’s the one that’s being watched most closely, it feels. Downside for both Verlander and for the Astros is that he’s not healing faster than expected. Initial reports were that he’d miss the season and while that report was colored as being “wrong” by Verlander himself, it’s more that it was translated incorrectly. If the phrase “this often will be season ending” was uttered, that’s not incorrect. This depends on the individual, their response to treatment, and the location and severity of the tearing.

Some of this feels like Verlander didn’t like the message, but a flexor strain for a power, spin-heavy pitcher isn’t something that he can just will into healing faster. Working harder is the answer for a lot of things, but with healing and rehab, it’s often counterproductive. This isn’t to say that Verlander is doing anything wrong or is missing extra time. He’s simply not way ahead of schedule or healing up like Wolverine. He’s human, after all. Six weeks, Justin, isn’t failure.

Madison Bumgarner SP ARI (back spasms)

Late word that Madison Bumgarner didn’t just leave his start (in the second), but left the building. He’s headed back to Arizona to meet with team doctors. Arizona does tend to keep a lot of its medical in house, so this isn’t a surprise and there’s no top docs in San Diego.*

The question now is whether these “spasms” - normally a transient symptom - have an underlying cause that’s problematic. Bumgarner has been off since the start of the season and I have some notes from the spring saying that Bumgarner’s velocity was off then as well. Lower back issues that linger are very problematic and Bumgarner doesn’t have the ability to just overthrow with his arms or legs if the back can’t hold up to the rotation.

The Diamondbacks have four more years on the Bumgarner deal, so if his back is breaking down already, the ol’ cowboy might have some real issues. He was supposed to be, at worst, an innings eater for the Dbacks that held serve in front of the young starters and made it so that the even younger starters didn’t have to be exposed. We’ll soon see whether any of that will come to pass (or if Ken Kendrick went against his normal policy and paid up for insurance.)

*Yes, that’s a joke. There are fine doctors in San Diego.

QUICK (NEW) CUTS:

“Lower half?” Judge first, now Xander Bogaerts? If MLB is going full hockey, they need to do better. It’s a minor hamstring issue and yeah, “fatigue” is a relatively accurate term from what I am told … It was a nasty looking hit into the wall for Jeff McNeil, but what I noticed is how calm and focused the medical staff was. Even in a weird year, they had drilled this and knew exactly what they were doing. McNeil was imaged and appears to have nothing worse than a nasty bruise on his knee … Andrew Kittredge will have Tommy John surgery, as expected. We’ll see when and with who over the next couple days for more clues … Here’s a new one. Jose Pedraza came in as a mop up pitcher, then was forced out when a comebacker hit him on the shin. No word on severity yet … Andrew Benintendi hits the DL with an odd intracostal strain. He did it while falling, so I’ll be honest, I’m not sure what happened and neither do any of the docs I spoke with. Best guess from out here is that he just got in an odd position and the tissue was stressed oddly …Stephen Strasburg got run from the cheap seats today for yapping at the ump. That was pretty entertaining. No word if he could be suspended as a result … Kris Bryant did not hurt his wrist gaming. He hurt it and his finger on a dive Wednesday. The Cubs won’t push him back, but they don’t think he’ll miss much either … If 120 feet is still “long toss,” that’s what Charlie Morton is doing. There’s a chance he could be back in the Rays rotation quickly, with a decision made this weekend … Roenis Elias had a major setback in his return from a forearm strain. As he amped up his throwing level, more pain came in. He’ll be headed back to the docs to see if he re-strained the forearm or if there’s new damage … No word on the severity for Edinson Volquez, but 45 day IL for an oblique strain? Never seen that before, though Levi Weaver of The Athletic speculates that Volquez’s career could be at an end.

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