Effectively Wild: A FanGraphs Baseball Podcast - Effectively Wild Episode 749: Stan Conte on Injury Unknowns and Brett Anderson’s 180

Episode Date: October 22, 2015

Ben and Sam talk to recently resigned Dodgers VP of Medical Services and Head Athletic Trainer Stan Conte about hidden injuries, fighting fatigue, and Brett Anderson’s almost-miraculous season....

Transcript
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Starting point is 00:00:00 They're the unattached All their plans remain unhatched They're just like you But with nothing to do They think I'm one of them But they don't know I'll send A counter book at all When they come now I'll send A dance of what girls are High fives on everyone
Starting point is 00:00:31 Good morning and welcome to episode 749 of Effectively Wild, the daily podcast from Baseball Perspectives presented by the Play Index at baseballreference.com. I'm Ben Lindberg of Grantland, joined as always by Sam Miller of Baseball Prospectus, and we have a guest today. So this is a Dodgers-related podcast, and it's been a rough week for the Dodgers. Last Thursday, of course, they were eliminated from the playoffs, and on Friday, John Heyman reported that Zach Greinke would be opting out of his contract, which was not a surprise, but maybe not the thing that Dodgers fans wanted to read the day after they were eliminated from the playoffs. And the day after that report, we saw another report that Stan Conte,
Starting point is 00:01:18 the team's longtime vice president of medical services and head trainer, had announced his resignation. And we had Stan on last year, last May, to talk about his research into injuries and how teams study injury risk. And we wanted to talk to him again. Now that he's a free man or an unattached man, we wanted to have him back to ask about some more recent developments. So, hey, Stan, thanks for coming back.
Starting point is 00:01:46 Yeah, I think I like the word unattached as opposed to unemployed. So that's nice. Well, it was by choice. So what was your reason for resigning now? Well, I think, you know, being the head trainer in a professional baseball team takes a huge amount of time. I don't know that a lot of the fans know what athletic trainers have to do during the baseball team. It takes a huge amount of time. I don't know that a lot of the fans know what athletic trainers have to do during the baseball season.
Starting point is 00:02:09 It's about 69 hours a day, seven days a week. It really starts in February and goes every day. So-called off days are typically not off days for the medical staff and then go hopefully through late October and then the next day start the off season which is a lot more involved than it used to be so I've been doing that for a while and I wanted to do the research uh into in baseball injuries and kind of get a better handle on those things and it just got to be a point where um unless someone was going to make a 27 hour day I just wasn't going to be able to do all the things that I wanted to.
Starting point is 00:02:47 So at some point, you just have to say, what is it that I want to concentrate on? And the research is what came through. So that was the main reason that I left, in order to really get a little deeper and spend more time on looking at these baseball injuries, which just continue to pile up. Yeah, it seems like there's always a clash between whether you can get more done inside of an organization or inside of an industry or somewhat removed from it. Do you anticipate any disadvantages to not being attached to a team and not having the access?
Starting point is 00:03:24 Yeah, that is a really good question. I think part of the reason that I haven't done this sooner is that you do have access to a lot of information, and I worked a lot with Major League Baseball in regards to research committees and those types of things, and the access to certain data you can't get when you're not associated with a team. So that sort of kept me around for a few more years, but I probably am still going to be
Starting point is 00:03:52 working with a lot of the research committees in Major League Baseball and will have some access to that information. But sometimes it's just a matter of spending the time crunching the data that you do have and looking at things. And thanks to people like yourselves and Baseball Perspectives and other websites, it's amazing the amount of data you can accumulate just on public sites in baseball. It's really a mountain of information. So there is some issues in regards to access to certain data, but I felt like this was a good time to do it.
Starting point is 00:04:25 Is there a flip side of that where there's some kind of conflict if you're someone who's just doing research and trying to bring all this to light and trying to prevent injuries for all players, and yet you're working for a team that derives some advantage from knowing more than everyone else knows? So was there a kind of conflict that you wanted to free yourself of, or was that not really a problem? Well, it wasn't really a problem. You know, if you work for the organization, and if you have the information, you share it with the organization, obviously, in order to do your job. I mean, my search for answers in regards to the injuries on research was really to be able to do medical risk assessments on each player.
Starting point is 00:05:08 In other words, give that idea at that particular point in time what we thought the probability was of a player going forward and staying healthy for a year. And that came hand in glove with my job. We still published several articles. In fact, we've had three articles published this year on different subjects, Tommy John specifically. So we're able to actually take those things out. I think you see that it's not really too much of a conflict. If you do get the secret plans,
Starting point is 00:05:41 you have to keep them to yourself and keep them to the organization. But it's not a big issue. No one within the Dodgers ever really restricted me from giving out information other than stuff that was specific to a player. So when a player leaves a team or an executive leaves a team, everyone reviews their time with the team and cites their stats and their best trades and their best signings. So what would the version of that be for you if you had to talk about your highlights with the team, whether it was, you know, keeping a guy on the field or recommending a guy that you thought
Starting point is 00:06:17 would stay on the field or what are the high points? Well, I think, you know, there's a lot of rehabs that we did that we're pretty proud of in regards to getting players back. And I think probably the one that pops up the quickest is Zach Greinke and his fractured collarbone. And his rehab that took about four weeks, that typically takes about eight to ten weeks, and getting him back and having him be able to perform as high level as he did. I think the other one is Clayton Kershaw. Last year, we tore his lat muscle when we went to Australia. That's a typical two and a half, three month injury. We got him back in about five weeks and he had a pretty good year last year, and so he's on the new VP.
Starting point is 00:07:07 So those kinds of ones that are sticking out, you know, those are somewhat what you're measured by. I think at the end of the day, you know, I think people start to look at the disabled list, which I think we should probably talk about at some point, which is really not a really good system to grade medical teams on because there's so many different factors that go into a player being placed on the DL. And there are certain inherent risks that we take with players.
Starting point is 00:07:35 We know those risks going in. And there's a tradeoff in regards to how good the player is on the upside on the baseball side. And so we're in a high-risk states game where you end up doing that. Sometimes it doesn't work out or the probability actually is right and there's more likely a chance that they're going to get hurt than not. So I think some teams are now, and maybe the media too, are looking at disabled list days and number of guys on the DL as an indicator
Starting point is 00:08:07 of whether the medical staff is good or bad. I think that's probably unfair generally, but you have to use something. I tell people, I'll tell you that a manager is retained or fired by wins and loss, yet he only has a small fraction of what actually goes into wins and losses. But he's responsible and accountable so he kind of is the guy that is taking a look at and i think
Starting point is 00:08:31 the medical department is probably in that same type of situation yeah i was going to ask you that because a week or so ago the nationals dismissed their whole training staff had a had an athletic trainer an assistant assistant trainer, and strength and conditioning coach. And obviously they had a disappointing season and injuries were a big part of that. But I was wondering how likely to be scapegoated a medical staff is. I don't know anything about their medical staff specifically, but for instance, when we see a team that doesn't hit and the hitting coach gets fired, we say, well, you know, someone had to go and maybe the hitting coach had something to do with it, but who knows, it could have just been completely out of their control. So does that
Starting point is 00:09:16 happen just as much to medical staffs? I think it's happening more. I don't think it's happened in the past as much, but I do think when people look at things, sometimes they believe that change is something that might improve a specific area, and the personnel that are doing it, I think, are responsible and accountable. kind of the way the world turns in regards to that. And, you know, this kind of gets us back to the absolute importance and maybe the primary importance of baseball right now is the injuries and how it affects everyone. You're seeing managers who couldn't win because they had a high level number of injuries. And they got fired. And so I think it behooves us to be able to sit back and say,
Starting point is 00:10:05 well, what exactly is going on in injuries? Injury is sort of like the weather. Everyone sort of blitzes about it, but there's not much you can do about it. Although if you knew it was going to rain, you might take an umbrella. There might be some protective things that you could do. And I think that part of the research aspect of all this stuff is to try to get a little bit deeper and be a little bit more accurate in the scientific regard of doing the risk assessments and looking at probabilities and building your team based on that, as well as the talent. just one aspect of health. And while we're aware in ways that we weren't 10 or 15 years ago, which teams have had the most disabled list, I don't think we're really anywhere close to having an idea about which teams are most affected by fatigue or by lingering injuries
Starting point is 00:10:57 or the sorts of things that drag a player's batting average from 280 down to 270 in a way that we might just brush off as noise. So this question that I'm going to ask you, I wouldn't, I don't know, I wouldn't ask anybody else because it's probably completely impossible, but I feel like you might actually be plausibly qualified to answer it. Do you have a sense of how many wins, like in your own head, do you have an opinion of how many wins a good training staff is worth compared to maybe an average one. And of those wins, how many would you say are keeping guys off the DL and how many would you say are keeping guys performing at their highest or at least as high as could be expected level throughout a long year?
Starting point is 00:11:39 Sounds like you're trying to develop a war for athletic trainers. Well, I'm wondering what your guess for that war for athletic trainers is. Well, you know, it's hard. That's a really good but hard question to answer in regards to numbers. You know, I would tell you that if you look at some injuries on some teams, the relative war is probably really six to eight games at least. And it depends, of course, where the injuries occur. But as we know, the starting pitchers are probably the most injured players,
Starting point is 00:12:16 which account for a lot of the overall wins and losses of a team starting rotation. And you see those are the guys that typically have a higher reward. So I think that, you know, and I think the reverse is true, too, that you're looking at seven or eight games on the negative column if the team is not healthy. So I think the makeup of the medical team and who's doing it does have an impact on that.
Starting point is 00:12:43 They may have a bigger impact in the off-season and in spring training and being involved in player selection than they are actually in treatments and rehabs. But if you've got a player back, if you look at Clayton Korshaw, he could have a war of 10 or so, and you lose him for two months, you lose all that, those stats and those wins, those two months, and getting him back in two months instead of three months makes a big difference too. Then complicating the issue is what you also alluded to, and that is guys who are hurt and are not performing.
Starting point is 00:13:21 And what you do with those particular guys, do you DL those guys or do you play them in hurt? Is an 80% Justin Turner better than 100% of somebody else? And those are factors that go into it. And if you keep playing him, does the performance go down or is he eventually going to be disabled and smaller than he would have if he would have done that and rested him and done things? I also think that you brought up also with the idea of
Starting point is 00:13:47 in-season management of an injury, and you're talking about Justin Turner, and I'll talk about him again, because Justin Turner played with a bad knee for really the second half of the season at least. How we rested him, when we gave him
Starting point is 00:14:03 rest, Bob Marley and I spent a lot of time together each day deciding where we were going to give him rest to do two things. One, keep his knee from getting worse, and two, to keep his performance up. And so we were able to do that pretty well, knowing what he had wrong with his knee, whether that was going to be something that was going to affect him career-wise and whether we could play through that safely, and getting it through the season. There's a price to pay for that.
Starting point is 00:14:33 Justin Turner is having a knee surgery tomorrow morning. How you manage those things in the season are big, too. I still think the biggest impact probably is still in the offseason when the GM is putting together his team and how he puts his team together from that portfolio of risk in regards to injury.
Starting point is 00:14:53 Did I answer your question? As far as an unanswerable question can be answered, you did very well. Thank you. So at this time of year, we're always kind of trying to puzzle out why certain players are not playing or you know why a certain guy is used as a bullpen instead of the rotation and a lot of the time we find out later that there was some hidden injury that we didn't know about that played into
Starting point is 00:15:20 that decision so at any one time how many guys on a 25-man roster are dealing with something that significantly impairs their performance that we don't know about? Probably half, I would think. And you have to quantify a little bit significantly affected their performance. And also, and this is something that's not talked about, and I don't want to put too much emphasis on it, but there are times when people actually get in slumps, whatever a slump is, the performance goes down, and all of a sudden they remember they have a little sore in somewhere. And so that gives them a way out of their slump or a reason for their slump,
Starting point is 00:16:09 I should say. So there's parts of that. But, you know, guys who are regular players, guys who have, you know, position players who are over 400 plate appearances in a season, starters who have thrown, you know, 20 to 30 starts, starters who have thrown 20 to 30 starts, relievers who have 40, 50, even 60 game appearances. All those guys are dealing with some issue,
Starting point is 00:16:37 and that's why it's a pretty busy place in the training room. Some of it is maintenance stuff and keeping things going. Other things are more serious and need rest or different things to try to get them on the field. And sometimes you'll see a guy take two or three days off. We did that with Justin Turner about a month ago. We had to give him four days off where he just couldn't play a pitch hit or anything to let things settle down and he was able to continue to play. And the estimate that you gave, does that go much higher by this point in the year, or is it pretty much consistent from day one to now that they're in constant
Starting point is 00:17:12 payment disruption? Yeah. Well, you know, again, significance is an issue, but, you know, I would tell you that if you walk through any major league training room in September, let's say August because you don't have the call-ups, almost everybody has something. The question is how significant is it and what they're playing with. The manager and I, Donnie, would sit together at 1 o'clock in the afternoon
Starting point is 00:17:38 and kind of go over the list of who he needs to stay away from, who needs a day, who would come out early if we had a game that was a blowout one way or the other. Who do we rest in that way, too? So these guys are dealing with a lot of things. I mean, you talked about, I think Sam brought up fatigue. And baseball, from a health standpoint, is all about recovery. I mean, 162-day games in 183 days. This isn't football where the collisions and the injuries occur that way.
Starting point is 00:18:08 These are injuries of fatigue, typically in overuse. So these guys have to go through this all the time, one day after another, and things start to break down, so things start to hurt and things get injured. So the fatigability is one of the factors that may be the most difficult to actually evaluate and understand and how you give them recovery enough once they are fatigued. Now, there's a ton of high-tech companies that are coming out trying to measure fatigability, There's a ton of high-tech companies that are coming out trying to measure fatigability. Catapult, some other ones that have worked in European soccer and European football and soccer that are being used in the NBA and different sports.
Starting point is 00:18:56 But baseball is a little bit different when it comes to fatigue. It's not cardiovascular. And, you know, when you look at a pitcher, how do you tell he's fatigued in the seventh inning? Number of pitches or his mechanics change or his velocity goes down. How do you measure that? And that's a real next-generation thing that's going to come is more accurately and objectively measuring fatigue. And then before someone actually gets fatigued, you rest them so you prevent the injuries associated with it.
Starting point is 00:19:31 Yeah. And I know the Dodgers worked with Kittman Labs and there are all these different companies doing various body tracking and wearable technology. Is that at a point where it's producing tangible benefits or is it still sort of at the intriguing technology with a lot of promise but little proof stage? I think it's intriguing. We've worked with a lot of different companies. We've looked at a ton of tech companies that are coming out sort of out of the woodwork right now. that are coming out sort of out of the woodwork right now. And the Dodgers will continue to go really high level in regards to trying to do this.
Starting point is 00:20:17 I would say now it's intriguing, but not a ton of benefits at this point. But I think it will grow exponentially. And within years, we'll be able to really get some real good tracking issues that can look at things and know when to return a guy to play or when to rest him. But we're not there yet. There will probably be people out there that would disagree with that, but from what I've seen, and I've seen quite a bit, it's just not there yet. So it's really in its infancy. So say, hypothetically, you're a head trainer of a team that finds itself up by about eight and a half games in early September. And there's,
Starting point is 00:20:50 you know, no real chance of winning the first seed in the playoffs. So you're basically playing for home field in the division series and not much else. If you went to your team and said, Hey, why don't we just rest all the regulars pretty much constantly for the next three weeks, get everybody healthy, give them about five days at the end of the year to rev back up, but use all of our call-ups to basically play out the rest of the season, not really worried about losing anything? Where do you get the strongest objection within the organization to that idea? Well, I don't know that I agree totally with what you said in regards to resting guys for
Starting point is 00:21:24 multiple days. I think that the balance is keeping players sharp, keeping players going, and resting them at the same time. And you have to kind of define what you mean by rest. Shutting down players and then trying to get them back going is a really difficult thing to do and typically hurts performance. is a really difficult thing to do and typically hurts performance. So the way to rest players as they're going down is to definitely give them days off at certain points, but not continuous. And we have to separate position players from pitchers when we do this too.
Starting point is 00:21:57 So position players, when we're trying to rest guys, we may give them two at-bats. It almost becomes a spring training type thing where you say, you're going to get two at-bats today, and then we're going to take you out so you're not playing nine innings, and you're going to have next Tuesday off. That kind of thing. Now, that's typically the manager doing that with the help of the medical department or guys who may have some minor injuries that they're playing with
Starting point is 00:22:24 and trying to get those better. The pushback typically is, unless you're out of the season altogether, you've been eliminated in September. There's always something to play for. Whole field advantage, even if you don't have whole field advantage, the first round you might get it,
Starting point is 00:22:41 the second round, so all those winning games are important. So it's a real difficult thing to do. It's not a simple formula in regards to doing this. So keeping guys fresh and sharp. Pitchers are even more difficult, especially starting pitchers. Most starting pitchers have a routine. It's a five-day routine.
Starting point is 00:23:04 And if you tell them they're only going to pitch 70 pitches, they don't like that very much. I kind of like it when you're trying to arrest somebody. Or if they want to skip a start. At that time of the season, that really throws them off a lot in regards to their performance. We use this during going down the stretch, we've actually used guys going on a six-day,
Starting point is 00:23:25 not necessarily a six-day rotation, but giving them extra days. But in fact, you have to rest them through the season. If you're at the end and you've got guys that are totally fatigued, a couple days here and there is not going to make a ton of difference. You really need to manage that throughout the whole season.
Starting point is 00:23:41 And you definitely see this with starting pitchers. You can keep them on five days. You can go on four-man rotations with days off. You end up paying for that at the end of the season, from my opinion. But you need to give them those extra days where they go on six days when there's a natural day off and try to move that along the staff so they still are pitching on a regular basis but don't get extended time off and is it something where you just go by feel and you say well this guy looks tired and
Starting point is 00:24:11 maybe he could use a day or is it more quantified like you know when a guy plays x number of games in a row his stats decrease by x percent and therefore, you know, how do you resolve the, how do you tell whether it's better to start your next best guy, even though that hurts you in a way, and, you know, compare that to the benefit you get from your best guy playing at his peak performance when he's in there? Yeah, I think you can quantify it, and, you know, we use a lot of metrics that indicate, especially in pitching, if we see a guy starting to become fatigued. All the different metrics that you look at. Velocity is the easiest one, but typically we see as we're going along objectively that this guy's getting tired.
Starting point is 00:25:14 We also look at previous levels of workload in previous years and how they performed. formed. We talk about Brett Anderson. Brett Anderson threw 180 innings this year, which is pretty good for a starting pitcher in the third, the fourth, or fifth slot in the rotation. But that's more of an innings he's pitched cumulatively in the last three years because of injuries. So where does he start to get fatigued and which ones would you monitor? Now in the minor leagues, we look at that quite a bit and be able to say, this guy, you know, if he threw 75 innings this year, he's not going to throw over 110 or 150 innings next year, no matter what. So we're going to build him up.
Starting point is 00:25:55 We believe, although we haven't been able to statistically show it yet, is that these big jumps, you know, from year to year can be devastating the next year out. In other words, jumping from 100 innings to 180 to 210 may be too abrupt from an overall conditioning standpoint and being able to stay healthy. That's sort of a takeoff on the so-called Vertucci effect, which really statistically wasn't all that good, but had the concept of building innings.
Starting point is 00:26:31 So if all of a sudden a guy is in no man's land in regards to number of innings pitched or number of appearances, then we look really, really closely at that and trying to do that. Now sometimes guys have to pitch because they're healthy and the team is winning and we need to win those games. So it becomes a trade-off of a million decisions every day is what it ends up doing. So we did want to ask you about Anderson and just about the Dodgers, I guess, rotation building strategy in general, because as a lot of people noted coming into this year, Dodgers acquired a bunch of pitchers who had injury track records, and maybe a lot of people
Starting point is 00:27:11 would have been scared off by them. And in some cases that worked out great. In some cases it didn't. But was the genesis of that a belief that you had maybe a better handle on projecting injuries or health than other teams and that there was an advantage there for you? Well, we like to think that we have a better advantage. But what really happens here in regards to medical risk assessment for me is looking at this like stocks and a portfolio. There's really some advantages to having high-risk stocks and if they get high rewards. But it really depends on what kind of portfolio you want.
Starting point is 00:27:54 You want a real high-risk one where you have a lot of high risk or you have a few risks that you're taking that you have ideas of what you're going to do with that player if and when he gets hurt. So there are great comeback stories of players who had devastating injuries who have been out of the game several years and come back, and they've done well. Nobody really talks about the other 25 that did that and didn't come back.
Starting point is 00:28:25 So you have to look at that. Brent Anderson was unique, and I think he's been well talked about, with the number of injuries he had really starting way back in 2011 when he had Tommy John surgery, and a series of injuries that derailed really his career, including a back surgery at the end of 2014. So what most teams do and what we do and what I do is a player will come on the radar from the front office
Starting point is 00:28:54 and they'll say, we're interested in Brett Anderson. And what I do is do a medical risk assessment based on histories, based on using a lot of different metrics of looking at his consistency or lack thereof or where he's going there. Strikeout rates are big. If you have a high strikeout rate and all of a sudden you don't, how does that affect the velocity? Is the velocity caused by the injury or that type of thing?
Starting point is 00:29:19 You also have to know about outcomes of certain injuries. And obviously, Tommy John is the most talked about and the most studied of all the injuries. You have this idea that 67% to 83% of all Tommy Johns come back. This guy is having Tommy John, so he has a pretty good probability to come back. How do they do when they come back? They all pitch pretty decently. At least come back to their level. When they do come back,
Starting point is 00:29:45 they have about a 57% chance of going back on the DL at some point in their career. So you kind of know that going ahead. Brett was interesting because he had a combination of different injuries. And I don't think you really have to be a rocket scientist or a medical expert to look at Brett knowing that coming in 2015, he was a significantly high medical risk. And he had lost velocity and strikeout rate, which, as you just mentioned, in addition to all the lost time. Yeah, he sort of had it all, really.
Starting point is 00:30:22 And as I'm running through the medical risk assessment, I think I can talk about this because I've talked to Brett about it, is that it's one of those that you're doing in the middle of the night because they need it the next morning, and about 2 o'clock in the morning your wife hears you screaming. You go, oh, my God, this guy's going to have no chance. He's going to stay healthy. But in Brett's particular case,
Starting point is 00:30:45 you had to step back from the trees and actually look at the forest and understand each particular tree is that Tommy John surgery he came back from, but then he had two different separate fractures, one in his foot and one in his finger.
Starting point is 00:31:02 And the Oakland A's actually found some issues with his vitamin D deficiencies and fixed that. And so he was having a little problems with that. That got corrected. He had not had a problem with those, but they took a lot of time to heal. And then he came back with Colorado and then he, you know, on one pitch blew out a disc in his low back and had to have surgery. So when we look at each one of these individually and separate them out before you put them all together, you see that each one of these is highly recoverable within themselves
Starting point is 00:31:34 and have a high outcome of success. The Tommy John does. The fractures heal. Either they heal or they didn't heal, and we had his medical records, and we were able to see that they healed fine and everything was good. And then he was in the middle of his rehab on his back surgery. And looking specifically at his back surgery and doing research on back surgeries and baseball players, we knew that he had, for just to throw out a number that happens to be true,
Starting point is 00:32:02 an 89.5% chance of coming back and performing well as a pitcher. Well, so if you step back and look at that, you say, this guy is a high risk cumulatively, but I see a scenario where he stays healthy. And because of each individual taken, and that he's recovered from the previous three, and was recovering from the fourth. So when you looked a little deeper, and when I read my medical risk assessment on him,
Starting point is 00:32:31 I said he's a high risk. But there is a scenario here. There's a nice scenario that says he does have a chance if all these things line up perfectly, and it's not unreasonable to think they can't. things line up perfectly and it's not unreasonable to think they can't. And then the front office takes that and decides where that fits in the puzzle of the 25-man roster and the five-man rotation. And they have to then decide what that risk is worthwhile and whether that particular piece is worth a high risk health-wise but a high reward.
Starting point is 00:33:04 And that one worked out. And so that one sort of fell into place and it was real nice to see Brett be able to do that. So when you guys made that move and some of your other off-season moves for players who had some injury histories, when Ben and I talked about what was guiding these decisions, there were kind of three possibilities. One was that you had a different risk assessment or a better risk assessment than some other teams. One was that you had more tolerance for risk than other teams. And the third was that you had perceived or identified your training staff as being more likely to keep these players healthy, either in the way you use them, the resources you put into your training staff that you had
Starting point is 00:33:42 available to you. Was the third one a factor? Do you feel like, I guess in a bigger question, do you feel like you guys were able to build something in your training staff that was able to set you apart from maybe the median major league team, or are most teams still kind of clustered in a fairly small range on that stuff? That's a real hard question. I think you have to ask our front office in regards to what they thought about the medical staff. I mean, you asked me, I think we have the best medical staff there is in baseball, and
Starting point is 00:34:15 I do think there's a cluster of very good ones. And I think when you start looking at medical staffs that are varied in the professional levels, athletic training, physical therapists, high performance coaches and strength coaches and how they blend together, it is really, really important. I think also looking at medical records in a more objective fashion, understanding the research that's out there, the medical research that's out there, but also understanding the metrics and what all those do in relationship to medicine. When people do fantasy football or baseball, they're looking at all these stats,
Starting point is 00:35:00 and they look at it like, can that guy give me a number of points in my fantasy game? We look at the metrics totally different, and we look at different changes in the metrics that may lead us down the path of a guy with an impending doom injury coming up, or did he recover from that? Where was his numbers two years ago before the injury? Where are they now? Are they going through? So I think all those factors.
Starting point is 00:35:29 And the fourth factor that you didn't mention is mitigating risk. How do you mitigate these risks? Well, that's a lot in the contracts. And really smart DMs and front offices will mitigate that risk and say, listen, you're a higher risk, but we think you're going to do well. Share some of that risk. Let us give you a lower base and higher incentives. And if you stay healthy, then you make all the money you want.
Starting point is 00:35:55 And maybe we don't want to go four years. Maybe we want to go three years. Of course, the market has a lot to do with that. But there are ways to mitigate your risk. It's harder to do but i think it's still a factor that goes into it so and reward the player for sharing the risk so baseball prospectus's projection system pakoda has percentile projections so a tenth percentile projection is you know the player is terrible and he has terrible stats worse than you'd ever think, and then 90% is everything goes right and he excels and he's an MVP.
Starting point is 00:36:28 So coming into this year, when you were building that risk assessment on Brett Anderson, what percentile would pitching 180 innings have been for him? I mean, what probability would you have assigned to him actually making 31 starts? Well, this is not where we need to be in regards to really getting this more objectively in percentages. I think that probably at the very beginning of this, I would give him a 25% chance of not making it to the DL. I would give him a 25% chance of not making it to the DL. I thought he had a pretty good chance to stay healthy, but I didn't think he would be able to throw 180 innings effectively the way he did because I thought the number of innings he had pitched
Starting point is 00:37:17 in the previous three years was not enough to keep his endurance going and the sharpness that we required at the end of the season. So I think I would have given him about a 25% chance of being able to do what he did. So that means a 75% chance that I thought he couldn't do. But the 25% was based, probably went from 10%, originally when I looked at it at 10%, to 25% because when I looked at each individual injury and painted a scenario, at least for myself, that he could stay healthy. I think that I have to go back, and I have written notes to myself on this stuff.
Starting point is 00:37:57 I haven't done it this season yet. But what I really thought, because it's easy to say now, oh, I do absolutely right Everybody thought Dalton in this but I'm the one who did funny. He was gonna be okay That's just yeah, you know, you know how that goes. It's not true So and I did tell Brett that at the end of the season we got his hundred eighty-fifty I said that never thought so And he's the guy to that you have to make sure you classify Correctly and not take it over to another guy and say well we hit with Brett Anderson how about Joe Snow here who you know
Starting point is 00:38:31 is coming off this terrible injury and hasn't played in three years and that kind of stuff and so you can't transfer anecdotally that win if you will other people, because then you end up using the analogy of Blackjack heading on 17 all the time. I mean, just because you got a 4 didn't mean that that was right for all the other cards that come up with 17. Okay, last question. You mentioned when I got in touch with you
Starting point is 00:38:58 that this was a record year for injuries based on disabled list numbers. So why is that? Does that reflect, you know, is that an accurate reflection of the state of injuries in baseball? And if so, why are they up? And now that you are unattached, what will you be turning your attention to primarily?
Starting point is 00:39:19 Well, I think, first of all, the disabled list, this is just a quick disclaimer on the disabled list. It's not an injury database. It's really a roster management tool for the 25-man roster as well as the 40-man roster. And so there are definitely errors in that and flaws in the system itself. But what's really valuable is that it's been consistent since 1989. So historically, the rules haven't changed. The strategies really haven't changed either. So from a historic standpoint, you really can kind of see trends.
Starting point is 00:39:53 You don't pick one year or five years. I look at 10-year trends and seeing what's going on. And since 2007, injuries have definitely been going up. There's some blips down, but mostly the trend is definitely up. And that trend since 1998 is statistically significant. So we run it through stats to show that it's just not by chance. So what we look at really in the DL is how many times players are placed on a DL and how many DL days are lost for this. And both of those were records this year of all time. You know, 536 placements on the DL.
Starting point is 00:40:35 The previous record was 529. There's only been four seasons where there's been over 500. They've all been in the last six years. For the first time ever, the DL days went over 30,000 DL days. So if you have 30 teams, that's 1,000 DL days per year per team. So that average is higher than it's ever been in regards to that. And then just the cost of lost wages is significantly over $600 million lost this year. So all these are things going up. So these are stats that are easily found in regards to the disabled list.
Starting point is 00:41:11 Actually, the disabled list undervalues the numbers, they're really higher than that as far as lost days. And Major League Baseball's injury surveillance system kind of shows that. So this is almost the tip of the iceberg in regards to lost days. Major League Baseball's injury surveillance system kind of shows that. This is almost the tip of the iceberg in regards to lost time on players. The key question is, okay, great, that's a word, great or terrible.
Starting point is 00:41:36 Why? Well, that's sort of what the research is about. We've seen an increase in the number of DL days because of Tommy John surgery. We definitely saw an increase starting really in increase in the number of DL days because of Tommy John surgery. We definitely saw an increase starting really in 2011 in the number of major league pitchers who were undergoing Tommy John, which take a lot of rehab.
Starting point is 00:41:55 So that lost time was somewhat understandable at that point. The number of Tommy Johns has leveled up and actually decreased a little bit, still way higher than it was before. But that's one reason. But I think generally people are being hurt more. That's kind of the bottom line to that. What we need to find out is where these are specifically. Shoulder and elbow make up about 53% to 55% of all the lost time.
Starting point is 00:42:24 That shouldn't surprise anyone. It's a thrilling sport. shoulder and elbow make up about 53% to 55% of all the lost time. That shouldn't surprise anyone. It's a thrilling sport. But how does it relate from relievers to starters and position players and those type of things? We're losing more time on the pitchers than we had before on the average DL times. And looking at that, is our strength and conditioning program correct? Is it too easy? Is it too hard? Is it not accurate? Are these guys actually doing the programs that we want? And you have to look at that. Are the medical people getting on top of this? Are we letting
Starting point is 00:42:59 people play too long with an injury that eventually has to put them on a disabled list. And then the other things are teams using the disabled list more for different reasons. One, resting players. There's been talk generally, I think there's been several articles, where teams may want to put a pitcher on a disabled list for two weeks to give him a break in the middle of the season, not looking for 34 or 35 starts, but looking for 30 or 31 quality starts. Is that a reasonable thing to do? And whether players are moved on the disabled list, it probably shouldn't be.
Starting point is 00:43:37 We can look at the stats that way and find out that actually the so-called phantom DL doesn't occur any more than it ever has. It's been consistent throughout the time the DL has been there. So it's not really that. And again, this is sort of what I'm pushing me to more of the research is I don't know the reason why. But I do know it's affecting wins and losses. I know it's affecting teams. And we need to have a better grasp on this and the only way you do is by studying it harder
Starting point is 00:44:07 and looking at different aspects of it and trying to figure out how functionally you can put that into play and still have players on the field all right well we hope that the dodgers loss is major league baseball's gain that you have more time to figure out why all this is happening and how it can be stopped. But thank you for coming on and giving us an update. All right, great. Thanks. All right. Well, thanks again to Stan Conti for joining us. You can send us emails at podcast at baseballperspectives.com.
Starting point is 00:44:38 You can join our Facebook group at facebook.com slash groups slash effectively wild. And we hope that you will rate and review and subscribe to the show on iTunes. We'll see you next time.

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