Earlier today I spoke with James McDonald at Pirate City, talking about his injury this year and his rehab work. McDonald mentioned that he had trouble getting his arm loose early in the year, and felt “constricted”. He originally thought it was dead arm, then told the Pirates when the condition got worse.
Later this evening, it was announced that Wandy Rodriguez would visit Dr. James Andrews after experiencing pain during a sim game. Rodriguez had felt pain before in his rehab work, which does raise a question why he was throwing so soon when he experienced pain before.
In each case the Pirates are in a tough situation. Only the pitcher can tell if he’s in pain. And in each case, you can see why the pitchers wouldn’t want to speak up right away.
In McDonald’s case, dead arm is very common. This article is a few years old (Francisco Liriano is in a Twins jersey in the video), but still relevant in discussing the condition. Every year pitchers get dead arm and experience a fatigue in their arm. A lot of times this happens during Spring Training. McDonald started experiencing problems near the end of Spring Training, so you can see how it would be easy to confuse the issue. Considering how he finished the 2012 season, you could also see how he might want to get back out there and rebound from his poor second half.
In Rodriguez’s case, he was experiencing some setbacks. There are a ton of reasons Rodriguez might have wanted to get back early. Personal reasons (better negotiating power if he finishes the year healthy), professional reasons (the Pirates are in a playoff race and need him in the rotation), and just the fact that he might have thought the pain was normal. I’ve talked to plenty of rehabbing players who have tried to come back, have felt pain or soreness early in the rehab, and have seen that disappear toward the end of the rehab.
The question here is, how do you prevent these situations? A lot of people are already upset about how cautious teams are with starting pitchers. So putting someone on the disabled list because of dead arm, or holding them out until they are 100% pain free after rehab wouldn’t be seen as a good approach. These are two different issues, but they both share the same frustrating problem.
Anyone who has ever had back pain, muscle pain, neck pain, arm, shoulder, or knee pain, or any other type of pain that is hard to diagnose knows about this frustrating problem. Sometimes there is no obvious solution. It doesn’t always work out where a player feels hurt, gets a scan, and finds the reason he is hurt. In a lot of cases the scans come back inconclusive.
Dead arm isn’t a medical issue, and fatigue won’t show up on any scans. McDonald thought he had dead arm, and it ended up that he had tendinitis, which won’t show up on X-Rays and is hard to determine on an MRI. We know that it wasn’t dead arm in hind sight, but if you treat every situation of dead arm with precaution, you’re going to be benching people who might just be tired for 1-2 starts. It might be useful to bench a player for a few starts when dead arm creeps up, but you’re still going to have the issue where you can’t figure out the exact problem, no matter what scans you perform.
Rodriguez went down in early June with “forearm tightness”. It was determined that he had inflammation in his left forearm, and he started throwing again almost immediately. He then went through cycles over the next two and a half months where he would throw, experience tightness or soreness, and then stop throwing. I think the easiest solution here would be to err on the side of caution. Inflammation isn’t a long-term thing, as anyone can get that to a varying degree. But Rodriguez was throwing about a week after his injury, and you could blame the Pirates for that, but any team would do the same if a test came back with just inflammation.
The pitchers aren’t going to step up and take themselves out of the rotation. No one wants to be seen as weak or injury prone. The team can have a tough time diagnosing the injury until it gets worse and more obvious. Therefore it becomes a situation where the pitcher doesn’t feel right, the team doesn’t know what it is, and everyone just hopes for the best. Unfortunately there’s not really a better option. The only solution might be to hold guys out for a longer period before they start throwing again. That might help guys like Rodriguez and McDonald recover sooner, but it also might take more guys out for time they don’t really need to miss.
Overall I think it’s a tough situation all around since there’s no clear way to diagnose the minor injuries. McDonald should be back in September, serving as bullpen depth, assuming no setbacks. The Pirates probably won’t see Rodriguez the rest of the year, and will hope that his condition isn’t serious enough to cause him to miss significant time in 2014, as he almost certainly will exercise his $13 M player option (of which the Pirates are on the hook for $7.5 M, with Houston paying $5.5 M). Perhaps some actual rest will do him some good.
Links and Notes
**The latest episode of the Pirates Prospects Podcast is out: P3 Episode 17: The Pirates Issues With RISP, Platoons, and Small Ball. A new episode will go up tomorrow morning at 9 AM.