April 27, 2011

Collateral Damage

Where No Man Has Gone Before

by Corey Dawkins and Marc Normandin

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Erick Almonte, MIL (Concussion)
Almonte may never end up in the Hall of Fame, but he will go into the record books as the first major leaguer placed on the 7-day disabled list for a concussion. Normally we see concussions occurring during game conditions, but Almonte suffered his after a ball thrown in batting practice hit him in the forehead.

During our special on concussions, we discussed how the 7-day disabled list functions more as a roster insurance tool for teams than a way to ensure that players return safely, although it does make it easier for clubs to do the right thing. Return-to-play guidelines have been in effect for some time now, so the creation of a shorter DL stint merely gives team a littles extra flexibility in dealing with those pesky injuries that fall between "day-to-day" and "15-day."

Almonte will have to take the computerized tests prior to returning to competition and have them compared to his baseline results. There have been discussions recently of some NFL players purposely doing poorly on the baseline tests so as to return earlier in case of a future concussion, but it's much more difficult to purposely tank a test with the ImPACT system.

The ImPACT test recently initiated a metric called the cognitive efficiency index, which measures the interaction between accuracy and speed of choices in one of the tests. This metric, while not to be used in return-to-play decisions, does measure how hard the athlete tried to work fast and get the answers correct, which gives evaluators another piece of the puzzle when considering whether to permit the athlete to return to full contact activities.

The Brewers have provided no update about how long they actually expect Almonte to be out. Once his symptoms clear, we will have a much better understanding, but at least now you know how well he can be expected to do once he is ready to return.

Jason Michaels, HOU (Partially dislocated left shoulder)
Michaels suffered a partially dislocated left shoulder after diving for a ball on Sunday and was placed on the 15-day disabled list on Tuesday. With any instability of the shoulder there is risk of damage to other structures, including ligaments and the labrum. The players with shoulder subluxations listed in our database (excluding pitchers) have all returned fairly quickly (usually within a month), assuming no rotator cuff or major labrum tears. No definitive timetable has been set forth for Michaels, but he should be back close to that month mark, if not sooner.

Albert Pujols, SLN (Left hamstring strain)
Just because your nickname is "The Machine" doesn't mean that you're invincible—after all, Sarah Connor helped to take out a few Terminators in her day—and Pujols suffered another nuisance injury on Sunday, straining his left hamstring in wet and slippery conditions.

The Cardinals are calling it a mild case for now. Pujols says that he could have pinch-hit on Tuesday, but the athletic trainers felt that he was still limited in some ways and required more rest. Hamstrings are not only important for running; as a right-handed first basemen, his left hamstring will be stretched every time he has to reach for a throw while covering first base. The medical staff takes all of this into consideration—not just how Pujols says he is feeling. He seems to feel that he will be fully ready today, but this is truly a day-to-day case.

Phil Hughes, NYA (Right shoulder inflammation/fatigue)
Hughes underwent enough tests on Tuesday to inflate insurance premiums across America. Hughes had two MRIs and a vascular exam to rule out any sort of blood clot that could be causing his dead arm sensation, but the results of the tests will not be fully known until later today.

Making matters all the more frustrating is the fact that the Yankees felt Hughes was beginning to improve late last week. Unfortunately, he was able to throw only about 20 pitches before he started to experience the dead arm feeling again during a side session on Monday. We should hear the results of his extensive testing today, and at that time we may be able to provide a more accurate prognosis.

The Yankees will need Hughes back completely healthy if they want him to succeed, as he struggled with reduced velocity over his first three starts. Hughes lasted just 10 1/3 innings in total, giving up 16 runs and fooling absolutely no one with his pitches. He had three punchouts and just seven swings-and-misses in his 207 pitches (3.3 percent), while averaging under 90 mph on his fastball, compared to the 92.5 mark he posted in 2010.

Velocity isn't the only thing that helps a pitcher succeed, but the dead arm clearly kept Hughes from bringing anything effective to the mound—the longest he lasted in a start was 4 1/3 innings, immediately before hitting the DL as we feared he would eventually. When he does return,  keep an eye on his velocity just to make sure he's the Hughes of old.

Flesh Wounds: Willie Bloomquist was placed on the 15-day disabled list with a strained right hamstring... Jose Contreras suffered only a mild right flexor pronator strain near his elbow and will likely be sidelined for three to four weeks... Corey Hart was activated from the disabled list on Tuesday after dealing with a strained oblique since spring training, but he was not in the startling lineup, as the Brewers clearly wanted to savor what might have been one of their last chances to see Mark Kotsay starting in right field.

PITCHf/x data courtesy of Texas Leaguers.

Corey Dawkins is an author of Baseball Prospectus. Follow @CoreyDawkinsBP
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