Lucas Seehafer PT

It goes without saying at this point, but the 2019 season was an utter success for the Minnesota Twins in terms of performance. The team won 101 games and the American League Central for the first time since 2010; three players - Jake Odorizzi, Jose Berrios, and Jorge Polanco - were named to the All-Star team; and the Bomba Squad was birthed, hitting a record 307 home runs.But how about in terms of health? One may assume that the Twins were pretty successful in that domain as well - after all, it’s pretty difficult to win over 100 games without the team’s best players remaining healthy for the majority of the season (the 2019 New York Yankees notwithstanding). But I decided to take a look into the data anyway because 1. I was interested and 2. What else am I going to do with my - suddenly expansive - free time anyway? My Method This was pretty simple, though it was rather tedious and time consuming. I scoured the Twins’ transactions pages on MLB.com from March to October 2019, so as to include all injuries that occurred from spring training to the end of the postseason. I logged the names, diagnoses, dates (both the date that athlete was injured as well as when they returned to play), and the total number of days missed of all Twins’ injuries that required a stint on the injured list. I then further broke down the data into pitcher and position player categories. The Results Prior to addressing the data, a quick disclaimer. A single season’s worth of data doesn’t provide enough of a sample size to draw big, sweeping conclusions. So what’s the purpose of this analysis, you ask? Again, I have free time and was curious. But, in all seriousness, it does provide a decent snapshot into whether or not the Twins’ players suffered from a particular type of injury (i.e. muscle strains or shoulder problems) more than others, as well as if one group of athletes (i.e. pitchers versus position players) were injured more frequently or seriously. Analyses such as this could help inform the team’s medical, front office, and coaching staffs and determine if more research needs to be conducted (such as if the data from previous seasons when combined with this displays any trends or if the team needs to look into establishing or refining rehab protocols). This type of analysis isn’t without its flaws - again don’t draw conclusions; this is more like a snapshot of a single moment in time rather than the whole movie. So, without further ado, the data. I developed the chart below from the information gathered during my research. Download attachment: gallery_12465_316_120733 (1).png Download attachment: gallery_12465_316_120733.png General takeaways: The Twins really only had two players of consequence suffer significant injuries: Byron Buxton and Willians Astudillo. The total days missed of these two combined (159) accounted for approximately one-quarter the team’s total (159 of 660; 24.1%).Injuries of the shoulder and wrist-hand complex accounted for over half of all injured list stints (14 of 26) and nearly half of total days missed (318 of 660; 48.2%).Position players accounted for more IL stints and total days missed compared to pitchers; however, both groups’ average days missed were essentially identical.Injuries care not for which side of the body they come for. What does this mean? Most likely nothing!The ConclusionIt would be difficult to argue that the Twins weren’t generally successful when it came to remaining healthy during the 2019 season. While 26 individual trips to the IL - provided that there aren’t any holes in the data - may seem like quite a bit, the fact of the matter is that the Twins only lost two players who were regular contributors for extended periods of time. Additionally, the Twins didn’t lose any of their starting pitchers - or relief pitchers of consequence, for that matter - to significant shoulder or elbow injuries. In a day and age where velocity is king - and many Twins’ pitchers saw their velocity increase last season - it was encouraging to see a lack of serious arm trouble. Consider that a win and potentially a positive sign moving forward for Wes Johnson and company. What are your thoughts? Do you think the Twins’ relative health during the 2019 season was luck? Or is it a sign of things to come? MORE FROM TWINS DAILY — Latest Twins coverage from our writers — Recent Twins discussion in our forums — Follow Twins Daily via Twitter, Facebook, or email Click here to view the article

There's decent research out there that says training with heavier and lighter bats can improve swing speed in the long run; that's part of what the guys at Driveline preach. As for golf, I guess I really haven't looked into it, but that is an interesting thought. My initial thoughts would be that it would produce a similar effect, but as you say timing and mechanics are incredibly important.

The title of the article really says it all. This was a question I began pondering after stumbling across a research article published in this month’s edition of the Journal of Strength and Conditioning Research, in which it was determined that warming up with a heavy bat (57-oz.) actually decreased subsequent swing velocity.Attend any baseball game at any level and you’ll find that a good chunk of athletes will be taking their practice cuts in the on-deck circle with a heavy bat; usually this involves swinging a “normal” bat with a weighted donut or sleeve around the barrel or an implement such as a metal rod or sand-filled tube designed to mimic the ergonomics of a typical baseball bat. It is an action that is ubiquitous in the game and, on the surface, it makes logical sense. Swinging a heavy bat primes the muscles and makes a lighter bat feel, well, lighter in the hand, allowing the athlete to generate a higher swing velocity; this is often referred to as “the overload approach.” It’s been well established that swing velocity correlates strongly with exit velocity, meaning the quicker one swings, the faster the ball leaves the bat. The faster the ball leaves the bat, the farther it flies; it’s simple physics. However, upon delving into the research, it appears as though warming up with a heavy bat does not actually produce this result. A term that popped up regularly was “kinesthetic illusion” - sometimes referred to as “kinesthetic aftereffect”. This term describes the athlete’s perception that they are swinging faster after warming up with a heavy bat, when in reality, they are not. Five studies published in 2009 or later (linked below) involving a total of 88 participants who participated in high-school or college baseball found that warming up with a heavy bat did not increase swing velocity in a statistically meaningful way when compared to warming up with a standard bat - no matter the modality used to make the bat “heavy.” (The standard bat was often 33-in., 30-oz. - though it wasn’t until the later studies that this became standardized.) All five studies also assessed whether or not warming up with a “light” bat impacted the resulting swing velocity with a standard bat. Four studies found that warming up with a light bat did not impact resulting swing velocity, though one study found that it improved swing velocity by (this same study also found that warming up with a heavy bat slowed resulting swing velocity). The overall range of light to heavy bats across all five studies was 6.9-96-oz. An additional study, looking at 30 collegiate baseball players, found that utilizing weighted batting gloves did not alter swing mechanics compared to swinging a standardized control bat; however, swinging a bat with a weight applied to the barrel did impact swing mechanics. So not only does warming up with a donut or weighted sleeve not impact - or possibly have a negative impact on - resulting swing velocity, but it may also change the mechanics of the athlete’s swing compared to that of a standard bat. I think that Charles Williams and his research team summed it up best when they concluded: “If presented with the current options, athletes should choose the warm up implement with which they are most comfortable using before an at-bat situation.” After all, kinesthetic illusion - a variant of the placebo effect - can be a powerful tool. Links and Resources Cited in this article: https://www.drivelin...at-speed-myths/https://www.tandfonl...41.2015.1123762https://journals.lww...Warm_Up.29.aspxhttps://cdn.journals...t_Swing.42.aspxhttps://journals.lww...Velocity.1.aspxhttps://journals.lww...ents_on.23.aspxhttps://journals.lww...ded_and.25.aspxhttps://bjsm.bmj.com...14/935.full.pdfMORE FROM TWINS DAILY— Latest Twins coverage from our writers — Recent Twins discussion in our forums — Follow Twins Daily via Twitter, Facebook or email Click here to view the article

When major league baseball will resume is anybody’s guess. But assuming baseball does have some semblance of a season during the 2020 calendar year, how will it impact the health of MLBers, however stunted it may be?When major league baseball will resume is anybody’s guess. But assuming baseball does have some semblance of a season during the 2020 calendar year, how will it impact the health of MLBers, however stunted it may be? In many ways this is an impossible question to answer with any sort of confidence at this time. For instance, we don’t know when the season will begin, when it will end, the amount of doubleheaders it will contain, if roster sizes will extend and for how long, nor to what extent will there be an extended Spring Training, among other factors that may be in play during the upcoming season. It seems intuitive that injury rates may increase during the upcoming season as athletes and teams will assuredly have less time to prepare physically compared to a typical season with a typical Spring Training; during the strike-shortened 1995 season, MLB had a three-week “Spring Training” prior to beginning the regular season on April 25th, which may serve as precedent for how MLB will handle the upcoming season. While athletes around the league are doing their best to remain in game-shape, each week without access to live pitching and batting practice at game speed decreases the likelihood that the athletes will remain ready for action. There is some debate, however, regarding the role that Spring Training plays in athlete injury prevention. Spring Training likely decreases injury rates as many musculoskeletal injuries - among athletes as well as the lay population - occur after a sharp increase in activity which was preceded by relatively less activity, however, to what extent is unknown and likely impossible to study with a high-degree of accuracy. Injury rates are usually highest among MLB athletes during the early portions of the season. A study conducted in 2011 found that injury rates during the 2002-2008 seasons were highest during April (5.73 injuries per 1,000 athlete exposures) and steadily decreased throughout the rest of the season, bottoming out at an injury rate of 0.54 during September. Later studies published in 2019 and 2020 found that lower body and upper body injuries, respectively, suffered during the 2010-2016 seasons had the highest occurrence during the month of April (24% of all upper extremity and 21% of all lower extremity injuries suffered over the six year timeframe); these same studies found, perhaps unsurprisingly, that pitchers were more likely to suffer upper extremity injuries, whereas position players were more likely to suffer lower extremity injuries. This is a guess, but it would not surprise me to see an increase in the rate of lower extremity soft tissue injuries - i.e. muscle strains - during the first month or two of the 2020 regular season compared to other seasons, particularly among position players, due in large part to the likely shortened “Spring Training” interval. However, as long as pitchers are stretched out and brought along at an appropriate pace - such as capping pitch counts and limiting innings - I could see upper extremity injuries maintaining similar rates compared to previous seasons. In all reality, it will be impossible to know how the shortened season impacts MLB athlete injury occurrence until after the 2020 season has been completed, and even then how late the season extends into the calendar year as well as the percentage of games that are played as doubleheaders will likely influence the overall rates of injury. We may never truly know the answer as to how MLB athlete health was impacted during the 2020 season. Blaine Hardy Undergoes Tommy John Surgery Phil Miller of the Star Tribune dropped a surprising nugget Saturday afternoon when he reported that reliever Blaine Hardy underwent Tommy John surgery recently to address a torn UCL and damaged flexor-pronator mass in his left elbow. Hardy was signed to a minor league contract by the Twins during the offseason. Hardy dealt with left elbow pain during his 2019 campaign with the Detroit Tigers - spending time on the injured list twice, including a 60-day stint - and received a PRP injection in August to address his pain under the recommendation of famed orthopedic surgeon Dr. James Andrews. PRP injections involve removing blood from the athlete, separating the plasma from the red blood cells, and injecting the plasma into the injured tissue; PRP is shorthand for “platelet-rich plasma” as the injected plasma is composed primarily of platelets and water. Platelets, which are small cells primarily involved with clotting, also release healing factors such as hormones. The increased density of platelets within the injected plasma theoretically spurs the tissue to recover at an higher-rate, however, the true efficacy of PRP injections is debated. The typical timeframe of return-to-play after Tommy John surgery is 12-18 months. MORE FROM TWINS DAILY — Latest Twins coverage from our writers — Recent Twins discussion in our forums — Follow Twins Daily via Twitter, Facebook or email Click here to view the article

I think for the most part he does a pretty good job. He doesn't seem to be exerting himself 100%, but if you look for all 6 components I outlined, he pretty much passes them all.

One of the best ways a pitcher can avoid injury, particularly of the shoulder and elbow, is by utilizing proper and repeatable throwing mechanics. The effect of faulty throwing mechanics on pitcher injury rates has been studied most extensively in high school and adolescent athletes, however, the concepts carry over to collegiate and professional pitchers as well. But what exactly does “proper throwing mechanics” entail?One of the best ways a pitcher can avoid injury, particularly of the shoulder and elbow, is by utilizing proper and repeatable throwing mechanics. The effect of faulty throwing mechanics on pitcher injury rates has been studied most extensively in high school and adolescent athletes, however, the concepts carry over to collegiate and professional pitchers as well. But what exactly does “proper throwing mechanics” entail? First, it would be best to break down the action involved during a pitch. Each pitch consists of six distinct phases: 1. windup, 2. stride (sometimes referred to as early cocking), 3. late cocking 4. acceleration, 5. deceleration, and 6. follow through. The windup phase includes any action that occurs from when the pitcher becomes set until they reach their balance point; the stride phase - as seen in the photo of Jose Berrios above - occurs from when the pitcher progresses from their balance point until the foot comes in contact with the ground; the late cocking phase occurs when the throwing arm achieves maximal external rotation (i.e. rotated “backwards”); the acceleration phase occurs once maximal rotation is achieved and lasts until the ball is released; the deceleration phase occurs after ball release; and the follow through phase occurs until the pitching motion is completed. Faulty mechanics can arise during any of the six phases of pitching, however, they are least likely to appear during the windup and follow through. The American Sports Medicine Institute (ASMI) was the first entity to develop an assessment tool to evaluate and critique a pitcher’s mechanics, however, the tool was not able to predict injury risk. The ASMI’s tool consists of 24 items, however, two studies - they can be found here and here - conducted separately were able to identify six items that increase a pitcher’s risk for injury if they are deemed to be faulty. These were: 1. supinated hand position when the elbow was maximally extended, 2. open or closed foot position at foot-ground contact, 3. backwards lean at foot-ground contact, 4. open shoulder positioning, 5. trunk to elbow angle below 90-degrees at foot-ground contact, and 6. excessive trunk lean at maximal shoulder external rotation. A study conducted by Emily Quatromoni - the inspiration of this article - found that these six items could be adequately identified upon visualization of a pitch. Of these six, a supinated hand is the least likely to be seen amongst professional pitchers - again most of these studies are conducted with children or high school athletes as the test subjects with less instruction on proper mechanics. However, the other five can be seen time and again in professional pitchers. As an example: below is an image of new Twins’ starting pitcher Jhoulys Chacin with a slightly closed foot position. Improper mechanics, such as the six highlighted above, increase the amount of stress placed through the shoulder and inner elbow, which in turn increases the risk for labral tearing and UCL sprain, among other injuries. These six mechanical faults can be avoided - or at least limited - with proper coaching, training, and minimizing pitcher fatigue, such as by establishing a firm maximum pitch count or innings limit. Below is again the image of Berrios displaying proper biomechanics (note: item six - minimal trunk lean at maximum shoulder external rotation - is not pictured as he has not reached that point in his throwing motion yet). For a more dynamic visualization, I encourage you to watch the videos that Twins’ pitcher Lewis Thorpe posted to his Twitter feed the other day. Try to see if you can pick out the six phases of the pitch as well as the avoidance - or lack thereof? - of the six faulty mechanics. MORE FROM TWINS DAILY — Latest Twins coverage from our writers — Recent Twins discussion in our forums — Follow Twins Daily via Twitter, Facebook or email Click here to view the article

I guess it would depend on a number of factors including how often he'd play multiple days in a row, how demanding those games would be, etc. I guess my short answer is that I doubt it. I think the Twins thought process is more that Gonzalez is better and more needed in the infield.

Minnesota Twins’ do-it-all utility man Marwin Gonzalez appeared in his first spring training action this past Tuesday in a (meaningless) victory over the Detroit Tigers, going 2-for-2 with a double and a homer run. It was an encouraging sign for the Twins and their faithful as Gonzalez figures to once again be a key member of the team’s regular rotation.However, The Athletic’s Dan Hayes sent a few ripples through the waters of Ft. Meyers and the some-10,000 lakes of Minnesota when he reported that Gonzalez underwent a patellar debridement procedure of his right knee after the season concluded this past October that prevented him from participating in baseball activities until December; Hayes also disclosed that Gonzalez had been playing through pain in his right knee “for the bulk of the 2019 season.” Patellar debridement is a surgical procedure that is usually undergone when conservative treatment (i.e. physical rehabilitation) is unable to reduce pain - typically at the front of the knee - and improve function caused by patellar tendinopathy. The procedure usually involves excising any damaged patellar tendon tissue as well as drilling into and possibly even removing the distal pole of the patella - a “bump” at the bottom of the knee cap where the patellar tendon attaches; inflamed synovial tissue - the tissue that lines joints - and frayed cartilage may also be removed if it is deemed necessary. Return-to-sport rates are usually extremely good, ranging from 75-90%. Rehabilitation after surgery focuses on regaining any lost range of motion of the knee, improving the strength of the quadriceps and the hip abductors - which are located at the side of the hip - to reduce the amount of pressure placed on and through the patellar tendon, and to, ultimately, resume baseball-related activities. This is completed in a graded, gradual manner with return-to-sport usually occurring after a couple of months. Prior to going under the knife, conservative rehabilitation focuses on similar areas, though a greater emphasis is often placed on eccentric strengthening - “strengthening while the muscle is lengthening” - of the quadriceps as well as soft tissue mobility and core strength. By all accounts, Gonzalez has returned to his prior level of function - see statline above - and is in minimal - or at least manageable levels of - pain. Tendinopathies can be tricky injuries as they are often prone to flare-up and can cause significant pain and impaired function. However, with proper recovery and rehabilitation (i.e. rest days, maintaining quadriceps strength, etc.), potential for and occurrence of flare-ups can be minimized. Footnote: For full transparency - I am in no way affiliated with the Twins and my articles focus on explaining what has already been reported in the media, not novel information. The Twins’ course of action, treatments, etc. may differ from what I lay out in my articles. MORE FROM TWINS DAILY — Latest Twins coverage from our writers — Recent Twins discussion in our forums — Follow Twins Daily via Twitter, Facebook or email Click here to view the article

There are only a few certainties in the world: death, taxes, and the Minnesota Twins’ need for Jose Berrios to be pitching at optimal performance come playoff time if they want to compete for the 2020 World Series title.Because of this, the Twins and Berrios decided it would be in the pitcher’s best interest to change up his rigorous off-season workout routine and place greater emphasis on rest, recovery, movement efficiency, and endurance, according to the Star Tribune’s LaVelle E. Neal III and The Athletic’s Dan Hayes. A major factor that drove Berrios to agree to the adjustment, according to Hayes, was the success the pitcher found after partaking in deep tissue massages before and after every start beginning in August; says Hayes, “[Twins’ pitching coach Wes Johnson] and athletic trainer Ian Kadish suspected Berríos’ struggles were due to his body not recovering enough to move efficiently and perform the way he wanted to and always had. Rather than work physically harder to find a solution, they convinced Berríos, 25, he actually needed to rest and recover more.” But what exactly does this mean? It is one thing to say that the Twins emphasized rest and recovery as well as “incorporate[d] more exercises that [were] designed to help build his stamina,” but what does that mean in practical application? What is so magical about deep tissue massages? Let’s try to tackle this. “Rest” and “recovery” are buzzwords often employed in and around sports that function to convey a simple message: an athlete or team is taking a step back to reduce pain and improve function after a difficult workout, series of games, and/or injury. However, lost in the message is that “rest” and “recovery” are frequently relative, not absolute. Rest does not mean that the athlete does nothing, only partaking in passive treatment or sitting on their couch watching television, nor does recovery mean that the athlete becomes completely pain free prior to returning to game activity. Rather rest and recovery should be interpreted as the athlete partaking in less activity — whether by volume and/or intensity — relative to their prior level. For Berrios this meant less car pushing and more massage, (likely) less heavy-weight training focusing on strength gains and more high repetition training focusing on muscular endurance, particularly of the rotator cuff, core, and hip musculature. The introduction of massage to Berrios’ pre- and post-game routine likely produced positive results for a couple of different reasons, and none of them are particularly magical. First, by spending more time on massage and less time exercising, Berrios placed relatively less stress on his body on a daily basis; it's not that the massage “healed” any of his injuries (read: had an “additive” effect on his health), it's more that massage replaced an activity that stressed the body (exercise) with an activity that did not (massage). Second, massage tends to improve performance and decrease pain, in part, due to a perceived notion that it is helpful. In essence, massage — while it may decrease muscle tension via increased local blood flow and dampening of the nervous system — has a powerful placebo effect. The placebo effect often gets a bad rap and has a negative connotation, which is unfair; the placebo effect is real, it’s effective at reducing pain and improving function, and at the end of the day that is what matters most. Massage can also have an effect on joint and muscle mobility, at least in the short-term. According to MLB.com’s Do-Hyoung Park, Wes Johnson and company have been working on the flexibility of Berrios’ hips, which they believe will have a positive effect on the pitchers’ durability and stamina. There is a plethora of data available in the scientific literature that backs up this assertion; baseball pitchers tend to lose rotation range of motion in the hip as the season progresses, which can alter their throwing mechanics, particularly at the knee and lumbar spine. Impaired knee flexion and early rotation of the core can lead to increased injury occurrence and decreased movement efficiency amongst pitchers. From here, there is a snowball effect. Impaired efficiency of movement can place undue stress on the rotator cuff, causing fatigue. Fatigue of the muscle group, particularly the internal rotators, can impair the dynamic stability of the shoulder joint, which may increase the risk for elbow injuries. One of the best ways to combat muscular fatigue and prevent upper extremity injury in pitchers is by improving their overall muscle endurance, particularly of the rotator cuff and core. Endurance is defined as the ability to complete repeated motions for a prolonged period of time. In sport there are two kinds of endurance: short-term (i.e. pitching a full game; often referred to as stamina) and long-term (i.e. starting 30 games in a season, averaging six-plus innings, and remaining healthy). Berrios has seen both his short-term and long-term endurance dwindle in the latter halves of the past two seasons. The hope is that Berrios will be able to perform better and more consistently later in the season by improving the endurance of his rotator cuff and core musculature — which was presumably a major point of emphasis during the past off-season. At the end of the day, there is nothing magical about the tweaks the Twins encouraged Berrios to adopt during the off-season. The decisions made by both parties are backed by science and data, which is yet another breath of fresh air provided by the “new” Twins’ regime. The organization is on the bleeding-edge of embracing technology and data to optimize the team’s on-field performance, and the way they handled Berrios’ off-season is just another shining example. MORE FROM TWINS DAILY — Latest Twins coverage from our writers — Recent Twins discussion in our forums — Follow Twins Daily via Twitter, Facebook or email Click here to view the article

I had been wanting to write about the topic of labeling athletes as injury-prone for quite some time. It’s a label that is bandied about willy-nilly whenever an athlete has a difficult time remaining on their field of play due to recurrent injuries and I believe that it is time to stop using the phrase that never should have been uttered in the first place.I was provided the opportunity to touch on this topic in regard to Twins’ center fielder Byron Buxton when Thieres Rabelo of @TwinsBrasil and the new blog Twinternationals with Mariana Guzman. Here's a link to his piece on Buxton. Here’s what I wrote in part: The 2020 season figures to be a big one for Byron Buxton; the speedy centerfielder is currently on track in his recovery from late season surgery that repaired a torn labrum in his non-throwing shoulder. Buxton has had to battle a number of injuries over his young career, causing some to label him as injury-prone, however, none of his previous injuries have much in common. Over the course of his career, Buxton has been placed on the injured list for a sprained left thumb, a migraine, a fractured left big toe, a left wrist strain, a left groin strain, a right wrist bruise, a concussion, and the aforementioned labrum tear that occurred because of a left shoulder subluxation. These are not chronic injuries that could have been prevented through strengthening of his rotator cuff muscles or by maintaining good joint flexibility. Groin and wrist strains are common amongst baseball players and many of Buxton’s other injuries were caused by acute events such as sliding into a base, crashing into a wall, or getting hit by a pitch. (Buxton has recently resumed swinging and will likely be ready to return to game action by opening day.) It is difficult for an athlete to shed the term once he is labeled injury-prone; the label takes a complex, multifactorial event — getting injured — and boils it down into a term that infers simplicity, and perhaps laziness or weakness of character. It is a term that serves to distance the human from the athlete. As outlined above, Buxton has suffered a number of injuries ever since he took his first swings in the minor leagues, however, none of his injuries have any connection to the others. They are all, in essence, freak events. This is, of course, the case with many athletic injuries, but whether or not an athlete suffers multiple hamstring strains or a rash of separate injuries such as Buxton, the injury-prone label appears and attaches itself as if it were the athlete’s shadow. A number of factors contribute to injury occurrence including muscle strength imbalance, chronic overuse, acute impacts, bad luck, and genetics. Some of these factors can be addressed through training and rehabilitation — muscle strength imbalance — however, often the most powerful ones cannot (genetics, bad luck). It is one thing to discuss the role that an athlete’s injuries have on his/her overall ability to contribute to their team, it is another thing entirely to belittle a player due to their past injury history. “Byron Buxton has suffered a number of injuries throughout his career, so that may impact his ability to contribute to the Twins moving forward” is a perfectly logical thought process; “The Twins shouldn’t extend Buxton because he’s injury-prone,” or “Buxton should be traded for a starting pitcher because he’s injury-prone” is reductive. This line of thought is perhaps only one standard deviation away from the thought process that the Boston Red Sox employed during their nixed trade to acquire Brusdar Graterol. So consider this my plea to stop the use of the term injury-prone and have a more nuanced conversation when it comes to athletic injuries. The athletes are in the public eye and billions of dollars are at stake, but that doesn’t mean they aren’t human. The label injury-prone is a reductive term that can ultimately have a negative impact on their career. MORE FROM TWINS DAILY — Latest Twins coverage from our writers — Recent Twins discussion in our forums — Follow Twins Daily via Twitter, Facebook or email Click here to view the article

They incorporated that strategy with Pineda a few times, largely because it was his first season back after TJ and an arthroscopic procedure of his knee. It's probably not a terrible strategy, but if I were on the Twins' staff I'd encourage skipping a start and giving Thorpe, Dobnak, etc. a start rather than a full on IL stint.

For all intents and purposes, it appears as if the mega-deal involving the Minnesota Twins, Boston Red Sox, and Los Angeles Dodgers is dead. At least as it was initially constructed. To quickly recap: Los Angeles would have received outfielder Mookie Betts and pitcher David Price from the Red Sox, Boston would have received outfielder Alex Verdugo from the Dodgers and pitcher Brusdar Graterol from the Twins, and Minnesota would have received pitcher Kenta Maeda from the Dodgers. But, again, the trade is reportedly holding on via life support as the Boston Red Sox - amongst blow back that they did not receive enough value in return for their All-World right fielder - balked after obtaining the medical records of Graterol from the Twins, according to the Star Tribune’s LaVelle E. Neal III. What has been most confusing during this whole ordeal is deciphering why Boston became so concerned about Graterol’s health and how they justified that this meant they required more trade compensation in return, particularly from the Twins. After all, Graterol’s injury history isn’t exactly a secret; the 21-year-old underwent Tommy John surgery when he was a teen and missed a chunk of time during the 2019 season while recovering from impingement in his right shoulder. According to Neal (via the Boston Globe), after the deal was agreed to in principle, the Red Sox were provided Graterol’s medical files, which “[included] magnetic resonance imaging exams and other images, trainer notes and virtually every detail about a player’s medical history since his entry into professional baseball.” It was apparently these images and notes that caused Boston’s knees to buckle. So what could these images and notes have revealed that would cause such concern on the part of the Red Sox? This is where the landscape gets potentially foggy. Advanced imaging techniques - such as magnetic resonance, radiographic pictures, CAT scans, etc. - provide great value in diagnosing athletic injuries. While athletic trainers, physical therapists, and orthopedic surgeons are trained to diagnose injuries by hands-on techniques, the severity and extent of the injury as well as the specific structures involved cannot be determined with 100% certainty - or at least near 100% certainty - without the use of imaging. However, the use of advanced imaging often reveals silent “pathology” - or incidental findings; I use pathology with quotations as perhaps the more correct term would be anatomical variation. If anatomical variation is detected, but it is absent of pain and dysfunction - the characteristics used to define injury - is the athlete truly injured? Do these findings predict risk of future injury? These questions are difficult to answer with any amount of certainty as the first is largely philosophical whereas the second has yet to be sufficiently researched. So, perhaps these questions should be reframed in this manner: Absent of imaging, would a team be hesitant to acquire a player of Graterol’s caliber knowing what they know about his injury history? The obvious answer is no as the Red Sox were willing to do just that as late as last week. It would be one thing to conclude, as both the Twins and Red Sox apparently did, that Graterol would be best off as a reliever in the long-term based on his past injury history. It is entirely different to use his past medical history and images to demand further trade compensation - in such a public way, no less - after the deal has already been agreed upon. As the linked clinical commentary from the Journal of Orthopedic and Sports Physical Therapy above states, it is common to find pain free, fully functional anatomical variation in the rotator cuff and glenohumeral labrum of the baseball pitcher’s throwing shoulder. Brusdar Graterol, an intriguing talent and 21-year-old kid, has had his health dragged through the mud based on past images and notes that may or may not have an impact on his future health and performance. That is what has been most disappointing about this entire process.

Whom is Kenta Maeda? Never heard of him.

The Minnesota Twins made waves this past week after being involved in a pending blockbuster three-team trade that centered around star outfielder Mookie Betts being shipped from the Boston Red Sox to the Los Angeles Dodgers. In the deal, the Twins are expected to send highly-touted, flame-throwing prospect Brusdar Graterol to the Red Sox and receive starting pitcher Kenta Maeda from the Dodgers.You can read more about Maeda here. While perhaps not as sexy as signing a top-tier free agent, Maeda is every bit the fulfillment of Derek Falvey and Thad Levine’s promise to acquire “impact pitching” during the off-season. Maeda figures to, at worst, slot in as the Twins’ third starter in the rotation behind Jose Berrios and Jake Odorizzi and ahead of Michael Pineda (when he returns from suspension), and Rich Hill (when he returns from injury). Maeda has been pitching professionally since 2007 after being drafted out of high school by the Hiroshima Toyo Carp of the Nippon Professional Baseball League in Japan and has been extremely durable over the course of his career. Since signing with the Dodgers prior to the 2016 season, Maeda has only landed on the injured list three times, all for lower body injuries. Maeda’s three lower extremity injuries were all minor — he never missed more than two weeks of action — and muscular in nature; he sat 14 days while recovering from left hamstring tightness, 14 days with a right hip strain, and nine days with a left adductor contusion that occurred when he fouled a ball off his inner thigh. Maeda’s hamstring and hip injuries are most consistent with grade 1 strains, which usually heal in a couple of weeks and involve less than 10% of the muscle fibers being disrupted. Rehabilitation focuses on improving the strength of the injured muscle as well as its synergistic — or supporting — muscles while also reducing any pain and swelling. One thing that may be interesting to note is that the report announcing Maeda’s right hip strain mentioned that, while he was more sore at his inner thigh, an MRI exam revealed “evidence of an earlier hip injury that [he] could not recall”; the precise location of the injury was not disclosed in the report. Despite the raising of the eyebrows this report may initially elicit, this nebulous previous injury shouldn’t be of major concern moving forward as Maeda did not undergo any additional treatments or miss more time as a result of it being discovered. Incidental findings such as Madeda’s hip injury are commonplace with imaging. Is an anatomic variation that is absent pain or dysfunction and does not limit sport participation truly an injury? Twins fans can take solace in the fact that Maeda has never suffered an injury to his throwing shoulder or elbow. According to Baseball Savant, Maeda primarily relies on three pitches: a four seamer that sits in the low-90s, a slider, and a changeup. Maeda possesses a smooth, low effort delivery which helps to reduce the amount of force placed through his upper extremity, particularly when combined with his pitch mix and their corresponding velocities. This isn’t to say that Maeda is immune to arm injuries — throwing a baseball repeatedly at any velocity places a great amount of stress on the arm, after all — rather his mechanics and repertoire may place him at a reduced risk compared to his harder-throwing, more explosive peers. All in all, this is another good acquisition for the Twins. Maeda has been the definition of durability throughout his 13-year professional career and, while injuries can strike at any moment, there is little to worry about health-wise headed into spring training and beyond. MORE FROM TWINS DAILY — Latest Twins coverage from our writers — Recent Twins discussion in our forums — Follow Twins Daily via Twitter, Facebook or email Click here to view the article

Thanks for sharing this! I was looking for an article like this and couldn't find one. I figured AJSM had something, must have been using the wrong key words. Good to see that the re-injury risk was so low. I wasn't aware of the rupture report either, though I have seen some studies - regarding other muscular locations - suggest that full rupture injuries are actually less likely to recur than grade 1-2 strains mostly due to the fact that those injuries are more likely to require surgical intervention.