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How Would a Shortened MLB Season Impact Athlete Health?; Hardy Undergoes Tommy John Surgery


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.

 

Blaine Hardy

 

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.

 

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The studies looking at injury early in the season for pitchers are often skewed IMO because they don't always account accurately for those injuries that have been simmering through the offseason. So if someone (like Sale, Severino etc.) ends up having TJ in March or April, the injury can get recorded as occurring in 'March' or 'April', when in reality it has (in most cases) occurred earlier, was being monitored in hopes that it would improve without surgery, but ultimately doesn't. So it's hard to know how to use that info when calculating injury rates. I do think the injury rate is probably higher earlier in the season, but probably not as dramatically different as some studies seem to show. For position players, I think it is likely more accurate.

 

A very minor point about PRP- the platelets release chemical signalers called cytokines that are somewhat different from hormones. Hormones can make people think things like 'steroids' (which are naturally produced- or sometimes injected- hormones), when what PRP provides is an alphabet soup of things like TGF-beta, IGF, PDGF, VEGF and others that regulate cell activities like inflammation and healing. I just think it is important to make a distinction that injecting PRP is different from a steroid injection (whether anabolic or corticosteroid- which is a whole other discussion).

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I've long suspected the rate of arm injuries correlates inversely with cold weather, i.e., the colder the playing weather, the more arm injuries.  Baseball before 4/15 or after 10/15, especially in Minnesota, seems risky.  Were I Commish, games wouldn't be played if the temp at game time were 45 degrees or less.

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