“…{Tommy} John also acknowledged that the honor is a dubious one: “But in another way, how did this surgery get so rampant that it became this commonplace?” www.forbes.com/
Various essays have dealt with what is clearly an epidemic of injuries in American sport (Charniga, 2015 – 2019). These essays have analyzed injures from a unique perspective of reverse engineering. A known outcome is the beginning: an athlete who falls or otherwise suffers some black swan event is not injured; logic dictates an injury should have occurred. The known outcome of the non – injury is the starting point for understanding the opposite circumstance; an athlete suffers a serious injury such as a ruptured Achilles tendon; or, torn ACL knee ligament, untouched, i.e., should not have been injured.
Although revealing figures of the magnitude of the injury epidemic of American sport have been cited in previous essays; an unscientific, certainly imprecise, even unlikely indicator of the scope of problem is the ubiquity of ‘medical patches’. This ubiquity, in its turn, has fostered the delusion that abnormally high injury rates are not abnormal; are in fact, by default, normal.
Subliminal Delusions
“…..they have invented something that will likely be on just about every sideline in college football and perhaps the NFL in the next few years.”
Proof positive there exists a preternaturally high injury rate in American sport is the outgrowth of a sizable commercial infrastructure consisting of, in many cases, ‘medical patches’; devoted to repair and prevention of the growing commonality of sport injury. Such a repair/prevention infrastructure is a natural outgrowth in response to ballooning costs of sport induced injury. This is not to say, it is necessarily a negative. However, it does cloud the underlying issue: why so many injuries in need of repair and prevention cottage industries?
As a result, an aberrant injury rate is considered normal; commercial solutions follow: to fix, or at least alleviate the problem.
For instance, so many football players go down, so often; in the middle of games, in both the collegiate and professional ranks; an inspired mitigation was a foregone conclusion. For example:
Detroit Lions injuries in one game 12-9-18:
“The Lions overcame a number of injuries in the contest. The team lost rookie defensive tackle Da’Shawn Hand and defensive end Ziggy Ansah in the span of two plays at the end of the first quarter and right tackle Rick Wanger to a concussion before the half.
Wide receiver Bruce Ellington and safety Charles Washington were both officially ruled out mid-game with hamstring injuries, while fullback Nick Bellore, safety Tavon Wilson and cornerback Marcus Cooper left the game and didn’t return.”
With so players dropping in the middle of games; like so many flies at a barbecue, expediency and privacy concerns; inspired engineering students at the university of Alabama to invent the ‘injury tent’ (see figure 1).
Figure 1. A collapsible injury tent is such a common site at football games some sponsors even advertise on the outside.
A collapsible injury tent like the one depicted in figure 1, allows an injured athlete to be evaluated expeditiously with some modicum of privacy. It has become so ubiquitous at football games; at both collegiate and professional games, it’s presence has become a normal part of the landscape. Unfortunately, too few stop to ask why and how so many injuries occur; as to necessitate a specialized tent to remove so many injured players out of site of a live and possible TV audience.
Can such a thing as the ubiquitous injury tent be a subliminal delusion? With so many tents at professional and collegiate football games; the image becomes subliminal. That is to say, tents become such a normal part of the landscape of football; most onlookers won’t even notice them. If a first time attendee at collegiate of professional games noticed tents on the sidelines he/she may just assume they belong. That is the subliminality of the delusion: you see something, it doesn’t register as anything out of the ordinary; or, you don’t even stop to wonder why it should be there.
Another example. According to the literature an ankle injury is the most common sport injury along with foot injuries. Not infrequently, these injuries require surgery when ligaments are damaged or result in fractures. Consequently the so – called knee walker; a crutch with three wheels; is an all too common sight (figure 2). Heisman trophy candidate Tua Tagovailoa attended the annual ceremony ambulating with the three wheeler model; following recent surgery for a high ankle sprain. There are even less expensive “hands free” knee crutches so one can hobble about wheel less.
Figure 2. Two major types of knee walkers. The less expensive model on the left is about half the cost of the three wheeler on the right.
A commonality (Bulatshinhala, B. 2015) of ankle injuries which have given rise to the various commercial devices like those in figure 2 are of course preceded by some medical treatment after which the walkers and such are used in the rehab stages. A relatively new surgical procedure called ‘tight rope’ is performed to fix a high ankle sprain. The tight rope surgery is designed to remedy loose or torn ligaments connecting the tibia and fibula. Two sutures are inserted through the holes in the base of the two bones and tightened down to hold the bones in place. A high ankle sprain has become so common this new procedure has become the rage at all levels including high school.
Injury tents are subliminal delusions. Knee walkers are subliminal delusions. Hot new surgeries like the tightrope procedure are subliminal delusions. Athletic trainers taping ankles and applying knee braces are subliminal delusions. 3D scanning of feet to make special shoes are subliminal delusions.
A proliferation of unusual and/or catastrophic injuries covered in previous essays dealt with comparisons of low to some almost non – existent injuries in weightlifting to the high, even aberrant injury rate, of football and basketball. The underlying cause/effect, the etiology of the high injury rate rests with the influencers fueling the fire: the athletic trainers, personal trainers, conditioning coaches, therapists, doctors and so forth.
Consequently, athletes across many sports are subjected to the same practices. Baseball is another example.
Over the course of a two hour baseball game sixteen of the starting 18 players are either sitting or standing still. The most active players are the pitchers and batters. Throughout its history these two ‘most’ active positions provide most of the dynamics of the game: the pitcher striking or otherwise getting batters to make an out; or the batter getting a base hit; especially a home run. Indeed, the fire ballers {pitchers} throwing 95 – 100 mile per hour pitches past the hitter and batters hitting tape measure home runs garner the the lion’s share of the attention; and, the big salaries.
The height weight data of Major league baseball’s (MLB) three premier power hitters are presented below. Height weight data of the game’s greatest home hitter Hank Aaron are listed for comparison. The dimensions of three power hitters of today, Stanton, Cespedes and Judge; dwarf a mere 81 kg Aaron.
Aaron had a long 23 year career en – route to hitting 755 home runs with lifetime batting average of .305. By comparison the 127 kg Judge so far has had an injury riddled four seasons in the prime (24 – 27 years) of a player’s career. Cespedes’ career has essentially been destroyed by personal training exercise regimes (see figure 3).
Figure 3. Yoenis Cespedes purportedly squatting (moving) 900 lbs in a misguided attempt to promote strength with stiffness to swing a bat; which can be a mere 34 – 35″ (0.86 m) in length and 32 – 34 ounces (1.33 kg) in weight; and is used to swing at a ball 73 – 75 mm in diameter and weigh only 142 – 149 grams.
And, as for Stanton, like the other two; he can be observed training for muscle mass and uncoordinated strength (see figure 4):
“Stanton, who turned 30 this month, will seek to rebound from the biceps, shoulder, knee and (in postseason) quad issues that limited him to 23 total games in 2019.” , Stanton is owed $214 million by the Yankees through the 2028 season.” https://www.usatoday.com/story/sports/mlb/2019/11/21/giancarlo-stanton-contract-new-york-yankees/4265370002/
Home run hitters:
Giancarlo Stanton: 6’6” 245 lbs 198 cm 111kg
Yoenis Cespedes 5’10” 220 lbs 178 cm 99 kg
Aaron Judge 6’7” 282 lbs 201 cm 127 kg
Hank Aaron: 6’0” 180 lbs 183 cm 81 kg
Pitcher:
Shohei Ohtani 6’4” 210 193 cm 95 kg
Figure 4. New York Yankee power hitter Giancarlo Stanton getting ready for the season 2019. He appeared in only 23 total games in 2019 recovering from multiple injuries.
The same old beliefs that brute strength and muscle building exercises and technique will translate into power; will benefit athletes for whom coordination and skill are the most crucial attributes; are still alive and well (see “There is no System” parts 1 – 6). The effect of this delusion is obvious in major league baseball; and, not limited to the havoc it has wrought on just these three athletes. For instance:
“The Yankees have used the injured list 36 separate times this {2019} season. Not surprisingly, New York has lost far and away the most man games to injury this year”
Compilation of MLB man games lost by the leaders of this statistic (https://www.cbssports.com/mlb/news/yankees-set-mlb-record-for-most-injured-players-in-a-single-season-as-gio-urshela-hits-il/):
Yankees: 2,246 games lost;
Padres: 1,653;
Phillies: 1,555;
Pirates: 1,382;
Angels: 1,314
The average salary of major baseball player is approximately $4.36 million dollars per 162 game season. The top five teams ranked according to ‘man’ games lost (a player misses a game due to injury) in a season are presented above. The New York Yankees lead the pack with 2,246 games lost in the 2019 season. With an average single game salary per player of about $29,913.00; based on 162 game season, the top five teams listed above lost an aggregate of $88,751,871.00 to missed man games due to injury.
In previous essays about injuries in football and basketball the commonality of injuries essentially preclude special circumstances such as bigger stronger players in football hitting harder, artificial turf, the wrong shoes, and so forth. The injury incidence in major league baseball is further corroboration of conclusions deduced of injury cause and effect put forth in previous essays (Charniga, 2015 – 2020); it is not happenstance.
A Misplaced Perception of Knowledge
“The dumb thing would be to ignore the science.”, M. Cuban, 2019
The quote above from a clueless NBA team owner about ignoring science to manage a players work capacity in the NBA season is correct; except it is backward. The dumb thing is to ignore common sense and the smart thing is, if not dump, at least minimize the influence of the doctors, trainers, physical therapists, and so forth, i.e., the science. (See Charniga, 2019, “Of Flat Tires and Brittle Basketball Players”; “Why Safe is Unsafe”)
This misplaced perception of knowledge applies to baseball as well. For instance:
“I have recorded more than 100 Tommy John surgeries performed each year on professional players, and we know the numbers are far higher among amateur pitchers in college and high school. There is a reason the term “epidemic” gets used regularly when referring to Tommy John surgeries”. Roegele, J., 2018
Tommy John surgery has become so ubiquitous, in April 2019, Merriam Webster added it to the dictionary.
Benevolent intervention such as this elbow surgery, named after the first recipient of this procedure, along with many others; without consideration such an intervention would cause more harm than good; or, most importantly, may simply be unnecessary; is lost in the rush to get an athlete, especially a professional or high level collegiate athlete; back onto the court or field.
Even more disturbing, many terribly misguided parents opt for Tommy John surgery to strengthen the arms of their children who are prospective pitchers; such that “15 – 19 years old males made up 56.7% of all Tommy John surgeries performed in the United States between 2007 – 11, a rate that was going up 9.1% per year.” https://www.forbes.com/sites/bobcook/2019/04/27/teens-sports-parents-deserve-credit-for-tommy-john-surgery-entering-the-dictionary/#133fadce69c4
Much has been expostulated (Charniga 2015 – 2020) about the contribution of conditioning coaches and an assortment of medical and academics to the aberrant injury incidence in American sport. Consequently, one has to wonder what would happen if instead of 1914; a potential super star; a great hitter and pitcher all in one; a reincarnation of Babe Ruth; were to enter the big leagues today. A super star teenager from Japan may be such a talent.
If that is indeed the case; perhaps a most telling (chilling?) circumstance of benevolent intervention gone bonkers is the Los Angeles wunderkind Shohei Ohtami. A throw back to Babe Ruth: a power hitter and super fastball pitcher all in one, Ohtami was unable to complete his maiden season with the California Angeles in the major leagues when he had to undergo Tommy John (TJ) surgery to repair his throwing arm.
“Ohtani spent the 2019 season as a designated hitter, rehabilitating from surgery to reconstruct the ulnar collateral ligament in his right (throwing) elbow in October 2018.”
While waiting for the surgically repaired throwing arm to heal he proceeded to play; just no pitching. That is until knee surgery to fix a congenital condition called biparte patella; which did not affect his play; just his ability to add weight in squats:
“The bipartite patella did not necessarily affect Ohtani offensively — Eppler referenced similar sprint speeds and exit velocities from his 2018 season — but did impact the amount of weight he took on during squatting sessions. “Knee surgery to end season for Angels’ Ohtani” https://www.espn.com/mlb/story/_/id/27602039/knee-surgery-end-season-angels-ohtani
If this is indeed true; this athlete underwent surgery so that he could lift more weight in squats. And, not because he couldn’t run. In America, strength coaches have athletes train on squats, stopping at parallel; the knee angle inflicting most strain on the knee joint; as opposed to deep squats which do not (Hartman, 2013). Parallel squatting means bending at knee and hip until the horizontal line thigh is approximately parallel to the floor. This exercise technique has been cited over and over (Charniga 2015 – 2020) as one of the prime culprits in the large number of lower extremity injuries in football and basketball; because, among many other things, ankle muscles are restricted in the movement.
To make a long story short. A budding super star pitcher/power hitter, a modern day Babe Ruth has come along; and, has undergone two major surgeries in the span of less than two years of his introduction to the big leagues; one on his pitching arm; the other to a knee. The surgery to his knee; the perceived problem of which; did not affect his play; just his ability to perform heavy knee joint straining squats with heavier weights.
Clearly for this unfortunate athlete, playing in Japan would have been safer than braving to play in the land of surgeries. Either that; or learn to throw with the feet.
Postscript to Ohtani:
“Ohtani, who underwent Tommy John surgery in October 2018, has recorded only five outs in his first two starts of the {2020} season. He exited after requiring 42 pitches to record the first two outs of the second inning on Sunday and later complained of discomfort in his pitching arm, prompting an MRI. Ohtani’s last three fastballs did not break 90 mph.” Gonzalez, A., ESPN Staff writer
August 24, 2023
https://www.sportsnet.ca/mlb/article/ohtani-batting-as-dh-against-mets-after-tearing-elbow-ligament/
“Shohei Ohtani‘s right elbow was fine until he tore his ulnar collateral ligament with a 94 mph fastball to Cincinnati‘s Christian Encarnacion-Strand on Wednesday, according to Los Angeles Angels manager Phil Nevin.
Baseball’s two-way superstar was back in the Angels’ lineup as a designated hitter Friday night against the New York Mets, two days after the injury ended his season as a pitcher and clouded his future months before potentially becoming a free agent.
Ohtani had Tommy John surgery in late 2018, following his AL Rookie of the Year season. Minasian said this injury was to a different part of the elbow and produced a different set of symptoms.”
Here are only a few of the too many examples to list; of a common thread of ignorance traversing the boundaries of American sports:
After a regimen of bulking up led to a disabled list stint due to a partly torn latissimus muscle on his right side, the Mets ace is rethinking his routine and developing a new training plan.”
“So much of what I’ve learned this year is that I thought I was doing what I needed to be doing,” Syndergaard said, via the New York Times. “But I realize now how messed up my body was, and I’m working hard to get it back to normal.” Chiapelli, 2017
“Mets right-hander Noah Syndergaard underwent successful Tommy John surgery on Thursday, a source tells ESPN. The Mets announced Tuesday that Syndergaard would need the surgery. He is expected to return sometime during the 2021 season.https://www.espn.com/mlb/story/_/id/28962215/noah-syndergaard-tommy-john-surgery-expected-back-20
Figure 5. Power hitter pictured at right at the approximate instant he tears biceps muscle in his left arm – swinging a bat. The same athlete is pictured on the left doing heavy dumbbell exercises one arm at a time.
Another example of an elite athlete stumbling in the dark is the case of the power hitter who tore his biceps on the follow – through of his swing (figure 5). The biceps muscle is a shoulder muscle. It is classified a bi – articular muscle because its attachments to bones cross two joints: at the elbow and shoulder. In the incidence depicted in figure 5 this muscle would tend to function as a brake or other wise to re – distribute the mechanical energy of the arm so that the elbow does not hyper-extend and excessive force is not operating on the shoulder joint. This is a perfectly normal movement for a baseball player swinging a bat; a follow through after releasing the grip with one hand; nothing out of the ordinary.
However, this ordinary action resulting in a serious injury in all probability; because a thirty something baseball player hastened the aging process with muscle – tendon stiffening bodybuilding exercises (see figure 5).
“Cabrera will undergo bicep tendon repair surgery on Thursday morning in New York City… He didn’t know why the rupture happened, or if there was anything he could have done to prevent it.” Detroit Free Press 6/14/18
“This is what passes for a big Miguel Cabrera play nowadays—an infield single made possible by a throwing error, captioned with a patronizing “atta boy.” Cabrera had an awful 2017 and a practically nonexistent 2018, due to injuries…”the complete disappearance of his power and the total breakdown of his body have combined to make him less than a shell of his former self.” Detroit Free Press 6/26/19ose muscles built up?
So, what happened to all of that strength; all of those muscles? The fate of the power hitter pictured in figure 5 is a redundancy, a reiteration put forth in prior essays of negative repercussions; caused by doing the wrong things at the wrong time. The long term effects of chronic application of bodybuilding exercises to develop power and muscle mass are irreconcilable with the dynamics of swinging a wooden bat 34 – 35″ (0.86 m) in length and 32 – 34 ounces (1.33 kg) in weight; at a ball 73 – 75 mm in diameter and weighing only 142 – 149 grams.
Does the fact that the dictionary people decided to include a surgical procedure named after the first athlete to receive it; substantiate the power of subliminal delusion; or maybe sublime delusion is a better descriptive?
A special surgery to repair a blown out elbow; an unfortunate outcome of trying to throw a baseball too hard; is such an everyday occurrence; so many have it done; it has become a normal part of contemporary life. That is why its in the dictionary!
The questions which should to be asked and of course answered; how, when; and, most importantly why this elbow – blow – out surgery became, in the words of its namesake “commonplace”?
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References |
/ Charniga, A., “Nine Straps”, www.sportivnypress.com
/ Charniga, A., “Muscles of the Shank, Movement of the Shin & Susceptibility to Lower Extremity Injury”, www.sportivnypress.com
/ Charniga, A., “Achilles tendon ruptures and the NFL”, www.sportivnypress.com
/ Charniga, A., “Of Flat Tires and Brittle and Basketball Players”, ww.sportivnypress.com
/ Charniga, A., “Ankle Breakers and Glasket – ball”, www.sportivnypress.com
/ Charniga, A., “Why Safe is Unsafe”, ww.sportivnypress.com
/ https://www.usatoday.com/story/sports/ncaaf/2016/01/05/alabama-football-tent-college-football-playoff-medical-trainer-sports-medicine-engineering-students/78312534
/ https://www.espn.com/nfl/story/_/id/28212594/foot-injury-hundreds-nfl-players-means-trip-green-bay
/ https://www.cbssports.com/mlb/news/yankees-set-mlb-record-for-most-injured-players-in-a-single-season-as-gio-urshela-hits-il/
/ https://www.forbes.com/sites/bobcook/2019/04/27/teens-sports-parents-deserve-credit-for-tommy-john-surgery-entering-the-dictionary/#269dec0169c4
/ Bulatshinhala, B. et al, “Epidemiology of ankle Sprains and the Risk of Separation from Service in the US Army’, Jr of Orthopaedic & Sports Physical Therapy 45:6:2015
/ https://www.statista.com/statistics/236213/mean-salaray-of-players-in-majpr-league-baseball/
/ Roegele, J., https://tht.fangraphs.com/ten-interesting-facts-about-tommy-john-surgery/