Why Johan Santana’s Arm is at Risk

One week ago today, Johan Santana accomplished what no other Mets pitcher ever did before. But was it damaging to his health?

After tossing 134 pitches in the first no-hitter in Mets history, Johan Santana was given an extra day of rest. There is the perception among some that the additional 24 hours will somehow be a cure-all for anything that may be ailing Johan as a result of the outing. Additionally, others don’t believe a “few extra pitches” can hurt a MLB pitcher such as Santana. And still others think that if a pitcher is going to get hurt, it can happen at any time, on any pitch — it’s just plain old dumb luck and/or inevitable.

To those people, let me introduce you to something new and fascinating called “science.” It’s a fairly recent concept, with its roots developing in 3500 BC (nascent, I know, considering that Earth has been around for between 100 million and 4 billion years). Also, there is something called causality — a.k.a., “cause and effect.” Causality is the relationship between an event (the cause) and a second event (the effect), where the second event is understood as a consequence of the first. This philosophy and the concept of science enjoy widespread acceptance — except in the societal subset known as “baseball.” For some reason, people in and around baseball deny science and causality, preferring instead to blame pitching injuries on mysterious forces such as lady luck or the “baseball gods.” If you are among the population that has either a belief or passing interest in science and causality, please read on; otherwise, click away to some other post or another website.

Here are the facts:

(btw, “facts” is a scientific term)

1. Johan Santana expended 134 pitches one week ago.
2. Prior to last Friday, Johan Santana was conditioned to throw about 92-95 pitches every five days.
3. Injuries result from subjecting it to, or being subjected by, a force for which the body is unprepared.

I don’t expect anyone to argue with fact #1; it’s public knowledge that Johan threw 134 pitches.

Fact #2 is explained thusly: over a period of about two months and through the ten starts preceding his no-hitter, Santana’s pitch counts were as follows: 84,99,55,105,90,108,82,107,96,96. If you add up all of those pitches and divide by 10, the average is 92 pitches per outing. To get a more accurate read on Santana’s conditioned workload, I’m going to remove his lowest count (55) and his highest count (108) and do the math again with the remaining eight games; the new result is just under 95 pitches per start.

Now, either you trust that I know what I’m talking about, or you know enough about general athletic conditioning to agree that based on his most recent two months of activity, Santana was conditioned to throw about 95 pitches. That doesn’t mean it was necessarily risky to throw 100 or 105, but it does set a baseline.

If you’re still with me, let’s do a bit more math. Subtract 95 from 134 and you get 39. So, in his no-hitter, Johan threw 39 pitches over what he’s been conditioned to throw. Is that a significant amount? Well, divide 39 by 95 and you get .41 — in other words, 41 percent.

Again: Johan Santana threw 41 percent more pitches than he was conditioned to throw.

(To be clear: 95 is not a “magic” number. If Santana’s throwing program conditioned him to throw 125 – 140 pitches every five days, then his 134-pitch effort would not be of concern to me.)

So again, is that significant? Does it correlate to fact #3 (subjecting the body to a force for which it is unprepared)? It’s up for debate, but scientific research suggests yes, it is significant — particularly when the activity is pitching, where it’s vital to coordinate several large and small body parts to prevent injury, and where some of the most overworked parts of the motion are the smallest muscles.

But we need to take this significance one step further, and look at the individual in question. The research is quantitative and therefore generalized; it’s based on many pitchers of varying ages and pitching motions. We must apply quantitative research to a qualitative analysis of the individual to get an idea of risk. According to experts in qualitative pitching analysis, Santana’s mechanics are dangerous and risky — in fact, those risky mechanics are exactly why he injured his shoulder in 2010. Combining both the qualitative and quantitative analysis and applying it to Santana’s no-hitter, my fear is that Santana likely injured himself in some way during his no-hitter.

But you don’t have to take it from me; consider checking out this interview with Dr. Glenn Fleisig that occurred earlier this week. There wasn’t too much specific to Santana, but Fleisig’s main point was this:

“Pitchers get hurt because they pitch with poor mechanics, and then they throw too many pitches; it’s a combination of that.”

Dr. Fleisig is the Research Director of the American Sports Medicine Institute — not some hack know-it-all blogger.

As for the hack know-it-all blogger, I believe there is a good chance that Johan hurt something at some point between pitches 95 and 134 last Friday. This fear comes from my belief in the research and my faith in causality — not to mention the uncertain strength of his surgically repaired shoulder. Is it possible that Johan didn’t hurt himself? Of course — anything is possible. If he did injure something, an extra day of rest isn’t likely to cure it. It may help with the overall recovery of his body, but it won’t necessarily reverse small tears and fraying in his shoulder and/or elbow that may have occurred. That’s why Terry Collins was still terrified that he may have done the wrong thing, even a few days after the no-no.

Now, what if Johan throws a three-hit shutout tonight against the Yankees? Does that mean he’s OK? Not necessarily — it IS possible to pitch with pain and/or injury, as we saw from Santana in the second half of 2010 (based on his mechanics, my guess is he was hurt as of late July, if not earlier).

What does it all mean? Should we be concerned that Johan’s no-no was a “no-no” in terms of what’s good and bad for one’s health? If we care about the team, then yes — because the Mets’ success or failure depends heavily on whether or not Santana can take the mound. Further, if that no-hitter turns out to be the beginning of the end of Santana’s career … well, that would be sad.

As it stands now, Johan Santana will take the mound tonight in the Bronx. Let’s collectively hope that he looks great, and continues to look great going forward.

In the meantime, I encourage all young pitchers, parents of pitchers, and baseball coaches to watch the interview with Dr. Glenn Fleisig below, as it will give you wonderful insight on the risks of pitching at all levels.

Mets 2012 Games

About the Author

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.

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