200 Innings for Harvey? How about 51 Pitches?

In a press conference on Wednesday afternoon, Matt Harvey announced that he was unlikely to pitch as many as 200 innings during the 2015 regular season.
Great, Matt, but how about we get past 50 PITCHES, first?
Some of you may be wondering why it was necessary for Harvey to make a public appearance and tell the world of the impending innings limit. Pretty simple: it’s the holiday shopping season, and now is when people buy season tickets for the Mets fans in their lives. And what better way to raise the hopes of Mets fans than to a) put Matt Harvey’s face on TV; and b) mention the word “postseason,” and have it regurgitated by every Mets beat writer and blogger. In the average Mets fan’s (that is, the fan who generally does NOT read Mets blogs) head, it works like this: Harvey + Postseason = Buy Season Ticket Plan!
It was nice, though, that Harvey also participated in the Mets’ annual coat drive as part of the day’s activities. That was cool, though it likely won’t be as well-reported.
In any case, let’s get back to Harvey’s health.
Before Matt Harvey — or anyone else — can even THINK about setting an irrational, illogical, and ridiculous innings limit on Harvey’s 2015 season, the righthander must first throw more than 50 pitches off a mound to find out if his elbow is OK. In case you forgot, the Mets took Harvey’s rehab prescription and threw it in the trash, believing that they knew better than the majority of doctors and scientists who spent years and years developing a standard rehabilitation plan specifically for pitchers coming off of Tommy John surgery. What do doctors and scientists know about the human body and the healing process, anyway? Never mind all the nonsense about progressive throwing programs that rebuild the arm based on research — this is Matt Harvey, and the Mets have to be “cautious,” and doing something other than tossing a ball 20 times once a week is dangerous and aggressive! Doing LESS than what is prescribed HAS TO BE safer, right? At least, that’s what any non-scientist or non-medical-professional would think, therefore it must be true.
Um, except it’s NOT. In fact, doing less than what is prescribed — and Harvey did FAR less than what was prescribed — is just as dangerous as going overboard. Think about it — if you have some kind of illness that requires you take an anti-biotic once every four hours for two weeks, would you take only one pill every 8 hours over the course of a month? Or if you broke your leg, and the doctor said you’d be in a cast for 6 weeks, would you choose instead to leave the plaster on for 12 weeks, just to be safe? Of course not, because there is a reason that a healing process is prescribed — prescriptions are created by people whose livelihood is based on being expert in physiology, medicine, and healing. Every medication, time frame, and step in the healing process has a very specific, fully researched and tested, reason for being there. Further, the steps are in place, along with associated guidelines, reference points, and conditions, so that the process can be properly and scientifically tweaked if things are either advancing more quickly than expected, and/or if the illness or injury is not responding as well as expected (i.e., a setback). It doesn’t matter if you are a first-grader with the chicken pox, a football player recovering from a torn ACL, or a baseball pitcher coming off Tommy John surgery — if you choose to veer off the prescribed path, you’re on your own, and you’ll have absolutely no idea what’s best, because you’ve just turned a scientific process into a complete crapshoot.
That’s where it is with Harvey’s rehab — it’s an absolute crapshoot. Because he was arbitrarily held back from advancing his throwing at every step, we have no idea whether or when he’ll be back at 100%. In fact, because Matt Harvey never threw more than 50 pitches off a mound after TJ surgery, we have no idea whether the elbow is completely healed, or if it needs further strengthening. You can’t know — for sure — how the elbow is doing until after it’s pushed, and, according to all research done in the past on patients recovering from TJ surgery, many issues won’t rear their ugly head until after the pitcher gets beyond 50-60 pitches, rests for two days, and pushes it toward 60+ again to see how the arm reacts. Simply resting or taking it easy or limiting the “aggressiveness” of a progressive throwing program doesn’t cause a muscle or ligament to get stronger — it needs to be built back up. In fact, too much rest can cause atrophy.
For whatever reason, the Mets made the arbitrary decision to stop Matt Harvey’s rehab after he reached 50 pitches. We also know that non-doctor Dan Warthen expected Harvey to shut down throwing completely for an entire month, because that’s what every other pitcher does to “recover.” I’m not sure what Harvey needed to “recover” from, and further, I don’t know why ANY healthy pitcher would completely shut down their throwing — it makes no sense from an athletic training nor scientific perspective. Do sprinters shut down their running program for a month? Do bodybuilders stop going to the gym? I’m not sure, maybe they do. Regardless, the point is that Harvey was/is an athlete recovering from injury, in the early stages of his rehab, and was shut down right at the point when he absolutely needed to progress. After reaching 50 pitches, a rehabbing pitcher can start to not only push himself but also start to correct the flaw or flaws that caused the injury in the first place. Oh, did you think that UCL injuries occurred because of dumb luck or because a pitcher’s arm “ran out of bullets”? Maybe those are legitimate reasons on planets were unicorns exist, but here on Earth we have discovered that everything — and athletic injuries in particular — happens for a reason. Wouldn’t it be great if Matt Harvey continued throwing off a mound after the end of September, and started working on correcting his mechanics, and maybe even began tinkering with his off-speed pitches, so that he’d be in shape and ready when spring training began? And/or, if some kind of issue came up, it could be dealt with in, say, November, still leaving plenty of time to get ready. Instead, he’ll be starting from square one at some point this month — from zero — and by the time spring training rolls around, MAYBE he’ll be at the same point where he was at the end of September (50 pitches). Then everyone will hold their collective breath and cross their fingers that Harvey doesn’t suffer some kind of setback. And hopefully there will be enough time for Harvey to identify the mechanical flaw that caused the elbow injury, and correct it. And enough time to work up to 100-120 pitches every five days. And get his secondary stuff working. And regain command. And if everything works out perfectly, is there any reason to stop him from pitching more than 200 innings? I’m looking high and low and seeing no scientific research anywhere that says a pitcher coming off TJ surgery should adhere to an innings limit. I see plenty of guesses, theories, and suggestions from people who are unqualified to speak on the topic, but I’ve yet to see hard scientific evidence that pinpoints a specific workload in a specific time frame — such as 200 innings over the course of six months. Even if there WAS some evidence suggesting that limiting innings was a good idea, it wouldn’t apply to Harvey, because the Mets chose to throw science out the window the moment they altered his rehabilitation regimen.
Hey, Matt Harvey might be absolutely fine come Opening Day 2015. He might well pitch 190-195 innings and do very well. And then all the Mets officials can pat themselves on the back for a job well done. But we won’t know for sure if what they did was “right” or if it was pure luck, because right now, that’s all we’re going on. Consider Matt Harvey a guinea pig, going through a lab experiment directed by a group of laypersons who are using only bits of science that fit their own baseless theories.
Then again, maybe Harvey is saying all the right things in public, but behind the scenes, away from the cameras, microphones, and social media channels, has been continuing his rehab on schedule — maybe in his parents’ basement in Connecticut or a barn in the middle of an Iowa cornfield. Agent Scott Boras has as much (if not more) invested in Harvey’s future as the Mets.
At times you logic and common sense is very depressing.
There’s a great deal of evidence on recovery from TJ surgery. List every pitcher who has had it, then do a before and after including innings pitched.
In any case, i see a good year from Harvey as 125-150 innings with an ERA+ between 100 and 110. The Mets had a great deal of good luck last season and won’t be able to afford at least one of Murphy, Niese, or Colon 2015. I have no idea why anyone projects the club to contend before 2016.
What will that prove? Nearly every (if not every) pitcher who had TJ surgery had a mechanical flaw that caused it, and how many had the flaw corrected afterward? We have no idea. Further, innings pitched means very little — it doesn’t take into consideration three INCREDIBLY important factors: 1. number of pitches thrown; 2. amount of rest/recovery time between starts; 3. routine during the rest/recovery time between starts.
Assuming Pitcher A and Pitcher B both are coming off TJ surgery, and assuming that mechanics are not a differentiating factor (which is an impossible assumption, but for this exercise, we’ll pretend), if Pitcher A’s in-between routine is that he throws 90-100 pitches per start, then doesn’t throw off a mound AT ALL until his next start (thus providing the recommended 4 days’ rest), then his results will be far different if Pitcher B does the typical MLB routine, which is taking one day off after 90+ pitches and throwing a “bullpen” on day 2 (which is dangerous and damaging). Another factor that completely changes results are whether or not pitchers include “long toss” in their off-day routine, how far “long” is for that pitcher (120 feet? 180 feet? 200+?), and the mechanics used to propel the ball during “long toss” sessions. Also, is the pitcher engaging in hand, wrist, forearm, and elbow strengthening exercises, to build and maintain UCL stability?
When you consider all the other factors that go into a pitcher’s health, it becomes more clear that raw data of innings pitched after TJ surgery is just that — raw data. That’s not the same as scientific research or evidence. It’s absolutely absurd that MLB continues to look at innings as if they count for something worthwhile — it’s as if we’re living in the 1700s. I’m almost surprised that MLB coaches haven’t considered blood letting or rubbing mercury on pitchers’ arms to keep them healthy.
I’m sure Boras would turn himself into an injury expert tomorrow if he had any power to dictate treatment, but he doesn’t. The best he can do is advise, and he’s never going to advise a client to violate their contract by taking their medical treatment into their own hands (and wallets).
Maybe the next big free agent pitcher Boras represents will request some unique contract language about scientific injury management! But until that happens, I don’t see a fix coming from this direction.
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