Berardino: Mastroianni Out Awhile + My Twins Med Staff Rant

[John Bonnes]

Mike Berardino gives us some bad news in a lot of ways....

 

Placed on the disabled list one week ago with a stress reaction in his left ankle, the speedster initially had hoped to return within three weeks. However, that is sounding less likely by the day.

 

 

The plan now is to have Mastroianni wear the walking boot another week or so, then undergo a third magnetic resonance imaging exam on his ankle. Even if he's able to escape the dreaded boot at that point, a lengthy period of rehabilitation figures to follow, including a minor league assignment.

 

 

This raises all kinds of questions....

 

1. If Hicks doesn't get any better, what the hell do the Twins do for CF? Is he stuck here now, no matter how much it might hurt him?

 

2. So the Twins waited three weeks to put him on the DL - and now he could be out for months?

 

3. How come the Twins are the only team that seems to never find anything the first few times on and MRI? Is it possible they're not using the right end?

 

And here, of course, is the best part when talking about the disfunctional nature of the Twins medical environment...

 

Mastroianni even took early batting practice that next day in an effort to get loose, but when Twins manager Ron Gardenhire saw him limping during regular BP, that was it.

 

 

"He caught me," Mastroianni said. "I wasn't going to say anything. I was going to try and play. I knew it hurt. It was getting close and I was trying to get through it. He said, 'Son, I can't put you in the outfield like that. You can't even walk.' I tried to tell him I could still go and he said, 'Go inside and get this thing worked on.' "

 

 

I guess one could say Maestro is a gamer. He likely is. But ultimately the freaking manager has to step in? Really? Is nobody on the training staff/medical team watching this stuff?

 

Minnesota Twins: Darin Mastroianni could be out awhile - TwinCities.com

[PseudoSABR]

Is nobody on the training staff/medical team watching this stuff?

This. It's not Gardy's job per se to notice when his players are injured. Don't the Twins pay actual people (i.e. more than one) to watch for these kind of things? It's hardly a new phenomenon that players fail to disclose injuries.

[Thrylos]

The other thing that really bugs me about the Twins is that they insult people's intelligence with their medical reports. Here is the issue with this case (Same quote, bold mine) :

 

placed on the disabled list one week ago with a stress reaction in his left ankle, the speedster initially had hoped to return within three weeks. However, that is sounding less likely by the day.

 

The plan now is to have Mastroianni wear the walking boot another week or so, then undergo a third magnetic resonance imaging exam on his ankle..

 

Stress reaction is a decrease in the bone density caused by stress and it is not detectable by an MRI. You need a bone scan to diagnose those. Since they are doing MRIs he likely has a stress fracture that is detectible and is monitored by MRIs. I don't know why they are doing this BS; maybe they are afraid of the backlash... And they are having a new head trainer too...

 

what's next? Booboos and owies and bumps?

 

Regardless, I think that Hicks stays. The only other option is Clete Thomas who is hitting .347/.448/.571 with 3 HR, but I doubt that they pull the trigger because that would mean DFAing Butera or something to add him to the 40-man roster.

[Ultima Ratio]

Well, with Hicks struggling and Mastro having good spring himself, it's to be expected that Mastro is going to do whatever he can to stay with the big club and the chance to start in CF. But everyone should know that, and that he's going to try to play through whatever he can in order to keep that job in sight. So I agree, the lays at the feet of the medical staff as it's not Gardy's job to find these things out, especially if his players have mixed motivations concerning telling the truth about injuries and pain.

 

What do we do now? Even if Hicks finds a way to improve, we have no good CF backup on the current 25 man. Escobear?

[gunnarthor]

1) If Hicks needs to go down, they'll find someone (Benson or a AAAA) to take his place. Mastro is a nice player but hardly irreplaceable.

2) Sounds like it.

3) You only pay attention to the Twins but I'm sure it's a somewhat fairly often occurrence. Orioles fans are going nuts over uber prospect Bundy needing a second MRI despite the first one looking great, for instance. Fangraphs did a study, using 10 years worth of data on DL trips. It found that the Twins were one of the healthier teams, by that model. Only three teams had lost fewer days to the DL. I know one common complaint is that the team doesn't use the DL fast enough (although I'm sure that's a common problem, too) so games missed while not on the DL wouldn't be counted but even if you added another 1000 days to their total, they'd still be in the lower half.

[DaveW]

I do enjoy when people who have no experience in the medical field try to second guess doctors who often times are at the top of their fields. It always comes off as silly to me.

 

The Yankee doctors missed a second fraction on Jeter until recently...these things happen all the time in baseball/sports/life in general, things take times to diagnose.

[greengoblinrulz]

Clete Thomas is next in line if they pull the plug on Hicks, but everyone knows how that will end. Guys had plenty of chances & wont do much more than Aaron is already doin.

[snepp]

I do enjoy when people who have no experience in the medical field try to second guess doctors who often times are at the top of their fields. It always comes off as silly to me.

 

Is experience a requirement to second guess someone for something? Should we apply this to every critique made on this forum? Somehow I doubt the majority of people have top-level baseball experience.

[TheLeviathan]

I do enjoy when people who have no experience in the medical field try to second guess doctors who often times are at the top of their fields. It always comes off as silly to me.

 

The Yankee doctors missed a second fraction on Jeter until recently...these things happen all the time in baseball/sports/life in general, things take times to diagnose.

 

I get your point Dave, but the issue I have is that this is borderline a culture with this organization. I don't know if players feel a pressure to mask injuries (god knows there have been plenty of public flaps for player's manhood being questioned) or if it's medical incompetence.

 

Either way, it needs to change.

[TheLeviathan]

Is experience a requirement to second guess someone for something? Should we apply this to every critique made on this forum? Somehow I doubt the majority of people have top-level baseball experience.

 

Not to mention - I don't need to be a certified mechanic to know the wheel falling off my car was probably not a professional fix.

[DaveW]

Is experience a requirement to second guess someone for something? Should we apply this to every critique made on this forum? Somehow I doubt the majority of people have top-level baseball experience.

It's fine, but it gets brought up EVERY SINGLE TIME a Twins player gets injured or has surgery.

 

Last year with Baker was the most ridiculous considering they didn't even know he needed Tommy John until he had his arm cut open.

 

Some of these injuries can just be fickle and every team deals with them, misdiagnosis or what not.

[jokin]

Mike Berardino gives us some bad news in a lot of ways....

 

 

 

This raises all kinds of questions....

 

1. If Hicks doesn't get any better, what the hell do the Twins do for CF? Is he stuck here now, no matter how much it might hurt him?

 

2. So the Twins waited three weeks to put him on the DL - and now he could be out for months?

 

3. How come the Twins are the only team that seems to never find anything the first few times on and MRI? Is it possible they're not using the right end?

 

And here, of course, is the best part when talking about the disfunctional nature of the Twins medical environment...

 

 

 

I guess one could say Maestro is a gamer. He likely is. But ultimately the freaking manager has to step in? Really? Is nobody on the training staff/medical team watching this stuff?

 

Minnesota Twins: Darin Mastroianni could be out awhile - TwinCities.com

 

One could be tempted to say, "welcome to the mouth-breathing 20%".

 

The Clete Thomas renaissance tour is just days away....

[DaveW]

I get your point Dave, but the issue I have is that this is borderline a culture with this organization. I don't know if players feel a pressure to mask injuries (god knows there have been plenty of public flaps for player's manhood being questioned) or if it's medical incompetence.

 

Either way, it needs to change.

 

Didn't the Twins replace several members of the training staff this year? Or was that just wishful thinking.

 

My only problem with the Twins is when you have some back up like Mastrio and he is going to miss more than 3 or 4 games you need to just stick him on the DL, especially considering he is very replaceable. If it's Mauer/Morneau or one of the SP I understand waiting a few extra days to be honest.

 

Then again, if Mastrio wasn't being 100% forthright it's on him quite a bit as well.

 

A lot of times people are good at masking pain/injury. For instance, I got hit in the nuts last Sunday during my baseball game (I was told I was DHing and at the last minute put in at 1st base), nobody knew I had gotten hit or was hurt until I literally thought I was going to vomit in the dugout the following half inning.

 

The only real way to find out if a guy is withholding pain is to give him a physical before and after every game. But I imagine the players union wouldn't be thrilled with having their players "turn their heads and cough" 300+ times a year.

[jokin]

It's fine, but it gets brought up EVERY SINGLE TIME a Twins player gets injured or has surgery.

 

Last year with Baker was the most ridiculous considering they didn't even know he needed Tommy John until he had his arm cut open.

 

Some of these injuries can just be fickle and every team deals with them, misdiagnosis or what not.

 

I thought it was "most ridiculous" that because "they didn't even know" about the TJ, but yet, they were still willing to let leak to the public that in their opinion, Baker wasn't toughing it out enough and be more willing to pitch through a little pain.

[snepp]

Last year with Baker was the most ridiculous considering they didn't even know he needed Tommy John until he had his arm cut open.

 

True, but much of that Baker angst was fueled by the ridiculous man-hood challenges thrown out by the team.

[John Bonnes]

Regardless of eveyone's medical background, the facts remain...

 

1) This problems started on 3/25

2) It took 3 weeks to get him on the DL

3) Within a few days, the diagnosis has changed dramatically and for the worse.

 

The most likely explanations seem to be:

1) that Mastro is REALLY good at hiding the problem, which he might be, but it's not like they didn't know he was injured. They openly talked about how limited he would be and when he could come back to the lineup. Or...

2) that he wasn't all that bad, but it got a lot worse. Well, yeah, that can happen when you continue to play on an injury.

 

And if it was one time, that would be fine, but it happens over and over. Baker, Pavano, Span, Plouffe, Morneau... and that's off the top of my head.

[The Greatest Poster Alive]

Is experience a requirement to second guess someone for something? Should we apply this to every critique made on this forum? Somehow I doubt the majority of people have top-level baseball experience.

 

Yes we should. There is a lot of talking out of one's ass that happens on a forum. People claim to know that the Twins could have signed player X but were cheap... or Lowballed player y.

 

My personal favorite is the people who claim to know the trade market for a player. Claiming that they know the Twins could have gotten a better package for a player with absolutely zero knowledge on the situation.

[The Greatest Poster Alive]

Regardless of eveyone's medical background, the facts remain...

 

1) This problems started on 3/25

2) It took 3 weeks to get him on the DL

3) Within a few days, the diagnosis has changed dramatically and for the worse.

 

The most likely explanations seem to be:

1) that Mastro is REALLY good at hiding the problem, which he might be, but it's not like they didn't know he was injured. They openly talked about how limited he would be and when he could come back to the lineup. Or...

2) that he wasn't all that bad, but it got a lot worse. Well, yeah, that can happen when you continue to play on an injury.

 

And if it was one time, that would be fine, but it happens over and over. Baker, Pavano, Span, Plouffe, Morneau... and that's off the top of my head.

 

It's almost as if a bubble player tried to play through an injury knowing was one of his last chances.

[snepp]

Yes we should. There is a lot of talking out of one's ass that happens on a forum. People claim to know that the Twins could have signed player X but were cheap... or Lowballed player y.

 

My personal favorite is the people who claim to know the trade market for a player. Claiming that they know the Twins could have gotten a better package for a player with absolutely zero knowledge on the situation.

 

Should I direct user resumes your way so that you can personally approve of who is allowed to provide opinions on any given subject?

 

Or should the proprietors just shut the forum down now given that there would be no one left to discuss anything?

[TheLeviathan]

The only real way to find out if a guy is withholding pain is to give him a physical before and after every game. But I imagine the players union wouldn't be thrilled with having their players "turn their heads and cough" 300+ times a year.

 

If this was an isolated incident, I'd probably agree with you completely. The problem is that this issue has happened across a whole range of players, injuries, and seasons. I'm inclined to believe there is a true issue of culture behind the scenes as evidenced by the Baker manhood comments. This team prides itself on being "old-school" and I wonder if there isn't too much pressure on players to not disclose injuries openly.

 

I thought they had replaced the trainers, but maybe the issue isn't the people, it's the methods/philosophies.

[PseudoSABR]

Honestly, it's one thing to offer non-expert critiques on game of baseball, because that information is readily available from watching the games and the statistical output of the game--but in terms of medicine and even front office management, we as fans just don't have the same quality of opinions because we're largely in the dark. That's frustrating, but lets not be so rash as to legitimize our medical critiques.

 

What bother's me is that not noticing Maestro limping either indicates 1) negligence 2) laziness 3) or lack of personnel.

[cmathewson]

Regardless of eveyone's medical background, the facts remain...

 

1) This problems started on 3/25

2) It took 3 weeks to get him on the DL

3) Within a few days, the diagnosis has changed dramatically and for the worse.

 

The most likely explanations seem to be:

1) that Mastro is REALLY good at hiding the problem, which he might be, but it's not like they didn't know he was injured. They openly talked about how limited he would be and when he could come back to the lineup. Or...

2) that he wasn't all that bad, but it got a lot worse. Well, yeah, that can happen when you continue to play on an injury.

 

And if it was one time, that would be fine, but it happens over and over. Baker, Pavano, Span, Plouffe, Morneau... and that's off the top of my head.

 

This, in a nutshell is my issue. I get that sports medicine is hard and these things happen once in a while. But every freeking time it's the same pattern. Meanwhile, Gardy is without that player or a suitable replacement for weeks. Last year, Plouffe was unavailable but not on the DL for weeks before they finally put him on. Gardy was playing with a 24-man team for much of last year between him and the others.

 

In this case, the eventual diagnosis doesn't even make any sense. A stress reaction is the precursor to a stress fracture. It is a thinning in the bone caused by stress, not blunt-force trauma. But the injury was caused by Mastro fouling a ball off his leg. And, as Thrylos said, you can't diagnose a stress reaction with an MRI. You can find a fracture with an MRI. So the only reason they are doing the MRI is to find a fracture.

 

I said this weeks ago. He probably never had a bone bruise. He probably had the kind of fracture Hunter had, which is sometimes called an impact fracture, like when a rock hits the windshield and leaves hairline cracks radiating from a central point. I'm no doctor, but I had this kind of fracture in my youth. They often don't show up on an X-Ray until they start healing. They are typically diagnosed as a bone bruise until they show up in medical imagery. At this point, a bone bruise should have healed. Instead it's getting worse. So they are probably looking for the signs of a hairline fracture. When they find it, they'll be wondering what might have been if they had immobilized the leg right away and allowed it to heal, rather than allowing the cracks to grow by sending the player into live action.

 

I sometimes wonder if the medical staff even leaves the training room until the game starts. Guys are limping around out there in warm-ups and they only hear about injuries when the player seeks treatment. I had hoped the shake-up in the medical staff would have changed the outcomes for these injuries. It's not a good sign that we see the same pattern in the first major injury this year.

 

What happens now? Well, it leaves the Twins dangerously thin in center field. Hicks is here to stay, and is showing signs of competence. And Arcia is probably here for the long haul as well. I'm sure Escobar is taking fly balls out there in practice. The twins will limp along as they always do. But it doesn't have to be this way.

[LaBombo]

It's almost as if a bubble player tried to play through an injury knowing was one of his last chances.

Yeah, people do crazy stuff to protect their jobs when they have titans of the game like Clete Thomas and Joe Benson breathing down their necks...

[drjim]

I highly doubt that the medical staff is so incompetent that they can't find a fracture on an MRI. If it was a stress reaction that is a touchy injury that can have varying levels of pain depending on the day - and I totally buy the theory that Mastro was trying to play through pain because he is a bubble player. I have been on teams in college that had players playing on different fractures and didn't really realize it until it kept getting worse. As an athlete you can push your body and these are among the best athletes in the world. This stuff just doesn't always get caught.

 

What I really find hilarious is the idea that only the Twins suffer from this. I guarantee every fan base has similar stories, we are just so close to the team that our perception is exaggerated.

 

The best point is that it is Mastro, there really is no reason to mess around with him. After 3-4 days put him on the DL.

[Nick Nelson]

Really? So we're all going to blast the medical staff (again) and no one is going to put any of the blame on Mastroianni, who undoubtedly continued to downplay the injury and -- by forcing his way through it -- ended up making it much worse?

 

These guys are professional athletes. It's their job to take care of their own bodies. If he's hiding a significant injury, that's his bad.

[cmathewson]

Yeah, people do crazy stuff to protect their jobs when they have titans of the game like Clete Thomas and Joe Benson breathing down their necks...

 

Reading the sarcasm as intended (I hope), I get your point. But I can excuse the player in his first full year of the majors after getting sent down from spring training four consecutive years and spending six years in the minors out of college. It was the most bitter of ironies that he was hurt just before making the team, when he had a good chance of eventually winning the starting job. If he could only play through it,....

[drjim]

Yeah, people do crazy stuff to protect their jobs when they have titans of the game like Clete Thomas and Joe Benson breathing down their necks...

 

I'm sure a guy who was barely staying afloat in AA at the beginning of last year is always nervous about his spot on a 25 man roster.

[TheLeviathan]

Here is where I downplay Mastro a bit.....they knew he was hurt, all he was telling them was that he wasn't hurt bad enough that some time off wouldn't help.

 

In this best case scenario you STILL put him on the DL because....well....why wouldn't you if he can't play and it's been dragging on for over a week? So yeah, shame on Mastro for it. Shame even moreso on the Twins for not giving a crap what a fringe roster player had to say about and doing the only reasonable, sane thing you should do because it's right for your ballclub.

 

And we've seen that same pattern of baffling (non) decision making multiple times now.

[gunnarthor]

I think one of the problems I have with attacking the Twins on this is that no one knows how well other teams handle the same issue. Some idiot will post some crap about JJ Hardy in Baltimore as if that makes the case. The only study I've seen on how teams stay healthy was the fangraphs link I posted and, according to that, the Twins were pretty good over a 10 year period.

[cmathewson]

I highly doubt that the medical staff is so incompetent that they can't find a fracture on an MRI. If it was a stress reaction that is a touchy injury that can have varying levels of pain depending on the day - and I totally buy the theory that Mastro was trying to play through pain because he is a bubble player.

 

They have missed worse. They missed the severity of the first Mauer knee injury and it almost ruined his career just as it was starting. Everyone knows about the torn meniscus. Only after the season did a sports writer interview his father (the medical staff doesn't discuss injuries for obvious reasons). He said Joe had a significant injury to the cap on his femur, which went undetected until his second MRI (after he struggled to return from surgery). If they had found it on the first MRI, Joe would never have played after surgery. Playing on it made it much worse. Point is, they miss stuff. Hairline fractures are the hardest to find.