Madmartigan said:
excellent question. This guy is what he is because of the split. He will get a 2nd TJ surgery by year 5 of the deal
Tanaka partially torn UCL; out minimum of 6 weeks
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excellent question. This guy is what he is because of the split. He will get a 2nd TJ surgery by year 5 of the deal
StuckOnYouk said:
I'd rather than happen and him be a stud, then him not throw the splitter and be half the pitcher.
He's got one of those "miss a year because of arm trouble and we get a year at MLB minimum salary" deals, right?
I don't follow this question, sorry. Why would throwing a splitter, which is essentially the same arm motion as a fastball but with a different grip, have a greater risk for reinjury than his other pitches?Madmartigan said:
VORP Speed said:
Not to mention runner-up ROY George Springer, who's been even more impressive since he wasn't called up until April 16th and didn't hit the first of his 19 home runs until May 8th (he's hit them all in a span of 53 games).
Wingack said:
One would hope he can keep his bread-and-butter when he returns. Otherwise you're looking at another reinvention (see: CC Sabathia and to a lesser extent Michael Pineda)
strek1 said:
In this column ( http://espn.go.com/blog/new-york/yankees/post/_/id/77231/yankees-take-huge-gamble-with-tanaka ), the writer cites the statistic that 83% of MLB pitchers return to their prior effectiveness. I can't vouch for the validity of that stat, but it seems in line with the my perception. Still, even with that high rate of return, 1 in 5 or 6 do not return to the prior effectiveness.
I sort of wondered about this too, but I think it's illustrative to try it out yourself. Hold up your arm, and put your index and middle finger up as if you were holding a fastball. Now spread those fingers as far apart as possible (the splitter grip), and think about where you are feeling the difference. Certainly near your fingers, but there's definitely additional strain all the way through the forearm in this configuration.EricFeczko said:
semsox said:
Love this post. Very illustrative and true. I've already sent the idea to a few people to try.
Interesting too, on that Fangraphs list there are only 9 or 10 starters in all of baseball who apparently use it. Sure, add in a few relievers, but they know they're only only throwing about 20 pitches every couple days. That alone seems telling of its risks.
Ed Hillel said:
Takashi Saito is the poster child for platelet-rich plasma therapy -- he's the only one I know of, though. He had alternative treatment because, already in his late 30s, he didn't have that many years to spare. He's still pitching in Japan at 44.
MLB Trade Rumors mentions Wainwright, Luke Hochevar, and Ervin Santana as guys who were able to put off surgery for several years with a partially torn ligament.
http://www.mlbtraderumors.com/2014/07/masahiro-tanaka-has-torn-ulnar-collateral-ligament.html
He'll need to go under the knife at some point, but there's a chance he can come back and pitch for a long time until he completely blows it out.
http://www.mlbtraderumors.com/2014/07/masahiro-tanaka-has-torn-ulnar-collateral-ligament.html
He'll need to go under the knife at some point, but there's a chance he can come back and pitch for a long time until he completely blows it out.
After saying what I said last night about just getting the surgery, I was intrigued by this subject so I did some research on PRP. It turns out that the success rate of this procedure is higher than I thought. This is an excerpt from a paper penned by, among others, the late Dr. Yokum. They ran a study on 34 people who had partially torn UCL's(16 of them pitchers). All of them went through approximately 2 months of treatments outside of surgery to try to get back on the field. The doctors ran them through a battery of tests to get a baseline reading on their injury then ran them through PRP treatments.
On average, it took the players an average of 12 weeks to get back on the field and only one of the 34 ended up needing TJ. They followed up on all of the 34 players over a span of 70 weeks and 30 of the 34 returned to the same level of production they had before their injury.
The link to the paper is here if anyone wants to read it.
http://ajs.sagepub.com/content/early/2013/05/10/0363546513487979.abstract
Baseball Prospectus summarizes it here.
http://www.baseballprospectus.com/article.php?articleid=21067
So, this is what Tanaka faces. If the average is 12 weeks that puts him in the start of October to get back on the field. Based on this information, it would be best if they just shut him down for the rest of the season.
On average, it took the players an average of 12 weeks to get back on the field and only one of the 34 ended up needing TJ. They followed up on all of the 34 players over a span of 70 weeks and 30 of the 34 returned to the same level of production they had before their injury.
The link to the paper is here if anyone wants to read it.
http://ajs.sagepub.com/content/early/2013/05/10/0363546513487979.abstract
Baseball Prospectus summarizes it here.
http://www.baseballprospectus.com/article.php?articleid=21067
So, this is what Tanaka faces. If the average is 12 weeks that puts him in the start of October to get back on the field. Based on this information, it would be best if they just shut him down for the rest of the season.
jon abbey said:
I've read that Wainwright was able to delay surgery by five years with his rehab. I imagine the Yankees would be thrilled if Tanaka was able to delay surgery by 5 years. I also read that Ervin Santana was able to rehab from a partially torn UCL.
So you have 3 examples of rehab working and dozens where is doesn't work.
I think the biggest question with delaying the procedure is that even if he's able to pitch, will he be able to pitch as effectively?
If not, you'd be burning through several of his prime years at less than 100%, with the inevitability of a year-long loss still bearing down on you at any time. I think if the Yankees were primed for a realistic shot at the whole thing, you take your chances with rehab and see what happens. As it stands now, and the potential issues of the 2015 squad, I believe it'd be a more prudent move to get him fixed up.
If not, you'd be burning through several of his prime years at less than 100%, with the inevitability of a year-long loss still bearing down on you at any time. I think if the Yankees were primed for a realistic shot at the whole thing, you take your chances with rehab and see what happens. As it stands now, and the potential issues of the 2015 squad, I believe it'd be a more prudent move to get him fixed up.
Japanese players are the only ones I know of that apologize when they get hurt and therefore can't help the team. In Japan, they also have these things called short swords, which, thankfully, injured players don't go so far as to fall on.soxhop411 said:Tanaka releases a statement
Lester's agents must be salivating - given the issues with CC and Tanaka - 7/200 may not be crazy-talk.
David Cone was talking about Tanaka's injury during the Yankee broadcast this evening. I didn't catch all of it, but I heard him say that Tanaka's tear was 5%. I have no idea how true it is, or if so, what it means for the chances for his rehab, eventual surgery, whatever. Figured it was worth mentioning. Something to keep an eye out for.
Well sure, but that additional strain may be coming because you are stretching the fingers, which causes the forearm muscle to twist further when the hand is pronated, which increases pressure on nerves leading through one's shoulder. In other words, the additional strain may not be a muscular strain, and it may not add to strain put on the UCL. Just because something is hard to do, doesn't mean there's an increased risk of injury.semsox said:
That being said, the effort required to maintain such a grip, could interfere with a smooth pitching motion, which would definitely increase the risk of injury. So I could see it going both ways.
I don't really know the literature on this topic, as I'm not an orthopedist (DRS? I've got 10 bucks here if you can address what is known about this). However, from the little that I've read (here's one citation, there are others that seem to echo the same thing in college/major league pitchers http://www.researchgate.net/publication/231215830_Prevention_of_elbow_injuries_in_youth_baseball_pitchers), it seems that overhand pitching, overuse, fatigue, and breaking balls are potential risk factors for a UCL injury. However, splitters are not.
Then again, the splitter is so rare, I don't know if it was even studied in any epidemiological paper.
According to this NY Times article, the conventional wisdom is that the splitter can indeed lead to elbow injury.
http://www.nytimes.com/2011/10/02/sports/baseball/split-finger-fastball-use-of-a-popular-pitch-falls-off-the-table.html?pagewanted=all&_r=0
http://www.nytimes.com/2011/10/02/sports/baseball/split-finger-fastball-use-of-a-popular-pitch-falls-off-the-table.html?pagewanted=all&_r=0
I don't know, this seems more like a fluff article than substantial research. Don Cooper says the exact opposite in the same article:Madmartigan said:
I don't know about you, but I respect Don Cooper's judgment a bit more than Scioscia or Anderson.
On top of that, I cannot find a single study demonstrating an empirical relationship between UCL injuries and the splitter. I can find a few that show some relationship with breaking balls, but the size of the effect varies from study to study.
Of course its an N of 1, but Koji has had only one major injury over his career, and he has thrown the split extensively throughout the career. Of course, he throws fewer pitches per year than a starter...then again, Jack Morris did it for 17+ years...
John Belushi would show Tanaka-san a thing or two about how to handle this situation.Al Zarilla said:
Sorry, all I meant by that, is that I respect Don Cooper as a coach more than the other two. He's done a better job getting pitching out of a farm system that had none than Anderson, and I have little respect for Mike Scioscia as a manager. I think he's one of the worst managers in MLB.Papelbon's Poutine said:
He's not a reliable source. None of them are, because they don't treat nor diagnose UCL injuries and they aren't representative of all of MLB. My point was that the article had no empirical data on the effect of throwing the splitter on baseball injuries, nor did it survey a representative field of players/coaches to see whether the splitter was avoided because a plurality of players/coaches thought it caused injuries. The article asked four coaches about what pitches may cause injuries, which is hardly a demonstration of conventional wisdom.
You're right that one pitcher doesn't mean anything. From the studies that I've been perusing, I haven't seen any effect of throwing the splitter on injuries. Here's a nice review that discusses the studies which have examined the effect of pitch type on UCL injuries in younger pitchers:http://www.jssm.org/vol6/n1/1/v6n1-1pdf.pdf
Not sure where these numbers are coming from - the most recent paper by Jimmy et al shows a 90% RTP by pitchers after UCL surgery.staz said:
http://ajs.sagepub.com/content/early/2014/04/03/0363546514528870.abstract
As for different pitch types putting more strain on the elbow, it's not easy to study scientifically in that there are a number of confounding factors that are hard to tease out, but I think the trend these days is towards thinking that it's more volume of pitches, especially at an early age, rather than specific types of pitches that leads to predisposition to injury.
DaveRoberts'Shoes said:
https://docs.google.com/spreadsheet/ccc?key=0ApDc5PGsBzgVdFpGbk84WnhNZlZ4VlFEY3pDVkFzNnc#gid=3
Maybe I'm just not understanding that chart or it's wrong, but I think there are a LOT of players who returned to their previous level but aren't listed as doing so.staz said:
DaveRoberts'Shoes said:
The table may also not reflect the state of the art -- it would make sense if the earliest surgeries had a lower success rate, which should rise over the decades as an experimental technique becomes standardized and improved.
Even when it was first introduced TJS had a higher RTP than that chart shows, and that's a lot of current players thereSprowl said:
What DRS said: I just briefly took a look at the chart, and I spotted over a dozen pitchers who returned to the majors and didn't have a return date listed. It's an impressive accumulation of TJS data and surgery dates and doctors, but the return section is not even close to being complete.
derekson said:
There appears to be no return date listed for anybody who had TJ surgery between 1/1/2000 and 6/1/2012. So there's that.
Via MLBTR
- Meanwhile, Masahiro Tanaka is still feeling pain in his elbow, which is “not good … at this stage,” GM Brian Cashman told Michael Kay of ESPN New York 98.7 (quotes via Brendan Kuty of NJ.com). Though the New York GM said that the plan remains to watch Tanaka closely and “adjust accordingly,” his statements seem to shed some doubt on the hurler’s efforts to return this year (if not also to avoid Tommy John surgery).
Papelbon's Poutine said:
How is it "apparent" the splitter "likely" played a significant role in this?
Olney was talking to players after the injury and from what I remembered they weren't shocked at all his elbow started barking considering how many splitters he threw as well as how hard.
StuckOnYouk said:
I don't think 25-30% splitters is some magical number, but the fact he basically doubled his usage from last year is what may have triggered the issue, coupled with pitching every 5-6 days instead of once a week.
Also, my understanding is the PED testing in Japan is pretty lax. MLB has HGH testing now and since it began there have been a rash of TJ Surgeries. Something to consider since HGH helps repair micro-tears in ligaments between starts.
I agree it's conventional wisdom. But I don't assume it's correct.
Is there any study that shows that pitchers who throw a splitter (at least a certain % of their pitches) are more likely to have UCL elbow surgery? That's not a smart aleck question either, I'm wondering if there is one.
Is there any study that shows that pitchers who throw a splitter (at least a certain % of their pitches) are more likely to have UCL elbow surgery? That's not a smart aleck question either, I'm wondering if there is one.
I don't see how you can put a percentage on it since no two pitchers are the same. I think the point everyone is making is that splitters are inherently more stressful than other pitches, so the more of them you throw your chances of sustaining an injury increase, relatively speaking.
My sense is he stops throwing the split when and if he returns in September. He can't throw the split with the small tear in his elbow not yet surgically repaired. So he goes with his other five pitches. What does that make him? Not as dominating, for sure. But still a pretty good pitcher who blows out his elbow and gets TJ surgery within two or three years anyway.
derekson said:
He threw the splitter more than 25% of the time. Yes, he has other pitches, but the splitter was clearly his best pitch, and everybody knew to wait on his fastball. It's not that easy to replace a pitcher's best pitch, even assuming that you believe that it was the splitter (and not general overuse) that frayed his UCL to the point of diagnosis.