Article: Ligaments Are Stupid

[Brad Swanson]

You can view the page at http://www.twinsdaily.com/content.php/2704-Ligaments-are-stupid

[Since71]

Thanks for the laughs I needed that. BTW Gardy already named it...you guessed it Liggy

[The Wise One]

People judge without knowledge of the process or the patient. It is not be the first time, nor will it be the last time.

Ligaments are stupid. Luckily attached to it there is a neuron attached to a brain.

[JB_Iowa]

Ligaments do suck (so do joints & tendons) but, then again, its hard to do without them for the most part (although apparently some BB players do without a UCL -- that must not be optimal, though or why wouldn't they just remove them instead of repair/replace them?)

[weinshie]

OK, I'm over the anger. But Twins Daily and other outlets need to begin asking questions. Why do so many Twins prospects suffer from major elbow issues? (Sano, Gibson, Chargois, Wimmers) Why does it take so long for Twins to figure out major issues, at least in the Gibson case? Are they learning poor throwing/pitching technique? Are the Twins using advanced kineseology reports/experts? If not, WHY? Is there a lack of communication in the organization? (Gibson pitched a MONTH with a jacked up elbow.) Yes, ligaments are stupid. But now we need to determine if members of the Twins' development system are troglodytes. (micdrop)

[JB_Iowa]

OK, I'm over the anger. But Twins Daily and other outlets need to begin asking questions. Why do so many Twins prospects suffer from major elbow issues? (Sano, Gibson, Chargois, Wimmers) Why does it take so long for Twins to figure out major issues, at least in the Gibson case? Are they learning poor throwing/pitching technique? Are the Twins using advanced kineseology reports/experts? If not, WHY? Is there a lack of communication in the organization? (Gibson pitched a MONTH with a jacked up elbow.) Yes, ligaments are stupid. But now we need to determine if members of the Twins' development system are troglodytes. (micdrop)

 

While I agree that the media needs to keep the pressure on the Twins by asking questions about medical treatment, please keep in mind that these players do use their elbows, knees, etc. BEFORE they come under Twins control.

 

I have yet to see a complete study showing that the Twins' results are significantly worse than the norm.

[Craig Arko]

But now we need to determine if members of the Twins' development system are troglodytes. (micdrop)

 

I vote for svirfneblin.

[Craig Arko]

If you think ligaments are stupid wait until you get to meet arthritic joints. IQ's of amoebae.

[Brad Swanson]

OK, I'm over the anger. But Twins Daily and other outlets need to begin asking questions. Why do so many Twins prospects suffer from major elbow issues? (Sano, Gibson, Chargois, Wimmers) Why does it take so long for Twins to figure out major issues, at least in the Gibson case? Are they learning poor throwing/pitching technique? Are the Twins using advanced kineseology reports/experts? If not, WHY? Is there a lack of communication in the organization? (Gibson pitched a MONTH with a jacked up elbow.) Yes, ligaments are stupid. But now we need to determine if members of the Twins' development system are troglodytes. (micdrop)

 

Well, there are two questions here. First, do the Twins have more prospects who suffer from elbow injuries than other organizations? I don't know the answer to that. It may seem that way, but we pay much closer attention to our system than any other. In other organizations, comparable guys to Wimmers and Chargois are fairly unknown to me. I can't imagine I'd even know who they are, much less whether or not they've had elbow issues.

 

The second question would only really need to be asked if the answer to the first question confirms our beliefs. Why do the Twins have more players with elbow issues than other organizations? I have no idea, but I'm just an idiot with Microsoft Word and access to the internet. I have no obligation to ask that question. I'd guess we're just dealing with a particularly annoying patch of bad luck.

[Wookiee of the Year]

R.A. Dickey has it figured out. Ligaments--who needs 'em?

[The Wise One]

Sigh A couple years old but about 30 seconds to find. Internet reported data about 2000-present. Might not be accurate, but as I am told with some baseball statistics, it is the best we got.

 

https://docs.google.com/spreadsheet/ccc?key=0ApDc5PGsBzgVdFpGbk84WnhNZlZ4VlFEY3pDVkFzNnc#gid=3

 

http://assets.sbnation.com/assets/1675617/TJbyTeam.png

[The Wise One]

Joe Mays, Fransico Lirians, Lester Oliveros, Joe Nathan, Grant Balfour, Pat Neshak, Scott Baker. That is the list of major league Twins to have had the procedure. Matt Bayshore, Mike Fetters, Angel Garcia, Kyle Gibson, Carlos Gutteriz, Jeff Manship, Frank Mata, and Alex Wimmers in the minors. Brian Duensing in college. This was into 2012.

Maybe somebody bright with analytics could tell me in what way any of these pitchers were similar in mechanics.

[Craig Arko]

Joe Mays, Fransico Lirians, Lester Oliveros, Joe Nathan, Grant Balfour, Pat Neshak, Scott Baker. That is the list of major league Twins to have had the procedure. Matt Bayshore, Mike Fetters, Angel Garcia, Kyle Gibson, Carlos Gutteriz, Jeff Manship, Frank Mata, and Alex Wimmers in the minors. Brian Duensing in college. This was into 2012.

Maybe somebody bright with analytics could tell me in what way any of these pitchers were similar in mechanics.

 

They all threw baseballs repititively.

[zchrz]

Joe Mays, Fransico Lirians, Lester Oliveros, Joe Nathan, Grant Balfour, Pat Neshak, Scott Baker. That is the list of major league Twins to have had the procedure. Matt Bayshore, Mike Fetters, Angel Garcia, Kyle Gibson, Carlos Gutteriz, Jeff Manship, Frank Mata, and Alex Wimmers in the minors. Brian Duensing in college. This was into 2012.

Maybe somebody bright with analytics could tell me in what way any of these pitchers were similar in mechanics.

 

A lot people say it is the inverted W position that pitchers get into with their elbows above their shoulders during delivery. It puts a ton of stress on the throwing elbow to lever at that high position and snap to throw the ball. It is also a big velocity factor making pitchers throw harder which is why so many use it. Guys like Prior, Strasburg, Smoltz ect all are good examples of it and have all been injury prone. Whereas guys like Maddux, Ryan, Johnson ect have been relatively injury free while avoiding the technique. Its not hard facts but more of a topic of debate with people strongly arguing for both its importance and non importance.

 

Here is a piece on it http://www.chrisoleary.com/projects/PitchingMechanics101/Essays/DeathToTheInvertedW.html

 

And just for kicks here is a video of the maxline pitching technique, that former cy young Mike Marshall has come up with that completely throws the traditional pitching mechanics out the window. Its an interesting watch and he has had one prospect get to the mlb that used a hybrid of the motion.

 

[zchrz]

Heres another interesting watch I found. Steve Delbar's story of blowing his arm out in A ball, getting a plate and 9 screws put in it, retiring, finding a training program as a high school coach, and coming back to make it to the majors throwing 3-4 mph harder. The training program was based off using weighted balls and actually holding them through the motion instead of releasing them all the time, which supposedly greatly strengthens the entire motion not just up to the release. I wonder if this is used by teams in the mlb much seems it would be much healthier to transfer some momentum to an object than just put it on your body, they liken to how tennis players rarely get shoulder injuries despite a similar motion to pitching.

 

[Heezy1323]

They all threw baseballs repititively.

 

Thats exactly correct. Many times it is not necessarily that it takes so long to make a diagnosis of UCL injury- it is deciding how long to try to treat it non operatively before resorting to surgery. Most guys that have UCL reconstruction don't have a completely torn ligament on MRI. The vast majority (probably 80% or more) have a partial tear. Some can play with a partial tear... some can't. Many variables in play including mechanics, degree of partial tear, condition of shoulder/elbow musculature, etc. Many lay people (as well as many baseball people) assume the success rate of UCL reconstruction is 100%. Not true. It is a highly successful operation, but most literature puts success rate around 85-90%. So that means one out of ten is unable to return to the same level of play. This is the main reason for trying conservative treatment (rest, rehab, PRP) prior to proceeding with surgery. It is true some position players can play without an intact UCL, but these are usually not players at positions requiring hard throws (3B, RF). As far as the W and inverted W position, that is one of probably a dozen or more current theories about predisposition to UCL injury. The issue is far from understood.

[Squirrel]

Thats exactly correct. Many times it is not necessarily that it takes so long to make a diagnosis of UCL injury- it is deciding how long to try to treat it non operatively before resorting to surgery. Most guys that have UCL reconstruction don't have a completely torn ligament on MRI. The vast majority (probably 80% or more) have a partial tear. Some can play with a partial tear... some can't. Many variables in play including mechanics, degree of partial tear, condition of shoulder/elbow musculature, etc. Many lay people (as well as many baseball people) assume the success rate of UCL reconstruction is 100%. Not true. It is a highly successful operation, but most literature puts success rate around 85-90%. So that means one out of ten is unable to return to the same level of play. This is the main reason for trying conservative treatment (rest, rehab, PRP) prior to proceeding with surgery. It is true some position players can play without an intact UCL, but these are usually not players at positions requiring hard throws (3B, RF). As far as the W and inverted W position, that is one of probably a dozen or more current theories about predisposition to UCL injury. The issue is far from understood.

 

This is interesting info. Are you a doctor? Or did you just spend some time and do some proper research?

[Heezy1323]

This is interesting info. Are you a doctor? Or did you just spend some time and do some proper research?

 

I'm an orthopedist yes. I trained with Dr. Andrews recently so I have a fairly decent understanding of some of the thought processes in play for these guys. I certainly don't have all the answers but am happy to put my two cents in here and there if it helps. Was born and raised in MN and a lifelong twins fan so kind of a bummer to hear about Sano. Sure hoping things go well with his surgery and recovery.

[Squirrel]

I'm an orthopedist yes. I trained with Dr. Andrews recently so I have a fairly decent understanding of some of the thought processes in play for these guys. I certainly don't have all the answers but am happy to put my two cents in here and there if it helps. Was born and raised in MN and a lifelong twins fan so kind of a bummer to hear about Sano. Sure hoping things go well with his surgery and recovery.

 

It helps! Thanks so much for the input and insight. Feel free to 'debunk' our armchair docs anytime ... although I suspect most of that is just built on frustration. My only experience with an orthopedic doctor was 'I'm not sure what the trouble is with your arm; but here's a cortizone shot and if that doesn't work we'll talk surgery.' I never went back and designed my own plan ... which was basically rest and rehabilitation. I'm always glad to see doctors choose non-invasive routes first, and the best usually do when there is a choice.

[nicksaviking]

OK, I'm over the anger. But Twins Daily and other outlets need to begin asking questions. Why do so many Twins prospects suffer from major elbow issues? (Sano, Gibson, Chargois, Wimmers) Why does it take so long for Twins to figure out major issues, at least in the Gibson case? Are they learning poor throwing/pitching technique? Are the Twins using advanced kineseology reports/experts? If not, WHY? Is there a lack of communication in the organization? (Gibson pitched a MONTH with a jacked up elbow.) Yes, ligaments are stupid. But now we need to determine if members of the Twins' development system are troglodytes. (micdrop)

 

Graph or not, I don't think the Twins are unique in the Tommy John market.

 

As to the question of letting them pitch/throw after having elbow pain, that may be a valid point. On the other hand, Ervin Santana has been pitching with a partially torn UCL for about half a decade.

[jimbo92107]

And who names a ligament Ulnar, anyway? Hey Ulnar, get a clue! Yeah you, ya weak little ligament that likes to pop, just to piss me off! Hey Ulnar, Thor called, he wants his hammer's name back!

 

Stupid ulnar...

[Brad Swanson]

I just want to say that I am very proud that the comments from an article titled "Ligaments are stupid" have real educational value. Thanks to Heezy for the sweet medical knowledge!