Carlos Zambrano Injury Explanation

It's been revealed that Carlos Zambrano is suffering from rotator cuff tendinitis but I started noticing a difference in his PFX data as early as June 20th. His delivery changed, his arm slot dropping and by many accounts he started to "sling" the ball in the words of Will Carroll.



The reason why the arm slot will drop down because of rotator cuff problems is an issue of mechanics. The following image is courtesy of athletic scholarship.net.

When the arm raises above the athletes head, the head of the humerus must rotate downwards or the tendons will become pinched between the acromion process and the humeral head. The Rotator Cuff muscles are absolutely key in this process as they have a force couple with the deltoid muscles to keep stability of the shoulder joint and move the arm. The rotator cuff must compress the humeral head into the labrum and rotate the humeral head downward allowing the deltoid to raise the arm above the shoulder. If the rotator cuff is insufficient, the deltoids raise the arm but the humeral head doesn't rotate. The arm cannot raise above the shoulder level without the rotator cuff and the tendons get pinched between the two bones.

Therefore, instead of coming from "over the top" the pitcher must drop down to 3/4 or approaching sidearm. Another adjustment is what Zambrano did by dropping ones elbow and shot-putting the ball up to the plate.

Tendinitis can caused by several things including laxity (looseness) of the shoulder or elbow, muscle imbalances, labrum tears, or overuse. Without seeing him everyday I can't give you an exact reason but normally in power pitchers it's a combination of muscle imbalances and very minor looseness.

Based on how long he appeared to have an altered throwing motion, it will likely take just as long to get him back to 100%. I expect that he's going to be around a week or two away from being able to pitch in an MLB game again. He's probably going to be on a strict pitch limit when he comes back which is the smart things to do. Hopefully this will help set up a Cubs-Red Sox World Series.

Injury News and Analysis

My new injury analysis column is up at Fighting Chance Fantasy. I will have a in depth analysis of the Beckett situation either later on tonight or tomorrow at the latest.

Carl Crawford Injury Analysis

Will Carroll defined Crawford's injury as a "subluxating extensor tendon" in his middle finger in today's Under The Knife column. One of the MDs he spoke with compared it to the worst type of fracture. This is definitely true and one comparable that I think of immediately is similar although different and that's Curt Schilling's bloody sock injury from 2004.

Schilling's ankle injury was a subluxating peroneal tendon in the ankle which eventually needed surgery to correct. Schilling's subluxating injury was extremely painful and diminished his effectiveness, power, and control. Crawford's injury is similar in that the tendon will most likely not heal on its own and could require surgery to fix it. The injury will cause a decrease in power, bat control, and of course effectiveness.


(courtesy of ASSH.org)

This is what happens. The area in question is the knuckle at the base of the finger on the back of your hand(right where the other tissue crosses and at the dark circle in the picture above). There is a sheath of connective tissue which basically forms the roof over the tendon in order to keep it place with movement. The other sides are all surrounded by bone and cartilage. If this sheath is torn the amount the tendon can slide around depends on the amount the sheath is torn. If the sheath is completely torn, the tendon can come all the way out (dislocate) and then go back in on its own. If the sheath isn't completely torn, the tendons don't go all the way out but they ride up to the top of one of the side lips, rendering it essentially non-functional.

The most aggregating motion for this is forceful side to side motion while gripping something like a bat. Swinging a bat requires the muscles controlling the fingers to contract forcibly which puts tension on all of the tendons. This tension is what can cause that extensor tendon to sublux.

The sheath when torn reacts just like a tendon when torn. If it is completely torn, it basically never heals without surgery. If it is partially torn, there is a chance that it will scar down, but even then it requires a length of time.

Unlike Schilling's injury, there is no bracing of the fingers which would allow him to play. In order to brace/split the finger appropriately, he would need to have his whole finger stabilized from moving in either direction.

This is why honestly, I don't expect he can avoid surgery. There usually isn't any problems long term, but there is always that small chance that it can recur.

Database issues

I'm having a slight issue with changing the database so that I can give you the fantasy numbers (HR, RBI, etc) as well as my normal in-depth analysis ones. I feel that I need to give you cold hard numbers on both end in order to maximize your reading time here.

I should have the issue resolved by this evening and should hopefully give me more time to my passion of Pitch FX. Thanks for being understanding.

If there is anything else you'd like to see in my posts, please let me know here.

Erik Bedard Injury Information

Today another piece of the Erik Bedard puzzle finally came to light courtesy of the Seattle - Post Intelligencer and that is he has internal impingement. Some places are describing this as merely soreness but nothing can be further from the truth. Internal impingement is a discernible pathology and one that is relatively serious for baseball pitchers.

First it is probably close to the leading cause of pain in the top back of shoulders in pitchers. Often times it's diagnosed as rotator cuff tendinitis. Internal impingement is where both the labrum and the rotator cuff tendons are involved and they get pinched between the head of humerus (the arm bone) and the acromion process of the shoulder blade (the bone on the very top outside of your shoulder).

Usually in pitchers it's because of the result of several things. One potential cause is the muscle weakness, in particular the subscapularis due to many minute traumas during pitching. This tends to be aggrevated during the cocking phase of throwing which occurs when the pitcher brings the arm out of the glove and lasts until the arm begins to accelerate forward. What happens is the muscle weakness cause the humeral head to slide around. This causes inflmmation and pain. The pain and inflammation causes the body to alter the motion and not use the muscles as much. This causes further weakening and the process kind of feeds into itself and snowballs out of control. When the shoulder blade muscles are weak, the shoulder blade moves around too much and it doesn't have a stable base or stay in the proper position. People who have rounded shoulders and/or slouch forward often have this problem.

Another potential cause is instability in the ligaments and joint capsule. During the throwing motion the same things happen. The range of motion that occurs during throwing stretches the ligaments over time which causes further instability. This instability can cause weakening of the muscles as noted above which can lead to further problems.

Another potential cause/problem is fraying at the top of the labrum. When this occurs the pinching of the tip of the labrum eventually begins to wear it down and break up the top of the labrum. This results in a loss of stability of the shoulder moving up which causes even further pinching. Again, it goes into a feedback mechanism where it gets worse and worse.

Summary: Shoulder injuries with baseball pitchers need advanced care when this begins to take hold. Ice and short rest often don't solve the problem. You need to attack all three problems at once or else you won't be successful. This is why it's going to take much longer for Erik to return than a normal 15 day rest. It often takes 4 weeks or more to calm the area down and strengthen the muscles to provide that stability. The ligaments never heal back to normal without surgery so strengthening the muscles is absolutely key.

Jorge Posada Injury Update

Jorge Posada has just made many a grown man cry as he said he’s likely to return to the DL according to Rotoworld and The New York Post with his recurring shoulder problem. This isn’t surprising to me if he was catching every day but it is surprising because he has been DHing so much. Previously he’s been noted to have a labrum tear, rotator cuff tendinitis, and a subscapularis tear.

To me this is quite concerning as I expect them to find more damage now than before. In terms of the type of surgery it depends on the type of tear they find in there once they go in. One type of common tear is known as a SLAP tear of the labrum which means that there is a tear in the top part of the labrum running from the back of the shoulder to the front. It can also involve the biceps at times. (see images below courtesy of ptclinic.com and eorthopod.com) The repair for this is fairly lengthy because they need to allow the biceps anchor to heal as well as the actual labrum to heal before beginning any exercises. If only the labrum is frayed then it will be a much shorter recovery but it would still come close to ending his season at this point.

Also what needs to be considered is what type of rotator cuff tear there is presently. The subscapularis tear may have progressed to involve other rotator cuff muscles or was worsened by playing. Rotator cuff repairs are much lengthier often approaching a year to 16 months before they are fully healed. Complicating matters further is there is often damage to the rotator cuff, labrum, and biceps tendon all at once. The more that’s going on, you can imagine there will be a longer rehab.

I want to take the time to explain one thing. A common myth is that an MRI diagnoses an injury but it really doesn’t. Posada has been said to have his MRI diagnose the subscapularis tear or even that he was diagnosed with a subscapularis tear after his MRI. MRIs are not foolproof especially in the complexities of the throwing shoulder. There are many times especially in throwers where rotator cuff tears look like labrum tears or vice versa. I have seen this twice already in my career. The only way to be 100% definitively correct is to go inside the shoulder and actually take a look at it.

Pretty much any surgery will end Posada’s season and depending on the severity could easily push him back into 2009. Like I said, it really depends on the severity of the labrum/rotator cuff issues. I’ll keep everyone up-to-date.

Aaron Harang PFX analysis

Cincinnati’s been searching for a reason behind the struggles of Harang over the year after having such high expectations for him coming into this year. After his latest start, he was examined and was given a preliminary diagnosis of a tight forearm. This is concerning to me because of what I have seen in my experience. During my experience, elbow problems, especially chronic Ulnar Collateral ligament injuries lead to control problems but not necessarily velocity. This has also been discussed by a authors who’s opinion I trust, Will Carroll (sorry subscription required but well worth it) being the one that I read most. With this in mind, I wanted to look at the PFX data to see if it backed it up.

First and foremost I wanted to see what the release point was for all of his starts. At first I isolated only his home starts to be as consistent as possible and see if it was a long running problem. That gave me the lines that gave me the “central” location of his average release point.
I used the median as the reference because if we use the mean, the position would be effected by outliers. The one thing you can notice right away is how inconsistent he was with his release point. Lately the last month or two, he has been right at the line or below it. This would possibly indicate a drop in the arm slot, but we can’t be absolutely sure. The side to side motion is somewhat effected by where the player is on the rubber, so we have to take this with a slight grain of salt.

What can we conclude with the above? Something might be wrong mechanically but it’s likely not his shoulder. With his reporting of forearm and elbow pain, any changes might not be significant enough to show up in the release point. We would be more likely to see changes in pitch location with elbow and forearm pain.

With that understanding, normally I would produce a chart showing a depiction of the strike zone, but with so many pitches and dates it would be too jumbled and hard to read. So instead the next chart shows how many balls, strikes, and balls that were hit into play over each start. While they may be slightly affected by the umpires’ strike zone, the general trends are true across all starts, not just the home starts.

This is really telling because except for one slight hiccup on June 8^th, he has been throwing more pitches in each outing since May 25^th when he came in relief and threw 63 pitches according to baseball-reference.com. Then 4 days later he threw 73 pitches. So in a 1 week period he threw 239 pitches. The percentages in the above graph represent the number of pitches in that category divided by the total number of pitches. Something that I find really alarming is that in the 4 -5 starts prior to the relief appearance he had declining pitch counts but then after the relief appearance he was allowed to jump back up to the previous max or even higher. For someone who has been used pretty hard the last several years, this makes me nervous.

I then did a comparison of all the pitches that were in the zone versus out of the zone before and after the relief appearance based on the PFX system and I came up with the following. The PFX system’s accuracy claims to be within a half inch at the plate so it’s incredibly accurate. Before and including the relief appearances he had 12 appearances and after the relief appearance he was in 8 games. He threw 347(43.2%) balls outside the zone and 456 (56.8%) balls inside the zone in those 12 appearances. In the 8 post-relief appearances he threw 487(43.5%) balls outside the zone and 633 (56.5%) balls inside the zone. If 0.3% doesn’t seem by much, it’s because it isn’t. That’s a difference of 6 “extra” balls after the relief appearance. I don’t think that is necessarily too significant a difference.

His control has changed a lot this year overall though. BB/9 from 2005 to present flow like this: 2.16, 2.15, 2.01, and then rises to 2.48. This really isn’t that different based on the number of Innings so far. It only amounts to a difference of 4BB in a half a season. The problem is that the difference is really just after the relief appearance. Pre-relief his BB/9 was 2.19 while after it was 3.06.

In terms of K/9, from 2005-present: 6.98, 8.3, 8.5, and then drops to 7.9 this year. This years’ breakdown is this: The same drop off after the relief appearance shows in the K/9 of 8.3 pre-relief while post-relief those numbers and 7.34. This is quite a difference of about 1.7 per start.

How is his velocity though?

Initially it doesn’t appear so. His velocity has been up and down but you notice that his fastball velocity deeply dropped off after his relief appearance on May 25^th. It didn’t just drop off for 1 start but actually for two starts before starting to rebound again. Most likely this was due to fatigue after having to throw relief that day. The first start after the relief point the release point was above the normal but the second start coincided with a clear drop of the release point. Dropping of a release point has been known to put more pressure on the anterior shoulder, biceps, and medial elbow.

Last I want to look at the movement of his pitches across starts. My assumption is that he will have less control of the movement during the later starts. The bars are only for graphical purposes only to help me guess as to how far apart the clusters are. As you can see, the last start the clusters are a lot closer together than previous ones but that just may be because it is at a different park. It does appear that they are becoming closer overall, but it is not a great difference.

This could result in the pitches moving with less bite making it easier to hit or make contact. Finally, again with a little help (mostly to make it faster) from baseball-reference.com, I looked at the percentage of called strikeouts versus swinging strikeouts. From 2005 they are: 24%, 20%, 16%, and 33%. That means that his stuff/movement was getting better and better from 2005-2007 but now in 2008 he has to rely on location. We have seen previously that his pitch location is off this year, especially after the relief appearance.

Summary: More work still needs to be done but initially it appears that there was a dramatic effect for the worse. From the work done with previous authors, control has been shown to be more effected by elbow injuries than velocity and we see it above. I don’t have enough reliable PFX data on the effects of UCL injuries, but unfortunately (from a health perspective) I’m sure we’ll have the data soon enough. Harang has been struggling mostly after the relief appearance in terms of striking people out. It appears that his pitches were more hittable or at least able to make contact and that is a symptom of fatigue or injury if over a long term. Something was bothering him with elbow since after the relief appearance according to PFX and I hope it was only a minor strain.

Mark Mulder diagnosed with strain

Mark Mulder has been diagnosed with a strain after only 16 pitches last night. He hasn't been able to pitch effectively since 2005 and given the history of 2 rotator cuff surgeries, this is not good. He said that he felt severe pain with it which was pretty evident as he grimaced on the last pitch. I wouldn't be surprised for him to be shut down until late August at the earliest.

Mark Mulder injured again

Mulder struggled mightily and was removed in the first due to an injury. Something still isn't right despite being back in the starting rotation. Once I find out more, I'll provide an in-depth analysis.

Injury News

We have some good (depending on how you look at it) news today.

1. Schilling will have season ending and likely career ending surgery to repair his shoulder. He is reported to have both rotator cuff and labrum/biceps tendon injuries. Given his age and his declining skill set already, the likely extensive surgery almost gaurentees his career is over. Too bad he can't bribe someone anyways for a Cy-Young vote (at least $1 mil is on the line for him)
2. Mike Gonzalez is returning from the DL and will slot into the closers role for now. When Soriano comes back there is a chance that he returns to the closers role and Gonzalez will move to the 7th but my gut feeling says he'll stay in the closers role. If you need saves, here's you chance to get some quick vulture saves for now.
3. Francisco Liriano will likely stay down in the minors for a "few more" good starts in order to make sure his head is in the right spot. Speculation is that it is only due to monetary reasons from the front office. Fantasy owners everywhere (including me) need him to come up sooner rather than later and help my d**n team.
4. Dr. Andrews confirmed that Hafner does not need surgery, which is good news. The bad news is that no-one knows (including the medical staff) how long he will continue to be out. What the hell are you going to do? You're just going to have to keep him on your bench/injury slot and hope he comes back strong. In the meantime, you're going to have to try and patch the production with guys on hot streaks (like Thames from a week ago or J.D. Drew for the past month)
5. As I believed, Tulowitzki returned to the team and is expected to play on Friday. Put him in your lineup right away and be thankful it wasn't longer.
   

Carlos Zambrano PFX analysis

As promised, here is the PFX analysis of Zambrano. One limitation I had was that this most recent start was in Tampa and this is the only time he's pitched there this year. Therefore some of the values might be not be the most accurate, but it is the best that we currently have so on we go.


To start with, looking at his release point, it appears that the whole game at Tampa Bay he was release the ball lower. This can both occur due to and cause an injury to the shoulder and elbow. Instead of the shoulder transferring the energy like a whip, some of the structures begins to fail as the energy is not transferred optimally for that person. In the next series looking at the release points across starts, it also appears that he wavers horizontally in his release point as well. As the release point comes closer to 0, his mechanics change. This can occur because he is dropping his shoulder, extending his elbow too late (again causing excess stress on the shoulder), releasing the ball later in the motion, or because of a purposeful mechanical change. I don't think it would have been due to a planned mechanics change or else we would have heard about it earlier.



Will Carroll of Baseball Prospectus have shown that control often goes first when an injury occurs. Looking at his pitch location chart, I don't really see any discernible difference between his home starts and his start against Tampa Bay.



It looks like he's consistent with his previous starts. Sure there are some that appears a little more inside, than others but overall they are spread apart evenly as expected. Normally the first sign of injury is loss of command but I think this is only in cases where the condition doesn't happen all at once, where it occurs over time. This didn't happen to Zambrano. He described it happening all at once, so the pitch location chart isn't very relevant to this discussion.

So looking at his velocity of his pitch types across the starts, it looks like there might be a slight dropoff in his fastball velocity (about 1 MPH). Again, this is ever so slight but because it is the average there are several better ones and several ones that are even slower that that. Looking at a table of his averages, you can see that almost all of his movement pitches were thrown at a less velocity in his last start than others.

pitch	CH	FA	FC	SI	SL
Start
1	76.9	84.1	81.3	----------	75.7
2	78.0	82.9	----------	82.8	74.6
3	78.4	83.6	82.1	82.5	75.9
4	77.1	84.5	82.7	81.5	78.1
5	76.9	82.8	82.3	79.9	75.8
6	77.6	83.5	82.9	----------	76.7
7	78.3	83.4	81.8	----------	74.2
8	79.3	83.9	82.9	82.8	75.9
9	78.4	83.7	82.2	83.2	74.7
10	77.0	83.2	77.3	82.8	74.3
Avg.	77.9	83.6	81.9	82.4	75.6

Looking at his movement, across his starts. One interesting thing comes up.
In his last start, there appears to be more movement horizontally than in his other starts. It almost appears that everything is shifted to the left. Unfortunately, I cannot definitely say this is because of an injury or if this is a minute difference in the PFX setup.

Summary, evaluating PFX data across starts to evaluate a pitchers health is at it's infancy. Like others have noted, I'd love to be able to synchronize, the PFX data and video in order to get a true accurate read on a pitchers' mechanics. That doesn't mean that people shouldn't analyze what they have available to them though, this is the foundation of true understanding. As time goes on, we'll have better tools available to us.

Zambrano appears to have slightly changed his delivery in his last start. His velocity also suffered which can provide more information. Based on his symptoms and how he described it, I still believe there will be a labral tear and/or at least a partial rotator cuff tear. Unfortunately that means a lengthy stay on the DL and a possibility of ruining your chances of a fantasy crown unless you take action immediately.

UPDATE: This is why they do these kinds of tests. Despite describing symptoms that mimic a more severe problem, Zambrano was diagnosed with a "minor rotator cuff strain, but no structural damage" according to team officials. The plan though is still unclear which still leaves me wondering a little bit. I guess this is good news but in terms of returning to pitch, noone is sure right now. It all depends on how long his symptoms last. These things are notorious for being minor but resulting in a DL stay of longer than the minimum. Everything needs to be perfect or else he could do major damage during pitching. Hopefully more updates will follow relatively soon, so everyone can fully plan their lineups.

Carlos Zambrano Injury Evaluation

I didn't want to comment on this until I had some idea of what was going on and now that I know what kind of MRI they're doing I can tell you.

Carlos Zambrano had his MRI pushed back to Friday because they are now going to be doing an arthrogram (basically a fancy name for an MRI where they inject dye inside the shoulder joint) They usually don't like to do this because it is an invasive procedure and that always carries at least some risk.

This can only mean one thing. They are worried about damage inside the shoulder in the form of either a tear to the labrum, rotator cuff, or joint capsule. Given his symptoms I wouldn't be surprised to see either a rotator cuff tear or a labral tear.

Honestly, I would try to shore up your pitching staff with other pitchers if possible because I expect he will be on the shelf for a little while. I will be doing a PFX article on him by tomorrow.

Injury Analysis - June 17th

I'm going to try something new with reporting and describing injuries. Instead of posting injury updates regarding only the biggest news, I'm going to list the top 5 injury news each day that effects your fantasy team. If you would rather have a different format or like to see more of a different topic please let me know.

1. Brad Penny - Shoulder Bursitis and Mild Tendinitis in Throwing Shoulder

He's been diagnosed with bursitis and tendinitis in his shoulder and has been placed on the 15-day DL. Penny said that it has been bothering him for a while and the results show it:

BABIP	K/BB	PTO%	QERA	ERA Dif	P/IP
0.333	1.310	23.2%	5.28	0.603	17.68
0.306	1.85	27.70%	4.63	-1.604	15.51
0.327	2.74	26.69%	4.12	0.210	17.11

Clearly his control problem and thus his P/IP was effected by the shoulder for some time. Rehab wise it's a fairly straight forward and relatively simple rehab, I expect him to come back in the 15-20 day range. Once he's back, look closely at his control over his first 2 starts. If his control doesn't return, assume that there is still something wrong with his mechanics (whether it's from an injury or something else)

2. Paul Konerko - Grade I Left Oblique Strain

Figures just as I suggest to pick him up he pulls his left oblique. Thankfully this is a very mild strain so he should be back in the minimum. What's important though is that this muscle turns the trunk to the left producing force and power to the right handed batters. I would keep an eye on his power at first, but most likely he'll be completely fine in 2 weeks.

3. Rafael Furcal - "Stiff Lower Back" (yeah right)

Low backs don't stay stiff on their own for 10 weeks. Don't be surprised if there is a degenerative condition or some sort of disc injury. Either way, they're calling it AS-break at best. I don't think he'll be much use for you for a couple of weeks after that.

4. Troy Tulowitski - Left Hip Strain

Troy is due to return near the end of the week if all goes well and I expect an explosion of offense from him the second half. I expect that he will get back to his numbers from last year. Also to consider is that he was extremely unlucky in the first part of the season:

BABIP	P/PA	BB/SO	GB/FB	HR/FB
0.160	3.69	1.20	1.310	3.45%
0.280	3.82	2.66	1.444	16.90%
0.237	3.67	8.50	2.313	6.25%

An extremely low BABIP despite being extremely aggressive and hitting a lot of FB. His HR rate is also extremely low. Get him while you can if someone was dumb enough to drop him.

5. Francisco Liriano (sorta an injury recovery) TJ recovery

He's gained a lot of confidence and has found his mechanics and lost the fear of hurting his elbow again. This is often the hardest thing for a pitcher recovering from TJ, just letting it go and trusting the arm again. Once the pitcher does this, something clicks and they return to the level they were at previously. After stinking his first start in AAA, all that he's done is thrown 6+ innings 8 out of 9 starts and walked less than 2 batters 7 times out of 9.

Again, if anyone was dumb enough to drop him then pick him up immediately. He should return to the Twins soon.


Please let me know if you prefer this format or another format. Of course when major injuries happen (such as Wang) I'll do a special post.

UPDATE: I just saw on ESPN that he has been dealing with a bulging disc. As anyone knows who ever had a bulging disc, it's a hard thing to live with once it becomes symptomatic. It can flare up at anytime and it really never fully heals, it simply becomes less painful/problematic. Again, this is another case where you really have to watch his rehab starts. The one good thing is that he was never really a power guy so his power won't be sapped as much.

Jeremy Bonderman injury analysis explained through Pitch FX

For those of you who having heard, Jeremy Bonderman will miss the rest of the season in order to undergo surgery for a blood clot resulting from Thoracic Outlet Syndrome (TOS). I didn't write about it until now because I wanted to look through the pitch FX data to see if there was anything we could really discern and I found out that Pitch FX can be more truthful sometimes than any athlete.

The axillary vein when compressed is a very big issue due to the large volume of blood flowing through it. (see image) You can also see based on the location the axillary vein is basically right where the arm meets the trunk of the body. A lot of times the pain can feel like general shoulder soreness or having a fatigued arm. Clots in the circulatory system are extremely dangerous as they can dislodge and eventually potentially cause strokes, heart attacks or more. I won't bore you with the details of the surgery other than that they have to remove a piece of rib and repair the vein as well. This will keep him out the rest of the year including the post-season as rehab is conservative due to the circulatory system aspect of it.

But has it been the cause of his issues on the mound? While I'm sure that it wasn't helping things, let's look at the Pitch FX data over his many starts to see if things have been worsening. One start didn't get measured correctly according to MLB so I threw that one out.



Just taking a look at it at quick glance, it appears that he wasn't consistent in any aspect of his game. Release point across each start overlaps some but it spreads out over 1.5 feet horizontally and over a foot vertically. I suspect that if his arm wasn't feeling completely normal he was trying to use his lower body and trunk more to get the pitches to act "normally". As he relied on this his arm became more of a "wet noodle" and less likely to be move about in space in a consistent manner. Looking at his average release point in the chart below it, you can see that even though it doesn't appear as bad, it still varies quite a lot for an average of 90 pitches per start.

His velocity on his pitches is also erratic. Up down Up down and then it's a big jump up and then down again. I can't explain the completely erratic nature of his velocity on all his pitches. I wonder if the data is somewhat corrupted but I doubt that.

After these two, I look at the movement of his pitches, his speed versus vertical movement (I don't care all that much about horizontal movement), and avg movement per pitch type per start. Again, reproducibility is non existent.

So, let's look at this a different way, let's start with the results and work backwords. Rotoworld.com first began to question the health of his arm back in mid to late April, specifically 4/24/08. They began to question this after he displayed extremely poor command over back to back starts where he couldn't find the strike zone. Both of these starts in particular have the furthest horizontal release point with it being almost at the bottom of his total release point zone. His average velocity started to tail off significantly at that point and then over the next several days. His average horizontal movement was the most and the average vertical movement was near the lowest amount on all his pitches over all of the starts.

To summarize this means to me that he was dropping down, trying to relieve some pressure off his shoulder and the vein. By dropping down he was throwing more in the horizontal plane and less in the vertical plane causing his movement to suffer as well as his pitch command.

			Average	Speed
FA	81.31	72.13	79.54	72.95	81.50	70.70	71.84	83.57	85.03	81.84	82.82
SI	82.20	79.25	80.34		81.36	79.50				78.10
CH	76.68	76.00	74.99	75.40	75.57	76.26	78.12	79.13	79.47		76.83
SL	77.20	75.13	74.50	74.98	75.15	75.52	77.97	78.02	78.78	75.46	76.14
CU		73.55	73.60		75.40	74.87	74.90		76.10
			Average	Horizontal	Movement
FA	-12.51	-7.68	-9.80	-7.23	-13.25	-12.35	-7.35	-10.31	-9.54	-7.54	-8.23
SI	-18.20	-11.50	-17.79		-17.60	-15.81				-11.51
CH	-9.66	-6.10	-7.72	-4.03	-7.82	-10.57	-9.20	-11.59	-7.64		-10.23
SL	-6.43	1.20	-5.89	2.76	-8.55	-2.50	1.06	-0.83	-0.60	0.75	0.55
CU		1.45	-8.30		-6.83	-6.61	2.07		0.647
			Average	Vertical	Movement
FA	4.65	7.48	2.57	9.91	7.64	7.15	7.16	7.01	6.10	8.60	9.04
SI	6.61	8.56	7.08		6.63	7.47				10.06
CH	1.10	4.08	1.12	2.07	0.92	3.13	3.83	5.99	3.08		8.13
SL	0.63	0.68	2.31	2.68	1.37	0.10	-0.12	0.00	-0.34	1.86	2.21
CU		-2.41	-0.79		-3.55	-0.64	-3.62		-2.48

This to me is one of the ways I think Pitch FX can actually help the baseball players, management, and fantasy baseball owners. As an Athletic Trainer, my first priority is always to the health of the players though. This kind of data could be examined more to possibly predict in the future that something is wrong that the pitcher isn't relaying. I'm sure that some of the MLB teams are looking at this and I hope that all of them do. Having this sort of data is hugely helpful and the next step would be to include the footstrike moment and note that on an x/y plot.

As a fantasy baseball owner, you can look at these graphs and see that something isn't right. Bad starts happen so one start is not a good reason to get rid of someone. However with a couple of starts in a row, looking like the above, and then getting whispers from the hometown newspapers and Rotoworld.com means you should unload him ASAP.