The Creation of an Epidemic: Tommy John Surgery in Baseball (Part One of Two)

                In baseball, a player with the ability to throw a ball with uncanny velocity and incredible movement has become an indispensable resource. Teams will pay millions of dollars for this kind of talent. In consequence, young players will do anything to secure that million dollar contract by pitching year round, maxing out their inning limits and forcing themselves to throw harder than ever. In actuality, these kids are throwing until their arm falls apart. Throwing a baseball at velocities upwards of 90 mph puts tremendous strain on the elbow. Putting too much strain on the elbow leads to injury and eventually to surgery. This is known as Tommy John surgery, a reconstructive surgery for the ulnar collateral ligament in the elbow named after pitcher Tommy John. Within recent years, Tommy John surgery has plagued Major League Baseball. Pitchers have received the surgery at rapidly increasing rates, creating an epidemic within the game of baseball.

According to Pitch Smart, over the past three years, the number of baseball pitchers receiving Tommy John surgery has increased yearly. As of 2012, approximately 25% of Major League pitchers and 15% of Minor League pitchers have had the surgery during their career. The rate of players receiving Tommy John surgery has also increased by 50% since 1990. Overuse has caused this epidemic. According to Doctor Glenn Fleisig, the research director at the American Sports Medicine Institute and advisor to Major League Baseball, Tommy John surgery usually occurs in 15-20 year old pitchers throwing more than 80 pitches per game and pitch in eight or more months a year. Pitching beyond these constraints generally results in pitching fatigued, leading to overuse of the throwing arm. According to Fleisig, throwing 100 pitches a game every fifth day is unnatural for the arm. This excessive throwing year round causes the inflation of Tommy John surgeries in baseball.

            Nineteen year old pitcher Brady Aiken, provides a great example for arm fatigue. Drafted first overall by the Houston Astros, Aiken did not sign his professional deal because the Astros organization noticed elbow inflammation in his throwing arm, outlined within an ESPN article. In this article, the writer acknowledges Aiken’s rise as a dominant pitcher and the leading cause of his elbow problems. Up until his junior year of high school, Aiken pitched all year round. Once Aiken’s senior year came around and knowing about the rise in elbow problems in pitchers, Aiken and his coach developed a plan to reduce his innings in order to save his elbow. Aiken took the winter season off because of a doctor recommendation. They kept him on a pitch limit and avoided any pitching outside of his regular starts.

            However, a major league scout contacted the two of them and wanted Aiken to pitch at the MLB showcase for promising talent. The showcase would take place during the winter, when Aiken was not throwing. In order to pitch, Aiken would need to build up his elbow strength by throwing every day to ready himself for the showcase. At first, Aiken did not want to start throwing in order to save his perfectly healthy elbow, but the scouts pressured him into ignoring the doctor’s recommendation. The scouts told Aiken that pitching would secure his place in major league baseball, his ticket to a million dollars. Aiken decided to pitch at the showcase. The following baseball season, the same season the Houston Astros drafted Aiken first overall in Major League Baseball’s amateur draft, Aiken would feel soreness in his throwing elbow. The team picked up on the inflammation in Aiken’s elbow during his physical. Houston would retract their offer to Aiken and Aiken would elect to receive Tommy John surgery.

            The sad part about this story is that it occurs regularly in the game of baseball. In today’s world, athletes must accept injury if they want to survive in the world of sports. According to Doctor Mary Lloyd, the competitive nature of sports has programmed youth players to think that they must bend the borders of injury as far as possible, which leads to the increase in elbow injuries. Lloyd warned players about the temptations to push themselves in order to pursue money and scholarships, saying “The 21^st century athlete of any age or sport must throw faster, play harder, earn the scholarship, and don’t tell anybody you’re hurt." The money causes the students to push the barriers and major league baseball takes advantage of the player’s wants. Aiken did not receive Tommy John surgery for the benefit of his health. He received the surgery because without it, Aiken would never make it to Major League Baseball. The surgery saved his career and his chance at earning millions of dollars.

            Rarely does a baseball organization hold it against a pitcher like Aiken for throwing too much. Most baseball organizations do not keep track of potential draftee’s innings nor worry about the overuse of a pitcher’s arm. According to Sam Miller, the author of the article on Aiken, most teams draft players solely based on their velocity and ball movement. So pitchers also disregard their inning limits and force themselves to pitch harder than their arm can handle. If a pitcher destroys their arm in the process, Major League Baseball bares no responsibility either. As shown in the Brady Aiken case, the team just retracts their offer and saves their money while the player forces themselves to undergo Tommy John surgery in hopes of prolonging their baseball tenure.

With First Base Open, the Time to Salvage Allen Craig is Now

With the trade of Mike Napoli to the Texas Rangers, the Red Sox now have a vacancy at first base. With the Red Sox on their way to another last place finish, the team should begin to take inventory of the players under contract and determine who can contribute in the future. Given this, it makes sense for the Red Sox to call up Allen Craig and give him the opportunity at first base.

Craig’s first two opportunities did not go so well in Boston. He batted .128 with the Red Sox in 2014 with only 12 hits and four extra base hits in 94 at-bats. In 2015, Craig showed no improvements. In 24 games, he batted .135 with seven hits in 52 at-bats before being optioned to Pawtucket.

In the minors, Craig has improved his batting average. He is currently batting .271 in 258 at-bats, a good enough sample size to gather a sense of productivity. Given that Napoli batted only .207 with the Red Sox, Craig would seem like an improvement.

However, Craig lacks the productivity that Napoli had.

Craig only has three home runs and eight doubles in Pawtucket, indicating a lack of power. Even though Napoli only batted .207, he did have 13 home runs and 32 extra base hits.

Craig isn’t the only option the Red Sox have either.

Recent call-up Travis Shaw, who has also seen playing time at third base, could replace Napoli. Since being called-up on August 1, Shaw has gone seven for 17 with two home runs and five runs scored as the only active first baseman on the Red Sox’s current roster.

Super utility-man Brock Holt has proven he can play any position as well.

Holt has struggled since the all-star break batting only .209 opposed to his .292 batting average prior to the break. Holt has also seen most of his playing time at second base while Dustin Pedroia remains out with a strained hamstring. When Pedroia returns to the lineup, Holt will return to the super utility role, but as long as first base remains open, the Red Sox’s lone all-star will forever be considered the apparent heir.

Shaw and Holt both seem like productive replacements to Napoli, but neither has any history in the major leagues, giving Craig the advantage.

As a member of the St. Louis Cardinals, Craig had a fair share of productive seasons as a vital member in the Cardinals’ offense. An all-star in 2013, the Cardinals rushed Craig’s return to the lineup during the 2013 World Series as a designated hitter against our very own Boston Red Sox. The Cardinals felt his production would give them the advantage against the Red Sox in the pursuit towards the World Series Banner.

In 2012, Craig hit 22 home runs. In both 2012 and 2013, Craig had more than 90 RBIs while batting .300 or better from 2011 through 2013.

This is why the Red Sox traded for Craig.

They obtained a player with a history of producing at an affordable price. Craig is currently owed $33 million through 2018, which at the time seemed like a bargain. Now not so much, but what if Craig found himself producing like he did in 2013, does the average annual salary of $11 million per year seem all that outrageous?

With the Red Sox playing for next season, they should take this time to evaluate what they acquired in trading for Allen Craig.

Is Craig a .130 hitter with no power or is he a .300 hitter in a really bad slump? The Red Sox will never know until they give Craig a chance at playing every day and with first base now open, the time to salvage Allen Craig is now.

Now Entering, for the Boston Red Sox, Closer...Joe Kelly?

Pitch Joe Kelly, receive a poor start, rinse, repeat.

It has now been six starts, 54 days and one demotion since Kelly has won a game for the Boston Red Sox. The Joe Kelly as a starter project has all but ended as the Red Sox have officially missed on their return for John Lackey, but one move could salvage the team’s failures.

Move Kelly into the bullpen, setting him up to become a possible closer.

Call me crazy, but I think it could work.

Kelly tops out at 100 mph with his fastball in practically every start, but yet still struggles in each time he takes the mound. He often shows flashes of potential in each start, throwing one or two great innings only to follow up with one disastrous inning, ruining his entire start.

Remove the mentality of having to make it through six or more quality innings for Kelly. Let him pitch for one inning, focus on only three batters. He could become a real asset in this situation. Imagine Kelly coming out of the bullpen slinging fastballs at 100 mph. Within this situation, I feel as if Kelly would improve drastically.

As a comparison, how about Tom Gordon?

Gordon came to the Red Sox as a starting pitcher. He could pitch five quality innings but would break down in the sixth inning and on. Gordon still had a good career as a starter, unlike Kelly, but he couldn’t throw 100 mph regularly for five innings or more, his arm couldn’t do it by the time the Red Sox had control over his services. So the team elected to turn Gordon into a closer and his career rejuvenated. Gordon became one of the best closers in the game, becoming an all-star for the first time in his career.

Will the same happen to Kelly? Probably not. But I truly believe Kelly has real potential as a closer, if not, definitely within the bullpen. Kelly cannot enter the closer role immediately as the Red Sox have a legitimate closer in Koji Uehara and Kelly’s struggles as a starter should still make the team apprehensive.

But in a lost season, the Red Sox have already started to take inventory. They traded right fielder Shane Victorino, granting outfielder Rusney Castillo a spot on the roster in order to see what he can contribute. Similar moves might happen in the Red Sox’s near future as well.

Starters become closer more often than one would think—Jonathan Papelbon, Andrew Miller, Zach Britton, even Uehara himself just to name a few. I would take any of those pitchers on my current team.

Will Kelly turn into the league’s best closer? Probably not. Is it worth the attempt? Probably. You can’t succeed unless you try and I have full confidence that Kelly would at least make a viable option out of the bullpen.

David Ortiz is not the Player Everyone Thinks He is

On Sunday, Red Sox fans watched David Ortiz play first base as well as any other option in Boston’s arsenal. Manager John Farrell publicly stated that he has full confidence in Ortiz’s ability to play the position. Fans will watch him play the position again tonight against Miami.

But the question lingers, why haven’t the Red Sox played Ortiz at first base on a regular basis? Most writers and fans agree that the best possible team the Red Sox can put on the field  has Ortiz at first base, Hanley Ramirez at designated hitter and Alejandro De Aza in left field. How has the Red Sox organization not realize this yet?

I suspect the reason is David Ortiz himself. Ortiz’s words insinuate he does not want to play first base regularly. When asked about playing first base, in a light-hearted way, Ortiz would always bring it back to his hitting, stating that playing first base keeps his mind off of hitting, distracting him even. And why should fans expect a 39 years old DH to accept a change of role after 10 years in the business?

Farrell seems to adhere. As a manager with great respect for veterans—the man benched Jackie Bradley Jr. in 2014 for veteran Grady Sizemore and made sure veteran Shane Victorino started this year in right field—I speculate that Farrell feels no need to upset Ortiz by playing him at first base regularly, even if it makes the team better. Farrell has the tendency to start veterans over the best possible scenario.

Publicly, Farrell can do and say whatever he wants, as can Ortiz. They certainly do not have to do what the media and fans say. But they should not deceive the fans. Again, Ortiz has not played first base regularly for more than 10 years, dating back to 2004, and again, no way does it appear Ortiz wants to start playing first base again.

That speaks about David Ortiz’s character.

The Red Sox’s best option of winning resides in Ortiz at first base and Ramirez at DH. However, Ortiz still will not embrace playing first base more often. As the veteran, a guy others look towards and a presumed leader of the clubhouse, Ortiz should be willing to do anything that gives the team the best chance to win.

But Ortiz will not play first base because it hurts his knees so much that he has to spend the entire next day on the couch. That cannot and should not count for leadership.

This gets to my second point. As a long time Bostonian and an essential part to the Red Sox’s 2000-era dynasty, most assume Ortiz can and will stay in a Red Sox uniform on his own time. He will choose when he retires. However, that should not hold true. I contest that if Ortiz plans to play longer than this season, the team needs to trade him at this year’s July 31 trade deadline.

Batting .228 at the age of 39 only looks bad for Ortiz. On a team with two designated hitters—that is Ramirez and Ortiz due to Ramirez’s sheer inability to play any position—in the long term, Ramirez wins. The Red Sox have Ramirez for four years, three more after this season. The Red Sox are contractually obligated to Ortiz only until the end of this season, the team holding two options on the contract. The Red Sox have more invested in Ramirez and Ramirez will outperform Ortiz within those years, if Ortiz continues to play. The Red Sox should focus more on exploiting Ramirez’s productivity than letting the Ortiz legacy play out.

Going forward, if the Red Sox continue to play the way like the last two weeks for the rest of the season, the team will push for winning the division. Their best chance to win is by sporting a team with Ramirez at DH and Ortiz at first base, but without Ortiz putting the team first, it will never happen.

A veteran, leader, contributor, call Ortiz whatever you want, but until Ortiz chooses to put the team before anything else, my adjective of choice remains selfish.

The Boston Red Sox are Most Like the...2011 Toronto Blue Jays?

Think back to the year 2011. Boston Red Sox fans had high hopes for a team that won 89 games the previous season. Ownership felt as if they had the game’s best organization, constantly producing championship caliber teams finishing in the top half of the division.

Now picture yourself during this time as a Toronto Blue Jays fan. Having put together a young, up-and-coming team, the 2011 season was the Blue Jay’s time to finally break free. Break free from the cellar, from constantly finishing last or near last in the division. Nearly 20 years since the team last made the playoffs, the Blue Jays had their target, only to fall flat with an 81-81 record, good for fourth in the American League East.

2012 comes around and Toronto had fixed their problems. They had the best home run hitter in all of baseball in Jose Bautista. Edwin Encarnacion finally caught up to his potential, along with promise from young guys like Brett Lawrie, J.P. Arencibia and newcomers Yunel Escobar and Colby Rasmus were to effectively produce.

For Blue Jays fans, 2012 definitely was Toronto’s year. They had it all. But once again, the team fell flat, only mustering up 73 wins, finishing fourth in the American League East for the fifth year in a row.

This story sounds eerily similar to the Boston Red Sox as of late.

After a 2013 World Series win, 2014 could only get better for the organization. They would integrate their young talent with their veterans. Rookie Xander Bogaerts would receive the starting shortstop position after a phenomenal playoff performance. Rookie Jackie Bradley Jr. would command center field as well. However, the two underperformed, as did the entire team, and the 2014 Boston Red Sox had a fire sale at the July 1 trading deadline and would go on to win only 71 games.

So far 2015 has been no different.

After handing out generous contracts to Pablo Sandoval and Hanley Ramirez, as well as adopting the “We do not need a true ace” philosophy, Red Sox fans had high hopes for the team, only to watch them become the second worst team by record in the American League and fourth worse in baseball.

Their story does not just sound the same as the 2011-12 Toronto Blue Jays, these teams were built in similar fashion.

Both guided by manager John Farrell, along with a similar coaching staff comprising of Brian Butterfield and Torey Lovullo, the teams have general managers with similar philosophies. Toronto had a general manager in Alex Anthopoulos who emphasized player development and building from within. He would hold onto his prospects a little too long and when they underperformed, their trade value diminished exponentially, explained through prospects Kyle Drabek, Travis Snider, J.P. Arencibia and others. Anthopoulos used the “We do not need a true ace” philosophy in 2011 as well. Each year’s rotation consisted of overpaid, mediocre pitchers that displayed potential to improve, but in the meantime, the team would have to win games to the tune of eight runs scored to seven runs given up.

Sound familiar?

The Red Sox have held onto their prospects in hopes that each reaches their potential, only to miss the mark and lose their trade value. It seems as if Bradley Jr. will never see the major leagues again, while invested prospect Wil Middlebrooks was traded for pennies on the dollar. Bogaerts has improved greatly since last year, but remains a step or two away from reaching his projected potential.

Red Sox general manager Ben Cherington has a similar rotation. Each starter had potential to rebound from a poor season. The front office and fans alike had reason to suspect improvement. However, the rotation as well as the lineup has failed and now consists of overpaid duds.

Guided by a poor front office and manager, both the Red Sox and then Blue Jays fell to the bottom of the division, gasping for any air they can get to climb out. Guided by hypothetical projections and possible potentials, neither quite hit their mark. As John Farrell managed both squads, it makes it all that much worse.

Frankly, I would laugh each year as the Blue Jays would expect to reach the playoffs, knowing that the team had no chance. Now, I sit back and realize this Red Sox team follows suit. They have become the 2011 Toronto Blue Jays. Yikes.

In Times of Needed Change, Firing Farrell is not the Answer, Fire Cherington Instead

BOSTON—So far, but yet so close. Four and a half games out of first, but yet the Red Sox sit in last place if the AL East with a 22-29 record.

These are the woes of Red Sox Nation. It has led to the firing of pitching coach Juan Nieves and now the nation seems to want manager John Farrell’s head as well.

Sitting last in the AL East with a real possibility of a third losing season in four years, fans have every right to ask for a firing. No acquisition of an “ace” can save this season, only something as drastic as a firing can.

However, Farrell is not the guy. The problem lies in general manager Ben Cherington.

Although Farrell’s decisions can impact a game, they do not decide a game. The team does not win or lose games solely on the decisions Farrell makes. The players lose the game, and guess who hires the players. Cherington.

Cherington has given Farrell a faulty roster. He signed a shortstop in Hanley Ramirez and told Farrell to stick him in left field, a position he has never played in his life. Ramirez does not have the work ethic to learn a whole new position up to par and Farrell certainly is not the guy that would make him.

A quote stuck out to me in last Sunday’s The Boston Globe’s sports section, which described that the reason Ramirez has problems in left field stem from not getting enough balls hit to him in spring training, thus he had not had enough experience to play defensively on balls in play in left field.

This is unacceptable. If Ramirez needed more experience in left field playing balls, then as the manager, Farrell should have taken him out every day and hit balls off of the wall and made him play it correctly. He did not, even though Ramirez probably has some of the blame most likely not wanting to go out there and practice, and now the team suffers from his -0.3 WAR statistic, even with his MVP caliber bat.

Cherington refused to sign Jon Lester because of his age, but then gave pitcher Rick Porcello $82.5 million before even pitching for the team. Porcello owns a 4-4 record and a 5.37 ERA. The team tried brain washing their fans by saying the team has five aces, only to distract the fans from the worst statistical starting pitching in the entire league.

He has reconstructed the roster three times by trading away Adrian Gonzalez, Josh Beckett and Carl Crawford and then signing players such as Mike Napoli, Ryan Dempster and Shane Victorino, only to blow it up again the next year by trading away four out of the team’s five starting pitchers.

Cherington has used up all of his excuses and options. He deserves no more chances. The team sits at seven games below .500. The team is built on a flawed system and Farrell has gotten all of the blame. Not fully excused, but Farrell did not do this to the team, Cherington did.

If someone gets fired, the Red Sox need to consider Cherington before Farrell. Cherington has gotten every chance in the world to turn the organization around and has failed at every step along the way. The 2013 World Series seems more of a fluke with every passing game and something needs to happen.

Fire the general manager, not the manager. Get rid of the virus, not the wound.

A Look Back: Was Miley-De La Rosa Swap Worth it?

BOSTON—Three weeks ago, Red Sox fans felt rock bottom with Wade Miley. One day removed from firing pitching coach Juan Nieves, Miley gave up four runs on eight hits in a 7-0 loss to the Blue Jays, bringing his record to 1-4 on the season and actually lowering his ERA from 7.15 to 6.91.

“It’s always difficult to go through when you go through a stretch like this,” said Miley after the loss with Red Sox fans ready to strangle him from their homes.

Now fast forward three starts.

On Sunday, Miley pitched yet another great effort, giving up only four hits and one run in eight innings, good enough for his third win and quality start in a row. Miley’s ERA has dropped from 6.91 to 4.47 during this time as well.

Manager John Farrell spoke about Miley’s recent success to reporters after the game on Sunday.

“He’s turned things around personally this month, that’s pretty clear,” said Farrell. “He’s back to a quick pace—but a comfortable one for him—and he’s commanding his pitches.”

After a terrible start, Miley definitely has turned a corner.

But then there is Rubby De La Rosa, the guy the Red Sox traded for Miley.

De La Rosa has pitched well so far for the Diamondbacks. In nine starts, De La Rosa owns a 4-2 record in 59 innings with a 4.27 ERA. He has 55 strikeouts and has given up 51 hits in those starts.

“He locates the ball so well,” said Diamondbacks manager Chip Hale about De La Rosa. “He’s got a swing-and-miss changeup and then his breaking ball. His breaking ball, can be really good.”

Although the two pitchers have provided some success for their respective teams, can the Red Sox still justify the trade at this point?

At this point of the season, the statistics are pretty comparable. Miley has pitched 50 innings, De La Rosa 59. Both has four wins, both have similar ERAs.

However, De La Rosa has a better future ahead of him.

At 28 years old, Miley has basically hit his peak. What Red Sox fans have seen so far will most likely continue for the rest of the year and the remainder of the contract. Miley will pitch sporadically, which will most likely lead to a decent record, innings pitched, and an ERA somewhere in the 4.00 range.

De La Rosa has more upside. At 26 years old, De La Rosa has more room to improve. He still hasn’t had a full season in the major leagues and he is still developing his pitches.

This doesn’t even include the contract status of each pitcher. The Red Sox owe Miley $3.6 million this season, which spikes to $6.1 million the next year, $8.9 million the following year, and then $12 million in the final year of the contract.

De La Rosa is owed $516,000 this season while he still remains arbitration eligible. The earliest he can hit free agency is the 2019 season.

Although both Miley and De La Rosa has comparable statistics, the difference between the two is potential. While Miley has little room to improve, De La Rosa has yet to even hit stride. The Diamondbacks have more financial flexibility with De La Rosa than the Red Sox have with Miley as well.

The comparison could be apples to oranges. But I like the financial flexibility and potential that comes with De La Rosa more than Miley.