Jimmy Lambert

[pcq]

So we have a pitcher who comes along as a pleasant surprise and now he may not be ready until he is 28. Something is very wrong. The game may not be able to sustain all of these pitching injuries. 

[ChiSox59]

Any update on Lambert?  Was the TJS speculation premature?  

[Chicago White Sox]

4 hours ago, ChiSox59 said:

Any update on Lambert?  Was the TJS speculation premature?  

I’m worried this will turn into a Dane Dunning 2.0 situation where they try to rest it out and he’ll ultimately need TJS next year.  That would not be good for Jimmy given his somewhat advanced age already.

[Lip Man 1]

5 hours ago, Chicago White Sox said:

I’m worried this will turn into a Dane Dunning 2.0 situation where they try to rest it out and he’ll ultimately need TJS next year.  That would not be good for Jimmy given his somewhat advanced age already.

Like a friend and a wise baseball sage told me after the Rodon fiasco from last year and Dunning this year, where things seemed to go months without any real information / progress, "I assume the worst with White Sox injuries until told otherwise."

Me thinks that is a good philosophy to have.

The entire medical / training / conditioning staff needs to be reevaluated at all levels in my opinion just in case and I've been saying that for awhile.

I also had an out of the box thought and I ran it by my doctor who also was a former minor league pitcher in the Orioles and Rangers organization. It went like this.

ANY pitcher drafted by the Sox say in the first five rounds, signs his deal and has TJS. He also gets a bonus to be put in escrow for agreeing to this (just in case something goes seriously wrong.) No exceptions.

I base it on the fact that so many of these kids growing up through high school and college are abused by people, many of who do not know what they are doing when it comes to protecting developing arms... that there has to be at least some damage to the elbow, ligaments...something. Especially at the younger levels where in a lot of cases you have parents coaching who wouldn't know their rear end from a hole in the ground about arms, pitching and potential injuries.

Have the surgery, have them work with the training staff and come back stronger (according to the statistics in the vast majority of cases) than before.

I thought him being a doctor he'd have a number of objections. I was surprised when he said he didn't and could see an organization doing this if they could get around the possible legal issues and issues with the MLBPA. 

Edited June 27, 2019 by Lip Man 1

[Lip Man 1]

On 6/15/2019 at 5:49 AM, pcq said:

So we have a pitcher who comes along as a pleasant surprise and now he may not be ready until he is 28. Something is very wrong. The game may not be able to sustain all of these pitching injuries. 

Or perhaps pitchers are being "babied" far to much today. I'm not a doctor or a trainer I have no idea. All I know is you look at a number of pitchers from years ago, without all the advanced training and nutritional benefits today when many of these guys had to actually find a second job in the off season and yet they somehow complete 25 games a season and throw 300 innings and even in some cases (like Juan Marichal) strenghten their arms by throwing batting practice between starts.

How did they do it?

Former Sox pitching coach Johnny Sain who was one of the best ever (along with Ray Berries) had a basic philosophy, 'you throw EVERY single day, even if it is just on the side for 10 minutes to build up the muscles.' He also didn't believe in pitchers running a lot. He once said, "You can't run the ball across the plate...if you could jesse Owens would have been a pitcher."

Like I said I don't have an answer but that could be part of it, that and guys getting abused by "coaches" growing up who don't know what the hell they are doing until they get to college (and even then some of those guys just murder pitchers because they need to win to keep their jobs.) 

Edited June 27, 2019 by Lip Man 1

[ptatc]

16 minutes ago, Lip Man 1 said:

Like a friend and a wise baseball sage told me after the Rodon fiasco from last year and Dunning this year, where things seemed to go months without any real information / progress, "I assume the worst with White Sox injuries until told otherwise."

Me thinks that is a good philosophy to have.

The entire medical / training / conditioning staff needs to be reevaluated at all levels in my opinion just in case and I've been saying that for awhile.

I also had an out of the box thought and I ran it by my doctor who also was a former minor league pitcher in the Orioles and Rangers organization. It went like this.

ANY pitcher drafted by the Sox say in the first five rounds, signs his deal and has TJS. He also gets a bonus to be put in escrow for agreeing to this (just in case something goes seriously wrong.) No exceptions.

I base it on the fact that so many of these kids growing up through high school and college are abused by people, many of who do not know what they are doing when it comes to protecting developing arms... that there has to be at least some damage to the elbow, ligaments...something. Especially at the younger levels where in a lot of cases you have parents coaching who wouldn't know their rear end from a hole in the ground about arms, pitching and potential injuries.

Have the surgery, have them work with the training staff and come back stronger (according to the statistics in the vast majority of cases) than before.

I thought him being a doctor he'd have a number of objections. I was surprised when he said he didn't and could see an organization doing this if they could get around the possible legal issues and issues with the MLBPA. 

People have brought the "pre-emptive" surgery idea up before. It has 2 significant draw backs. 1. Only 85% get back to their previous level of play. That's really good but with no injury is a senseless risk. 2. The 1 in 100,000 chance of significant side effects including death, from the anesthesia.  

It's really not worth the risks to do the surgeries with those risks. 

[ptatc]

14 minutes ago, Lip Man 1 said:

Or perhaps pitchers are being "babied" far to much today. I'm not a doctor or a trainer I have no idea. All I know is you look at a number of pitchers from years ago, without all the advanced training and nutritional benefits today when many of these guys had to actually find a second job in the off season and yet they somehow complete 25 games a season and throw 300 innings and even in some cases (like Juan Marichal) strenghten their arms by throwing batting practice between starts.

How did they do it?

Former Sox pitching coach Johnny Sain who was one of the best ever (along with Ray Berries) had a basic philosophy, 'you throw EVERY single day, even if it is just on the side for 10 minutes to build up the muscles.' He also didn't believe in pitchers running a lot. He once said, "You can't run the ball across the plate...if you could jesse Owens would have been a pitcher."

Like I said I don't have an answer but that could be part of it, that and guys getting abused by "coaches" growing up who don't know what the hell they are doing until they get to college (and even then some of those guys just murder pitchers because they need to win to keep their jobs.) 

On this we somewhat agree.

I do think the pitchers don't work enough. Part of the reason is that there needs to be so many more pitchers today than in the past that not all of them could handle it. In the past if pitchers showed talent but got injured the mindset was, just get the next one this guy couldn't handle it. Teams can't afford to do that today as more pitchers are needed for the increased number of teams and games.

[Lip Man 1]

1 hour ago, ptatc said:

People have brought the "pre-emptive" surgery idea up before. It has 2 significant draw backs. 1. Only 85% get back to their previous level of play. That's really good but with no injury is a senseless risk. 2. The 1 in 100,000 chance of significant side effects including death, from the anesthesia.  

It's really not worth the risks to do the surgeries with those risks. 

I guess that's my point though PTATC; in almost 100% of the cases there is SOME type of injury through abuse. It is just a question of how much, can the player handle it and when is it going to blow up (apart) whatever word you choose to use. Again because pitchers are more or less abused by folks who have no idea what they are doing.

[BamaDoc]

11 minutes ago, Lip Man 1 said:

I guess that's my point though PTATC; in almost 100% of the cases there is SOME type of injury through abuse. It is just a question of how much, can the player handle it and when is it going to blow up (apart) whatever word you choose to use. Again because pitchers are more or less abused by folks who have no idea what they are doing.

Perhaps every pitching signee gets a elbow MRI.  With modern therapies like PRP etc we may soon establish to what degree a partially torn UCL can be rehabilitated.  At some point you may get where preemptive of a partially torn UCL makes sense.  But I can't think of any reason seeing a perfectly fine UCL to repair what isn't torn.  

[BamaDoc]

1 hour ago, ptatc said:

On this we somewhat agree.

I do think the pitchers don't work enough. Part of the reason is that there needs to be so many more pitchers today than in the past that not all of them could handle it. In the past if pitchers showed talent but got injured the mindset was, just get the next one this guy couldn't handle it. Teams can't afford to do that today as more pitchers are needed for the increased number of teams and games.

ptatc love your input here.  I am also medical.  Agree something is weird here seeing olden day pitchers go 300 innings and in the last ten years we are to the point 200 is becoming rare.  Is it the off season rest as kids the elders got while working second jobs?  Ala Andrews thinking year round throwing when young is a big factor.  In Japan, I think they throw a lot more between starts, any studies on their rates of UCL that you are aware of?

[ptatc]

3 hours ago, BamaDoc said:

Perhaps every pitching signee gets a elbow MRI.  With modern therapies like PRP etc we may soon establish to what degree a partially torn UCL can be rehabilitated.  At some point you may get where preemptive of a partially torn UCL makes sense.  But I can't think of any reason seeing a perfectly fine UCL to repair what isn't torn.  

The MRI for signees already happens. The partially torn rehab already happens as well, it's just not perfect. They are pretty good though.

[ptatc]

3 hours ago, BamaDoc said:

ptatc love your input here.  I am also medical.  Agree something is weird here seeing olden day pitchers go 300 innings and in the last ten years we are to the point 200 is becoming rare.  Is it the off season rest as kids the elders got while working second jobs?  Ala Andrews thinking year round throwing when young is a big factor.  In Japan, I think they throw a lot more between starts, any studies on their rates of UCL that you are aware of?

In Japan the pitchers pitch less due to a 144 game season and six man rotations. The most starts they make in a season is about 24. Their mechanics are different mostly due to the fact that they are smaller and weigh less than American counterparts and generate less torque. They throw more between but get more rest between starts. Here is a decent article on it.

2325967119825625.pdf

Edited June 27, 2019 by ptatc

[ptatc]

3 hours ago, Lip Man 1 said:

I guess that's my point though PTATC; in almost 100% of the cases there is SOME type of injury through abuse. It is just a question of how much, can the player handle it and when is it going to blow up (apart) whatever word you choose to use. Again because pitchers are more or less abused by folks who have no idea what they are doing.

There isn't anyway near 100% incidence in injury rate, if I'm reading your post right. The current ucl rate in MLB pitchers is about 30%.

[caulfield12]

Dr. Brian Schulz said the latest research shows that after a first-time UCL reconstruction, about 80 percent of professional baseball players return to their previous level or progress beyond it. The success rate after a revision surgery represents a dip, though not a massive one. A study published last year in the Journal of Shoulder and Elbow Surgery reviewed 93 “revision” surgeries and found that roughly 63 percent of those players returned to their prior rung of competition.

...

According to Jon Roegele’s database of reported operations, the former top prospect became the 101st professional or high-level amateur player known to require multiple Tommy John surgeries since 1991. The list of one-time patients such as Kirby is roughly 15 times longer.

 

https://theathletic.com/958536/2019/05/02/the-outlook-for-repeat-tommy-john-patients-has-improved-but-will-that-hold-true-for-anderson-espinoza/

 

[Lip Man 1]

13 hours ago, ptatc said:

There isn't anyway near 100% incidence in injury rate, if I'm reading your post right. The current ucl rate in MLB pitchers is about 30%.

PTATC: I'm not specifically talking about UCL's but about pitching abuse in general terms, elbows, shoulder, rotator. Kids are being ruined by folks who don't know what they are doing and I'm suggesting that those who are good enough to be drafted have some damage, somewhere in the pitching arm / shoulder.

[ptatc]

43 minutes ago, Lip Man 1 said:

PTATC: I'm not specifically talking about UCL's but about pitching abuse in general terms, elbows, shoulder, rotator. Kids are being ruined by folks who don't know what they are doing and I'm suggesting that those who are good enough to be drafted have some damage, somewhere in the pitching arm / shoulder.

Got it. Sorry. I thought you were talking about the MLB.

There is no doubt the worst thing that happens to these kids is pitching all year long from summer travel, to fall league to their regular season. They should be doing other sports during their developmental years. Unfortunately in the environment today high school coaches won't even look at kids unless they play travel ball all year long.

[Lip Man 1]

1 hour ago, ptatc said:

Got it. Sorry. I thought you were talking about the MLB.

There is no doubt the worst thing that happens to these kids is pitching all year long from summer travel, to fall league to their regular season. They should be doing other sports during their developmental years. Unfortunately in the environment today high school coaches won't even look at kids unless they play travel ball all year long.

Agree it's a bad situation. The late Ed Herrmann told me he was the head coach for the top 14 year old team in the nation in the San Diego area. They played about 140 games year round because of the weather.

That's absolutely insane.

The only good thing was that as a former Major League catcher Ed knew what the hell he was doing.

[justBLAZE]

Confirmed per Scot Gregor on twitter.

[zisk]

Do all the TJS have to do with guys being bigger than 40 years ago? Muscles and bones are larger. Do the tendons become less durable with

the added stress larger size adds? Do tendons lose some flexibility if they become too large?

[MyNamesRod]

Hopefully we got our 20% tj failure out of the way in burdi and rodon/kopech/dunning/lambert all come back to the pitchers they were before. 

[ptatc]

22 hours ago, zisk said:

Do all the TJS have to do with guys being bigger than 40 years ago? Muscles and bones are larger. Do the tendons become less durable with

the added stress larger size adds? Do tendons lose some flexibility if they become too large?

This is one 9f the important variables. The ligaments can only take so much stress. This is one arguement for increased workload. Ligaments will increase tensile strength with increased load.