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remindmeofthe) wrote2007-07-14 01:21 pm
remindmeofthe) wrote2007-07-14 01:21 pm
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So, usually I leave the injury analysis to people who have, like, the first clue what they're talking about when it comes to anatomy. Because seriously, I have no clue. I don't know which bone is connected to which bone. I mentally smile and nod when Sam at Blue Cats and Red Sox/Roar of the Tigers writes entries about injuries complete with lovely color-coded diagrams to help the scientifically-impaired like myself grasp what she is talking about.
But I had to dive in and do a little poking around in the subject myself, and what I found isn't exactly rocket science.
Backing up for a second. Since Rich Harden's return to the DL, there has been discussion of how much of his lengthy injury history is his body being fragile and how much might be attributable to the Oakland medical staff. By "discussion," I of course mean, "a thread in a friend's locked journal entry," but it caught my attention.
As some of you know, I've been following the Ongoing A's Catching Saga, in which there has been a couple new developments with Mike Piazza in the last couple of days. These are the first new things to happen since my entry about a month ago. The past month has mostly contained the occasional, "Yeah, we're working on the shoulder, but it's not really coming along to throwing strength as fast as we'd like." A few days ago, though, Piazza's agent finally had a little chat with Billy Beane about the whole thing, and lo and behold, Piazza finally started rehabbing for real - as a DH - yesterday in Sacramento. (I also found an interesting observation here about the possibility of the players' union getting involved: "Since the A's signed Piazza strictly as a DH over the winter and he has been ready to hit since mid-June, there's some thought that the union might have grounds for a grievance if Piazza's return is delayed much longer." I wonder if that came up during that little chat.)
In other words, Piazza lost a month of his season trying to rehabilitate to throwing strength a shoulder that was not even catching-ready before his injury, as he had been told specifically during Spring Training not to bother keeping himself in catching shape. And this decision was made at the last possible minute (seriously, Piazza didn't even get the message that they wanted to have him extend his recovery time until he was practically out the door on his way to rehab at Sacramento the first time), so he was not working to come back from the injury with an eye toward catching until almost two months after he hurt his shoulder in the first place. I don't know anything about physical therapy, but that sounds damn sloppy to me. The abrupt change of tune on the catching is just amazingly bad planning - like, hilariously bad - and the injury was bad luck. But, considering that they did in fact make the decision to have Piazza be backup catcher several days before the injury, why not rehab him with that in mind from the beginning? Especially since they freaking traded Melhuse and there was no guarantee that Kurt Suzuki would do in the majors anything approaching what he had done in the minors? There is a lot of wasted time here, and last I heard, Piazza's shoulder is still bothering him when he works it too hard. How severe does a sprain have to be to still be causing problems two and a half months after the fact? With more organized management of his recovery, could he have been back and catching by now? (These are not rhetorical questions. I welcome any answers anyone might have.)
So these are things I am thinking about in the last couple of days, wondering if Harden and Piazza are in fact the victims of crackmonkeys with medical training, when, tucked into the latest article about Piazza's rehab assignment, I find this little tidbit:
Little has been heard from lefty Brad Halsey since he slammed the A's for not properly diagnosing an arm problem he had this spring and for not calling him up for a potential start at Baltimore. On Tuesday, noted orthopedist Dr. James Andrews performed surgery to repair a torn labrum in Halsey's left shoulder. Halsey said he can begin throwing again in four months and be ready for spring training.
Halsey said he has filed a grievance against the A's with the players association over the handling of his injury. He said he was told the problem was biceps tendinitis and he was not given an MRI exam when he requested one. Halsey contends the matter wasn't attended to properly until he was no longer on the big-league roster, which cost him both his big-league salary and major-league service time.
OH MY GOD. He said he was told the problem was biceps tendinitis and he was not given an MRI exam when he requested one. Oh. my. GOD.
And this is where my intro about me and injury analysis comes in, because I had to check this shit out. How, I wanted to know, could a torn labrum be mistaken for biceps tendinitis? The labrum is in the shoulder and the bicep is in the arm, right?
Sort of. The biceps tendon is connected to the labrum, and an injury to the labrum can involve the tendon as well. A torn labrum can be confused with any number of other shoulder injuries. So a diagnosis of biceps tendinitis is not unreasonable, which gets the A's medical crackmonkeys off the hook, right?
NO. Because he is a pitcher, which involves exactly the sort of repetitive motion that can tear the shit out of his labrum, it is not exactly an unheard-of injury, AND THEY WOULDN'T GIVE HIM AN MRI. OH MY GOD.
Creepily enough, the med staff might not even be entirely to blame for this one. If you believe Halsey's side of the story, the A's deliberately delayed the MRI until he was in the minors just to avoid paying him a major league salary if he ended up on the DL. Which, in late April, he did. Given everything I've outlined here already, guess whose side I'm on?
At this point, that entire organization breaks my brain. I want to kidnap my favorite A's and squirrel them away in Detroit and Boston, where the med staffs may not be perfect, but the disabled lists have not been used seventeen times already. RUN, BOYS. RUN.
I would like to conclude by briefly revisiting the Harden question. His official diagnosis at the moment is "shoulder impingement," which I looked up while I was getting all carried away with the research, and damn if that doesn't look to my inexpert eye like something that could be confused with a torn labrum. He did, however, receive diagnosis from a doctor not on the A's staff. I am still disinclined to hold my breath.
By the way, anyone who knows better than I do what the hell I am talking about is more than welcome to chime in and correct any errors I've made.
But I had to dive in and do a little poking around in the subject myself, and what I found isn't exactly rocket science.
Backing up for a second. Since Rich Harden's return to the DL, there has been discussion of how much of his lengthy injury history is his body being fragile and how much might be attributable to the Oakland medical staff. By "discussion," I of course mean, "a thread in a friend's locked journal entry," but it caught my attention.
As some of you know, I've been following the Ongoing A's Catching Saga, in which there has been a couple new developments with Mike Piazza in the last couple of days. These are the first new things to happen since my entry about a month ago. The past month has mostly contained the occasional, "Yeah, we're working on the shoulder, but it's not really coming along to throwing strength as fast as we'd like." A few days ago, though, Piazza's agent finally had a little chat with Billy Beane about the whole thing, and lo and behold, Piazza finally started rehabbing for real - as a DH - yesterday in Sacramento. (I also found an interesting observation here about the possibility of the players' union getting involved: "Since the A's signed Piazza strictly as a DH over the winter and he has been ready to hit since mid-June, there's some thought that the union might have grounds for a grievance if Piazza's return is delayed much longer." I wonder if that came up during that little chat.)
In other words, Piazza lost a month of his season trying to rehabilitate to throwing strength a shoulder that was not even catching-ready before his injury, as he had been told specifically during Spring Training not to bother keeping himself in catching shape. And this decision was made at the last possible minute (seriously, Piazza didn't even get the message that they wanted to have him extend his recovery time until he was practically out the door on his way to rehab at Sacramento the first time), so he was not working to come back from the injury with an eye toward catching until almost two months after he hurt his shoulder in the first place. I don't know anything about physical therapy, but that sounds damn sloppy to me. The abrupt change of tune on the catching is just amazingly bad planning - like, hilariously bad - and the injury was bad luck. But, considering that they did in fact make the decision to have Piazza be backup catcher several days before the injury, why not rehab him with that in mind from the beginning? Especially since they freaking traded Melhuse and there was no guarantee that Kurt Suzuki would do in the majors anything approaching what he had done in the minors? There is a lot of wasted time here, and last I heard, Piazza's shoulder is still bothering him when he works it too hard. How severe does a sprain have to be to still be causing problems two and a half months after the fact? With more organized management of his recovery, could he have been back and catching by now? (These are not rhetorical questions. I welcome any answers anyone might have.)
So these are things I am thinking about in the last couple of days, wondering if Harden and Piazza are in fact the victims of crackmonkeys with medical training, when, tucked into the latest article about Piazza's rehab assignment, I find this little tidbit:
Little has been heard from lefty Brad Halsey since he slammed the A's for not properly diagnosing an arm problem he had this spring and for not calling him up for a potential start at Baltimore. On Tuesday, noted orthopedist Dr. James Andrews performed surgery to repair a torn labrum in Halsey's left shoulder. Halsey said he can begin throwing again in four months and be ready for spring training.
Halsey said he has filed a grievance against the A's with the players association over the handling of his injury. He said he was told the problem was biceps tendinitis and he was not given an MRI exam when he requested one. Halsey contends the matter wasn't attended to properly until he was no longer on the big-league roster, which cost him both his big-league salary and major-league service time.
OH MY GOD. He said he was told the problem was biceps tendinitis and he was not given an MRI exam when he requested one. Oh. my. GOD.
And this is where my intro about me and injury analysis comes in, because I had to check this shit out. How, I wanted to know, could a torn labrum be mistaken for biceps tendinitis? The labrum is in the shoulder and the bicep is in the arm, right?
Sort of. The biceps tendon is connected to the labrum, and an injury to the labrum can involve the tendon as well. A torn labrum can be confused with any number of other shoulder injuries. So a diagnosis of biceps tendinitis is not unreasonable, which gets the A's medical crackmonkeys off the hook, right?
NO. Because he is a pitcher, which involves exactly the sort of repetitive motion that can tear the shit out of his labrum, it is not exactly an unheard-of injury, AND THEY WOULDN'T GIVE HIM AN MRI. OH MY GOD.
Creepily enough, the med staff might not even be entirely to blame for this one. If you believe Halsey's side of the story, the A's deliberately delayed the MRI until he was in the minors just to avoid paying him a major league salary if he ended up on the DL. Which, in late April, he did. Given everything I've outlined here already, guess whose side I'm on?
At this point, that entire organization breaks my brain. I want to kidnap my favorite A's and squirrel them away in Detroit and Boston, where the med staffs may not be perfect, but the disabled lists have not been used seventeen times already. RUN, BOYS. RUN.
I would like to conclude by briefly revisiting the Harden question. His official diagnosis at the moment is "shoulder impingement," which I looked up while I was getting all carried away with the research, and damn if that doesn't look to my inexpert eye like something that could be confused with a torn labrum. He did, however, receive diagnosis from a doctor not on the A's staff. I am still disinclined to hold my breath.
By the way, anyone who knows better than I do what the hell I am talking about is more than welcome to chime in and correct any errors I've made.
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. . . sigh.
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(very long but read anyway)
*cries* I swear to all that is holy, if Haren gets hurt...
No. I'm not going to jinx him. He's gonna win the Cy Young, you know.
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The thing that's always struck me as so very odd about Harden's injuries is their frightening similarity to the kinds of injuries suffered by Tim Hudson. They're both hard throwers, but Hudson is a hard thrower coping with a small frame. Harden shouldn't have that problem. Where Hudson has oblique problems, Harden's problems should be located more around his shoulder and elbow. I know that his current injury is in the shoulder (or so we are told), but he had a LOT of oblique problems, and those tend to recur.
This always seemed so weird to me because it was like Harden was throwing as if he were a little guy, when he has absolutely no need to. I always wondered if he came up with those mechanics on his own, or if the A's did.
//How severe does a sprain have to be to still be causing problems two and a half months after the fact? With more organized management of his recovery, could he have been back and catching by now?//
The problem is that the word "sprain" is so very imprecise, even more so in the magical land of baseball injuries. Baseball people use it (and "strain") as kind of a catch-all term to refer to any kind of persistent soreness that is not otherwise immediately diagnosable (a break, an obvious tear, the arm actually falling out of the socket, etc.). There are SO many different parts of the shoulder that can be involved in a "sprain". Muscles, ligaments, tendons, they're all fair game.... the rotator cuff... everything in there.
He could have a degree of actual shoulder SEPARATION and they'd be calling it a sprain. I'm trying to remember how this happened; he collided with Lowell, right? So he got hit on the shoulder, and also landed pretty hard on it? I mean, right off the top of my head, that sounds like ligamentous tears in two different directions, resulting in partial separation. But people call that a sprain. Y'see?
Given his age and the amount of wear already on those ligaments and tendons and muscles from his long catching career, I don't think it's too likely he would be back much before now even IF his rehab had been more "properly" managed.
//If you believe Halsey's side of the story, the A's deliberately delayed the MRI until he was in the minors just to avoid paying him a major league salary if he ended up on the DL.//
This is inexcuseable, and if it turns out to be true, the Union would have everything they need to eat the A's alive. And they should. The Player's Union exists PRECISELY to stop this sort of player abuse. EXACTLY this sort of player abuse. Fuckin' hell.
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That's really interesting. I continue to be impressed by how much I don't know after watching baseball for almost four years. My question is this: If Harden did indeed come up with those mechanics on his own, and they've been causing problems, wouldn't a good coach or trainer or whatever work with him to develop different, more appropriate mechanics? (Notice my use of the adjective "good" . . .)
But people call that a sprain. Y'see?
Yep, that makes sense. I looked up shoulder sprains while I was doing my research, and I ended up not using what I found because of exactly what you said - it was so vague and covered such a wide range. It sounded like a sprain could be anything from "oops, I pulled that" to "oops, I shredded those."
Because I am a dork, I knew exactly where to find the clip of the injury. Lowell landed full force on Piazza's shoulder while Piazza was on his stomach with his arm spread a little bit away from his body. I do remember him mentioning that for a moment, it went numb and he was afraid it had separated. So, yeah. Looks like it was definitely in the upper levels of "severe."
This is inexcuseable, and if it turns out to be true, the Union would have everything they need to eat the A's alive.
Man, I hope so. If I had just run across that story by itself, I'd have my doubts, but in the context of what's been going on this season alone - well, I have to find Halsey's version of events a little more plausible than Beane's blandly indifferent quotes. I will definitely be keeping a close eye on this one.
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