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Is it fair to do a biomechanical pitching analysis of first-pitch hurler Carly Rae Jepsen?

We start with a small sample size of only one pitch. We don’t have the best angles from the endless animated GIFs that swept the web. There was no PitchF/X, both because the system is not normally turned on for ceremonial pitches and because the pitch didn’t travel far enough to register.

But just look at this:

That pitch, thrown Sunday at a Tampa Bay Rays game, demands the kind of serious biomechanical analysis that major league pitchers get, if only to answer one question: What the bleep happened?

As it turns out, it’s a simple issue.

The announcers at the time and her personal catcher, Rays pitcher Matt Moore, said Jepsen was throwing strikes in warm-ups, and an analysis of her delivery shows that it’s entirely possible. While I don’t have sophisticated biomechanical tools available, this doesn’t require more than a basic knowledge of pitching to understand.

Jepsen is throwing the full distance from the top of the mound. It’s a bold move, one that most first-pitch throwers avoid.

Her foot placement is a bit questionable, but she appears to have a solid base and good traction. Her stride is short, but not too short and is in line with the delivery. Her arm is into external rotation a bit early, but we’re talking about one pitch, not an injury concern over 35 starts. 

In the second picture, things still look on track. Her body is coming forward, her knee is over her foot and her torso is just slightly behind the normal “stack” position where foot, knee, glove and chest are all in a vertical line. Her elbow is slightly below the acromial line, with a bit of a head tilt to the “glove” side. This is not ideal, but not hugely problematic.

We see this from another angle in this picture. While it’s a better angle for Carly, it’s not a better angle for pitching. It’s more clear how far down her elbow is below the acromial line and how much weight has already been transferred to the front foot. This picture is the root of the problem that’s about to occur.

It’s here in this picture, just before release, that we see how the problem is beginning to manifest—and worse, it’s amplifying itself.

Because her weight transferred forward, her “push” comes from the back foot and raises her up rather than pushing her forward. Because her elbow was low, it’s forced to go up to get to the normal release point. Both her hand and foot are going up rather than forward, which is normally going to result in a looping arc pitch.

Instead, Jepsen does something unexpected and frankly, a bit more kinesthetically aware than she’ll get credit for. It’s as if she realizes that her body and her release point are going high.

In response, she cocks her wrist, dropping the release point and unintentionally changing the vector of force. It’s that simple mistake that results in the ball going down and across her body. 

Which results in this look from Carly and universal disdain from a snarky internet.

And let’s face it, Jepsen did look pretty cute failing. At least she has that over Cincinnati mayor Mark Mallory, who in my mind still holds the record for worst first pitch ever. Though as you’ll see in this article, there are more than a few candidates.

Jepsen‘s pitch result was bad, but the mechanical flaws are easily correctable. Jepsen needs to have a longer stride to keep her back foot from pushing up. Plus, her elbow needs to be brought up slightly in order to direct the force towards home plate more than up. 

So Carly, don’t feel so bad. The pitch result was bad, but with a little work, we can have you throwing strikes in no time. Here’s my number, call me maybe? 

Will Carroll has been studying pitchers for over a decade. He wrote “Saving The Pitcher” in 2004 and has been part of the faculty at the ASMI Injuries in Baseball Course twice. He’s done similar mechanical analysis for MLB.com. All pictures in this taken directly from this YouTube video.

Read more MLB news on BleacherReport.com

Under The Knife has always been about more than just listing the injuries around baseball. Sure, the focus is explaining the injury status of players like Albert Pujols, Derek Jeter and Ryan Howard, among others. But, it’s also been about updating the injury status of MLB in general and taking opportunities to find ways to reduce or prevent injuries. 

I like to take the intro to highlight some larger concept or an article from the last week that caught my eye on the topic of sports medicine. Today, you won’t get that here. I started work on it, but when it gets close to 1,000 words, it’s not an intro—it’s another article.

So later this week, I’ll show you what I was working on. The focus of the article is innings limits for young pitchers, specifically Matt Harvey, who is likely to add an inning of work at the All-Star Game (probably the first inning!) and how the Mets could handle him in the second half. With the counter-example of Stephen Strasburg and the attack on the Verducci Effect out there, this is something I’ve been discussing all season, but we’re no closer to any big answers for the game of baseball.

For you panicking Mets fans, I’ll ease your mind. They seem to be doing things the right way, using more of a checklist approach to when they’ll shut Harvey down. Again, I’ll have lots more on this later in the week. 

Until then, let’s take a look around the league at some big-name injuries as we head into the All-Star break.

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As you look at the next 10 slides, think about how much value each of these players have to their respective teams. Not just salary, but value. Even just the names tell you a lot—Bryce Harper, Alex Rodriguez, Jose Reyes and more. Teams can overcome injuries, but they cannot replace value in most cases and if you add in the value of time lost, it’s pretty clear that teams need to be doing more. 

That’s easy to say, but if injuries are “part of the game,” as some will try to infer, and since all injuries can’t be prevented, then finding solutions is rendered moot in their mind. That’s defeatist. If a team can’t hit, the hitting coach is going to be asked why. More and more teams have hired assistant hitting coaches for the major league team in addition to coaches at every level. Some teams even have a bunting coach!

For injuries, which has as demonstrable an effect on a team as a hitting coach, the simple solution would be to add one more assistant trainer. The ratio of two trainers to a roster of 25 seems manageable until you see how many man-hours are required per injury, and that’s before we talk about how much is required for immediate care, rehab and the administrative tasks. 

Another assistant trainer would add one-third more man hours immediately and, if a team simply called up its Triple-A trainer, there would be very little change since they should be familiar with many of the players and procedures. The reason teams do this simply can’t be cost. It can’t be availability either, since finding a competent athletic trainer for short-season ball could be done in an afternoon. 

Baseball is seeing a significant increase in injuries this season and I believe it’s the result of being penny wise and pound foolish. Lack of manpower in the medical staff, a lack of knowledge about biomechanics and predictive measures and little to no research on sports science is going to leave teams exactly where they are now, or worse, and that’s not a good place. 

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About a decade ago, I got a text from Peter Gammons. “When did baseball players start having obliques?” Peter knew that players had always had the muscle, but it did seem that we were suddenly seeing more of them injured about that time. This year, it seems to be rib injuries that are the hot new thing in training rooms around the league.

But why?

Anatomically, there’s no difference. Ribs are ribs, and we have to assume that in almost all cases, MLB players have normal ribs in structure and strength. The game is also much the same—at least in terms of the stresses that it places on the ribs. 

We then have to look at the method of injury in context. For Troy Tulowitzki, he was injured on a diving stop of a grounder while at shortstop. Ian Kinsler injured himself twisting away from an inside pitch at the plate, though many point to an awkward headfirst slide earlier in the game as a possible injury point. Pitcher Jake Peavy of the White Sox is a bit tougher to pin down, as he was lifted early but showed poor velocity all through the last start he made before heading to the DL.

One interesting point on all these is that the diagnosis wasn’t simple. In each case, an MRI was necessary, and in both Kinsler and Peavy’s case, X-rays were negative. Simple rib fractures—the result of collisions—tend to be very visible on X-rays, so that fact tells us that the fractures are either small or in an unusual location.

There are other rib injuries around the league, with Edwin Nunez of the Yankees and Josh Kinney of the Mariners also listed, but those go less noticed, in large part because they’re not All-Star-caliber players like Tulowitzki, Kinsler and Peavy.

In other words, this may well be a cluster of injuries that is noticeable due to the player’s visibility and notoriety rather than an increase in the incidence of the injury itself. Looking through my database of injuries, there is only a slight increase over previous seasons. This seems to be random variation, which is typical of traumatic injuries like this.

Last season, there were six ACL sprains in MLB, but this year only two (and one of those was a flukish recurrence). There is almost no known way of preventing these kinds of injuries, so the focus is on reducing the rehab time necessary.

It appears to be much the same way for rib fractures.

Injuries will happen, on dives, odd pitches or strange swings, but it’s up to the medical staff to minimize the time lost. Getting Kinsler, Tulowitzki and Peavy back just a week early could have huge implications for their team.

For example, Kinsler has been worth about a win every 20 games played, so a week is worth around one-third of a win. All you have to do is think back to last season’s AL West finish to know how valuable that can be.

There is no answer to why there are more rib injuries because, simply put, there really aren’t more. Traumatic injuries are inconvenient and unpredictable, even for big stars like these. 

Read more MLB news on BleacherReport.com

Stephen Strasburg and Bryce Harper were drafted not so long ago, but the health questions they face now were also brought up at that draft. People seem to be putting more importance on the draft since players do seem to be coming up more quickly. There are five already in the big leagues from last year’s draft.

That makes assessing future health as much a key as assessing any other skill—and yes, health is a skill. 

The downside is that there’s no real way to capture this information. Scouts are left guessing at biomechanics, talking to coaches and travel teams to dig up any injury history and hoping that there’s nothing that was missed. They do a great job, but not having a combine process, the way every other professional league does, leaves them at a disadvantage.

There are always tales about pre-draft workouts, how a team fell in love with a player over one workout, but ignored an injury history.

We’ll likely see players fall some due to injury, but looking back over the past few drafts, it’s clear that injuries should be at or near the top of the list. Players fail on injury much more often than they fail on talent, especially for pitchers. At best, there are lost years or delays, not to mention how much a pitcher leaves on the table after a significant injury or surgery.

Risky players can be successful; no one is going to knock the White Sox for drafting Chris Sale, even if his career ended today. He made the majors and he won games, which is the definition of success for the scouts.

This weekend, we’ll see more players taken and a lot of talented, risky ones in the bunch as well. Taking risks is part of how teams win, but taking smart risks and understanding those risks is how teams win consistently.

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One of the greats has passed. Dr. Lewis Yocum, one of the top sports surgeons in the world, died on Tuesday according to Mike DiGiovanna of the Los Angeles Times. Long the team physician for the Los Angeles Angels and a consulting surgeon to hundreds of major league players, Yocum‘s work at the Kerlan-Jobe Clinic in Los Angeles placed him on a high pedestal. While no sports surgeon is in any Hall of Fame, Yocum deserves consideration, along with his mentor, Dr. Frank Jobe.

The esteem he was held in was manifest in two ways. The surgeons he trained and the medical staffs he consulted with often identified themselves as “Yocum guys.” The orthopaedic fellows from Yocum‘s Kerlan-Jobe program, along with those from James Andrews’ ASMI fellows make up the majority of sports surgeons today. The legacy Yocum built through his mentorship is strong, with some of the top names in sports medicine today amongst them.

Yocum was also honored by his own team. The Angels’ training room was named on May 5th for Dr. Yocum, an honor to be sure, but one even more than most realize. The training room is the holy of holies in most locker rooms, a place where no one enjoys going, but within those walls, the trust that must be shared takes on an element of the confessional. That everyone in an organization would agree that one man, one doctor, was worthy is truly notable.

The list of Yocum‘s patients is extensive. Returning players in recent years like Stephen Strasburg, Dustin Pedroia and Daniel Hudson barely scrapes the surface. Just the list from the last few years would be enough to fill out the rosters of a couple All-Star teams (the list is below). 

Yocum‘s research was also groundbreaking. His work on the rotator cuff, along with Dr. Frank Jobe, led to the near universal use of the “thrower’s ten” exercises which helped reduce the number of shoulder injuries. His work on shoulder impingement also led to a much greater understanding of what could be done to help baseball pitchers. His work went beyond the shoulder, with key papers on the knee and elbow to his credit as well. 

Dr. Tim Kremchek, the team physician for the Cincinnati Reds worked with Yocum and sums up how so many in the industry feels. Kremchek told me “I got to know Lew over the last 15 years and taking care of high profile athletes, there was no one better. He was always calm, straight up, experienced. Always invaluable assistance. Great doctor, great human being, and a better friend. In this business, too many people are trying to keep the case. Lew was there to help the player.

The loss of Dr. Yocum is one not just for the Angels, for whom he served so long and well, but for all of baseball. As yet, there is no doctor enshrined in the Baseball Hall of Fame, but when it does, Dr. Yocum should be noted alongside the giants of his profession and the best of baseball. 

Patient List:

Major patients:  Stephen Strasburg, Dustin Pedroia, Jacoby Ellsbury, Jordan Zimmermann, Kendrys Morales, Ted Lilly, Robb Nen, John Lackey, Randy Wolf, CJ Wilson, Francisco Liriano, Billy Wagner, Joakim Soria, Jake Westbrook, Cal Eldred, Scott Erickson, Daniel Hudson

Others: Chris Narveson, Cory Luebke, Joe Wieland, John Lamb, Ryan Kalish, Sergio Santos, David Riske, Tsuyoshi Wada, Trevor Crowe, Anthony Reyes, Danny Duffy, Felipe Paulino, David Aardsma, Hector Ambriz, Carlos Gutierrez, Mike Aviles, Zach Miner, John Franco,  Lucas Giolito, Daisuke Matsuzaka, Jeremy Bonderman, Jose Arredondo

Special thanks to Dan Wade for his research assistance on this piece.

Read more MLB news on BleacherReport.com

There’s more than enough injuries to fill 20 slides this week. Big injuries to big names are good for my job security but bad for the game. Missing Bryce Harper, Clay Buchholz or David Price costs teams wins and dollars, but beyond that, the lack of effort in prevention and research is problematic for the future of the game. 

The old quote from Joe DiMaggio—”There is always some kid who may be seeing me for the first or last time, I owe him my best”—holds true here. Fans do come to see Harper play like his hair is on fire or to see the smooth swing of Ryan Braun. That they’re missing games means that fans are missing out. 

The doctors and athletic trainers around baseball are doing all they can, but they’re not given much support. The owners seem content to lose billions of dollars to the DL. Quick, tell me the last MLB-funded research initiative that you read about. (If you have one, please drop it in the comments because aside from the ongoing work on pitcher head protection, I can’t think of one from the last 18 months.) 

There’s another old quote, probably as apocryphal as DiMaggio’s, that billionaires can look as stupid as they want because they can afford it. While true, you have to wonder how long the game can afford it. It’s time that MLB as a whole tackled this issue, making prevention a strategy and letting the findings trickle down to the millions of baseball players at lower levels.

For the injuries that have already happened, let’s get to it.

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Injuries have continued to plague some of the biggest names in baseball. With David Price the latest Cy Young contender to come up with a sore arm, Bryce Harper bouncing his head off an unprotected section of fencing and Ryan Howard limping again, we can only wonder about the hours that the medical staff is putting in.

And while those good men and women work 18-hour days, we’re left wondering if anyone else seems to care. I’ll pass on stepping back up on my normal soapbox here. You know the next stanza on your own by now. At some point, some team will realize the advantage it can gain.

In the meantime, we’re left trying to find where the advantages are in our own fantasy world. You’ll know if your favorite team is serious about managing injuries, but on a fantasy team, it’s a game of minimization and prediction. The simplest way to gain an advantage is to understand the severity and effects of the inevitable injuries, so let’s get to it.

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On Thursday night, Yu Darvish beat the Detroit Tigers and threw 130 pitches. It wasn’t his best performance this year or even this month, but it may end up the most scrutinized. 

As Darvish’s pitch count climbed, everyone—including announcer Matt Vasgersian and analyst Tom Verducci—had something to say about it. Vasgersian called Darvish’s deep pitch count a “Herculean feat.” 

Unfortunately, Rangers CEO Nolan Ryan wasn’t in his customary seat just to the left of the Texas Rangers dugout, so the camera couldn’t cut to him. Ryan, who pitched in the major leagues for over two decades and was inducted into the Hall of Fame in 1999, was as well known for his durability as he was for his fastball.

While I don’t know what Ryan thought about Darvish pitching the eighth inning with a six-run lead or giving up the ball in the ninth, we can look back and see what Ryan the pitcher did in similar situations. It’s food for thought when considering whether more pitchers could go as long as Darvish, if only their managers would let them.

Even the amazing Baseball Reference doesn’t have pitch-count data before 1988, but that doesn’t mean we can’t make solid estimates. Stats analyst Nate Silver, known for his work with Baseball Prospectus and The New York Times, created a pitch-count estimator that uses the known data, such as batters faced, walks and strikeouts, to tell us what a pitcher likely did on a given day in history.

The estimator was able to be tested against the pitch counts kept by Allan Roth, the statistician hired by Branch Rickey to track the Dodgers throughout the 1950s. It proved to be very accurate.

I had my stats guru, Dan Wade, run Nolan Ryan’s career starts through the pitch-count estimator, and here is what he found:

> 200: 3

190-200: 1

180-190: 3

170-180: 8

160-170: 14

150-160: 37

140-150: 67

130-140: 85

120-130: 80

110-120: 85

100-110: 72

If 130 pitches is “Herculean,” then Ryan was that almost 300 times in his career. That means of his 773 career starts, almost 38 percent of them ended up with a pitch count north of 120, and 28 percent were at Darvish’s level or greater.

Of course, Ryan pitched in a different era. It wasn’t that long ago that pitchers went deeper into games, coasting against the weak hitters and saving their best stuff for when they needed it. Today, pitchers go all out all the time, putting stress and fatigue on their arms. 

It’s also important to remember that Ryan pitched the last decade of his career with an elbow ligament that was hanging by a string. In his last start it popped, and he walked off into the sunset.

Darvish’s outing is notable not only in the amount of pitches he threw, but also that he was even allowed to throw them. Pitching coach Mike Maddux focused on his pitch effectiveness, not his pitch count.

While this is likely the discussion of two outliers—Darvish’s start and Ryan’s career—we do have to remember that outliers are what make the game great. Darvish’s durability and ability to go deep into games is what makes him one of the top pitchers in MLB. There are likely more out there if managers would stop relying on a stat and start relying on what they know.

Pitchers’ fatigue levels and durability should be measured and maximized not by fear, but by ability.

Statistics courtesy of Baseball Reference.

Will Carroll has been writing about sports injuries for 12 years. His work has appeared at SI.com and ESPN.com, and he wrote the book “Saving The Pitcher.”

Read more MLB news on BleacherReport.com

There are a lot of pitchers close to comebacks. With Zack Greinke making a quick comeback from his collarbone fracture and Jered Weaver not far behind him, not to mention Johnny Cueto’s return, we will see a lot of pitching coming back to the mound. The problem is that there are just as many heading out with injury. 

It’s been 15 years since Pitcher Abuse Points was debuted by Dr. Rany Jazayerli, and it may be the most influential piece of baseball research in the history of the game.

When it came in, 150-pitch games were a regular occurrence—not common, but regular—and today, the media freaks out when Yu Darvish goes 127. Managers, even the ones that say they’re not sabermetrically minded, are managing by a stat, just like they are handling their bullpens by the save. 

The issue is that while Jazayerli‘s research was intended as a warning against regular overuse and gave teams a tool by which to measure the risk of an extended outing, teams decided against measuring and largely abandoned the practice. Adding to the issue was the contemporary La Russization of bullpens, increasing the size and changing the usage of the pen. It allowed managers to pull their starter at 100 pitches or less.

I’m not advocating a return to the days of complete games and huge pitch counts. Those aren’t coming back. Pitchers have to throw too hard to today’s power-filled lineups and don’t have the ability to “coast.” (Though I do think they have the ability to try and force hitters to act more quickly in counts, but that’s a story for another day.) 

I do think that another shift in pitching usage could help—a progressive approach to development and usage, a data-driven approach or maybe something I haven’t thought of. There are a full complement of smart people inside the game and more pitching wisdom than I can catalog. Plus it’s impossible for these people to say that change isn’t possible since the game has changed drastically already! 

It’s going to take one smart team with the guts to take some risk that wins with a new plan before everyone else will follow. We’ll see who wants to be the kind of team the Cardinals were over the last decade. You know—winners.

For now, let’s get to the injuries… 

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