Trust the Process: The Twins Are Navigating Uncharted Injury Waters As Best They Can

The season is one-third of its usual length; the amount of teams that will qualify for the playoffs has increased by 33%; drones are interrupting games; and the designated hitter is now universal, at least for the time being (but, let’s be real, it’ll probably stay that way).

But the game of baseball is still, well, baseball in its essence despite all of the changes. However, that isn’t necessarily the case when it comes to rehabilitation and the athletic training, medical, and strength and conditioning staffs that coordinate and administer treatments.

A number of factors have contributed to this increase, but the two biggest culprits are likely the short “Summer Camp” ramp up period as well as the grueling game schedule. Rehabilitation science is a legitimate science, though it is young compared to other medical sciences and is peppered with many so-called gray areas; very few laws (in the scientific sense) exist when it comes to rehabilitation and recovery. However, one fact that is pretty set in stone is that injuries are more likely to occur when an athlete undergoes a large increase in activity in a relatively short amount of time.

This is essentially what the Twins and the league’s 29 other teams experienced as their second spring training was only three weeks long and very few games were ultimately played. And not only that, but now teams are playing games with fewer off days built into the schedule compared to a normal season. If a normal season is a marathon, the 2020 season is a marathon-sprint hybrid. It’s a marathon in the sense that athletes need the neuromuscular endurance to be able perform at a high level without much time or opportunity for rest, but it’s a sprint in that every team will play 60 games in approximately 65 days.

The established rehabilitation protocols and processes, particularly in regard to professional baseball, aren’t necessarily designed for such an environment. The teams who are best able to adapt, both with in-game decision making as well as with injury management, are likely to be the most successful...and healthy.

The Twins’ training staff has caught some flack this season for how they’ve handled and communicated the injuries of Jake Odorizzi, Josh Donaldson, Luis Arraez, and Homer Bailey, among others. There are a few realities that need to be taken into account when broaching this topic.

First and foremost, each of these players is suffering from a soft tissue injury that is nagging, but not overly serious if handled correctly; the injuries also fit the description to a T of what would be expected to be seen early in a marathon-sprint hybrid season preceded by a short ramp up period.

Second, and this bears repeating, the current circumstances call for a new rehabilitation and recovery playbook. Take the case of Josh Donaldson for example.

Twins’ President of Baseball Operations Derek Falvey explained during Friday night’s broadcast the reasoning behind placing Donaldson on the injured list a week after he was removed from the game with right calf tightness.

“Josh came out of a game against the Indians in that last series we played here at home and was a little tight in his calf. We felt like we wanted to take this day-to-day, if we could, and slow it down. With 30-man rosters, we felt we had the flexibility to maybe play this out for a few days. After having him run a little bit today he was still sore and we felt like the best thing to do was to be smart about this and make sure he gets this fully taken care of before he gets back on the field. So we’re going to put him on the IL for a few days.”

The logic is solid. The Twins have an expanded roster, were winning without him, and Donaldson has a history of calf injuries, so it’s in both parties’ best interest for him to be fully healthy before returning to play. Donaldson’s pain levels and ability to tolerate activity were very likely assessed every day since the injury first occurred, and with it improving slowly the Twins decided it was the best decision to place him on the IL. That’s not an example of a team being nefarious or coy with their decision or press conference wording, but rather the example of adaptability and good process.

Soft tissue injuries, particularly relatively minor soft tissue injuries, can be difficult to treat even when the times are precedented. MRIs usually return negative or largely inconclusive; the injured tissue can feel great one day and not so much the next; one twist of a nearby joint can either make the pain better or worse and it's anyone’s guess as to why. All of these factors likely contributed to Donaldson being placed on the IL later rather than sooner. That doesn’t mean the Twins were lying when they defined his absence as “day-to-day” or handled the situation poorly. I’d argue it actually means the opposite; again, the result is less than ideal and it may be frustrating, but the decision making process - employed with Donaldson as well as Odorizzi and Hill and Bailey - is good.

Falvey continued when discussing the most important aspect of the 2020 season, “Making sure our guys are healthy every day and on the field. We talk about quick summer camp, getting guys back on the field; you didn’t have your normal spring training ramp up, so that’s part of it. Beyond COVID, you want to make sure everyone is healthy. So, we’ve been slow to bring guys back. I know it’s a 60-game season, it’s a sprint, but you can’t speed up health. And I do feel like we’ve got to make sure that guys are healthy and going as we get ramped up and back into this ‘cause we’ll play a lot of games in a short period of time and it’s important for us to be healthy into September and hopefully into a good playoff run.”

The Twins have a method to their madness and it can - understandably - be frustrating from a fan’s perspective. But the Twins’ process is good and their ability to be adaptive in a difficult situation is an advantage than many teams wish they had. Trust the process.

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