Thursday, April 26, 2012
Seattle Times: Stone: The dreaded labrum: Five case studies
Here are five case studies, three of them successful comebacks (Chris Carpenter, Trevor Hoffman and Jon Rauch), one of them unsuccessful (Jason Schmidt), and one of them still in progress (Casey Janssen). All were reported as having surgeries to repair a torn labrum, but keep in mind that I don’t really know how similar the operations were to Bedard’s.
This article’s two years old, and it was written in regard to Erik Bedard trying to come back from a labrum tear of his own, but it does provide some examples of what may be in store for Michael Pineda following his surgery and attempted recovery. I suppose we can also add Bedard to the mix. He’s seemingly recovered most of his effectiveness, although his durability is almost non-existent.
Some other pitchers who suffered labrum tears include Roger Clemens, Curt Schilling, Brandon Webb, Ted Lilly, Jeff Francis and Ben Sheets. Clemens, Schilling and Lilly were able to recover pretty well from them. Webb and Sheets thus far have not recovered to the point of being effective MLB pitchers again. Francis is still trying, but it doesn’t look particularly good for him.
Comments
My assumption that there are more or less severe labrum tears, which could affect the prospect of recovery. If so, how bad is Pinheada’s and what are his prospects?
It sounds like they think it can be fixed arthroscopically which I suppose means it’s less severe than a tear that would require a more invasive procedure. You’ll probably have to talk to the Mets’ team doctor if you want more detail than that.
Probably worth looking at context. Wasn’t Bedard an injury prone guy prior to this?
Also, no one seems to be talking about why this happened. Cashman makes what, $6M a year? And the report he is giving to his boss is that ‘it was something minor that magically blew up in the 15th pitch of his side session.’
Um, what caused this in the first place?
Chris O’Leary did a work up on Pineda. He doesn’t like his pitching arm elbow getting above his shoulder:
http://www.chrisoleary.com/projects/PitchingMechanics101/Analyses/MichaelPineda.html
[3] I agree that the stuff Cashman has been saying to the press is transparently self-serving. But I don’t see any point to bashing him. Something could be gained by reviewing the team’s due diligence on trade prospects. Maybe the team should require all trade prospects submit to a colonoscopy, if only for the joy of it.
Two game losing streak then Verlander Friday and Fredo Saturday.
[3] You can probably find articles about the bad mechanics of lots of pitchers who don’t get hurt. There is no concensus (or anything approaching it, really) in the industry regarding proper mechanics and, therefore, it’s pretty hard for me to blame the Yankees for not divining that Pineda’s mechanics were wack (if they even were wack).
[4] I guess my point is that due diligence isn’t just an MRI. It’s looking at the guys mechanics and assessing the risk. Chris O’Leary does this in his spare time and predict a labrum problem for Pineda. All those pictures are of him in a Seattle Mariners uniform.
[6] Are Pinata’s mechanics wack or out of wack?
[7] I agree. Without knowing the Yankees’ due diligence procedures, I can’t see why they wouldn’t use this debacle as an occasion to consider improvements, including principally colonoscopies and enemas. Amirite?
[9] I dunno about colonoscopies (actually, I know a lot about them) but if you’re gonna do an MRI, may as well make it high contrast with the dye. I’m not at all convinced there wasn’t already something minor that could have been found prior to the transaction which, combined with an analysis of the mechanics, might have given them a better understanding of the risk.
It might not have changed the decision, but then again, maybe it would have.
Well, the MLB sample size is tiny. The MiLB sample size isn’t. Phelps has almost 500 IP across all levels of the minors with a 3.66 K/BB.
Of course, J – that’s why I specified ML SS. That and the fact that no one was championing “Phelps to the rotation now” until the ML SS came along.
it’s pretty hard for me to blame the Yankees for not divining that Pineda’s mechanics were wack (if they even were wack).
Face it, the Man is schwag.
[10] What do you know about colonoscopies?
[12] Wait until you turn 40…
Remember the collective feeling of bullet-dodging we all had when Jimenez proceeded to suck in Cleveland after Cashman refused to part with Montero? Sigh.
FWIW, I’ll mention that I’m not into Cashman bashing, I’m just scratching my head on this shit and am frustrated/pissed like the rest of you. I’m optimistic that we now basically traded 5 years of Pineda for 5 years of Montero instead of 6 years of Pineda for 5 years of Montero.
[7] Well, we don’t know what they did, right? I mean, saying Chris O’Leary predicted a problem…doesn’t mean much. Lots of guys predict problems in the stock market, write books about them…and fail to predict anything else. Because you know, this stuff is difficult.
but if you’re gonna do an MRI, may as well make it high contrast with the dye
Perhaps I don’t know enough about these things, but doesn’t this stuff need to be targeted? IOW, you wouldn’t give a full body MRI with the dye, right? Because what happens then? They do it on the shoulder and he tears an ACL doing something that you normally wouldn’t associate with that; do we then complain, “if they did the shoulder, they may as well have done the knee!” Should they also do this to FA? Would any submit to that? Would other teams even deal with the Yankees?
IDK, it seems some non-Yankee fan analysis that I’ve read indicates the Yankees did their due-diligence, it was just bad luck…
That and the fact that no one was championing “Phelps to the rotation now” until the ML SS came along.
I was!
[16] I mean, saying Chris O’Leary predicted a problem…doesn’t mean much.
Yeah, I didn’t mention that I really believe in Chris O’Leary’s stuff re: pitching and hitting - that’s just my opinion on his stuff. I think it’s also something you need to reconcile. He compares Pineda’s mechanics to a lot of pitchers with labrum problems, predicts a labrum problem, and then he has a labrum problem.
[16] I’m willing to bet the players have negotiated rights when it comes to trades/physicals. For exam, you don’t want overexposure to ionizing radiation (MRI’s are not ionizing radiation, but other procedures are). The team may want to know everything about every molecule in your body to cover their risk, but it shouldn’t be at the expense of the health of the players. There has to be a middle ground somewhere.
“That and the fact that no one was championing “Phelps to the rotation now” until the ML SS came along.”
And when it turned out that this isn’t, in fact, the year Hughes puts it all together.
It is the year Hughes puts it all together - all the things he’s done wrong at various points over his career, that is.
That GM in Minnesota was such a moron for wanting Lester when he could have had Hughes or Laptop.
Is Chris O’Leary the same guy who I once laughed at for saying Hughes reminded him of Jaret Wright? Nobody listens to prophets…
Perhaps I don’t know enough about these things, but doesn’t this stuff need to be targeted? IOW, you wouldn’t give a full body MRI with the dye, right?
Depends. MRI contrast is an IV. Same as CT. The problem is it’s really for highlighting blood vessels etc. which may not be terribly helpful in a joint situation. It would certainly help identify inflamation and such.
Of course, you have a very brief time span before the circulatory system flushes the stuff out, so in effect, you only have enough time to use it to see a specific area.
You can also use a flouroscope, and inject into the middle of the joint. That increases the definition of all the surfaces, but jabbing a needle into the middle of the joint is itself a bit of a trauma so you don’t really do it unless you already have an idea there’s a problem.
Both flouroscopes and CT’s use X-rays so there’s a radiation exposure issue there, which is why you see MRI’s instead. You can pretty well do MRI’s as often as you like, whereas X-Ray radiation exposure is a more serious concern.
Warning, highly politically partisan and pro-Jesus content, but given the title…: Sometimes Jesus Is Just Plain Wrong.
It’s just easy to want to blame people for this, it’s so mind-blowingly frustrating and seemingly typical based on the Yanks’ luck with young, touted arms. It’s remarkable their luck (or perhaps it isn’t luck but stupidity) with developing their “top” young arms.
[25]
Patterns suggest causation.
The question is really one for a statistician: are the number in which we’re seeing a pattern sufficient to be statistically meaningful?
If they are, they’re pretty damning.
Also, I remember how we were all so gung-ho about developing pitchers instead of buying them when they’re most expensive. And we were willing to ride through the highs and lows.
I was right along with you all… somehow the other side of the argument is looking a lot more compelling to me now. The team’s record with overpaying for stars is a lot brighter than its record developing starters out of the minors.
Which may have something with that “dividing by zero” error thing.
I’m optimistic that we now basically traded 5 years of Pineda for 5 years of Montero instead of 6 years of Pineda for 5 years of Montero.
You mean 5 years of Pineda for 6 years of Montero has now become 4 years of Pineda for 6 years of Montero, right?
I want to blame someone too, and I’m still pretty annoyed that Cashman cited a Fangraphs article as part of the process of their due diligence on Pineda. They really should have had a lot more comprehensive information on him and not the kind of stuff anyone who writes about baseball in their spare time could provide.
They should have had Rothchild breaking down his mechanics, they should have probably had more concern about the drop in velocity in his last start, but most importantly they really should have been more careful with him when he came into spring throwing with less velocity than expected, particularly when it lingered.
Hyping up the importance of his last spring start and all the crap in the papers about his fastball surely didn’t help, and you wonder if they rushed him back from shoulder tendinitis and should have waited longer.
But really, sh!t happens. They could have handled everything flawlessly and this still could have happened. So now I’ll just hope for the best while expecting Pineda will never throw another pitch in the majors.
[28] You mean 5 years of Pineda for 6 years of Montero has now become 4 years of Pineda for 6 years of Montero, right?
Oops, right, yes.
I’m looking at this differently, hoping for Pineda to become the next Henry Rowengartner. Kid was only 12 and could throw 100+ ‘cause he broke his arm and it healed oddly.
They could have handled everything flawlessly and this still could have happened.
I agree. You may argue with the results. As fans, we have the luxury of hindsight. But I still think Cashman’s reasoning behind this move was sound. Given ownership’s desire to get under $189M in 2 years, and the premium pitchers being signed by their home teams to prevent them from hitting the free agent market, this was a good trade to address the Yankees immediate and future needs. Because Pineda had a catastrophic injury doesn’t negate the strategy behind the transaction. I’d rather have a trade blow up in our collective faces because of an injury over a trade made without the benefit of foresight and long-term strategic benefits.
[28] They could have handled everything flawlessly and this still could have happened.
But this is not the same as taking the blame away from them. I think a lot of people think there are things that they didn’t necessarily do right, and that it’s possible that this situation - beit trading for Pineda in the first place or the schedule with which he came back from injury/ineffectivenesss - was handled incorrectly.
They could have handled everything flawlessly and this still could have happened.
And there’s nothing to argue with - if it’s that case. There are reasons to doubt that it’s that case. It may be that it was unavoidable chance. It may also be that it was avoidable and they handled it badly. Street record raise questions.
The strategy behind the trade [31] is a completely different issue. I, for one, am fine with that.
[33] Not to dissect this any further, but Kay mentioned last night that Cone saw Pineda’s pitches cutting during ST, a result of him not getting his arm up high enough? Was it that he didn’t get his arm up high enough, or couldn’t get his arm up high enough? In retrospect it seems like the latter, which indicates a shoulder issue all the way back to spring training.
The question is really one for a statistician: are the number in which we’re seeing a pattern sufficient to be statistically meaningful?
The Yankees are certainly not alone in having difficulty developing young starters. The Orioles, Mets, and Pirates have all had little success with bumper crops of young pitching. At the same time, teams like Tampa, San Francisco, Oakland, St. Louis, and Texas seem to have built pretty good young pitching staffs in recent years.
Also, re: [27], it’s not clear whether the takeaway is to be more patient, or to admit defeat and go forward knowing that signing fully-developed, post-injury-nexus starters is the way to go.
But I do feel like I’ve lost a significant degree of faith in the organization to build/develop a consistently championship caliber pitching rotation.
Since we missed out on Yu Dawrvish, maybe we can salvage something by trading Fuse for this japanese pitching prospect.
Scouting report says lots of swinging strikes, but endurance might be a question.
Edit: dagumit ! Something’s filtering and redirecting that link. You’ll have to copy/paste http://d.yimg.com/nl/yahoo sports/site/player.html#vid=29076459
Hey, it could be worse. The Yanks could have signed Pujols.
[37] I direct you to ARod’s contract.
[38] I mean, in addition to that. And yet still, even when he’s played injured, I don’t think A-Rod has ever had a month as a Yankee quite as sucky as Pujols’ April has been.
I just realized there are three colons in the title of this thread.
But not one is on the Yankees…..
I’m packing my computer up in preparation of my move. I’ll see you all on the other side.
(39) Pick an October in the last 9 years and you’ll probably find one. Zing!
[42] I pick 2009. The Month of the Centaur.
It will never happen again, unless we resign Johnny Damon.
Isn’t he on some 15 day contract with…Cleveland, of all Moforsaken places ?
Set Johnny Damon Free !!! He will not only free us from Andruw and Iguana, but restore out pitching mojo.
BTW, Player D is OPS+ing 123. He can play both OF corners and 1B, not to mention DH. He’sin the top 3 LF in the league, by total ZR.
TSCC out 3 months.
[47] Wow. SOSH must be filled with loving comments. I kind of feel bad for the dude…not.
We’re not ones to be taking joy in other teams losing key players to injury, fellas. Bad kharma and all that.
Besides, I’d rather Youk were out than anyone else on that team.
[49] I rather Youk continue to play and have a Teix-esque decline. It hurts more to have a player become ineffective than not play, as we know all too well.
The Yankees felt the pain of having to trade Jesus Montero to the Mariners to acquire Pineda, but as Cashman said Wednesday night, “I wouldn’t have done anything differently. I would make that same trade today, no questions asked.”
See, just as we thought: it’s that “no questions asked” that’s getting him into trouble. Perhaps he might reconsider that generous policy.
As someone told me when I said I felt bad for Hughes…C.C. is now getting paid like $20M to rehab. I don’t feel bad for him.
Panthers tie it with 3.28 left.
Townies may never lose again.
47 who? What?
[55] The Sucky Carl Crawford, I presume?
Crawford. Relax my friend.
They got the great, clutch, gritty Cody Ross
Is it fitting that Youks initials are those of a lube?
While the arm of Pineda has gotten us towards negativity in general and dangerously close to complaining in particular, we obviously need something to feel good of ourselves as Yankees fans. The easiest way to do this when you are down is to revel at the misfortune of your actual or imagined rival. So, I give you the following: Alex Remington has written an article in fangraphs where he argues convincingly that David Wright is the Greatest Met Ever. Well, on the position player front, anyway. Now, Wright is a fine player, and perhaps catches more grief from the Mets fan base than he really deserves, but if he is a franchise’s best position player ever, then that is perhaps more unfortunate than the Mets involvement with Bernie Madoff.
According to this article, field-fx has been implemented in Giants stadium, and they plan on tracking a catcher’s mitt also.
[43] Well I did say ‘probably.’
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