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  • Twins injury policy needs rehabilitation

    Denard Span
    On Thursday night, Denard Span played in his first game in 10 days since injuring his clavicle on a Jeff Keppinger line drive on August 12.

    Span’s absence triggered yet another debate amongst Twins fans and pundits alike who questioned the team’s inability to properly handle their disabled. Rather than place Span on the DL a day or two after the injury appeared to be more than simply a day-to-day situation and keep the dugout stocked with healthy bodies, the Twins allowed the situation to drag on for over a week – culminating in an MRI attempt that never happened because of Span’s claustrophobia.
    Of course, Span is not the Twins’ first encounter with a prolonged injury this year either.
    Prior to Span’s ordeal, it was Trevor Plouffe who had the extended time off. On July 20, Plouffe bruised his thumb on his throwing hand and left the game against the Royals early. The prognosis at the time was that it was originally thought of as day-to-day. It took seven days before he was placed on the DL only to finally return on August 13.

    Before Plouffe it was Justin Morneau who, at the end of April, re-injured his surgically repaired wrist. Morneau missed three games in May in addition to five calendar days before the Twins ultimately made the move to put him on the DL.
    At some point, these missed games add up.

    Clearly, I’m not a doctor. I diagnose most injuries regardless of the severity with Vitamin I (Ibuprofen) and a few (dozen) Grain Belt Premiums. The Twins, on the other hand, have (presumably) a well-paid, well-educated medical staff that should, by most accounts, identify and set out a clear path of recovery. Yet, somehow, these injuries and ailments – no matter how seemingly minor – continue to drag out and leave the team short-handed for extended periods of time.

    Truthfully, I have no idea on how the internal decision process is made to DL or not to DL but it appears that the team puts the onus on the players on these ostensibly innocuous injuries. It harkens back to 1993’s The Program, in which James Caan’s character asked one of his football players if he was hurt or injured; the difference being, if he was hurt, he could still play. In Span, Plouffe and Morneau’s case, the players communicated to the medical and coaching staff that they were simply hurt and that they could play in no time. The response from each was “I’ll be fine in a day or two.”

    For instance, the Star Tribune’s LaVelle Neal wrote that the team was counting on Span to let them know if or when he’s able to suit back up:

    The Twins want their players to be honest with them, and they believed Span when he told them he would need just a few days before returning to the lineup.
    Like Span, Plouffe told reporters and coaches that he would expect to miss “a day” at that time. Ron Gardenhire told reporters after the game that “We've all done that as a hitter -- you get a deep bone bruise right in there and it's pretty painful. So we'll give him a day or two with a little ice and treatment, and he should be back in there."

    Similarly, after the decision was made to send Morneau to the disabled list, then acting manager Scott Ullger told reporters that “It’s up to him to let us know when he can play.”

    This has become a crappy policy. After two seasons it is obvious that the players cannot be counted on to do this kind of determination. They have machismo and often millions at stake. They certainly WANT to play, there’s no question there. To be fair, the players are the ones actually playing and feeling the pain so they should have an open dialogue with the coaching staff but, ultimately, should they be the influential factor when contemplating the well-being of the roster?

    Again, I’m not a doctor – if you needed the reminder. I am a baseball analyst who relies on statistics and data and I have little to no baseline to judge or rate the Twins organization’s methods against another. There is no Wins Above Replacement Level For Guys Your Just DL’ed found on Fangraphs.com. A measuring stick does not exist (it should and some enterprising researcher needs to take up the cause). What does seem obvious is that playing short-handed hinders the team to some degree.

    Now, whether or not summoning someone like Clete Thomas or Chris Parmelee would have changed the outcome is certainly debatable but it would seem that continuing down this path regularly puts a team in a deficit. Had this been a contending team, a few games lost because of the disabled list indecision could have cost them vital ground in the standings.

    The policy in the Twins clubhouse regarding injuries needs to be re-examined and return rehabilitated in 2013.
    This article was originally published in blog: Twins injury policy needs rehabilitation started by Parker Hageman
    Comments 25 Comments
    1. Cody Christie's Avatar
      Cody Christie -
      Can they send the medical staff on a rehab assignment in the minor leagues? Won't happen but something needs to change.
    1. IdahoPilgrim's Avatar
      IdahoPilgrim -
      How does the Twins policy compare to other teams?
    1. Seth Stohs's Avatar
      Seth Stohs -
      Elizabethton's Trainer was named the Appalachian League Trainer of the Year... I wonder if he would consider the big league gig?
    1. Seth Stohs's Avatar
      Seth Stohs -
      This is actually a tough situation, tougher than some might want us to think. If we're talking about a starter, particularly a key contributor in the lineup, the decision should not be easy to DL. I'd say, until you KNOW for sure that the hitter will be out for more than 8 days, you shouldn't DL him. Why? Because that's a week longer of Denard Span or Justin Morneau in the lineup.

      I 100% agree that it shouldn't be 100% in the player's hands. It should be an honest dialogue.
    1. SeanS7921's Avatar
      SeanS7921 -
      You do know that the only loss for Span or Plouffe was the absence of another player to replace them right? The DL is retroactive so if say Span needed another 5 days off they could have then put him on the DL but only for a few days. Its not like they were like okay know he has to spend 15 days on the DL after waiting 13 days... So what's the big deal? Seriously? Did the Twins really need that 4th bench guy when they are 20 games+ under 500? If it turned out that Span could come back in 10 days then they saved 5 days from putting him on the DL! Glad we brought up Nishioka to replace Plouffe there for a bit! Oh wait, I guess healthy bodies isn't all it's cracked up to be. Let's waste an option or mess up the 40 man roster because we need Span on that DL right now! The Twins should just know how injured somebody is within a day or two despite what the players says. We need that extra guy! We need to throw pitchers under the knife at the first sign of an elbow injury! Do you hear! The first sign. If we try to let Alex Wimmers heal himself and save 12 months of rehab that's dumb. We need to have guys just say - Tommy John even if it's a foot injury. Granted I'm not a Doctor per say. But, I know that the Twins aren't handling their injuries correctly and they need to change it. I don't like when players say they will be better in 4-5 days and it takes 10-11 days instead!
    1. Brock Beauchamp's Avatar
      Brock Beauchamp -
      As I mentioned to Nick last night, I wonder if the front office was hesitant to DL Span because they want to trade him this offseason. A few days missed with no DL stint looks better than hitting the 15 day DL.
    1. OldManWinter's Avatar
      OldManWinter -
      Maybe the injury thing is like flipping coins. Though the odds are 50-50 with each flip there can be a prolonged string for either heads or tails. My point is the Twins injury issue is not necessarily any lack of competence ... it may just be a string of bad luck. That the Twins will evaluate the staff and procedures in hindsight is important but it may not be a fault situation.
    1. Brad Swanson's Avatar
      Brad Swanson -
      The policy of letting players dictate when they come back has to be amended. I am quite certain that Denard Span and I have the same level of medical knowledge. When something hurts, I know what it feels like, but I have no clue how long it will hurt for. Typically, this team is pretty protective of its players, so it surprises me that they are putting that responsibility on the players instead of the medical experts.

      I did hear Dan Gladden go on a rant about doctors playing too large of a role in baseball during one of the radio broadcasts. I was kind of surprised by it, but it fits the philosophy mentioned in this article. He basically said that they have too much power and that players should be able to decide whether they can play or not. It was the typical ex-player position in my mind, but when you consider that most coaches are former players, it can't be too surprising that they would feel the same way. Maybe there is a disconnect between the medical staff and the coaching staff on how long players should miss time for minor injuries. Gardy's quote where he says that we (former players) have all had Plouffe's type of injury as hitters kind of points in that direction.

      Its like in Happy Gilmore when Happy gets hit by the Volkswagen. The doctor suggests that he stops playing, but Happy says he'll be fine. The doctor then mutters, "Fine, Do whatever you like! What do I know, I'm just a Doctor."
    1. Brock Beauchamp's Avatar
      Brock Beauchamp -
      Quote Originally Posted by Brad Swanson View Post
      I did hear Dan Gladden go on a rant about doctors playing too large of a role in baseball during one of the radio broadcasts. I was kind of surprised by it, but it fits the philosophy mentioned in this article. He basically said that they have too much power and that players should be able to decide whether they can play or not. It was the typical ex-player position in my mind, but when you consider that most coaches are former players, it can't be too surprising that they would feel the same way. Maybe there is a disconnect between the medical staff and the coaching staff on how long players should miss time for minor injuries. Gardy's quote where he says that we (former players) have all had Plouffe's type of injury as hitters kind of points in that direction.
      The thing that bothers me about comments like Gladden's is that they don't look at what is best for the team a lot of times. If a guy is mildly injured, there's a chance he "toughs it out" and takes the field for two months, hitting 100 or more points below his typical OPS and struggling in the field. If he would have sat for 15 days and let it heal, he could have been on the field again (at full strength) in less than three weeks.

      At some point, it needs to become an argument of "How much of a loss will the team suffer with a replacement player in the short term versus a struggling star player over the long term?"

      "Toughing it out and playing" is often more damaging to the team than just DLing the player for a few weeks.
    1. Rosterman's Avatar
      Rosterman -
      I think the Twins need to give Wayne Hattaway a room in the clubhouse so he can apply his long-used magic elixir that proved successful over a minor league career (something like IbuprofUN crushed into a brew). Wayne would probably work for nothing, still!
    1. Parker Hageman's Avatar
      Parker Hageman -
      The thing that bothers me about comments like Gladden's is that they don't look at what is best for the team a lot of times. If a guy is mildly injured, there's a chance he "toughs it out" and takes the field for two months, hitting 100 or more points below his typical OPS and struggling in the field. If he would have sat for 15 days and let it heal, he could have been on the field again (at full strength) in less than three weeks.
      Well said.
    1. SteadyDietOfCheese's Avatar
      SteadyDietOfCheese -
      ... it is obvious that the players cannot be counted on to do this kind of determination. They have machismo and often millions at stake.

      I get the machismo part, but aren't their contracts guaranteed? Surely there's no financial hit taken by going on the DL, is there?
    1. Parker Hageman's Avatar
      Parker Hageman -
      I get the machismo part, but aren't their contracts guaranteed? Surely there's no financial hit taken by going on the DL, is there?
      It was more of an implication to those who have future paydays at stake. For example, Matt Capps last year said he pitched through a forearm injury - which was likely because he was going to be a free agent at the end of the year. Michael Cuddyer supposedly gritted through a few ailments last year - maybe he did so because of his impending free agency/contract year.
    1. diehardtwinsfan's Avatar
      diehardtwinsfan -
      the problem with the rehab policy is that it should have been put on the DL about 3 years ago. Yet they continue to trot it out every day and handicap the team by one policy on the bench... I'm guessing it will go on the 5 year DL around year 4 or so.
    1. greengoblinrulz's Avatar
      greengoblinrulz -
      This last part with Span...IMO...had more to do with they didnt have anyone they wanted to call up .
      Benson was hurt, Arcia/Parm arent getting called up till Sept at earliest, Dozier is being punished & may not be back in Sept, & they didnt need another INF like Escobar (nobody to replace him in ROC) & they didnt want/need a 13th pitcher.
      I think its assinine to not call up Arcia/Parm due to playoff chases where the teams may miss them anyways. Twins are to do whats best for the MLB team FIRST imo. If its service time, fine...stay a cheap franchise.
      However, the continued joke that is their injury policies have got to embarrass them. Add in the recent Pavano news as well as Bakers problems the last 2 yrs & something needs to change
    1. JB_Iowa's Avatar
      JB_Iowa -
      It seems to me that there is an objective factor and a subjective factor in making any of these determinations.

      There's objective evidence: what do the x-ray or the MRI or any other tests actually tell the medical staff? What do things like range of motion tests or other performace-type tests tell them?

      But there is always the subjective, too. How does it FEEL when I rotate your arm (or whatever)? What is your level of pain?

      It would seem to me that when there is a lot of objective information, the staff should be able to make a pretty good determination (e.g. a tear, a break, etc.) There may be different treatment methods but at least they should be able to get a handle on what is going on.

      But when it is subjective (bruising, general soreness, etc.), they don't have much choice but to rely on what the player is telling them.

      Player's can't diagnose themselves -- but obviously their feedback plays a large part in whatever diagnosis is made. And it seems to me that is where "art" means "science" when it comes to medicine.

      It would be really interesting if there were a way to compare the results of various medical staffs. I think most of us generally grumble about what has/is going on with injuries on the Twins. I just don't pay close enough attention to other teams to know how that compares.
    1. OldManWinter's Avatar
      OldManWinter -
      JB of Iowa ... good points. Further, no two injuries/fixes are alike.

      Which part is injured? How significant is the injury? Does it require surgery? How long ago did it occur? Has there been any additional abuse such as being bumped in the rehab stage?

      I have had three large rotator cuff tears. Results have been way different in each repair. Probably everyone who has had orthopaedic surgery would have a story to add.

      The fans heap the pressure by their continual disapproval. If a player is not in the lineup fans complain about being injury prone. If they play in spite of it their performance suffers. Managers/coaches lose jobs if teams lose so they want the strongest lineup.

      Sort of a no win situation all the way around I would say.
    1. biggentleben's Avatar
      biggentleben -
      Quote Originally Posted by Brock Beauchamp View Post
      As I mentioned to Nick last night, I wonder if the front office was hesitant to DL Span because they want to trade him this offseason. A few days missed with no DL stint looks better than hitting the 15 day DL.
      Tommy Hanson for Denard Span base of a deal. Let the minions work out the details. Get it done!
    1. greengoblinrulz's Avatar
      greengoblinrulz -
      In Spans case, they didnt play him that 11gms as they felt they may need to retroactively DL him. If they legitimitly thought he was day to day, wonder why we didnt see him as a pinchrunner.....tho I dont know if they ever needed that. Seemed like they werent so sure of his day to day status either....at least to me.
      Nothing wrong with a player missing a series but a red light should come on if he's not ready for days 4-7. If by day 7/8 and a player isnt ready....make it a policy to DL him, no questions asked. It doesnt keep the AAA roster short for long, keeps the MLB team full & player plays when healthy.
    1. greengoblinrulz's Avatar
      greengoblinrulz -
      Quote Originally Posted by biggentleben View Post
      Quote Originally Posted by Brock Beauchamp View Post
      As I mentioned to Nick last night, I wonder if the front office was hesitant to DL Span because they want to trade him this offseason. A few days missed with no DL stint looks better than hitting the 15 day DL.
      Tommy Hanson for Denard Span base of a deal. Let the minions work out the details. Get it done!
      Myself, hoping for a deal involving Tampa involving Davis/Niemann or Cobb/Shields individually.
      Good thinking tho....Hanson has gotten a lil worse each yr & arm problems scare me a bit
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