Feb 16, 2014; Lake Buena Vistas, FL, USA; Atlanta Braves pitching coach Roger McDowell works with Kris Medlen (54) during spring training at Champion Stadium. Mandatory Credit: Jonathan Dyer-USA TODAY Sports

Braves Starting to Look into the Mirror... But is that Enough?


Feb 16, 2014; Lake Buena Vistas, FL, USA; Atlanta Braves pitching coach Roger McDowell works with Kris Medlen (54) during spring training at Champion Stadium. Mandatory Credit: Jonathan Dyer-USA TODAY Sports

Let’s first list a few of the more prominent pitching casualties:

  • August 2008:  Tim Hudson has a “Tommy John” surgery.  He returned to pitching September 1st, 2009.  No issues since.
  • August 2010:  Kris Medlen was placed on the 15-day disabled list with a partially torn ulnar collateral ligament tear in his right elbow.  “Tommy John” surgery.
  • June 2012:  Brandon Beachy placed on the DL with elbow discomfort. On June 18, he was diagnosed with a partially torn ulnar collateral ligament in his right elbow.
  • Beginning of 2013 season:  Jonny Venters is hit with a second TJ incident. Curiously, a Wikipedia report notes that” Venters was placed on the disabled list on July 5, 2012 due to a sore left elbow.”  His first Tommy John surgery came back in 2005.
  • May 2013:  Eric O’Flaherty.  An elbow strain turned out to be a torn Ulnar Collateral Ligament.
  • March 2014:  Both Kris Medlen and Brandon Beachy end their scheduled starts early and abruptly.  Both are likely to have second UCL procedures performed (Medlen for sure as of this writing).

 

If you think that the Braves are bitten by this problem more than other teams, then you’d be right.  But it’s probably worse than you’d think, too.

I’m now going to cite two charts below, copied from this excellently researched post from BeyondTheBoxScore.comall credit to Jon Roegele for this work, which is now nearly 18 months old.

TJbyYear

TJbyTeam

The first chart is really no surprise… we know that this surgery is on the increase.  The question I do have about it is this:  “what’s changed in the past twenty years?”  Are pitchers throwing differently, or was the UCL problem still happening at the same rate (and those experiencing the injury simply fading off into baseball oblivion?)?

 

The second chart, though, is absolutely alarming.  You never want to be the worst at anything, and yet here we are:  the Braves’ organization is, in fact, the worst in all of baseball with TJ surgeries – all time.  The scope is staggering:  over triple the quantity of the Chicago White Sox.  In fact, the Braves would have to cut their number in half just to get into the middle of the pack.

One important note:  Leo Mazzone believes that his training methods result in fewer injuries, and points to guys like Greg Maddux and Tom Glavine as evidence.  The failing of these charts is that we do not have dates attached to them… except in the aggregate of all teams together.  Leo’s tenure with Atlanta lasted through the 2005 season, and we simply do not know if the TJ rate under his leadership is better, worse, or the same as that under pitching coach Roger McDowell.  

Another quick note:  Gavin Floyd is now a Braves’ employee, though he was a ChiSox player until last year.  His surgery post-dates this chart, but also moves the White Sox’ number up only one notch.

 

Is Anybody Noticing This Stuff?

Yeah – finally.  But maybe not sufficiently, either.  Here’s MLB.com’s Mark Bowman writing on the subject:

“I think we’re always evaluating and looking at how we do things and why we do them and do we need to make changes,” Braves general manager Frank Wren said. “That’s an ongoing process. I think you are probably tempted to look more deeply when something like this happens.”  …

Along with losing two of the top members of their starting rotation, the Braves now have to evaluate what might have led these pitchers to both potentially have to undergo this procedure for a second time in less than four years.

“There are a lot of factors involved and every rehab is different,” Wren said. “It’s unfortunate. I don’t think we’ll ever stop researching and analyzing. But I can’t tell you today that we feel there is a common link [between Medlen and Beachy] other than that they’re wearing the same uniform.”

He goes on from there:

The Braves plan to evaluate a range of potential factors including the treatment their trainers and physical therapists provide to pitchers coming off Tommy John surgery. There will also be an analysis of the strength-and-conditioning activities some of the rehabbing pitchers have done outside of the team’s care.

Wren refers to an “internal audit” of their rehab protocols.  The rehab is based, he says, on the recovery plans outlined by Dr. James Andrews himself.  I find it interesting that there used to be a 13-14 month recovery plan and now – while saying that the player will not be rushed back – this time frame seems to be a bit on the long side.  Note Tim Hudson’s return shown above:  12 months (he pitched in rehab games prior to his 9/1/2009 return to the majors).  Gavin Floyd, despite an extensive surgery, thinks he will be ready to pitch in May.

Kris Medlen was worked back in somewhat slowly – with bullpen appearances, though his timing was considerably different: missing virtually a year-and-a-half of calendar time.  Beachy tried to return after just 12 months… and failed.  Another attempt was aborted late in 2013.  As Wren states, “every rehab is different.”

 

But is an Audit Enough?

It sounds as if Wren is interested in the rehab process – it disturbs him that these players are having to start over again with a second surgery, particularly one so quickly after the initial injury.  I submit that there’s a bigger problem.

If I’m Roger McDowell, I’m sitting down with Gavin Floyd (and others from that team) and talking with them at length to see what the Chicago White Sox are doing that must be so different from what the Braves are doing.  The problem here is systematic, and organizationally wide.  There’s simply no statistical way to account for such a disparity between the numbers in the charts above:  there must be a reason that involves conditioning, preparation, workout routines… something.  This audit is well overdue.  And it’s not like they need me to expose this:  that data is from an 18-month old blog post!

The Braves are known for their excellent pitching across the organization.  That part need not be changed.  But those pitchers are also dropping like flies.  And that could impact much more than just one season:

  • Will free agent pitchers want to reconsider Atlanta as a destination, fearing that they could be at risk for injury?
  • Can this team afford to replace pitchers so often – especially since many of the casualties happen at or near the major league level?  Certainly from the unemotional business point of view, it is much cheaper to do the necessary things to keep pitchers on the field.

I certainly hope this internal audit extends to more than the rehab procedures and protocols.  It needs to extend to prevention techniques as well.  These players deserve no less.  The fans also want to see the best pitchers on the field.

 

 

 

 

Tags: Atlanta Braves Injuries Tommy John Surgery

  • Ryan Cothran

    One “a-ha” that I had the other day was something I recalled happening 3 Spring Trainings ago. When Jonny Venters donned an Atlanta Braves’ uniform in 2010, his sinker was the rave of baseball. That offseason, that pitch was awarded “best in baseball” taking the reigns from Mariano Rivera’s cutter. In Spring of 2011, I seem to recall many pitchers picking up that pitch and adding it to their repertoire as they were also finding serious success with it. I can’t recall what pitchers that started using it, but a pitch that nasty and that highly regarded can’t be good for the elbow, right?

    • Lee Trocinski

      Generally, pronation of the elbow is much less risky than supination, so sinkers are generally alright. It was the fact that Venters completely turned over his fastball that made it so great/harmful. The bigger problem was him moving his elbow well behind his shoulders before hip rotation. This causes his front shoulder to fly open and his arm drags through the pitch.

      • Ryan Cothran

        Thanks for the reply. Learned something today.

    • Sealift67

      Take the numbers and run a correlation by team and control for age. It
      seems Braves bring up a good number of young pitchers as a % of staff.
      Hudson went a long while career-wise versus Medlen, Beachy etc. Younger
      pitchers are also known to under-report early signs of injury for a variety of
      reasons. Just a thought. Glavine and Maddux had ‘effortless’ motion vs. power
      pitchers like Pete Smith and Smoltz; Avery had strange mechanics.

      • Lee Trocinski

        Funny you mention Avery, as Smoltz compared Patrick Corbin to him last year, and Corbin has ligament damage himself. History isn’t a perfect indicator of the future, but it’s better than ignoring it.

      • fireboss

        At the time Avery’s motion was widely considered as good as anyone had seen. Can’t put my fingers on a video right now but I will go look

        • Sealift67

          Be sure to view the breaking stuff. He reminded me of Buzz
          Capra, though Buzz didn’t last as long.

  • http://www.tomahawktake.com/ Chris Headrick

    Many others are in fact noticing the trends with the Braves. Lee Trocinski shared a link with me via twitter the other day, which you guys may have seen. I subscribe to the authors opinion, because I was a pitcher, and I recall being trained the right way when I was in my last years in high school and college.

    http://baseballrebellion.com/jorenduff/tommy-john-surgery-are-pitchers-a-ticking-time-bomb/

    • Lee Trocinski

      Something ironic about that article is that a conversation that site had with Jarrod Parker on Twitter was the basis for the post. He said pitchers have little control of whether they get hurt or not. That being said, Parker is going in for TJS #2 himself now, due to not changing his mechanics. I know major league talents are very confident in their abilities, but one would think after a major injury or two, they would realize something is wrong and find a way to fix it.

      • http://www.tomahawktake.com/ Chris Headrick

        Agreed. Definition of insanity.. doing the same thing over and over and expecting different results. Despite the sample sizes Alan referenced, I just feel like Leo was more adept at avoiding the mechanical mistakes that seem so prevalent under Roger.

      • fireboss

        This whole thing is generational. The pitchers now have been taught this stand tall and fall stuff in an effort to whip an extra mph or two out of there are. The WSJ had an article March of 13 that pointed out the sharp increase in pitch speeds. In the 2003 season only one pitcher who threw 25
        pitches 100 mph or faster (Billy Wagner); in 2012, there were seven, That same season only 3 pitchers 700 or more pitches 95 mph or better. In 2012, there were 17. This endless search for more power instead of actual pitching ability has led to teaching kids the wrong way to pitch as the article you sent me pointed out superbly. When Leo was pitching coach his pitchers were from a different generation when while speed was desirable the ability to locate and repeat the motion was the focus. This isn’t to say Leo’s program wasn’t a factor. If you look at what happened on other teams and how the pitchers performed its success is indisputable.
        Pitchers don’t adjust because they don;t know any other way and quite frankly successfully changing a pitcher’s motion at age 20 and over is almost impossible. They’ve been doing it that way for 10 years almost year around – which is another problem – and muscle memory fights any kind of change subconsciously. Look what happened when they made minor adjustment’s in Teheran’s motion. The solution to this is changing the way the youth coaches teach and getting the emphasis back to power derived from the legs instead of the cocking whipping motion. This is starting to look like a post so I’ll quit but the short term answer is that for the tall/fall pitchers seeking an extra mph injury is almost certain. It will take MLB and the medics getting together and retraining coaches and the filtering of the resultant generation through the minors to stop the exponential increase in TJ surgery

        • Lee Trocinski

          I do think that an increase of emphasis on swing-and-miss stuff was necessary with the tightening of the strike zone. Glavine would still be a very good pitcher, but he’d be more on a Buehrle level, not the HOF level he accomplished, with this zone.

          Also, I was able to change my mechanics after my junior year of college. Given I didn’t have the repetitions that major leaguers have had, it probably was easier for me. However, I was able to do this with only a couple of days throwing a week and a month in front of a mirror. One would think someone who plays baseball for their day job could do it fairly quickly too.

          • fireboss

            You’re correct, Glavine would not be looked at the same way today he was in the 80s. The whole idea that power is king is ingrained into American society. Baseball started looking for it on the mound when the sluggers started growing extra body parts and shrinking others in order to compete. That mindset seeped downwards aided by the myth that post TJ pitchers threw harder because the transplanted ligament was stronger when in fact any increase was simple due to being stronger through the core.
            RE: Change. I’m sure some – the best and those with open minds – but major league pitchers are notoriously hard headed; see also Jason Marquis, Tommy Hanson, etc etc etc.

          • Lee Trocinski

            I’m not saying he’d be looked at differently, as that’s obvious. I’m saying he wouldn’t be as successful, though he likely would have still been very good. Would he have been more like Buehrle or Tommy Milone? I don’t know, but it is hard to think he would have had the same results.

  • http://tomahawktake.com/ carpengui

    Reading through these comments – very interesting stuff. It does make me wonder if the Braves may not be guilty of going slightly too far in trying to eke out another mph or so while other organizations aren’t doing that as much.

    Also of note: Braves supposedly going for ‘power arms’ in the draft lately… maybe some guys that they _don’t_ have to coax the extra speed out of, because they already have it? Something to watch.

    • fireboss

      Until they shortage in 08 when they veered into nearly ready collegiate pitchers to shorten the lead time the Braves always went for power arms when they had the chance; Wainwright, Schmidt Millwood etc and I’m not blaming the Braves or any major league team the need for speed is born in little league coaches who see there sons as hall of fame pitchers and continues with high school coaches who tell a kid who throws 8o to build up that arm when he should be building up his legs. Scouts look for 6’6″ guys that throw like a trebuchet forgetting that the pivot is where the wear is highest.Once the Braves get them they just try to get consistency.

      • http://tomahawktake.com/ carpengui

        Hmmm…. still looking for that underlying reason that Atlanta has so many more TJ’s than others.

  • Mushy Peas

    I’m a little late with my novel-length comment. Didn’t get a chance to read this article until this evening. First of all, a thank you to Alan Carpenter for writing this piece. Alot more needs to be investigated and written on this particular subject. I still have alot of questions and there are still alot of unknowns, but what I see happening has led me to some strong feelings about what may be going on. My opinions may sound a bit harsh, though they also seem to reflect some of what others have said. I see the problem as multifaceted. Of course, it’s always easier to look for a singular solution- one that is simple and easily remedied; however, it ends up being nothing more than a band-aid and the underlying problem continues. Tommy John surgery, though it has saved many careers, is baseball’s band-aid for an epidemic that has been left unchecked. My last job, actually, was working in a TCU, akin to a post surgical step-down unit, which, naturally, includes physical therapy. The biggest variable in the rehabilitation process is that each patient is unique. Just as no one pitcher is the same. Even if the surgical correction was essentially the same, everyone was treated with a holistic approach; taking into account every aspect of their physiology, their mentality, and any future endeavors. ALL variables are considered. Revisions in individual therapies are always necessary, sometimes as much as on a weekly basis. I hope like hell the TJS rehab routine is much more individualized than what it seems. Another hinderance is that we live in an era where tv endorsements, etc. are driving more and more the way teams do business and which players are cultivated. Going back to the 90′s, fans were more inclined to watch/attend games where there was alot of scoring via the monster home runs. The players, then, were chosen accordingly and, sadly, many chose the use of steroids with hopes of becoming that performance player that teams desired and, thus, would help provide a substantial rise in revenues. Now the emphasis seems to have shifted to the “power” pitcher. Even if they aren’t labeled a power pitcher, they are still encouraged to throw harder. Their thought pattern probably being that the extra mph will be the key that unlocks the door to a career in the majors or at least get them noticed. It’s obviously easier for some than others. Those who don’t seem to throw as well as some end up overworking themselves in off-season alternative leagues. Then you have the various farm systems which, now, seem to value both quantity and quality. In other words, let’s see how many guys we can round up, then pick and choose which ones we can exploit at the expense of their well-being. Nevermind if their mechanics or methods of conditioning could potentially cause a problem, let’s focus on the NOW. It is a system that has evolved to equate every extra mph to an additional (x) amount of dollars.These players are, after all, investments; so let’s push them to see if we can’t get another mph or two on that pitch. Now, I know not everyone is guilty, but the trend is now so dramatic that one can no longer just sweep it under the rug. The pitchers are all willing to comply, of course, because they are told that this is the way to get yourself a shot at “the dream”. Another thing that disturbs me is the fact that now TJS is nearly a routine procedure, and pitchers have rehabbed successfully. On the surface, this looks very much like a positive, but this positive can quickly give rise to a negative. It makes me think of some diabetics I know who think they can get away with an unhealthy lifestyle because they have their insulin pens at the ready. There is no longer any thought given to prevention. PREVENTION, PREVENTION, PREVENTION. It is the number one emphasis of patient education. Baseball needs to be saved from itself. The entire sport needs to reexamine and reshape the way they go about things from the majors all the way down to the high school level because it’s only going to get worse. More and more players are becoming dependant on new medical interventions that need not ever be necessary and it is only being reinforced by the blind eyes of the coaches and organizations. I realize this may come off as an angry rant, but that’s because I am angry. It’s frustrating, not to mention heartbreaking, to see so many young athletes exposed to what I consider to be nothing less than a plague. Maybe its my medical background that feeds the way I feel people, not just athletes, should be taken care of. Maybe its because I love baseball. It has and always will be my favorite sport. Or it could be that I just have some sense of humanity that leads me to believe that the potential of big business revenues and corporate sponsorships have overcome the compassion for the individual. Most likely all of the above. I think anyone who truly loves baseball SHOULD be angry. Or I could have completely missed the mark! Either way, a serious problem still exists, and it is at the heart the game. It can no longer be ignored. It has already been neglected for far too long with devastating consequences for the individual players and the game itself.

  • BJ

    FW AND staff have been great at getting bargain bin players. I feel they took the approach to insure this problem didn’t happen but they were aggressive enough. at least 2-3 of those pitchers you named are on the same path that gilmartin was on. aren’t ready and no top tier make up. braves will have to continue at least for another 2-3yrs to depend on pitchers that are 3-4 rotation spots. excluding minor and julio. or they could rely on stopgaps until the minor leagues pitchers develop. but then we are talking about having 3 Freddy Garcia’s in the rotations. best bet I see. lower level trades and bargain bins until a stud comes along via trade or farm. and when I say trade. I mean a player that could be under the radar.