Monday, June 30, 2008

This Really Bothers Me

Sorry, but this really bothers me. If any player for Our Washington Nationals is hurt--why are we waiting until the situation gets far worse than anyone expected? Or wants to see? Why do we wait until all is lost?

The announcement late this afternoon that "The Most Thrilling Closer In The Game" is gone for the season is very disheartening. What made it worse is the rampant speculation from so called "experts" like Bob Carpenter on MASN claiming that Chad Cordero will be gone for a full two years. How does he know that? When he probably has zero contact with the situation. Our Washington Nationals have made no official announcement on the information coming out late this day. Sure, some reporters are told on background, but usually not the entire story.

Well known Los Angeles Surgeon Lewis Slocum is reportedly in line to perform surgery for a torn labrum in Our Number 32's right shoulder. A meeting is set for Thursday in California. The same injury Ryan Zimmerman has on his left shoulder. Yet, Dr. Slocum has yet to see Chad Cordero on this latest of injury news fronts. So who really knows?

Why is it that The Washington Post is reporting that "many" within the organization KNEW Chad Cordero was hurt all along, but didn't fess up to it? Even The Washington Times has chimed in. Well if someone high up in the organization KNEW--why was Our Number 32 NOT GIVEN a full checkup? Why was he sent to extended spring training knowing he may well be hurt?

Sorry, but that makes no sense to me. Is not Our Players Health of 100% importance?

Which brings up another point.

I can live with the injuries. I can live with so many that you just shake your head in wonder over the calamity of it all. But what I can't live with is the consistent inability to find out what is wrong with Our Players--in a timely manner--before said player is gone for year, maybe more.

Who is making these decisions?

If anyone in my family had an illness or injury--even a slightly sprained ankle--you can bet I would be making every single effort to find out the details, the prognosis, and the solutions to the end--for a healthy recovery. The African Queen would expect no less.

Yet, time after time after time--Our Washington Nationals consistently have an injured player announced as day to day, then week to week, eventually, some are out for the year. Cristian Guzman, Jose Guillen, Nick Johnson, John Patterson, Shawn Hill, Ryan Wagner, Dmitri Young, Brian Lawrence and Ryan Drese all come to mind. Now--it's Chad Cordero. Why do I have this feeling that Ryan Zimmerman is next?

It just makes no sense. No it really doesn't.

Hopefully, Chad Cordero will make a full and healthy recovery from whatever degree of torn labrum he may have. He is a pitcher. A tremendous amount of wear and tear is the norm. But, before all the speculation and rumor builds and the hype takes over--lets find out EXACTLY WHAT'S WRONG WITH "THE MOST THRILLING CLOSER IN THE GAME".

And after those facts are figured out--lets find out what's going on in determining injuries to players for Our Washington Nationals.

As Rickey Ricardo always told Lucy on the infamous "I LOVE LUCY!! Television Program of the 1950's--"There is some 'Splaining' to do." Yeah, there is. Like right now.

This whole situation really, really bothers me.

PS--This stunning late breaking news forced me to put off for another day The Baseball 101 For Women Story set to post this afternoon. Rest assured, that well needed feature is coming in the next day or two. At the same time, I could barely pay attention to Our Washington Nationals game tonight in Florida. Glad I really didn't after Big Jon Rauch gave it up BIG TIME in the 9th and 10th to lose the game.


Anonymous said...

So sorry to lose Chad for the season. I'll miss the, uh, excitement he can provide in the 9th.

I have been wondering for some time if there is something wrong with the training regimen for the team. Being a professional athlete is clearly rough on your body. Are our guys getting effective and balanced strength and flexibility training? The number of injuries seems suspect, even after considering the possibility of a horrible run of bad luck.

Given the importance of players' health, I'm not ready to believe that our team may not get timely medical evaluations. It just wouldn't make sense.

Could the issue instead be one of poor communication? It's not hard to imagine scenarios in which the team has an incentive to hold back information, for strategic or other purposes?

Regarding Chad's case, it sounds like a labrum tear is difficult to diagnose. But looking collectively at all of the injuries, you can only wonder if something more systemic is wrong, whether with training, medical care, communication, or some combination of these.

Whatever the issues are, the next step is clear. Chad, please get well soon.

Unknown said...

SBF, we're on the same page.

Check this out:

If you want to join in, leave a comment with your name/link. I linked your post, because it's a similar sentiment.

Anonymous said...

Re: Chad -- Agreed. I'm not sure what upsets me more -- losing Chad for the season, listening to the experts speculate, or wondering if the delay in the diagnosis and the strengthening exercises for the weak shoulder and the rehab for the lat muscle have complicated the injury.

While I don't want to give in to listening to the hype, I'm beginning to wonder if the Nationals record with injuries is enough to discourage a free agent from signing here.

JayB said...


You know none of these issues are new. Nats have been bumbling through injuries and rehabs for well over two years.

Washington Media does not care about the team or fans enough o hold them accountable. Season ticket holders do not have the access to ask and follow up with Stan and Jimbo in order to get real answers to tough questions.

You once had both the access and the motivation to get results. Can you help us here? If ever we needed an advocate it is now. We need to know if our team is incompetent and out money wasted on supporting a blind front office. While I do enjoy all your posts we do not need a Baseball 101 for the ladies post right now. We need tough questions and straight answers from the decision makers at the Nats.

PS. The problem as you know is much more pronounced than the latest Chad report. It goes back as you noted with a few examples. Do not forget Nick limping into camp last year and Jimbo being surprised. Do not forget D Young coming in this year way over 300 lbs. Dukes hurting his leg in Spring Training and then again on opening day and missing 30 games, Hill and Patterson being pronounced fit this many examples of blown medicals, so little space.....Thanks for whatever you can get done with your contacts.

An Briosca Mor said...

Apparently the labrum injury is a hard one to diagnose. The test is like an MRI but with dye injected. You may recall that Cordero underwent this test a month or so ago before he was sent down to extended spring training. The results must have been negative then because they surely wouldn't have sent him down there if they knew he had a labrum tear. He was not making progress while at extended spring training, so they did the test again and this time found the labrum tear.

It is pretty obvious in hindsight that Chad has been pitching hurt all season - the 82 mph fastballs were evidence of that. So of course St. Claire and probably everyone else associated with the team knew he was hurt. But them saying that does not mean they knew the extent of his injury. They were relying on the doctors to let them know what he should be doing in the way of rest or rehab. Of course the player is always going to want to play unless the pain is so bad that they can't or the doctor shuts them down. Really, the front office has little say in this matter, so all these conspiracy theories related to medical issues are way off base. I bet if you looked at every other team in the majors you'd find the same level of uncertainty when it comes to diagnoses. (Example one: David Ortiz. Example two: Pedro Martinez. Are the Red Sox and Mets front offices incompetent too when it comes to medical issues?)

So I think all this "Lerners are too cheap to get good medical care" talk is way, way off base. Now, if you want to talk conditioning and injury-preventive issues, you may have a point. But consider this: If Cordero has had the labrum tear all season, as evidenced by his pitching performance, then when did he tear it? He didn't pitch much at all in spring training, had a very light load, and then went on the DL right at the start of the season. He did however lose weight and change his conditioning regimen during the off season. Could he have hurt himself while doing good things from a conditioning standpoint? What does that do to all of your conspiracy theories?

Bottom line: These are not robots playing this game. Sooner or later many of them are going to get hurt, no matter what the team does to try to prevent it from happening.

Keith said...

If they cut on that shoulder, he's out for the season. If they mess with the cartilage holding ball to socket, it'll take a year to mend enough to withstand the thrust of a 92mph fastball. I ain't no doctor, but I have an erector set. I know basic mechanics. Hell, I am a basic mechanic.
On the field, losing Chad is not a big deal. Rauch will close enough games this year to be viable. That is, if the team gets to the ninth and actually needs a closer.
The real problem is that Jim Bowden just lost his trade bait.

JayB said...

Difference between Mets and Red Sox and Nats in this issue is on case each for them and 10's of cases for the Nats in a year or two. Yes, you are correct that the whole medical spectrum needs to be looked at and not just the diagnosis.....

The first honest question that needs answering is, "have you looked at your whole medical process with an independent eye and how does it compare to the MLB norms?". The answer can not be, "no we have not looked because we know it is fine based on our own internal reviews".

Steven said...

Isn't this JimBo's bottom line? I know he's not a doctor, and I'm sure this would be a group decision to some extent, but isn't the GM the BL guy who needs to be deciding who gets shut down and who pitches through pain?

This is an honest question. I'm really not sure in an MLB FO who would be bottom line on a decision like this.

An Briosca Mor said...

It's ridiculous to think that of the 30 MLB teams only the Nationals have incompetent medical procedures, doctors and trainers because the owners are too cheap to pay for top line care or the GM is too incompetent to listen to the doctors' advice. Each of you who is demanding an in-depth investigation of the medical practices of the Nationals needs to first train your microscopes on each and every other team to the same level of depth you do the Nationals. Objectively. Totally objectively. Injuries occur randomly. There's little aside from conditioning that a team can do to prevent them, and even conditioning is a hard thing to police. Are you going to send a personal trainer along with every player during the offseason? No. No team does that. So quit complaining that the Nationals don't.

As for diagnosis, treatment and rehab, even though we are definitely in the age of modern medicine it is still far from perfect. Even if the injury is diagnosed immediately and the standard course of treatment is applied immediately, no doctor will ever guarantee recovery in a fixed amount of time. The Nationals use many of the same doctors, specialists and facilities as every other MLB team. Do you honestly believe that these medical professionals do a substandard job when dealing with Nationals players and a great job for everyone else? Get real.

I can understand the frustration that fans have with the large number of injuries that have hit the team this year, but really the front office is the last place to lay blame for that. Every other team has the same kind of issues. If they don't have as many as the Nationals do, it goes back to what I first said: Injuries are random. The other teams will have their day, sooner or later.

Steven said...

ABM is right. SBF is such a HATER. Geez, SBF, why are you such a HATER???

I mean, after 4 years of loyally defending even the most indefensible moves, I'm really disappointed to see that all this time you've secretly been such a Nationals HATER.

(In case irony doesn't come across, I'm making fun of ABM for torching you for once, just once, being critical.)

Anonymous said...

I don't think the care is bad because of the alleged cheapness of the owners, but I do think there needs to be a complete and objective investigation of the teams training and medical care. These are some of the healthiest men in the country (o.k. -- not Dmitri), and they're dropping like flies. If it turns out that the Nats' training and medical procedures are as top notch as they should be, great. We then know that this is just a year of disastrous bad luck. The team owes as much to the players and to the fans.

An Briosca Mor said...

These are some of the healthiest men in the country (o.k. -- not Dmitri), and they're dropping like flies.

Really? As Don Sutton often says on the broadcast, there are pitchers and there are athletes, but there are not many who are both. Cordero is clearly not one who is an athlete. Asthmatic, overweight, yet able to pitch for many years successfully. Finally, though, the body part that he was abusing in order to pitch (his shoulder - and yes any pitcher no matter how healthy is abusing his body in order to do his job, because the human body was not meant to throw 90+ mph fastballs over and over again) gave out. For this, you blame the front office?

The same could be said of any of the other players who got hurt, even those who are the most athletic. Even the best of athletes cannot keep from getting hurt sometime during their career, including those with the most rigorous of conditioning programs. Just ask Tiger Woods. (Who unfortunately has no front office to lay blame on...)

Anonymous said...

I don't blame the front office for a minute. I don't know that there is any blame to be fixed. You don't know that there is not. Why not find out?

An Briosca Mor said...

I don't blame the front office for a minute. I don't know that there is any blame to be fixed. You don't know that there is not. Why not find out?

Okay. Who do you propose should do the "finding out"? Who pays for the investigation, which of course needs to be "independent"? Are you willing to support a surcharge of 20-25%, a co-pay if you will, on every ticket you buy to fund this investigation? What, you're not? You think the Lerners should pay for it, because they're already ripping you off with high ticket prices and mis-spending your money?

Again, get real. The front office has invested a ton of money in these players. You think they are negligent and unconcerned when these players in whom they have invested so much are getting hurt? Why would you think that they're not doing everything they can to get the best medical opinions and care for their players? Of course they care about it, and if heads need to roll then heads will roll - or at least they will switch to different doctors if they think doctors are the problem. Why would that not be the case? Really, what is there to "find out"?

Keith said...

An electrician I know got zapped on the job. The first thing lots of people asked him was if he planned to sue somebody. His reply, though not fit for print, was sagely.
"Sometimes s#!^ just gets f-@&$) up."

Cordero is a competent 26 year old man, who is a millionaire. He gets hurt doing a job that has well-documented and specific risks, and the first thing some of you do is look around the room to place the blame. We're a country of whiners.

An Briosca Mor said...

Sometimes s#!^ just gets f-@&$) up.

I nominate this for the back of a future T-Shirt Tuesday shirt, followed by a listing of all the players to hit the DL this year.

Jim H said...

I understand that the medical staff may be no more or less better than other MLB teams, so I ask the question:

- Why wait to get stuff fixed when you KNOW it's broken?

A couple of years ago, the Nats let Guzman try to rehab and strengthen muscles surrounding his identified slap tear. Valuable time wasted, as he eventually had to have the surgery.

A similar pattern held with Guillen.

The team waited several months on Nick's identifiably torn wrist tendon sheath.

Zimmerman. 23 years old. HAS A TEAR IN HIS SHOULDER. (Yes, I know it's not his throwing shoulder, but it's been shown to negatively impact his offense.) Wants to strenthen the area around the identified tear. He's young, and this team is not going anywhere this year. WHY WAIT? Get it fixed!

Whose decision is this? Is this the GM? Do they give players too much lattitude?

Players are investments that you want 100% operational, unless 75% or so will make a difference. Don't muck with the youth with which you are so desparately trying to build.

Get this stuff fixed immediately. Don't toy around.

Can I blame someone for that? ;)

An Briosca Mor said...

Get this stuff fixed immediately. Don't toy around.

Can I blame someone for that? ;)

No, unless you want to blame the player. Because ultimately when the doctor says to the player "You can rehab, which will put you out X weeks or months, or you can have surgery, which will put you out for the season", there's not a player in the game who would choose surgery over rehab. And there's not a GM in the game who could ever force them to. It's only when the rehab doesn't work, or the pain is too great, or the doctor says "You have no choice but to have surgery if you ever want to play again" that a player will choose season-ending surgery. All of the examples you cite fit that pattern. The only thing that the Nats have done differently this year in comparison with other teams has been to delay placing players on the DL when they're hurt, thereby leaving Manny shorthanded at times. But thankfully, based on how quickly they put Milledge on the DL, they have realized the error of their ways now on that practice.

SenatorNat said...

I tend to agree with An Briosca Mor's running commentary. Will only say that Nats have tended to send folks to medical experts in Cincinnati and Birmingham for these past four years; perhaps, based on some of the delays in full diagnosis and the resulting surgeries and rehabilitation, they should evaluate their triage practices. As I commented awhile ago, there are no good ortho folks in D.C.?

Trust in inertia trumping conspiracy as an explanation every time. All on the Mend...

Chris Needham said...

ABM, I think, is right on most of these things.

Injuries happen. Sometimes there's not a thing you can do.

Cordero had two separate MRIS. Has evaluations from a few specialists -- including James Andrews, the BEST in the business. And other than some weakness, no tearing or ripping showed up.

He DID have a muscle tear, so they put him on a rehab and strengthening program for that and the shoulder, and in the process, he blew out what was left of the labrum.

That's life.

Seems like they gave him plenty of examinations.

Edward J. Cunningham said...

Since I think Virginia's "Lady Luck" may be retired, Jim Bowden needs to deal with the situation as it is, not as he or we Nationals fans would like it to be. We need bodies. Do we have to call up everybody from Potomac to Harrisburg to Columbus or is there anybody off of waivers we can pick up. I'm not talking about outbidding the Yankees or Cubs for C.C. Sebathia. I'm talking about getting LESSER free agents to fill in the gap---the pitching equivalent of Aaron F. Boone.

(Any Yankee who beats the Red Sox with a dramatic home run in the postseason gets the honorary middle initial of "F" like Bucky F. Dent)

Keith said...

Jim H, you seem to consider surgery to be the conservative approach to the fixing these injuries. Cutting and sewing on the human body is a violent and destructive process that introduces at least as many problems as it solves. Exhaust all options before slicing and dicing, that's my take. The only minor surgery is surgery that's done on somebody else.

ABM, thanks for being the voice of reason.

Jim H said...

Okay, I know I'm asking for it, but how many baseball players are now playing with full productivity, long term, with an known existing shoulder tear?

I get the concept that cutting is the most violent solution (though hardly unreasonable). I'll open myself up to the arrows...have we heard of the last one of these slap tear procedures that went bad? Who? What were the ramifications? Have failed procedures in any way been even significantly challenged by the exercise regime as a long term solution? I suppose it's possible.

(By the way, let's not compare a slap tear labrum procedure on a non-throwing shoulder to ligament replacement Tommy John surgery. Worlds of difference.)

ABM, you apparently know more than I about GMs not being willing to force surgery on players. I just disagree with that approach. It seems, given the odds of successful surgery, vs. the odds of successful "exercise programs", that the choice for the long term seems clear. And I keep hearing that this team is being built for the long term.

Just an opinion...however ill informed.

Bergmann on Man said...

Love this. We consider ourselves the Anti-Nats 320, but agree totally here. Fight the power!

An Briosca Mor said...

ABM, you apparently know more than I about GMs not being willing to force surgery on players.

All I know is common sense. A GM might want to force a player to have surgery, but there are powerful forces working against him unless the doctor is totally on his side and telling the player that surgery is the only option. The first powerful force is, as I already said, the player. No player thinks long term, except possibly one who is signed for many years ahead such as ARod or Soriano. Surgery plus the added rehab afterward is likely going to put a player into the no-man's-land of contractual limbo before they will be able to return to the field. If they think that rehab only without surgery is a viable option that will get them back on the field sooner so they can play for the next contract, they are going to take that option every time.

The second big obstacle is the players union. If a GM was ever to try to force a player into surgery against his will, the union would be all over him like white on rice. We have just seen an example of a GM who was thrown to the ground by a player not being able to release that player without the union raising its hackles. The union would never let management be the final arbiter of whether or not a player will undergo a procedure that could very well end his career. The only ones who can make that choice are the player and his doctors.

Chris Needham said...

Surgery is ALWAYS, ALWAYS the last option.

With the labrum, that's doubly so. TJ surgery is 'simple' enough that many players (not all) can come back from it.

Labrum surgery is such a mess, in part, because of what they're actually operating on. You don't want to go in and cut or manipulate the labrum unless you have good reason to. In Cordero's case, there wasn't a good reason to. He DIDN'T HAVE A TEAR earlier this offseason -- probably some fraying, but that's not easily noticeable. NOBODY would do the surgery in that situation.

Jim H said...

ABM: Okay. Thanks.

Chris: I appreciate that sentiment and it appears as if the majority of folks writing in this thread do, as well. I submit.

But I am curious as to the answer to my other questions about whether anyone is out there today with a KNOWN comparable tear that has rehabbed it via exercise and continues to be as productive as before. The corollary, of course, is whether there are players out there how have had the surgery and been completely worthless since.

I'm no longer fighting the wave, just curious as to whether anyone is aware of exercise regimes working long term for these kinds of issues.

Chris Needham said...

I'm sure some have. Many players typically play through it because the surgery is often a death sentence for pitchers. This is worth the read.

Procedures are a little bit better, but recovery really hinges on the type of tear -- big? small? where? -- and just the randomness of life. Some people are better healers than others.

The key is that rehab is the way to go, since surgery works so infrequently.

To make an absurd comparison, we're not going to chop off Dmitri's feet because we know that he's likely to have circulation and infection problems because of his diabetes in a few years. :P

SenatorNat said...

But, like Shaq, should Dmetri have a deputy sheriff's badge entitling him to free Dunk'in Doughnuts, we should have that privilege confiscated ASAP!

Trust in exhaustive layman discussion of complex medical issues to numb the simple baseball fan's brain. All Learned.

Anonymous said...

As someone who finally had the SLAP surgery to repair my labrum (30 years of lap swimming) last year at this time, I can tell you it only took my doctor three streching exericises to know I had a labrum tear in my left shoulder. The protocal (for insurance purposes) is first six week of rehab. When I reported the rehab wasn't working it was on to the SLAP surgery and rehab for life. From my experience the article hit the nail on the head. If players who still have not yet signed a multi-year contract have a labrum issue they will try to hidethe injury until after they sign their first free agent contract. They have toomuch invested.

Jim H said...

Chris: Thanks for the article. I officially stand corrected and appreciate the information. I had no idea.