MASH Report (3/4/13)

I have been working my way through Dr. James Andrew’s book, Any Given Monday. Here are his top seven myths surrounding sports medicine.

#1: Tommy John surgery will improve pitching performance.

A few quotes on this subject

I cannot be clearer about this: There is nothing that sports medicine can do for a throwing arm that is better than how the good Lord created it. There is no surgery that enhances performance. It simply doesn’t exist. If the body entered this world whole and healthy, you can never repair something in the body to make it better than its original condition. It’s just not possible. Cutting something always makes it weaker. I cannot stress this enough: A healthy pitching arm will always be more stable and more capable than one that has been operated on.

On pitchers come back throwing better

Yes it is true that many pitchers do see an upswing in their pitching speeds after undergoing the surgery….Pitching improves because of the type of reconditioning and physical therapy that the athlete undergoes as he heals from the procedure.

#2: Certain other orthopedic surgeries will actually increase overall joint capabilities and, ultimately, performance.

See Myth 1

#3: There is sufficient medical oversight in scholastic athletic leagues.

#4: No pain, no gain.

To put it bluntly, no child or teen should ever play with pain. Period. If the body is alerting the brain that something is wrong, the brain should listen. Parents, coaches, and players all need to remember that nothing is more important than the the athlete’s health.

#5: The earlier a child begins a sport and the more he or she practices, the better the chances are for a scholarship or professional career.

While I am certainly an advocate of organized sports, this level [four to five hours a day] of intensity at such a young age is neither healthy or beneficial to the child’s overall health and long-term career prospects….Variance in motion is far more beneficial to a child than concentrated and repetitive instruction at a young age.

#6: Fast-pitch softball, with its windmill delivery, can’t produce injuries to the thrower’s shoulder or elbow.

Pitching limits matter in softball as much as they do in baseball.

#7: The sooner the problem can be diagnosed, the sooner the athlete can return to the game.

Sometimes the problem faced by young athletes is not an injury at all — it’s burnout … They recognize that their parents or coaches or siblings might not react well to the news that they don’t want a future in the sport, so they read up on injuries that would force them to take some time off. They know the causes, they know the symptoms, they know the right complaint to get them out of the starting lineup and into the doctor’s office – anything for a break. And I don’t blame them.

Recent injury data

 • Chris Perez has a strained right shoulder. He is off for 7-10 days and will likely not be ready for the start of the season.

 • Martin Perez is out with a broken forearm and won’t begin throwing for 4 weeks. He will likely return, at the earliest, in early May.

 • Matt Garza will start the season on the DL and says he will be ready by April. This injury has been full of the return date getting pushed back and back. I would not be surprised if it gets pushed back again.

 • Carl Crawford is unlikely to be ready for opening day according to Dodgers manager, Don Mattingly. Replacement pool contains Hairston, Castellanos and Schumaker.

 • Looks like Johan Santana will not be ready by opening day. Like Garza, Don’t expect it to be the last time his date is pushed back.

 • Frank Francisco, elbow inflammation, will likely not be the Mets closer on opening day. Bobby Parnell will likely get the closer role and can keep it if he is effective stated Terry Collins.

 • Ryan Zimmerman is making progress after shoulder surgery.

 • David Ortiz is still having problems with his Achilles tendon. He easily may not be ready for opening day with more information to be coming out within the next few days.

 • Christian Garcia may miss opening day because of a partially torn tendon. He was vying for 5th starter position with the Nationals. Garcia’s career has been full of injuries including two TJ surgeries.

Here is some great medical lingo from the article

The Nationals had been calling Garcia’s ailment a “strain,” and the partial-tear diagnosis is only a more specific label — all strains are small tears.

 • Chad Billingsley’s fastball speed is at 2012 levels (91.6 mph on Saturday). He is trying to pitch with a torn UCL.

 • Russell Martin is dealing with a sore right shoulder.

 • Franklin Gutierrez is feeling healthy after being on the DL four times during the last 2 seasons.

Player Return Timetables

Name	Injury	Injury/Surgery Date	Early Return Date	Later Return date	Status	Source(s)
Scott Baker	TJS	4/17/12	Mid April	May	Throwing off mound	(1)
Grant Balfour	Knee	2/14/13	Late March	Middle April	Throwing off mound	(1)
Brandon Beachy	TJS	6/21/12	Mid June	Mid June	Playing Catch	(1)
Lance Berkman	Knee	10/1/12	Late April	Mid March	Working out	(1)
Jeremy Bonderman	TJS	04/24/12	Late March	Late March	Healthy	(1)
Tim Byrdak	Shoulder Surgery	07/01/12	Early July	Early July	Bullpen Sessions	(1)
Edwar Cabrera (**)	Shoulder	08/01/12	Mid March	Unknown	Unknown	(1)
Chris Carpenter (**)	Nerve	02/05/13	September	Retire	Rest	(1)
Andrew Cashner	Thumb laceration	1/25/13	Late March	May	Rest	(1)
Carl Crawford	TJS	8/23/12	Late March	Early April	Throwing	(1)
Scott Diamond	Elbow Surgery	10/1/12	Early April	Early May	Unknown	(1)
Kyle Drabek (**)	TJS	6/19/12	Mid Season	Mid Season	Unknown	(1)
Danny Duffy	TJS	6/13/12	Early June	All Star Game	Throwing	(1)
Neftali Feliz	TJS	8/1/12	July	August	Playing Catch	(1)
Frank Francisco	Elbow	2/14/13	Late March	Early April	Throwing	(1)
Rafael Furcal	Elbow	2/20/13	Mid March	Mid April	Rest	(1)
Mat Gamel	Knee	2/18/13	2014	2014	Rest	(1)
Matt Garza	Strained Lat	2/21/13	April	April	Throwing	(1)
Curtis Granderson	Right forearm	2/24/13	Early May	Middle May	Rest	(1)
Corey Hart	Right knee surgery	1/26/13	Late April	Late May	Rest	(1)
Daniel Hudson (**)	TJS	7/9/12	July	July	Playing Catch	(1)
Phil Hughes	Bulging Disk	2/28/13	Late March	Middle April	Rest	(1)
Drew Hutchison	TJS	08/08/12	August	October	Rehabilitation	(1)
Derek Jeter	Fractured Left Ankle	10/1/12	Late March	Late March	Fielding	(1)
Ryan Kalish (**)	Shoulder Surgery	1/25/13	Early April	Unknown	Rest	(1)
Matt Kemp	Shoulder	8/1/12	Late March	Late March	Light Training	(1)
Colby Lewis	Elbow Surgery	7/1/12	Late May	June	Throwing	(1)
Francisco Liriano	Broken humerus	12/1/12	Early April	Late May	Rest	(1)
Cory Luebke	TJS	5/23/12	July	July	Unknown	(1)
Ryan Madson	TJS	04/11/12	April	May	Rest	(1)
Nick Masset	Shoulder Surgery	09/07/12	Unknown	Unknown	Throwing	(1)
Jeff Mathis	Broken Collarbone	02/23/13	Mid March	Mid March	Rest	(1)
Brian McCann	Torn labrum	7/4/12	April	April	Batting Practice	(1)
Logan Morrison	Knee	9/1/12	Late March	Late April	Light Training	(1)
Charlie Morton	TJS	06/21/12	June	Unknown	Throwing	(1)
David Ortiz	Achilles	03/03/13	Late March	April	Hitting	(1)
Juan Oviedo	TJS	09/06/12	September	2014	Rest	(1)
Felipe Paulino (**)	TJS	7/3/12	Early July	Early July	Throwing	(1)
Carl Pavano	Ruptured spleen	1/25/13	Late March	Mid April	Rest	(1)
Mike Pelfrey	TJS	05/01/12	Late March	Late March	Throwing	(1)
Chris Perez	Strained Shoulder	03/01/13	Late March	Early April	Rest	(1)
Luis Perez (**)	TJS	7/1/12	Early July	Early September	Rest	UNK
Martin Perez	Broken Forearm	03/03/13	Late April	Late May	Rest	(1)
Michael Pineda	Shoulder Surgery	5/1/12	June	Early July	Rest	(1)
Wilson Ramos	ACL	5/1/12	Late March	Late March	Catching	(1)
Alex Rodriguez (**)	Hip surgery	1/16/13	Early July	2014 season	Rest	(1)(2)
CC Sabathia	Bone Spur	10/1/12	Late March	Late March	Throwing	(1)
Johan Santana	Back	2/25/13	Late March	Middle April	Throwing off mound	(1)
George Sherrill	TJS	5/1/11	Late April	May	Bullpen Sessions	(1)
Joakim Soria	TJS	4/2/12	Late May	Early June	Playing Catch	(1)
Eric Surkamp	TJS	07/24/12	Late July	September	Unknown	(1)
Tsuyoshi Wada	TJS	05/11/12	May	June	Throwing off mound	(1)
Josh Tomlin (**)	TJS	08/22/12	August	2014	Rest	(1)
Joe Wieland (**)	TJS	07/27/12	Early August	2014	Catch	(1)
Brian Wilson	TJS	4/19/12	Unknown	Unknown	Not ready to pitch	(1)
Randy Wolf	TJS	10/30/12	2014	2014	Rest	(1)
Delmon Young	Right ankle	10/1/12	Mid April	Early May	Rest	(1)

* Player is officially on the 15-day disabled list
** Player is officially on the 60-day disabled list

Pitchers with Velocity Drops

Name	2013	2012	2011	2010
Jeremy Bonderman	87.0			89.8
Louis Coleman	88.0	90.3	89.6
Kelvin Herrera	95.9	98.5	96.2
Greg Holland	93.9	96.1	94.9	95.8
Joe Nathan	91.9	94.0	92.3
Alexi Ogando	93.1	96.9	95.0	96.2
Mike Pelfrey	88.0	93.5	92.2	92.0
Oliver Perez	90.7	93.7	88.0	90.0
Stephen Pryor	92.0	96.6
Addison Reed	92.5	94.6	94.9
Clayton Richardson	88.5	90.7	90.4	91.3
Joe Saunders	84.0	88.9	89.6	90.5

For reference, fastball speeds stabilize quickly and spring training values are on average 0.6 mph slower than the regular season.

Players Returning From Injury

No information yet.

Players Playing Through Injuries

Name	Injury	Source
Hanley Ramirez	Shoulder	(1)
Will Middlebrooks	Wrist	(1)
Nolan Reimold	Shoulder	(1)
Russell Martin	Shoulder	(1)

Here is the list of players who should exceed their power projections for 2013:

Ryan Zimmerman, Ryan Howard, Cameron Maybin, Trevor Plouffe, Justin Upton, Paul Konerko, Dustin Pedroia, Luke Scott, Matt Kemp, Joey Votto, Mike Moustakas, Pablo Sandoval, Carl Crawford, Giancarlo Stanton, Jacoby Ellsbury, Evan Longoria, and Troy Tulowitzki. New additions: Dustin Ackley, Matt LaPorta and Howie Kendrick