Craig Arko reacted to Heezy1323 for a blog entry, Rich Hill Elbow Surgery Discussion
Rich Hill Elbow Surgery Discussion
Happy Supposed-To-Be Opening Day everyone. Since the baseball season is (unfortunately) on hold due to the coronavirus pandemic, about the only recent baseball-related news to report has been that both Chris Sale and Noah Syndergaard (in addition to Luis Severino earlier this spring) are in need of Tommy John surgery. I covered some information about Sale’s injury and some discussion regarding techniques used in UCL reconstruction in previous blog posts. In the comment section of the latter post, TD user wabene asked an astute question about Rich Hill’s surgery and how it is similar or different from typical UCL reconstruction. Hill’s surgery is indeed different from a typical Tommy John surgery, and I thought a post about it might be interesting to some readers.
As usual, my disclaimer: I am not an MLB team physician. I have not seen or examined Hill or reviewed his imaging studies. I am not speaking on behalf of the Twins or MLB. I am only planning to cover general information about this type of surgery and my take on what it might mean.
Twins Daily contributor Lucas Seehafer posted an excellent article about Hill’s surgery back in January that was a good look into the surgery basics and some background about UCL primary repair. There was some additional discussion in the comments as well. Since Lucas did such a nice job covering the surgery, I won’t go into excessive detail in this post, but I’ll give my version of the basics, and then cover how Hill’s surgery is similar and different.
Basics of UCL Primary Repair
As covered in my post about Sale, the UCL is a strong ligament at the inside of the elbow that resists the stretching forces that occur when trying to throw a baseball. Obviously, hurling a baseball 90+ mph can take a toll on this ligament and it can, in some cases, result in a tear. These tears can occur at the top (humeral) end, bottom (ulnar) end or in the middle (called midsubstance).
The figure above is from a study we did when I was in fellowship indicating the location of the ligament injury in 302 patients who had undergone surgery with Dr. Andrews. The most common areas of injury are at either end of the ligament, with the humeral end being slightly more common (at least in this series) than the ulnar end. These patients all underwent UCL reconstruction, which is the standard operation to treat these injuries when non-surgery treatments have failed to result in adequate improvement.
More recently (I would say within the past 5-7 years), there has been emerging interest in performing a different operation for a subset of these patients called UCL Primary Repair. This operation differs from UCL Reconstruction in that when the repair is chosen, the injured ligament is reattached back to the bone at the site of the injury using special anchors. There is typically also a strong stitch called an ‘internal brace’ that is passed across the joint along the path of the repaired UCL as well. I often refer to this internal brace as a ‘seat belt’ stitch. The idea behind the internal brace is that early in the healing process, before it has re-developed strong attachments to the bone, the ligament is susceptible to reinjury which could cause failure to heal (or compromised strength of healing). The internal brace (theoretically) helps protect the healing ligament and allows for development of a stronger attachment back to the bone. Once healing has occurred, the internal brace is thought to act like ‘rebar’, adding some strength to the ligament (though the exact magnitude of this contribution is unclear).
This figure illustrates the repair technique with the blue ‘internal brace’ also in place.
This is different from UCL reconstruction, where tissue from elsewhere in the body (typically either a forearm tendon called palmaris or a hamstring tendon called gracilis) is passed through bone tunnels and used to create a ‘new’ ligament.
One of the reasons for the interest in primary repair of the UCL has to do with the length of time needed for recovery from UCL reconstruction. As many of us know from having watched numerous pitchers undergo (and subsequently return from) Tommy John surgery, there is usually around 12-18 months needed for full return to pitching at the major league level. There are a number of reasons for this long time frame, but a major contributor is that this is the amount of time needed for the graft to fully heal. Recall, we are taking a tendon (which normally attaches muscle to bone) and putting it in the place of a ligament (which normally attaches one bone to another bone). Though tendons and ligaments are similar, there are differences in their microscopic structure. Over time, as the graft starts to heal and have new stresses placed on it (namely throwing), it begins to change its microscopic structure and actually becomes a ligament. In fact, there have been animal studies done that have shown that a biopsy of a sheep ACL graft (which was originally a tendon) over time evolves into what is nearly indistinguishable from a ligament. We call this process ‘ligamentization’, and it is probably the most important part of what allows the new ligament to withstand the stresses of throwing.
This process, however, takes time. And because of this, the recovery from UCL reconstruction is lengthy. With primary repair of the UCL, this process of conversion of the tendon to ligament is not necessary since we are repairing the patient’s own ligament back to its normal position. Some healing is still required; namely the healing of the detached ligament back to the bone where it tore away. But this process does not typically require the same amount of time as the ligamentization process.
So why, then, wouldn’t everyone who needed surgery for this injury just have a primary repair? In practice, there are a few issues that require consideration when choosing what surgery is most suitable for a particular athlete. The first brings us back to the first graph from this post regarding location of injury to the UCL. It turns out that asking an injured ligament to heal back to bone is a much different thing than asking a torn ligament to heal back to itself. Specifically, trying to heal a tear in the midsubstance of the UCL (which requires the two torn edges of the ligament to heal back together) results in a much less strong situation than a ligament healing to bone. That makes those injuries that involve the midsubstance of the UCL (about 12% in our study) not suitable for primary repair. It can only be realistically considered in those athletes who have an injury at one end of the ligament or the other.
In addition, there is significant consideration given to the overall condition of the ligament. One can imagine that repairing a nearly pristine ligament that has a single area of injury (one end pulled away from the bone) is a different situation than trying to successfully repair a ligament that has a poorer overall condition. Imagine looking at a piece of rope that is suspending a swing from a tree branch- if the rope is basically brand new, but for some reason breaks at its attachment to the swing, it seems logical that reattaching the rope to the swing securely is likely to result in a well-functioning swing with less cause for concern about repeat failure. Conversely, if you examine the rope in the same situation and notice that it is thin and frayed in a number of places, but just happened to fail at its attachment to the swing, you would be much less likely to try and repair the existing rope. More likely, you would go to the store and buy a new rope to reattach the swing (analogous to reconstruction). Similarly, when we are considering surgical options, we examine the overall health of the ligament on the MRI scan, and also during the surgery to determine whether repair is suitable or whether a reconstruction is needed. If there is a significant amount of damage to the UCL on MRI, primary repair may not be presented to the athlete as an option.
Also, consideration is given to the particulars of an athlete’s situation. For example, let’s say I see a high school junior pitcher who has injured his elbow during the spring season. Let’s also say that he wants to return to pitching for his senior year but has no interest in playing baseball competitively beyond high school. In this case, the athlete is trying to return relatively quickly (the next spring) and is not planning to place long term throwing stress on the UCL beyond the next season. If this athlete fails to improve without surgery (such that all agree a surgery is needed), and his MRI is favorable- he is a good candidate for UCL primary repair. This would hopefully allow him to return in a shorter time frame (6-9 months) for his senior season, which would not be possible if a reconstruction was performed. Indeed, this is the exact type of patient that first underwent this type of surgery by Dr. Jeff Dugas at American Sports Medicine Institute in Birmingham, AL. Dr. Dugas is a protégé of Dr. James Andrews and has been instrumental in pioneering the research behind UCL primary repair.
As you can probably imagine, the longer players (and pitchers in particular) play baseball, the more likely it is that there is an accumulation of damage to the UCL over time. This is the factor that most commonly eliminates the option of primary repair of the UCL in many of these players.
So how does any of this relate to Twins pitcher Rich Hill? Let’s discuss.
Hill underwent UCL reconstruction of his left elbow in 2011. He was able to successfully return from his surgery but has certainly faced his share of injury concerns since then (as described nicely in Lucas Seehafer’s article). This past season he began to have elbow pain once again and was placed on the 60-day IL as a result. He then underwent surgery on the elbow in October 2019 by Dr. Dugas (noted above). The procedure performed was a repair procedure, but in this case instead of repairing Hill’s own UCL, the repair was performed to reattach the previously placed UCL graft. I don’t have any first-hand knowledge of Hill’s surgery, but my best guess is that the technique was very similar to what was described above for a typical primary repair with internal brace. To my knowledge, this has not been attempted before in a major league pitcher.
There is data showing a relatively good return to play rate with primary repair that is very similar to UCL reconstruction. However, most UCL repair patients are much younger than Hill and the vast majority that have been studied to this point are not major league pitchers. There are a couple of ways you can interpret this data when it comes to Hill. One perspective is that he had a repair of a ‘ligament’ (his UCL graft) that was only 8 years old (since his TJ was done in 2011), and as such it likely doesn’t have as much cumulative damage as his UCL might otherwise have if he had not had any prior surgery. An opposing perspective would be that this is his second UCL operation, and even though his most recent surgery was not a reconstruction, the data that would be most applicable to him would be data regarding athletes who have undergone revision UCL reconstruction (meaning they have had a repeat TJ procedure after the UCL failed a second time). This data is less optimistic. Most studies would put the rate of return to play after normal UCL reconstruction around 85% (depending on exactly how you define successful return to play). In most studies, the rate of return to play after revision UCL reconstruction is much lower, around 60-70%. There are two MLB pitchers that I am aware of that have undergone primary repair of the UCL (Seth Maness and Jesse Hahn). Maness has yet to return to MLB and Hahn didn’t fare very well in 6 appearances in 2019.
Finally, my last input on this topic as it pertains to Hill is to imagine the specific position he is/was in. He is likely nearing the end of his career (he turned 40 in March 2020). He had a significant elbow injury that was not getting better without surgery. Presumably his choices were four:
1) Continue trying to rehab without surgery and see how it goes, understanding that the possibility exists that rehab may not be successful. (Perhaps a PRP injection could be tried)
3) Undergo revision UCL reconstruction with its associated 12-18 month recovery timeline, likely putting him out for all of 2020 with a possible return in 2021 at age 41.
4) Undergo this relatively new primary repair procedure with the possibility of allowing him to return to play for part of the 2020 season, but with a much less known track record. In fact, a basically completely unknown track record for his specific situation.
If that doesn’t seem like a list filled with great options, it’s because it isn’t. If I’m being honest, I think Hill probably made the best choice (presuming that he still has a desire to play), even with the unknowns regarding his recovery. He obviously couldn’t have seen this virus pandemic coming, but that would seem to make the choice even better since he is not missing any games (because none are being played).
For Hill’s and the Twins sake, I hope his recovery goes smoothly and he is able to return and pitch at the high level he is used to. He sure seems like a warrior and is certainly the kind of person that is easy to root for. But based on what we know about his situation, there is an element of uncertainty. If I were Hill’s surgeon, I likely would have told him that he had around a 50-60% chance to return and pitch meaningful innings after this type of surgery. Let’s hope the coin falls his way, and also that we can figure out how to best handle this virus and get everyone back to their normal way of life as soon and safely as possible.
Thanks for reading. Be safe everyone. Feel free to leave any questions in the comment section.
Craig Arko reacted to Heezy1323 for a blog entry, UCL Reconstruction Techniques
UCL Reconstruction Surgery
I recently posted a blog about Chris Sale and the news that he was set to undergo UCL reconstruction. That post covered some questions surrounding the diagnosis and decision-making that occurs when players/teams are faced with this dilemma. That post got a little lengthy, and I chose not to delve into the surgery itself, as I felt that may be better presented as a separate entry. My intention with this post is to discuss some of the different techniques that are used to perform UCL reconstruction. This does get fairly technical, and I apologize in advance if it is more than people would like to know.
First, we should revisit the anatomy. The ulnar collateral ligament (UCL) is a small but strong ligament on the medial (or inner) part of the elbow. It is around the size of a small paper clip. Ligaments (by definition) connect one bone to an adjacent bone. The UCL spans from the medial epicondyle of the humerus (the bump you can likely feel on the inside of your elbow) to the sublime tubercle of the ulna (one of the two forearm bones). (As an aside, sublime tubercle is one of my favorite terms in all of anatomy).
As with nearly any reconstructive surgery in orthopedics, our aim is to recreate the native/normal anatomy as closely as possible. In order to do this, most techniques utilize small tunnels that are drilled into the bone at the ligament attachment sites. The tissue that is used to reconstruct the ligament is then woven through these tunnels and tightened to create a secure new ‘ligament’ that heals and strengthens over time.
The primary differences between different techniques are the ‘approach’ (or how tissues are moved aside to see the damaged areas), the specifics of how the tunnels are made and used, the type of tissue (or graft) that is used to make the new ligament, and the way that the graft is secured in place. There are a number of variations that exist, but I’ll cover a few of the most commonly used methods.
First, some history may be in order. The first UCL reconstruction was, famously, performed on Tommy John. Tommy John was an outstanding pitcher for the LA Dodgers in the early 1970’s, and had compiled a 13-3 record in 1974 when he had a sudden injury to his elbow and was unable to throw. Imaging was performed, and the diagnosis of a UCL tear was made by pioneering orthopedic surgeon, Dr. Frank Jobe (of the famous Kerlan Jobe clinic in LA). Dr. Jobe had an idea to perform a reconstruction of the UCL, and practiced on several cadavers until he felt he had worked out a promising technique. He told Tommy that he thought he had a 1 in 100 chance of a successful return to MLB pitching. John decided to go ahead. The surgery was ultimately successful, and John returned to pitching in 1976. Though Tommy made it back, he did have a temporary palsy of his ulnar nerve after surgery, which is the ‘funny bone’ nerve that is near the UCL. This caused him significant weakness in his hand at first, but fortunately the strength returned over time and Tommy was able to return to pitching. Interestingly, he won more MLB games after surgery than he did before surgery, and pitched until 1989. There is a story that Jose Canseco hit a homer off John late in his career. Apparently Canseco’s father was Tommy’s dentist, and Tommy said something to the effect of “When your dentist’s kid starts hitting home runs off you, it’s time to retire.”
The technique used for this first surgery was termed the Jobe Technique (for obvious reasons). It involved removing the attachment of the muscles to the inner part of the elbow and pulling the muscles toward the wrist to get a good look at the UCL itself. Tunnels were drilled in the bone at the normal attachment sites of the ligament, and a small tendon from the forearm (called the palmaris) was used to weave through the tunnels making a ‘figure-8’ in order to make a new ligament. (The palmaris is a non-necessary tendon that is located in the forearm of about 2/3 of the population. For those patients who don’t have a palmaris, we usually use a hamstring tendon called the gracilis for this procedure.) The old ligament was left in place and sewed into the graft. The nerve was also moved from its normal location (behind the bump) to in front of the bump to take some of the tension off. This is called a ‘transposition’ of the ulnar nerve.
This technique was used for a while, but it did have some drawbacks, such as a high percentage of patients having ulnar nerve problems after surgery and some weakness resulting from detaching and reattaching the muscles of the forearm. Because of this, other surgeons sought new ways to perform this surgery.
One commonly used technique was termed the ASMI-modification of the Jobe Technique. ASMI stand for American Sports Medicine Institute (in Birmingham, AL) and this modification was initially described by Dr. James Andrews and colleagues. This involved similar bone tunnels, but the main difference was in the way that the muscles were treated. Rather than detaching the muscle and reattaching at the end of the surgery, in the ASMI technique the muscle was lifted up (and not detached) and the work was done underneath the muscle. The ulnar nerve is transposed when this technique is used (like the Jobe technique). The passing and fixation of the graft is essentially identical to the Jobe Technique as well.
Another commonly used technique is called the ‘docking method’. There are a couple of main differences between the docking method and ASMI method. First, the docking method utilizes a ‘muscle-splitting’ approach rather than a ‘muscle-lifting’ approach like the AMSI technique (see figure). This means that the muscle is divided between its fibers and a ‘window’ is created in the muscle in order to see the torn UCL and make the tunnels. There is also a difference in the way the tunnels are made. In the ASMI technique, the tunnels are the same size all the way through, and the graft tissue is passed all the way through the tunnels. In the docking technique, the tunnel on the ulna side is the same. But on the humeral side, the tunnels are sort-of half tunnels with smaller tunnels continuing on through the back side of the bone. This is because the graft is fixed in a different way- there are strong stitches that are attached to the ends of the graft that pull each end into the large tunnels. The stitches then pass through the small portion of the tunnels and are tied behind the bone, which secures the graft in place.
This technique does not require transposition of the ulnar nerve, which is an advantage because less handling of the nerve generally means less risk of trouble with the nerve after surgery.
There are a handful of other techniques that are slight variations on these themes, primarily using different devices such as anchors, interference screws or metal buttons to achieve graft fixation. There have been a number of cadaver biomechanical studies done that have compared methods, and they have been found to be largely equivalent. There seems to be a smaller incidence of ulnar nerve symptoms after surgery when the nerve is not handled/transposed (which makes some sense). The return to play rates are very similar regardless of which technique is used, with perhaps a slight favor to docking technique depending on the study.
I trained with Dr. Andrews, and performed nearly 100 UCL reconstruction cases during my fellowship using the ASMI technique. In my own practice, I tend to use the docking technique most commonly. I do this because I would prefer not to transpose the nerve if I don’t have to in order to decrease the likelihood of nerve problems after surgery. We also saw some problems with fracture of the bone near the humeral tunnels when using the ASMI technique, and using the docking technique allows us to make smaller tunnels. This makes fracture in this area less likely. That said, Dr. Andrews has had (and continues to have) tremendous success using this technique. As we have learned more about this type of surgery, it has become clear that it is important that the bone tunnels be made very accurately, as improperly placed tunnels seem to be a risk factor for inability to return to full participation. There has also been some investigation as to whether addition of PRP or other biologics to the reconstruction area at the time of surgery makes a difference in healing speed or strength. At this time, I am not aware that any research has shown a difference.
If anyone has managed to make it this far without falling asleep, I hope you found this discussion interesting. Feel free to leave a comment below if you have additional questions. Thanks for reading. Safe wishes to you and your families.
Craig Arko reacted to stringer bell for a blog entry, Strange Times
I write this blog entry when I was expecting to do other things. I am in Fort Myers in 80 degree weather with just a hint of a breeze on a nice Thursday afternoon. What could be wrong? Well, actually, plenty.
My significant other and I made plans for the rest of winter sometime in January. Because we had made an extended trip of the Christmas/New Year holidays and because we were planning a family gathering for the summer, we decided to stay in Minnesota for the rest of January and I decided I would stay in February until I could make it to spring training for my favorite baseball team. The plan was for me to drive to Florida by way of my daughter's residence in Indiana. I would be in Fort Myers by myself until she was on semester break and then we could enjoy a week together in Florida--baseball, beaches, warm weather--before driving back together so that she could be ready for college to start up again.
Things often don't go as you plan them. The expensive ticket for her flight could now be purchased for pennies on the dollar. The Minnesota Twins and all of major league baseball have cancelled the remainder of spring training games. The Final Four won't happen, to quote a song "Broadway is dark tonight" and I would expect more cancellations going forward.
This has brought me to think about what is important and what isn't. Having something like baseball to occupy my time is important. Filling that gap is essential. Having health is really crucial. I am thankful to be in good health at this time and I certainly don't want to get the coronavirus, even though it likely wouldn't effect me long term. Many people could die needlessly if measures aren't taken to diminish the acceleration of exposure. I'll do what I can to avoid getting the virus and spreading it to others.
Oh yes. I did get to watch the future of the Minnesota Twins (IMHO). On Tuesday, in Clearwater, the starting lineup included Alex Kirilloff, Trevor Larnach, Brent Rooker and Royce Lewis. They all impressed me, particularly Lewis, who homered and made an outstanding defensive play at shortstop. If two or three of these prospects pan out, the pipeline will be intact and the Twins should be able to have a first-division lineup for most of the next decade.
Today, before MLB's announcement suspending exhibition games, I watched Twins minor leaguers play. I saw Duran throwing absolute gas, Matt Wallner (big kid--6'5") looking good, but not making contact and I found out about a Twins prospect Seth Gray (4th round draft choice from Wright State) from his dad. I'll be a Gray fan now. Seems like a nice kid. Finally, as I was walking back to my car I saw a man walking over to a somewhat elderly guy wearing a Twins hat. Tony-O!. I waited until the conversation was over and asked Tony if I could take a picture. He said that we should make it a selfie, but that he couldn't sign autographs--bosses orders.
I asked Tony how old he really was and he said something to the effect of "in America, I'm 81" with a chuckle. According to BB Reference, that is his correct age FWIW. I got back to my room excited about spending more days like today at the spring training complex, meeting icons and nice people from Twins Territory, and now it seems it is over almost before it started. Since I started writing this entry, Disneyland announced they were closing and March Madness was cancelled. This is serious stuff folks.
Craig Arko reacted to Brandon Warne for a blog entry, Common Health Concern Spawns Special Bond Between Kohl Stewart and Young Fan
WRITER NOTE: This is an excerpt from a story that appears in full on Zone Coverage here.
Sometimes you’re just in the right place at the right time.
On Saturday afternoon, that place was Bat & Barrel — the restaurant that used to be known as the Metropolitan Club — down the right-field line at Target Field.
Twins players and fans gathered at the stadium for the yearly gathering known as TwinsFest, which caps the club’s winter caravan and begins the road to Spring Training each year. Most of the 40-man roster and a smattering of prospects show up each year to what has to be among the top five or so best fan fests in the game today.
The whole thing is basically a large autograph party, with fun events mixed in where players and fans — especially kids — can mingle on the concourse and surrounding areas of Target Field. Beyond that, it also gives fans a look into the Legend’s and Champion’s Clubs — two exclusive areas that have more restricted access at the stadium.
The Legend’s Club housed food areas, a few games and booths and the WCCO radio setup, while the Champion’s Club housed a large majority of the vendors selling game-used apparel, baseball cards and etc.
Bat & Barrel was set up half as a restaurant, but also a stage for players to take questions from fans or play games with a crowd watching. In this case, it was a quartet of Twins playing Headbandz, a charades game with players teaming up in pairs — Matt Magill with Trevor May and Blake Parker with Kohl Stewart — with a player holding an iPad to their forehead while the other gave clues to the mystery word on the screen.
After Magill and May beat Parker and Stewart, stadium announcer Jim Cunningham said they had a few more minutes left to take some questions from the fans. One kid asked May how he got so good at Fortnite — “Get injured kids, and you’ll have a lot of time for video games.” — and another asked what position each of the players played.
Another humorously asked if he could get autographs from each of the pitchers, but it was the final question that brought the room to a poignant silence.
A young girl got the microphone, and meekly asked Stewart how he handles playing in the big leagues with Type-1 diabetes. Stewart climbed off the stage, knelt down next to the girl and talked to her for a few minutes and took a number of pictures while also signing her jersey.
Craig Arko reacted to Heezy1323 for a blog entry, Jason Castro Knee Surgery Q&A
Jason Castro Meniscus Surgery Q&A
Twins starting catcher Jason Castro went on the DL May 5th with pain in his right knee. Initially, it was reported that Castro underwent a cortisone injection and was hopeful to return to the lineup soon. Unfortunately, after traveling to Vail, CO to see noted orthopedic surgeon Dr. Robert LaPrade, Castro is now scheduled to undergo surgery May 15th to address a meniscus tear. (Update: Now being reported that he underwent more extensive surgery including a meniscus repair and is now out for the season). This will be the third surgery for Castro’s troublesome right knee, according to the Pioneer Press. He sustained an ACL tear along with a meniscus tear in spring training 2011 and underwent surgery, which caused him to miss the entire season. He also underwent arthroscopic surgery on the same knee in September 2013.
Let’s discuss some knee anatomy and some meniscus ‘fun facts’ (Note: these facts may only be considered fun to me…)
Question 1: What is the meniscus? What is its function?
The meniscus is a C-shaped cartilage cushion that is positioned between the bones of the knee (the femur and tibia). It has several functions including acting as a shock absorber, a protector of the surface cartilage and a stabilizer of the knee. There are two menisci in each knee- a medial and lateral meniscus. The medial is positioned at the inside of the knee, the lateral to the outside. Both the medial and lateral meniscus increase the surface area of bone contact within the knee when walking/running, thereby spreading out the contact forces over a larger area. This function protects the surface gliding cartilage (called articular cartilage) from being damaged.
Question 2: How is a meniscus torn/damaged?
A meniscus can be torn in several ways, but most commonly it is damaged when the knee undergoes an abrupt change of direction and the stress is more than the meniscus can withstand. In the case of Castro, it sounds as though he had some damage to his meniscus in 2011 when he also tore his ACL. A meniscus tear accompanies an ACL tear about 50% of the time. Either the medial or lateral meniscus can be torn, and in some cases both sustain injury.
Question 3: How are meniscus tears assessed?
Most commonly an MRI is ordered to look at the meniscus more closely. The meniscus can’t be seen on xrays. There is a device that is similar to a large needle that has a camera inside it that can be inserted into the knee during an office visit to view the meniscus directly, but I don’t have much experience with this device.
Question 4: What types of tears can occur?
There are a number of different types of meniscus tears, and there are many tears which don’t fit neatly into a single category as well.
Question 5: What are the treatment options for meniscus tears?
There are a number of different options for treatment of meniscus tears. Not every meniscus tear will require surgery- in fact, many people may have a meniscus tear in their knee and not even be aware of it. Anti-inflammatory medication, injections (including cortisone, gel/lubricant, and PRP injections), and physical therapy are among the non-surgical options. When these are not successful (or surgery is deemed necessary early on), knee arthroscopy is performed.
During knee arthroscopy, the knee is inflated with fluid and a camera is inserted inside the joint. The structures of the knee can be readily assessed, and tools are used to examine and probe the meniscus, surface cartilage and ligaments. The specifics of the meniscus tear are then evaluated. A decision is then made whether to repair the meniscus or remove the torn portion of meniscus (called a partial meniscectomy). This decision can be complex and is based on a number of factors including the size, location and orientation of the tear, patient-specific factors such as age, weight, health, prior surgery to the knee and others.
Ideally, we would repair all meniscus tears, as removing meniscus can lead to the development of arthritis later on. However, some tears are simply unable to be repaired and must be partially removed. Tears closer to the outer edge of the meniscus have better blood supply are more likely to heal, and thus are better suited to repair.
Question 6: What is the recovery time?
This can vary significantly, but for partial removal, most athletes can return to sports between 6-10 weeks after surgery. For repair, the recovery is longer because of the additional time required for the repaired tissue to heal. Typically, a return to sports for a meniscus repair is around 3-5 months.
Question 7: Are there any special circumstances with Castro’s knee?
I would say yes. The fact that he has had two prior surgeries on the knee (including an ACL reconstruction) often makes the MRI more challenging to interpret and can complicate decision-making. It is unclear to me if the current meniscus damage is in the same area where he previously had surgery, which can create an already abnormal appearance on MRI. Thus, it is difficult to know whether what appears abnormal on a current MRI is ‘new’ or ‘old’. However, it sounds like he has continued to have intermittent problems over a lengthy amount of time now, and it seems reasonable to go ahead with arthroscopy. One concern is that a tear can enlarge in size over time if left alone (though this is difficult to predict).
Dr. LaPrade is a world’s authority on knee problems and I’m sure he will do his best to get Castro back to action quickly and safely.
Craig Arko reacted to mikelink45 for a blog entry, Jim Kaat makes sense
I just finished reading Jim Kaat's essay on ESPN - http://www.espn.com/mlb/story/_/id/23474497/jim-kaat-says-mlb-adapt-7-inning-games-effort-improve-sport and I really liked it. I think it is well thought out and he strengthens it with some notes about how the game has already changed so drastically over the years. This is a good change and I would love to see it, but won't because it will be resisted by the union, the league, the traditionalists.
But what is tradition? Is it a pitcher throwing half the games and winning 50? Is it one pitcher winning 511 games? Is it an era of 400 hitters? Is it the murderers row and the sluggers who followed (sluggers who could also get hits and not strike out all the time)? Is it the war years when a 15 year old starts for Cincinnati? Can we say it is when Jackie Robinson integrated baseball and changed the rosters and stars? Is it the Bronx Bombers who dominated the 50's? Maybe it is the expansion era when lots of new records were set and we went from 154 to 162 games but kept all the same records? Is it PEDs? Is it the era of Latin ballplayers? Perhaps we can say it is the era of wildcard teams. Is it the demise of starters and rosters of all relief pitchers? Is it the era of big Ks and lots of HRs? There is no true tradition. Each season stands alone.
That's why we can argue about eras and great players without winning or losing. Its why the HOF is merely an annual pissing contest of my era was better than your era and your stats don't count because now we do not care about BA and ERA and Wins.
The very discussion that games are too long is a reasonable topic and a serious one. Change is not going to come by the little things that have been done. Shaving 3 minutes off the game is not the answer. Go Jim. I hope someone else is listening. And by the way - I would put you in the HOF!
Craig Arko reacted to mikelink45 for a blog entry, Catcher, eccentric, Spy – a baseball original
Moe Berg was born to a Jewish family in New Jersey and became one of baseball’s most intriguing stories. First, he went to Princeton where his Jewish heritage stood out among his classmates and by the time he graduated in 1923 he was not only an outstanding student who could speak 4 – 8 languages, but he was also the star shortstop on an excellent team.
He graduated with a law degree and served a very brief stint as a lawyer, but signed with the Brooklyn Robins – soon to be Dodgers and played 15 years in the major leagues. He moved from team to team and ended up a Red Sox. He also quickly changed from a shortstop to a catcher and his fifteen year batting line was .243 batting average, 278 on base average and 299 slugging average. He was not a star hitter and he was not a starter either.
Today he would be more highly valued because he had a great arm to throw to the bases and hall of famer Ted Lyons said he was the best at calling a game. He would have been a pitch framer and he would have stood out by the measurements of today, but not by the standards of his day. And yet he kept playing.
He was loved as a teammate and his story telling in the bullpen was legendary. Every day he read seven or more newspapers and he seemed to have the charisma to accompany some of the biggest names of his era – like Nelson Rockefeller. But he was also a loner, who loved attention, but needed to get away by himself. The life of every party, but someone who would disappear with an aura of mystery.
In many ways he was the bench coach while still active and remained in love with the game. He also authored one of the classic essays on pitching and catching. But he really did not care if he played, his pleasure was in being near the game.
He went to Japan to teach baseball and he organized and was with Babe Ruth, Lou Gehrig and other HOF stars when they were in Japan. Moe learned the language and even how to write in Japanese. He loved the country and he took photos while he was there that would later be valuable to the war effort.
He was a favorite of the sports writers – they called him the professor. Then his career ended with a little coaching and the nation faced the onset of the war. The nation lacked a CIA, they did not have spies and intelligence, so the country formed the OSS and Wild Bill Donovan recruited the most eccentric group of spies we have ever had and Moe was one.
The fascinating story is told in the book – The Catcher was a Spy, by Nicholas Dawidoff, and it is amazing. Moe was in Europe and meeting with scientists who were being lured to the US or asked to work with the US to develop the Nuclear Bomb. He met Einstein, Scherer, Heisenberg and other leading scientists. He was at international scientific meetings and moved in a circle that few people and fewer spies could navigate and he loved it.
But his life spun in different ways after his OSS days. He was an independent operator and it is hard to make that work in life. He ended up moving from friend to friend, lived with his brother until their relationship fell apart and then with his sister until he died. His last question on his death bed was, “How are the Mets doing today?”
In death this mystery man remains a mystery – Berg’s ashes were buried in Newark in a Cemetery and his brother visited every year on his birthday. His sister Ethel Berg died on her 87th birthday the next year and it was discovered that Ethel had taken the urn from the grave and went to Israel. There she asked a Rabbi to bury him, but he refused because cremation was not accepted, so she asked where he would bury someone if he could and he pointed to Mount Scopus. His brother Sam asked the same Rabbi and he would not tell him the location. His brother Sam died in 1990 at age 92 without ever finding the grave. The location, like the mystery man himself is unknown.
Craig Arko reacted to mikelink45 for a blog entry, The long journey of Black Players into MLB
I am always interested in the back stories – some of which are not typical baseball anecdotes. Each year now we celebrate #42 – in fact most of you reading this have already identified Jackie Robinson from his number and we can look at his Hall of Fame plaque and celebrate his strength of character as well as his baseball prowess. And there is no doubt his ten-year career is Hall Worthy. He averaged 6.1 WAR with a peak of 9.7 despite the hate and abuse he endured daily. His career average was .311 and he had just under 20 stolen bases per year at a time when his baserunning forced a change in the opposing teams fielding and pitching strategies. He had a career OPS+ of 132. Late summer saw pitcher Dan Bankhead join Jackie on the team.
Of course, he was not the first black player in the majors – that would be Moses Fleetwood Walker of the Toledo Blue Stockings, however, because of the racism of the game’s biggest star – Cap Anson – he was forced not to play against the Chicago team and it established a racist code that would not be broken until Robinson over a half century later. Yes, I do resent Anson and I admit that he was not the only racist, but no one else had his leverage or sought to use it like he did.
Mid-season of 1947 the American League brought in it’s first black player – Larry Doby with the Cleveland Indians. He had played for the Newark Eagles in the Negro League and like Jackie, served in the war before breaking in to MLB. In his second season with Cleveland he was joined by the already ancient – Satchell Paige – and they won the world series. He accumulated 49.6 WAR in 12 ½ years with a 286 BA and 135 OPS+. He too is in the Hall of Fame.
Less recognized was Hank Thompson and Willard Brown who played for the St Louis Browns in 1947. Coming in two days apart they were the third and fourth African American players to integrate the game. Thompson was a third baseman with seven seasons in the Negro Leagues and was known for his strong arm. He played nine years of MLB before being sold to the Minneapolis Millers. He achieved 24.8 WAR in 8 ½ years batting 267 with a 116 OPS+. When Brown joined him it was the first game with two African Americans starting for one team. “Home Run” Brown had played in the Negro Leagues for 13 years before coming to MLB and he opened his career with an inside the park home run, but racism drove him from the game and back to the Negro Leagues.
1948 saw the Dodgers add another Hall of Famer – Roy Campanella and Cleveland add Hall of Famer Satchel Paige. Campanella suffered a terrible car accident and paralysis to end his career. The Catcher had 34.1 WAR for 10 years, batted 276, averaged 24 homeruns and had 123 OPS+. How does his stats match up with Mauer before his concussion? Roy had three MVPs.
Entering 1949 only three teams had added black players and only one team – The New York Giants with a very old Monte Irvin would add to the ranks. Irvin had only 7 1/2 years left on his Hall of Fame career, but he made the most of them with 21.3 WAR, 293 BA, and 125 OPS+. The other teams that had black players added to their rosters too. Minnie Minoso joined the Cleveland Indians and should be in the Hall of Fame. He had 50.3 WAR, nine times an all-star, a 298 average and OPS+ of 130. Luke Easter was 33 and played only three full seasons out of six that he appeared in with 9.3 WAR, 274BA and 125 OPS+ . The Dodgers added too – Don Newcombe. Newcombe would go 149 – 90, 3.56 ERA with 38 WAR in 10 years with a two year military service breaking up the consecutive years of playing.
Going in to the 1950’s the braves added Sam Jethroe in centerfield. He would achieve 8.7 WAR in three years and was 33 when he debuted. In 1951 the league had its biggest surge in black players. The Braves added Luis Marquez, the Giants Ray Noble and Artie Wilson, and a guy named Willie Mays! I do not need to give Mays stats to remind you of his status. The White Sox joined the list of teams with two signings in 1951 – Sam Hairston and Bob Boyd, while the Indians continued to add with pitcher Sam Jones (102- 101).
Entering the 1952 season there were 16 teams and only six had African-American players. In 1953 Philadelphia (Now Oakland) A’’s added Bob Trice and the Cubs hit the jackpot with Ernie Banks! This meant half the teams now had crossed the colored barrier.
1954 saw that jump to ¾ when Curt Roberts signed with the Pirates, Tom Alston with the Cardinals, Nino Escalero and Chuck Harmon joined the Reds and Carlos Paula signed with our predecessors – the Senators.
The Yankees finally moved in 1955 with Elston Howard, a terrific catcher, who might have been a HOF except for having to share a position with Yogi Berra. John Kennedy signed with the Phillies in 1957 leaving just two teams without African American representation.
Detroit with the largest African American population of any city in the US was next to move and signed Ozzie Virgil, Sr in 1958! It took the team 11 years to get the courage or rather to overcome their biases.
And this left Boston. It was 1959 when the last team broke the color barrier and signed Elijah "Pumpsie" Green. Green pinch-ran for Vic Wertz in a 2-1 loss to the Chicago White Sox. Later in 1959 Earl Wilson became the first black pitcher to play for the Boston Red Sox.
According to baseball historians the Red Sox held a try out for Jackie Robinson in 1945 but decided not to sign him. They could have been first but ended up last and certainly lost out on a lot more. Jackie led the Dodgers to six pennants and one World Series victory in his 10 seasons in Brooklyn. We know how long it took the Red Sox to get their series title.
As bad as that miss was, two years later, the Red Sox had a chance to sign Willie Mays, but passed again.
Pumpsie Green retired in 1963 after five seasons in the big leagues, four in Boston and one as a sub for the New York Mets. He hit .246 added 2.9 War, 721 OPS.
Think of what this initial class meant to baseball – Hall of Famers: Jackie Robinson, Larry Doby, Satchel Paige, Roy Campanella, Ernie Banks, Monte Irvin, and Willie Mays. Add to that list Hank Aaron who also debuted in the Negro League before signing with the Braves. Plus all-stars – Elston Howard and Minnie Minoso. Considering the time from Fleetwood Walker to Jackie Robinson it is acceptable to look at the baseball records with some question marks.
Craig Arko reacted to SD Buhr for a blog entry, Thank You, Betsy
If you're a Minnesota Twins fan, you're probably already well aware of the allegations that independent photographer Betsy Bissen went public via Twitter a couple days ago with her #MeToo experience involving Twins star Miguel Sano. I won't go into all the details but you can easily find them with a quick browser search.
(This article was originally posted at Knuckleballsblog.com)
In a nutshell, Betsy's account is that, following an autograph session at a memorabilia store in 2015, Sano forcibly attempted to pull her into a restroom. The struggle, from which she ultimately extricated herself, lasted several terrifying minutes.
Over the past few weeks and months, we've seen victim after victim of male abuse of power/position come to light, most predominantly in the Hollywood, political and corporate environments. However, to my limited knowledge, this is perhaps the first allegation against a major league professional athlete, at least since the #MeToo movement came to prominence.
Given the historically misogynistic world of professional sports, the only surprising thing is that it took this long for experiences such as Betsy's to become public. Her allegation may or may not have been the first involving a MLB, NFL, NBA, NHL player, but I think we can be pretty certain it won't be the last.
MLB is beginning an investigation into the allegations regarding Sano, as is their responsibility and duty, apparently, under the current Collective Bargaining Agreement with the MLB Players Association. It is proper, I know, for those who know neither Sano nor Bissen personally, to decide they want to hold off on judgement until MLB does it's investigation thing.
Most of us who know Betsy at all (I consider myself her friend, though we are not what either of us, I'm sure, would consider to be close friends) are not generally feeling compelled to wait out an investigation before expressing our unequivocal support for her.
In fact, since she went public, she has received what would at least be considered public corroborative support from various parties who have, in the past, been at least somewhat familiar with Mr. Sano's treatment of women in manners not inconsistent with what Betsy described.
One person, Mike Holmdahl, recounted via Twitter that he had observed Sano making a female usher in Chattanooga uncomfortable during Sano's playing days with the Lookouts earlier in the same season that the event involving Bissen took place. That person was told by a senior usher there that they were so aware of Sano's activities with regard to female ushers that they had made an effort to avoid posting females near the home dugout. (You can find Holmdahl's full recounting as part of Brandon Warne's excellent piece at Zone Coverage.)
Jeff Passan of Yahoo Sports wrote that he had been told by, "five people, including teammates, ex-teammates and confidants, with whom he has spent time," that they characterized Sano as someone who, "saw the pursuit of women as sport," One of them called Sano "a ticking time bomb."
Jeff Goldklang, a member of the ownership group that currently owns the St. Paul Saints (for whom Bissen does some photography work) and previously owned the Twins' class high-A Ft. Myers Miracle related via Twitter that, "I've seen enough of both people to have absolutely no doubts in this story's veracity. I've personally seen Sano act inappropriately towards a woman- while in uniform, no less."
In fact, given these statements of at least partial corroboration, it does lead one to wonder what the Twins' front office knew about Sano's issues with women and when they knew it. But that's a question for another day and, if the MLB and the media do their jobs, we'll possibly get some answers some day.
All of this is just by way of saying that it would appear that Betsy Bissen is worthy of the support that her friends and many others are giving her.
But I'm not writing this to say I support her. She deserves more than that.
I'm writing to say, "Thank you," to Betsy for having the courage to speak out, knowing that the result would not be 100% supportive - that there would be a significant - and very vocal - segment of the population of Twins Territory who would demonize her for speaking out (conveniently hiding behind anonymous social media pseudonyms in most cases, of course}.
I will admit that Betsy's public allegations made me uncomfortable, just as the whole #MeToo movement has made me uncomfortable. But you know what? It's SUPPOSED to make me uncomfortable.
It's supposed to make me take stock of my own views and treatment of women - past, present and, in particular, future. And it has done just that.
I'm a 61 year old man. And while I certainly have never behaved toward any woman the way that Betsy related that Sano behaved toward her, I'm absolutely certain my words and actions toward women at various points in my life would not stand up to the spotlight that #MeToo is shining on us today.
I'm not naive enough to think #MeToo and people like Betsy Bissen are going to quickly and dramatically change the way we view and treat women in our society, especially, perhaps, in an era where our country has elected an openly misogynist President, sending a signal to a considerable segment of our population that it's OK to behave similarly toward our wives, girlfriends, sisters, daughters and granddaughters.
In fact, I doubt we'll see the kind of change that is needed take hold fully during my lifetime.
But, thanks to people like Betsy and others possessing similar courage, I have hope that my two grandsons (ages 2 and 4) will grow up in a world where they don't even question whether it's appropriate to treat girls and women with respect and, frankly, just common decency.
More importantly yet, I have hope that my not-quite-yet born granddaughter will grow up in such a world.
I have hope that she will grow up knowing that, if she aspires to be a sports photographer (or an actress or a political aide or a corporate executive), she shouldn't have to accept that being subject to what Betsy Bissen went through (or much worse) is considered just the price of admission into her chosen profession or avocation.
So, on behalf of my granddaughter and myself, let me just say it.
Thank you, Betsy.
Craig Arko reacted to Brandon Warne for a blog entry, WARNE: Twins Unequivocally Did the Right Thing at the Trade Deadline
It’s not often that I allow someone in my mentions to get me so wound up that I devote an entire, stand-alone article to a single person, but here we are.
The tweet in question — feel free to click and read the mind-bending thread in all its glory — appears as follows:
NOTE: This person has since blocked me for reasons that don’t entirely make sense. He has also deleted the tweets, so I have saved this screenshot to remember his weird rant, which also included alluding to the Twins not going after Shohei Otani because of how poorly ByungHo Park and Tsuyoshi Nishioka panned out. Bad takes all around!
It’s not often that baseball provides irrefutable evidence in a discussion. Nobody can rationally debate that the Houston Astros won the World Series or who won the Gold Glove awards which were handed out on Tuesday night. Those are set in stone.
But in debates, there can always be varying levels of certainty, different angles being pursued by those involved and a number of other situations at play. In this case, the general debate is that the Twins front office messed up at the trade deadline.
And quite frankly, there is no evidence to back that up.
The back story to the debate centers around the Twins having the second-most available in their July 2 pool to sign international free agents. This looms especially large this offseason with Japanese phenom Shohei Otani petitioning to come over.
Part of the reason the Twins have that much money is that they received some back from the Washington Nationals in the Brandon Kintzler trade.
This is where that debate begins, as the party in question says the Twins “had no business trading legitimate major-league pitching at the deadline last year.”
The simplest — and possibly laziest — form of logical fallacy is revisionism. In other words, looking at a situation and how it plays out, then saying “Well I wouldn’t have done THAT” without offering anything in the way of a solution.
Even that isn’t in Mr. Papas’ favor. Why?
Please click through to Zone Coverage here to read this story in its entirety.
Craig Arko reacted to stringer bell for a blog entry, Thoughts on Brian Dozier
Let me preface what will undoubtedly be a long entry by saying I am a Dozier fan. I have spoken to him at Spring Training a couple of times and like the young man. I believe he has been the Twins MVP for each of the last four seasons (counting this one) and I have no doubt that he is the team's best player at this point. Certainly, he isn't flawless, but the Twins need more players like Brian Dozier, not less.
Over the course of this long, horrible season, Brian Dozier has often been a hot topic of conversation in Twins Territory. He isn't shy about stepping up to a microphone, my wife and daughters think he's good-looking and he's been a regular with the club as their second baseman for four years. If someone casually follows the Twins, they know who Dozier is, so it figures that he would be a topic of conversation.
Let's see why Dozier has been discussed so much and what I think should be the conclusion for the topic: First of all, as the Twins started the season, Dozier couldn't get it going. After a bad second half in 2015, Dozier came out of the gate slow in 2016. Through all of April and May, Dozier barely reached .200 and the signature power was lacking. Had the league figured him out? Was the 28 year old (turned 29 in mid-May) regressing already? Should he be benched or put at the bottom of the order? My thought, then and now, was that it is a long season. If a guy is a good player, he'll come out of a funk. Robbie Cano had a similar stretch at the end of 2014 and beginning of 2015 and Cano might be a Hall-of-Famer. Along for the ride early in the season was the question whether BD was too pull-happy and if he used the whole field, he would be a more consistent and productive hitter. My thought was that Dozier needed to be able to hit the ball with authority when he was pitched away and as the season has progressed, he has accumulated some oppo hits and several to the middle of the field, the key being that he hit the ball hard, not a lazy popup or routine fly ball.
Moving on, Dozier has spent most of the season hitting #1 or #2. Many have thought it wasn't ideal for a guy whose calling card is big power for his position to hit first or second. My thought then was that the Twins simply didn't have a better option. Dozier takes some of the longest at-bats on the team, he's walked a fair amount since arriving in the majors and he's a good base runner who doesn't clog the bases for those behind him. Ideally, he should have hit lower in the order to make a few more of his homers multi-run shots and I think that where Dozier hits in the lineup in 2017 will be a hot controversial topic if he is in a Twins' uniform next year.
As the season rolled toward the All-Star break, the call to sell and rebuild the Twins included Dozier's name prominently. He had some value and the club is/was going nowhere in '16, so cashier him for a prospect or two and let Jorge Polanco handle second base. In June and July, Dozier recovered from his slow start. He put up a great line in June, posting an OPS for the month in excess of 1.000, he slowed in July, hitting only .240 but still putting up an OPS of .824. Trade Dozier at the deadline? Didn't happen and IMHO shouldn't have happened. He hasn't slowed down much since his monster June and with a team-friendly contract and relative youth, his value should only be higher in the off-season or at next year's trade deadline.
Another topic that has emerged is defense. After a truly stout year in 2013, Dozier's defense has been categorized as below average by most metrics. While I don't believe Dozier is elite defensively, my eyes tell me he is in the average range. He makes a few outstanding plays (probably more than any other Twins player) and doesn't get to some balls he should, perhaps because of shifting, maybe because the position of shortstop has been in flux since he became a second baseman, maybe because in three of the last four years, the team never had a shot at contention. I don't know. In checking BB Ref, Dozier lags in zone rating, but is above average in runs saved. I see it as a wash, making Dozier average in the field. I'm waiting for someone to refute this, but in the final analysis, defense probably is an "eyes of the beholder" topic.
Since the All-Star break, Brian Dozier has been en fuego. He's hitting .320, with an OPS of 1.091 and a mlb-leading 21 homers. I guess that puts to rest the "first half player" meme that was circulating among the diehard fans remaining. The question that stems from his performance both the cold April and May and his elite performance since is what to expect going forward. I have turned over in my mind what the most likely trajectory of Dozier's career figures to be. One extreme is Dan Uggla, who like Dozier wasn't highly regarded, got a chance in his mid-twenties and became a star in large part because of his power numbers. Uggla fell off a cliff in his early thirties. An opposing example is Jeff Kent. Kent was an okay player, but not even a full-time regular until he was 29. Starting from age 30, Kent won an MVP, was an All-Star five times with three different teams and posted OPS+ numbers over 119 every year until he was 39. This seems to be the extremes for power-hitting second basemen. Is Dozier going to be productive for most of another decade or is regression going to meet him around his 30th birthday? My answer is that no one knows for sure. It appears to me that Dozier has made adjustments to become a more complete hitter without diminishing his best asset--home run power. IMHO, it makes him a candidate to sustain high-end performance, although the end of 2015 and April-May of this year give a good argument that he could turn into a pumpkin at any time.
In the last few weeks as the tumult in my life has moved Twins baseball on the back burner, I've managed to check the box scores, cluck over the disastrous pitching and watch highlights of games. Dozier has been front and center continuing his power surge. He now projects to exceed 40 homers and if he hits just one more long ball, he will have hit more in a single season than any Twin since Harmon in 1970. 40 homers would be a Top Ten season in franchise history dating back to the Senators who started playing at the turn of the 20th century. Only Harmon and Roy Sievers (once) have ever hit 40 homers in a single season in franchise history. Dozier is projected to score and drive in over 100 runs, also a rare feat, especially for guy who has hit first or second most of the season. He may or may not make 40 homers, 100 RBI or 100 runs, but on such a bad team those numbers stand out big and bold. Although I'm not a big fan of WAR, it does represent a quick and dirty assessment of value and Dozier's 5.6 WAR for this season is in the Top Ten in the league. Because the season has been so bad, I don't think Dozier has gotten the attention he deserves for his huge season. He won't win a Silver Slugger or MVP, he won't win the HR championship or set any other records, so there hasn't been any national coverage, but his overall season and particularly his production since June has been off the charts.
Now in the season's final month, most Twins fans are thinking about the future (with good reason). Augmenting a terrible rotation is Priority One and trading Brian Dozier to get pitching help makes sense, since his value should be at an all-time high. This argument is buttressed by the play of Polanco, who has hit over .300, showing good on-base skills, but a questionable glove at short or third. I believe Jorge Polanco is best suited to second base and I believe adding him for Dozier wouldn't be all bad since Polanco is a switch hitter and wouldn't be prone to long slumps with his swing and approach. However, unless the payoff is monumental, Brian Dozier should be the Twins second baseman next year. He has had a season for the ages despite the wreckage around him, he's only 29 and if the last 100 days are an indication, he might get even better. Finally, he's been a solid citizen off the field. If the club wants somebody as the face of the franchise, they could do worse than Mr. Dozier.
Just a couple more thoughts before I summarize--Dozier has been durable. Since becoming the team's second baseman, he hasn't been disabled and has missed only a handful of games with injuries. Secondly, my observation is that he is a good teammate. He doesn't sulk, cheers for his mates, appears to like their company off the field (loved the State Fair video) and despite having strong religious views, doesn't put that in the face of his teammates or the media.
I have mentioned many of these thoughts in previous threads on the forums of Twins Daily. I find this player to be fascinating, especially in light of his minor league career and low status when drafted. I think Brian Dozier is a fine player who hasn't gotten the appreciation he deserves for this, his best season. I will continue to be a Dozier fan, hopefully as he continues to be a Minnesota Twin, but even if he's traded. In the event that he is traded, I will be pulling for the players acquired in return and hope they make the Twins better.
Craig Arko reacted to Squirrel for a blog entry, Posting styles discussing our frustrations about the Twins
In light of some posting styles we have been seeing lately on TD, I thought I'd do some venting of my own ... in a blog. The thread that broke this camel's back was this thread, 'It is time to end the insanity.' I've been meaning to address this for a while now, and have here and there in threads when posts become nothing more than venting general frustrations rather than addressing the topic at hand; and redundant threads get started on this same topic of frustration that seem more like rants than opening a new thread to discuss the latest news. Okay, okay ... the general topic of 'This is what's wrong with the Twins' is a topic of discussion ... but we've seen this in several threads already. Obviously there are new salient points that must be addressed, but it is this 'venting' and 'ranting' that becomes a detriment to my and others' enjoyment and participation in the forums.
I've always thought the purpose of the forums on TD is for discussion, critical discussion. Yes, with disagreements and passion, but, nonetheless, critical discussion, with maybe a little humor and/or snark mixed in from time to time, no matter what side you fall on with any given issue. Posters have always been encouraged to start threads to discuss a particular topic, or general topic, or a news item you saw, or a blog you read, or a question you have, or a move that was made/not made, management issues, player issues etc. And yes, those discussions will get emotional and passionate as we all have a vested interest in the outcome of the Twins, and have our own opinions on what should/should not be, and often disagree on the best way forward. And sometimes threads do get a bit meandering and off topic despite our best efforts to try and keep them within loose boundaries. But this recent posting style, such as the OP, in my opinion, really needs to be directed towards the Blogs area on this site. These threads, such as the one I made example of, serve no purpose other than to regurgitate a list of generalized complaints and are not focussed points of discussion and only invite generalized regurgitating of someone else's complaints. The title of this thread 'End the insanity' in and of itself just opens the floor to everyone's complaints and soon we have a morass of unpleasant vomiting to wade through. Yes, we're frustrated and I'm not trying to take that away from anyone, not in the least, because well, it IS frustrating, to no end, at least for me. And I guess we each have our own way of dealing, but the Blogs are there for you to let it all out. You want to vent? Start a blog and vent away. You want to have a legitimate, critical discussion, stick to the forums and structure a thread that leads to that; a post or a thread that has been thought out and isn't some generalized rant that has no real basis in reality other than it's some emotional response, not a genuine reading of facts, to what you think should have happened. Don't just vomit up all your frustration for the rest of us to wade through; that's just lazy. Those are the types of threads and posts that keep me from the forums, not the stances people may take on the Twins in general or specifically. If you don't like a topic, you are free to not read it. If you don't like a particular poster, put them on ignore or skip over their posts. So I find myself more and more throwing my hands up and 'walking away' because threads just become unreadable the more this style continues.
(Edit: I want to add that the thread I used as an example has generated a pretty fair and decent discussion. Many threads and posts of this 'listing of wrongs venting' have not. I'm in no way suggesting we can't be critical of the team and its management ... I mean, come on, look at the team ... I'm suggesting that don't just start a thread or make a post listing all that bothers you. Try to frame things so we can have legitimate discussions without being critical of fellow posters who might have a differing point of view, otherwise, try starting a blog. If you have to end a post or a thread start with '/end rant,' which this one did not, it probably would be better suited for a blog. They are very useful for 'getting it out' of your system. But given the OP of that thread, it was very easy for all of us to think to ourselves, 'Oy, this again?' and either walk away or get defensive or pile on. The following paragraph stands ... for all and everything. Stop the divisive language!)
Another issue I want to address: this generalized characterization of posters some of you think necessary to throw into their posts. This 'The Twins can do no wrong crowd' or the 'Twins can do no right crowd' is hugely disrespectful and dismissive, and from this moderator, will not be tolerated. If you want to divide and pick sides, fine, go play a game of dodge ball, your posts will be removed. Lumping posters into such 'all or nothing' categories because they choose to disagree with a point here and there needs to stop. I try to stay fairly objective, as objective as I can in my own like/dislike of certain topics, in my reading here, despite my own frustrations with the team, but there really are only two or three posters that fall into those mentioned categories on each end of this spectrum. The large majority of posters fall everywhere in between. Yes, some have definite leanings, but I have seen very, very few posters who have blindly taken these all or nothing stances on everything Twins. If all you want to do is read posts only in agreement with you, then you are in the wrong place. It is nothing but smug self-righteousness to declare yourself so right and others wrong and then to label others in such a dismissive way. It's the same with the negative/positive crowd. This is nothing but from your perspective, and your perspective is NOT the end all to defining anyone else. Say your piece. Have at it. And if others disagree, so be it. Have a debate, be open-minded to another's views and why they take them, give them the benefit of the doubt, ask for explanations, and disagree if you just disagree, but don't be dismissive about it by saying 'You're just part of that crowd.' If one poster likes a move and another doesn't, they are not in any of the above-mentioned crowds, they just differ in opinions. And if a poster wants to point out a silver lining or a black cloud, so what? It's their opinion and no one is right or wrong here. I'm not sure why that is so difficult to understand. Does it bruise egos when someone doesn't like your point, or picks it apart with their own interpretation of the facts, or their own use (right or wrong) of various metrics, stats, other numbers? Get over it. Don't double down and hunker down so hard you develop tunnel vision, and resort to the "Oh, you just hate so and so" or "Oh, you just love so and so" as an argument. It's unproductive, lazy and weak. And it gets old, and frankly, loses credibility for the poster who uses that as an argument. And maybe, just maybe, we don't need to fight to the end. When it gets to the point of labeling posters, I think it's time to agree to disagree and just let it go.
Okay ... I've run out of steam. Whew! That was so cathartic!!! You should give it a try.
See what I did there? Here's how I got started and so can you. There are all sorts of things to click on to help you find your way through the blogs. There's even a tutorial ... which I didn't click, because I didn't need to. So ... have at it.
1. On the red menu strip across the top, click on the word “Blogs”
2. Click on the black rectangle that says ‘Create a Blog’
3. Read the terms and rules, then check the box that says you have read and understood the terms, then click ‘Continue—>’
4. Fill in the blanks with the Blog name, Blog description, choose blog type, then click continue.
Example: Blog Name: ChiTown’s Fun Takes
Blog Description: All that frustrates me about the Twins
Blog Type: Local Blog
5. Choose your settings
At that point you can choose ‘Options’ and then ‘Add new entry’ and go to town. Or leave, collect your thoughts, come back and choose ‘Blogs’ from the red menu strip across the top, click ‘Add Entry’ and go to town.
Craig Arko reacted to ashbury for a blog entry, An Unexpected Night At Fenway
My wife phoned to say someone at work was looking to sell a couple of bleacher tickets at Fenway. So, mere hours later (well, 30 is "mere", no?), I was on the Worcester commuter train, getting off at Yawkey Station.
Fun game versus the Marlins. Tied 1-1 for a long while, then the Sox starter Miley tired at around the 100-pitch mark and the score became 3-1 at the seventh inning stretch. But the home team came right back and loaded the bases against Cishek in relief of Haren, with a single, walk, and infield error, and (after LOOGY Dunn got what seemed a key strikeout) with two outs Xander Bogaerts fouled off several pitches from Carter "Not Matt" Capps before coming through with a single on a full count that cleared the bases for the 4-3 lead that turned out to be the final score. The eighth inning stretch (Sweet Caroline) is always fun, and with the Sox in the lead the mood was bubbly.
Sandoval facing Haren:
Kazoo, the Fenway fan:
Mary and me: