How Serious is Chris Young’s Injury?

It only took two starts for oft-injured Chris Young to land on the disabled list with the diagnosis of “biceps tendinitis”. Young was reluctant to be removed from the 25-man roster, but understood the decision from the standpoint of the team.

From The New York Times:

Young, who will miss at least two starts, said Friday night that he still felt some soreness in his shoulder but that no M.R.I. was scheduled. He planned to rest it for a few days, then begin throwing on Tuesday.

“The irritation in the biceps tendon is lingering, and the best thing for it is rest,” he said.

From Newsday:

The Mets’ desperate pitching situation actually got worse Saturday when Chris Young was placed on the 15-day disabled list with biceps tendinitis. Removing him from the rotation, however, was better than risking him against the Braves Sunday with a tired bullpen and the possibility of a setback.

“I understand completely,” Young said before Saturday’s doubleheader at Turner Field. “Doing what’s right for the team first, and secondly for my long-term health. Obviously, there’s a level of disappointment, too — this wasn’t what I’d hoped for coming into the season. But you can’t predict these things.”

Young, 31, made only four starts last season because of shoulder problems, and the Mets — taking into account those health issues — signed him to an incentive-laden one-year contract worth a guaranteed $1.1 million. Despite that history, manager Terry Collins said the team has no plans for an MRI, and Young said he doesn’t want one.

“I think at this point, the symptoms are more important than what you can see on the test,” Young said. “The MRI may or may not show something. It may or may not show something completely different than where I feel the discomfort. We’ve talked to the doctors, and treating the symptoms, I think, is the better solution at this point.”

From the above quotes, it doesn’t sound like Young’s issue is so serious; after all, if it was, he’d be getting an MRI, right? And to the common layperson, “biceps tendinitis” doesn’t sound all that dangerous. It sounds like something that might happen when one over-flexes his “muscle” to show off.

In truth, however, biceps tendinitis can be a very serious problem. Don’t take it from me, though — instead, consider what a scientist has to say.

Curious about Young’s injury, and having heard the term “biceps tendinitis” before, I called on Angel Borrelli, MA, CSCS, USAW. All those letters after her name mean that she’s qualified to speak on the matter of pitching injuries (and pitching mechanics, as well). Angel, in fact, works with pitchers all the time — from little leaguers to MLBers — she is a Sport Kinesiologist who is an expert in troubleshooting the pitching motion.

This is what Angel says:

“The Chris Young thing…it can be bad.

Bicep tendonitis usually refers to inflammation of the long-head of the biceps in the bicipital groove which is located on the upper arm bone. The first problem can cause the tendon to slip out of the groove causing damage to the tendon and/or wearing down the bone…both of which cause the shoulder to become unstable.

The second problem is that the long-head of the biceps inserts on the inside of the shoulder joint and problems with it can create problems for the labrum.

The third issue is…bicep tendon problems are intimately associated with supraspinatus problems (one of the muscles of the rotator cuff).

It’s one of the worst warning signs a pitcher can have; it’s a huge precursor to labral or supraspinatus problems.

The good news is…it is a “warning” sign…and it is usually a pitching-mechanics issue.”

Allow me to repeat: “one of the worst warning signs a pitcher can have”. Yikes! But as Angel says, it is good that Young’s issue is a warning sign and could be related to mechanics — which means it can be corrected. I asked Angel what might be a recommended course of treatment. Her response:

“treating the symptoms” + “the cause of the problem” would be the best formula. On Tuesday, when he begins to throw, unless he plays catch with arm mechanics that do not exacerbate the problem, he will feel pain again; if not when playing catch…possibly pitching. The biceps tendon becomes aggravated for very specific reasons, all of which are easy to detect when you know what to look for in this throwing/pitching mechanics.

I wasn’t sure if Angel was aware of Young’s shoulder surgery from 2009, so I mentioned it to her, thinking that maybe this was “typical” of someone recovering from such a surgery. Her answer:

I wasn’t aware of the surgery but it means that it is more important than ever to get rid of this problem, and its cause (which is always mechanical) as soon as is possible. He is probably not presenting any symptoms in his shoulder and that is probably why they are opting not to have an MRI. But they should do a film analysis of his last outing and have all the arm angles checked before he starts playing catch. It is so simple to do — and if you think about it a “no-brainer”. You should always return to the scene of the crime to figure out what happened. They have the film sitting there — from all four angles — they should use it.

Again, this could be good news — IF there’s someone who is qualified to look at the film and help Chris Young throw with proper mechanics. But does such a person exist? In other words, do the Mets have someone on staff or that they can call on who is an expert in kinesiology?

Likely not, unfortunately; there are only a handful of MLB organizations that recognize the value of that kind of expertise. For all the much-hyped intelligence of the Mets’ new front office, I’m not sure they are among that handful — considering all the injury-riddled pitchers signed this past winter. It’s remarkable that for all the millions of dollars big-league clubs spend on pitching, and all the attention paid to comparatively trivial details such as pitch counts, most teams make no investment in experts of human motion, who can do far more to keep pitchers healthy than the 100-pitch count ever will.

Joe Janish began MetsToday in 2005 to provide the unique perspective of a high-level player and coach -- he earned NCAA D-1 All-American honors as a catcher and coached several players who went on to play pro ball. As a result his posts often include mechanical evaluations, scout-like analysis, and opinions that go beyond the numbers. Follow Joe's baseball tips on Twitter at @onbaseball and at the On Baseball Google Plus page.
  1. gary s. April 18, 2011 at 9:20 am
    I wish Chris Young the best, but him saying that u couldn’t predict this happenning is a bit of a stretch.He has been an injury waiting to happen his whole career.The minute i heard his arm was sore, i knew he would end up on the DL.Now, the question is, will he ever come off the DL.Another move forved on Alderson by the Wilpons going broke amd being forced to sign injured players on the cheap.The next time one of those lying owners insists their involvement with their pal Mafoff has not impacted the ballclub. ask them why the only pitching we can afford is broken fdown pitchers coming off arm surgery..
    • Joe Janish April 18, 2011 at 10:19 am
      Gary, glad you also took note of the “… you can’t predict these things” comment — I may put it in bold for emphasis, because it is a patently untrue statement. OF COURSE you can predict these things — based on previous history and the fact that he hasn’t made the necessary changes to his pitching mechanics to alleviate the stress put on his shoulder. For all the intelligence a Princeton grad should have, you’d think he’d be smart enough to find someone who can help him ease his pain. Though I can’t be too hard on Young; he’s in an industry that is stuck in the 19th century in terms of recognizing the resources available (i.e., modern science, technology, etc.).
  2. Joe April 18, 2011 at 9:35 am
    Ugh. The only thing good here is that you didn’t pay much for the guy. Compare this to all the times you paid a lot of money for people and got little in return. Still, hopefully two starts and done isn’t all we get from the guy.
  3. xDanTanna April 18, 2011 at 10:03 am
    I am not expecting Chris Young back. Such is the way of life… when an organization is never upfront w/ injuries. Not even this new regime was completely honest here. What do you accomplish by saying Chris Young is fine. We are just pushing him back a start, nothing to worry about. He will definitely not miss a start & what happened ? exactly what many expected pushed back further & winding up on DL.

    Ah if Rainbows were Curses we would be riding high :)

    • Mike April 18, 2011 at 10:51 am
      Dan I think the point is that it’s not the Mets hiding injuries, it’s the Mets being too dumb to know how to fix injuries and improper mechanics, along with 90% of the industry.

      Joe, why doesn’t this doctor Angel call up Sandy Alderson and off to consult the organization. I’m sure someone of her credentials would at least be given a meeting with Alderson.

      • Joe Janish April 18, 2011 at 11:08 am
        Mike, with all due respect you have it backward: the question is why doesn’t Sandy (or Chris Young) call Angel? She has been doing this for at least a decade and is already helping several MLBers. Her contact info is publicly available on the internet (gymscience.com) and I’m sure she would help Alderson or Young if they sought her advice.

        When your car breaks down, does the mechanic call you or do you call the mechanic?

        :-)

  4. Kevin Easton April 18, 2011 at 3:01 pm
    During the off-season, Sandy Alderson held a few round-table discussions with bloggers. I recall that Joe had the opportunity to speak with Sandy directly. Does anyone know if that sort of thing is scheduled to happen again? It would be a great opportunity to find out what the front office’s take on kinesiology is. It sounds like proper treatment and prevention of motion-related injury could be a way to exploit a currently undervalued market, which is supposed to be what the current front office is all about.
    • Joe Janish April 18, 2011 at 4:02 pm
      That’s a good point, Kevin (exploiting the undervalued).

      There should be another opportunity for me to speak with Sandy, though not sure when. In the meantime I’m going to stand on my MetsToday soapbox and keep screaming until someone pays attention.

  5. Mark April 18, 2011 at 3:15 pm
    I am not expecting CY back, unfortunately. It was a low risk high reward signing, too bad it doesn’t seem like it is going to work out. At least it is only $1.1 million down the tubes. Welcome aboard, Dillon Gee.
  6. Mark Rak April 18, 2011 at 4:34 pm
    This may not be a popular notion, but the fact is that Mets scientific evaluations for monitoring pitchers and preventing injuries went out the door with Rick Petersen. It is known that the older pitchers (Pedro, El Duque) did not really buy into his science. But young guys like Perez, Pelfrey & Maine did follow preventative routines, and were injury free while working with Petersen.
    • Steve from Norfolk April 18, 2011 at 11:50 pm
      Why not hire Petersen back! I always thought he kind of got thrown out with Willie’s bathwater and never deserved to be fired. Next year, we’re going to have another young pitcher or two on the staff. It would be nice to have a coach that knows how to help them stay healthy.
  7. ChrisXL April 18, 2011 at 5:56 pm
    Joe, you’ve written in the past about the “drop and throw” pitching method used by Seaver, Koosman and Matlack among others. Those guys pitched more innings and with fewer injuries than today’s staffs. Is it worth a “back to basics” movement to re-learn how those guys did it? And on a different tack, can you imagine how dominant Seaver or Koosman would have been knowing they could hand the ball off to an 8th inning guy and a closer every time out?
    • Joe Janish April 19, 2011 at 1:13 am
      Chris, thanks for the comment. The term is actually “drop and drive”, but close enough. I am curious to see what a kiniesiologist thinks about that old approach, which was taught as a rule to all Mets pitchers back in the 1960s and 70s. Considering the long-term success (and rare injuries) of Koosman, Seaver, Ryan, and others, it seems worth it to find out whether “drop and drive” was part of the reason or just a coincidence.

      If Kooz and The Franchise had a closer, they still wouldn’t have won many games because the Mets offense back then resembled that of a dead-ball era club. ;-) But I get where you’re going, and yes it is an interesting point to ponder. If nothing else, having a closer pitch the ninth would have shaved off about 10-15 innings per season for each starter … might that have made them stronger? Who knows?

  8. Dan April 18, 2011 at 6:49 pm
    When buying a car, I try to pick one that doesn’t spend more time in the shop than on the road :)

    Unfortunately, pitchers returning from shoulder injuries are about as dependable as used Hugos.

    And as easy as it is to say change Young’s mechanics; changing a pitcher’s mechanics may make him less effective. And even subtle changes in mechanics can effect the movement on different pitches and obviously command.

    Look what happened when Warthen tried to improve Ollie’s control by squaring his finish up to the plate, no more velocity. Remember Henry Owens? If only someone could have fixed his mechanics.

    It was still a good risk by the Mets, incentive deal and perfect fit from a stadium standpoint. Ideally he pitches enough to give us some quality innings, qualifies as a type B free agent and we get a pick for him next year. If not, he didn’t cost us much.

    Joe, a little late, but amazing job with the Rule 5, you nailed it!!! I have to admit, I never considered Emaus, I liked Nate Spears at 2B, but obviously he doesn’t have the power. Savery would have been nice. Thanks for all your insight.

    • Joe Janish April 19, 2011 at 1:20 am
      First, thanks on the Rule 5 post. Sometimes I get lucky.

      As for this:

      “And as easy as it is to say change Young’s mechanics; changing a pitcher’s mechanics may make him less effective. And even subtle changes in mechanics can effect the movement on different pitches and obviously command.”

      I have to disagree. First, changing a pitcher’s mechanics could (and should) make him MORE effective. Pitch movement has less to do with mechanics and more about finger pressure, hand angle, and wrist movement at the release point. Your example of Ollie Perez actually goes against your argument, because in reality, Ollie pitched his best while under Rick Peterson’s tutelage. Peterson was one of the few (only?) coaches to get Ollie on a decent path toward the plate — not great, but decent — and more importantly, put him on a program to repeat his mechanics consistently. I don’t know that Ollie ever had “good” or “safe” mechanics, but Peterson definitely made tweaks that allowed him to be a more reliable pitcher.

      If Angel is paying attention to the comments, maybe she can weigh in as well. She has real-world experience in applying adjustments to pro pitchers and is more qualified to speak to this subject.

      • Angel Borrelli April 19, 2011 at 10:27 am
        With regard to the issue of changing mechanics and the pitcher becoming less effective…if that is the case, then the motion was not adjusted correctly. Looking at film and seeing flaws is easy to do; understanding how to determine the cause of the flaws is a job that takes formal knowledge of the body, anatomy, muscle mechanics, and movement mechanics. Once you determine the cause of the major flaw (which might be on a completely different part of the body) you have to create a solution for the pitcher that first and foremost…preserves who he is and what makes him great. That is a respect for the pitcher that you have to lead with and then, from there, you can create improvements and adjustments that feel better, not worse, to the pitcher. The ability to teach is the third skill that is needed to successfully change the pitching motion. I work all year round changing mechanics every day. If I didn’t know how to interface change in a seamless fashion, I would not have clients or just be able to work in the off-season. A pitcher in pain embraces and welcomes things that make sense. Once he understands and then feels the possibility of an adjustment to his mechanics, he is one happy guy. No disrespect intended, but pitching coaches do not have the background to handle all parts of the above process. They should not be asked to; let us experts do that…then they, the pitching coaches, can worry about strikes and movement etc. After all, isn’t that a big enough job?
        • Dan April 19, 2011 at 5:59 pm
          Thank you both for your response. I really find this stuff so interesting. I know very little about mechanics, I just know that watching a great pitcher throw is similar to watching a great boxer punch, everything is moving in the same direction, it is like a ballet move, smooth music (as opposed to bad mechanics which are like jazz, moving in different unexpected directions). I was fortunate, as a kid I got to watch Nolan Ryan and Tom Seaver, both were near flawless.

          I definitely believe there are many cases when someone with the knowledge of the doctor can have an immediate and extremely positive impact on a pitcher. But I also think there are some pitchers whose unorthodox delivery contributes to their effectiveness. Sid Fernandez is the perfect example. Young, although not as extreme as Sid, may fall into that category.

          As for Ollie, I am no expert, but watching video of him under Peterson, it looked like there was a lot more power being generated from his trunk, to the point where it was dangerous because his back was almost to the plate. Under Warthen he looked like a golfer trying to drive without raising his club above either shoulder. But with that said, I only had one game recorded of Ollie under Peterson, and as you said Joe, Ollie didn’t always repeat the same delivery. I have read that Peterson was not popular with some of the players, but I wish they could have found another role for him in the organization, he was talented.

          Personally, it worries me that Young doesn’t even want an MRI of the shoulder, I have to wonder if the damage was already done.

          I would love to hear the doctors thoughts on the best arm slot for a pitcher. Looking at pitchers that have gone high in the draft, it certainly seems like guys who throw straight over the top have more shoulder issues than guys who throw from a 3/4 slot. If I were running a team I would be talking to someone like Dr. Borrelli before I drafted a pitcher. Joe, maybe a future subject around draft time? :)

          Thank you both again for all your time.

          A fan,
          Dan

        • Joe Janish April 19, 2011 at 8:37 pm
          Dan, Angel will probably back me up on this, but the arm slot is not necessarily all that vital — IF you are talking about the release point. The most important thing for a pitcher is to make sure that the elbow is at the same level as the shoulder (Angel?), and from there, the angle of the forearm and the release point can be pretty much anywhere. Problems occur when the elbow gets above the shoulder (could cause shoulder impingement, for example) or below the shoulder (could put undue strain on elbow and shoulder). Though, again, I’ll defer to Angel on this.

          As for submarine pitchers, I will defer completely to Angel as I’ve always thought it seemed safe but don’t know for sure.

          Believe it or not, there are a few MLB teams that confer with scientists with backgrounds similar to Angel’s when it comes to drafting, trading for, and retaining pitchers. However it is something of an “industry secret” right now so we don’t hear much about it. If I get lucky I may be able to blow the lid on that soon — because in the end, it can help literally thousands (millions?) of pitchers in the future.

        • Angel Borrelli April 20, 2011 at 11:04 am
          You are right, Joe…it is not the release point per se that can cause shoulder stress but how the pitcher gets to his release point. There are places in the motion where the shoulder should not be stressed as well as places where the shoulder has to be positioned correctly in its joint so as to be able to prepare for the acceleration. If the shoulder is working when it doesn’t need to be…or if it is positioned incorrectly, the musculature gets cranky. Additionally, the length of the arm during the pitching motion (controlled by the elbow) changes; if the length is too long or too short for the particular phase of the motion that the pitcher is in…then again, the musculature around the shoulder becomes overstressed. The shoulder musculature is responsible for lifting the arm to shoulder height, rotating the shoulder into the stretched position prior to acceleration, accelerating the arm, and decelerating the arm. All these responsibilities happen easily when the shoulder joint and elbow joint are in their most efficient positions for the particular part of the motion in which they are in. These efficient positions are predetermined by scientific data and it is that data that I apply when evaluating a pitcher’s mechanics.
        • argonbunnies April 19, 2011 at 6:32 pm
          Dr. Borrelli,

          I hear you on tailoring solutions to the individual pitcher, allowing them to retain what keeps them effective. I imagine that’s an easier task for some pitchers than others, though, right?

          I’ve often heard that by the time the landing foot hits, the throwing arm should be cocked at a 90-degree angle. If the arm is not yet at that position, it is considered “late”, and a late arm is correlated with stress on the joints and with shoulder injuries. Does this rule of thumb hold true in your experience?

          I ask because Young is always late (by that definition), and it seems to help him hide the ball from hitters. (His arm stays tucked back behind his body longer than usual.) So, if that’s part of what’s wrong with him, wouldn’t fixing it inherently make him less effective? Watching him throw 85mph fastballs by major league hitters, it seems to me that Young absolutely relies on hiding the ball as long as he can!

        • Joe Janish April 19, 2011 at 8:45 pm
          Good point argonbunnies. Hopefully Angel will have time to respond as she is definitely the expert on this.

          But I want to bring up something: if indeed that is what makes Chris Young effective, you have to wonder if it is really worth it? Meaning, is it better to have a Chris Young who is lucky to be healthy enough to pitch only 10-15 games a year before getting injured, or does it make more sense for him to adjust his mechanics and find out if he can stay healthy through an entire season? From the team’s standpoint, I’d take that chance (change the mechanics). From the pitcher’s perspective, I’m not sure, since it seems that teams pay huge sums of money on the chance that a chronically injured pitcher might stay healthy enough to justify the contract.

        • argonbunnies April 20, 2011 at 1:28 pm
          My guess based on Young’s velocity and command is that, without deception, he’d be a #5 starter at best. I figure our front office is resourceful enough to duplicate that performance on the cheap via retreads and minor leaguers. So, yes, if the other 22 starts are the same quality either way, I’d rather have good Chris Young for 12 starts, and I think $1.5 mil is a bargain for that (that’s like paying $4.5 mil a year for a #3 starter, right?).

          Maybe I’m over-estimating how easy it is to find an adequate #5, or maybe I just liked watching Gee the other day…

        • Angel Borrelli April 20, 2011 at 2:23 pm
          If an adjustment is made in a pitcher’s initial movement out of the glove and he loses deception, then the adjustment made was not correct. Deception is the priority of an effective pitching motion and when hand break-to-early cocking is done kinesiologically correct, there is deception. Also, because the joints are moving so efficiently and correctly, the ball is not stopping anywhere in the motion and the motion is happening fast. If Chris wanted to once for all fix his shoulder problems with alterations to his mechanics, he should not settle for an adjustment that makes him less good than he can be. Adjustments to mechanics to improve an injury situation should move the pitcher into a better performance, not worse. This is why people who make their living making adjustments to mechanics are the ones to turn to in delicate situation like this. And, I also understand your question and concern because often times, changes end-up being not so good for the pitcher…and believe me, it breaks my heart when I hear that because it doesn’t have to be that way. I hope Chris is going to be okay.
        • argonbunnies April 20, 2011 at 2:40 pm
          If, with proper mechanics, it should be possible to hide the ball as long as Young does, without injury, then why isn’t every pitcher doing that?

          I kind of assumed that most pitchers are already hiding it as well as they can, and that Young hides it longer because he’s doing something that others aren’t willing do, possibly for good reason. The only alternative would seem to me to be that most pitchers have been taught mechanics that are vastly sub-optimal. Which I could believe; I just wonder if I’m understanding you right.

          After watching the kinesiology-inspired mechanics Mike Marshall teaches, it seems to me that different motions have different strengths, and no one way is optimal on all fronts. Like how Marshall’s protege Jeff Sparks got great movement on his pitches and was never injured, but couldn’t throw strikes or reach 90mph.

        • Angel Borrelli April 20, 2011 at 3:08 pm
          Mike Marshall does not teach what is considered to be the “overarm throwing motion” as is described in the literature (biomechanical and kinesiological). He uses a different motion completely.

          Unless I spoke with Chris, I could not say if he uses his unusual method of hand-break (actually there is no hand-break because his pitching arm does not move with the glove movement) for the purpose of hiding the ball…or…if his method is for another reason…and it just happens to hide the ball.

        • Joe Janish April 20, 2011 at 3:21 pm
          Why isn’t every pitcher doing it, indeed. For the same reason nearly every pitcher has poor mechanics — because they’re not being taught correct mechanics at any stage of their life. There is almost no coach in little league through MLB who is qualified to speak to the science of kiniesiology.

          Think about it: does Dan Warthen know about kiniesiology? Should he? Even Rick Peterson is FAR from being an expert on the subject, but he is one of the few who sought advice from “non-traditional” (i.e., people who never pitched professionally) sources such as surgeons, Dr. Glenn Fleisig, etc. And some might even argue that Peterson knows “just enough to be dangerous”.

          And here is what makes things more difficult: let’s say there is a parent of a 16-year-old boy who is throwing 90+ MPH. The parent goes to a local batting cage and has the choice of hiring either a former pro pitcher or a kiniesiologist to work with the kid on his mechanics. How many parents are going to choose the scientist?

  9. Walnutz15 April 26, 2011 at 10:59 am
    Chris Young = Pedro Astacio