Jonathon Niese Not Out of the Woods

The good news, which you likely already heard: the MRI of Jonathon Niese‘s elbow came back clean — there was no sign of damage.

The bad news: that doesn’t necessarily mean that Niese will be OK, able to start Opening Day, and give the Mets 200+ innings in 2014.

After Mets physician Dr. David Altchek pronounced Niese’s elbow as

Let’s examine some of Niese’s quotes. First, his words prior to the MRI.

“It’s the back of the elbow, which is good,” Niese said. “I’m almost 100 percent sure it’s nothing serious like Tommy John or anything. It’s just a little discomfort. I wanted to go back out there. It’s something that I could definitely pitch through.

He was right, sort of. It was “good” in that the pain wasn’t symptomatic of UCL damage. Though, it could have indicated MCL irritation. The pain he described, as Angel Borrelli suggested, was most likely indicative of a deceleration issue. And that’s good news, as long as he understands the reason he’s having a deceleration issue and takes the steps / makes the adjustments to fix it (which are not drastic changes, by the way).

“My mechanics were definitely off when I had that shoulder discomfort,” Niese said. “After that, I think everything was fine.”

Yes, his mechanics were off — they were off for a while, going back to last year and probably prior (at times), and the repeated “offness” slowly tore away at his rotator cuff. I’m not sure what he means by “After that …” because he’s still exhibiting the same flaw that caused the shoulder injury.

And here is a quote from Mets GM Sandy Alderson prior to the MRI:

“The positive is it’s not his shoulder,” general manager Sandy Alderson said. “But obviously as we get closer to Opening Day it becomes more and more problematic. Hopefully it’s nothing serious, regardless of its impact on Opening Day.”

Agreed, sort of. The “positive” is that — AS OF NOW — there appears to be no further damage to Niese’s shoulder. HOWEVER, what Niese has experienced this spring — in terms of pain/discomfort — is a signal that something in his pitching motion is causing a problem, and needs to be fixed. Contrary to popular belief, throwing a baseball overhand is no more “unnatural” than standing upright or walking. Contrary to popular belief, injuries don’t occur due to “luck of the draw” or some mystic, uncontrollable reason. Arm injuries happen when pitchers use inefficient, poorly timed, and/or otherwise dangerous movements. There is science behind this. (In other breaking news, the world is not flat.)

Why does my back hurt? Because I sit at a desk with bad posture all day, and I lift heavy objects without dropping my butt and bending at the knees. It’s similar with throwing a baseball: if there’s pain, there’s almost always a reason that can be tied to an unsafe body movement.

Here’s the rub: Niese’s issue is NOT serious — so long as he understands the WHY behind the pain and makes appropriate changes. Do I sound like a broken record yet? I don’t care, because the concept of cause and effect bears repeating.

Now, let’s look at some of Niese’s comments and other notes reported by Adam Rubin at ESPN AFTER the MRI results.

“It came back real strong,” Niese said Tuesday, after returning to camp. “They said the UCL is strong and big and strong — no bone arthritis or spurs or anything. So all the bones and ligaments are perfect. There’s just a little inflammation in that joint in the back of my elbow. So I got a cortisone shot. It’s a little sore today from the shot, but the soreness is going down. So I should be able to throw tomorrow. … I doubt the mound, but I’ll start throwing again.”

He received a cortisone injection in the back of his left elbow to address inflammation but was informed his ligaments are fully intact. He is expected to resume throwing as soon as Wednesday.

We can all agree that the UCL being strong is great news. At the same time, based on the symptoms, the UCL wasn’t necessarily at risk. The issue is not whether or not Tommy John surgery is in Niese’s future, but rather, “what is the reason for the elbow pain? Or more specifically, “what in the pitching motion is causing the pain that sent Niese for the MRI?” The answer is that Niese’s shoulder is not moving correctly because of his body position at the point of acceleration (he’s not facing the target), and as a result, he’s leading with his elbow to get his release point to fact the target, and in turn, more pressure is put on the elbow. Why is he in an incorrect position at the point of acceleration (a.k.a., max )? He’s landing so far to his left with his right leg, he can’t properly rotate his hips. Don’t confuse this with “using his elbow to compensate for shoulder pain” because that’s not what we’re seeing on film — what we’re seeing is a flaw in his lower body (specifically, in where his front foot is landing / stride). But that’s not MY opinion — it’s what was seen and evaluated on video by sport kinesiologist Angel Borrelli, who specializes in qualitative analysis.

“He sent [pitching coach] Dan [Warthen] a text this morning. He said they felt there was nothing and he’ll be back on the mound here in a couple of days,” manager Terry Collins said. “It was good to hear. Now we’ll do a sigh of relief and come up with a plan to finish out the last two weeks with him.”

OK, super, but what is “… a plan to finish out the last two weeks with him”? Does it include adjusting where his front foot lands?

Niese said the cause was overthrowing, according to the doctor’s estimation.

“Altchek pretty much said that he thinks it’s probably from trying to look at the radar gun — overexertion, just trying to get that extra mile an hour,” Niese said. “And all of a sudden mechanically you go the wrong way one time and all of a sudden it pinches and it’s irritated. One thing I’m going to try to stop looking at this spring is the radar gun and just go by feel, because I know if I feel good the velocity is going to be there.”

Wait, what? First off, while Dr. David Altchek is a specialist in surgery, and I would rely on his ability to identify injuries and fix them, I’m not 100% convinced that he’s also a specialist in human body movement. Let me make a comparison: is a computer programmer or software developer necessarily able to build a computer? Does the neighborhood mechanic know how engineer a car? Does the car engineer / designer know how to change the oil or fix the brakes? Does that same car engineer know what a race car driver needs to do to win the Daytona 500? Can a HVAC specialist do the job of an architect and build a house? Not necessarily.

Based on Dr. Altchek’s “estimation” and Niese’s comments about “overthrowing,” there should be concern that neither knows the root cause of Niese’s elbow pain. And if there’s no understanding of the root cause, then it’s going to be difficult, if not impossible, to fix it. Is it possible that Niese steps more toward first base when he tries to throw with more velocity? Well, anything is possible, but that doesn’t make much sense to me. Though, I could be wrong — maybe he strides longer or shorter than normal when trying to throw harder, and that change in stride causes him to step somewhere other than forward. For the record, he’s not doing it once in a while — he’s doing it most of the time. And it’s an easy, minor fix.

Instead of Niese worrying about looking at the radar gun, someone — ideally, a qualified someone — should be looking at the film. Angel Borrelli and I did, and we saw something that, according to science, would lead to exactly the symptoms that Niese has been experiencing. That’s not dumb luck, it’s science.

Will Niese, Altchek, Collins, Warthen, Alderson, and/or anyone in the Mets organization consider the science behind the pain? Or will everyone simply take the doctor’s estimation at face value, treat the pain with a cortisone shot, and hope for the best?

My guess is the latter. The cortisone will make Niese’s elbow feel fantastic for a while, but he’ll continue to land improperly, throw across his body, lead with his elbow, and be at risk for another injury (possibly, a labrum tear). For those who care more about performance than health, it’s going to be difficult for Niese to get the fastball going far past 89-90 as long as his upper body and shoulder rotation is limited by the lower body flaw.

But don’t take it from me, I’m just a blogger. To get a full explanation of what’s happening with Niese, and how it can be fixed listen to my discussion with Angel Borrelli below.

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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. Original Met March 20, 2014 at 9:16 am
    To say the pitching motion is not unnatural is entirely untrue. Every one knows that. Softball pitchers can pitch an almost unlimited amount while baseball pitchers have to ice their arms/shoulders after 80 pitches.
    • Joe Janish March 20, 2014 at 12:11 pm
      First off, who is “Every one” in the “Every one knows that” statement? Is it the same “Every one” who insisted that the world was flat?

      What does softball pitching have to do with baseball pitching? They are entirely different movements. If you want to make a comparison, try javelin throwing, tennis serving, or cricket bowling.

      As for icing, according to science, icing the arm after pitching is not necessary unless the arm has been injured in some way. Do sprinters ice down their legs after running? If they do, that’s news to me.

      Regardless, I’m not sure why you’re trying to correct that one specific statement from this post. Are you suggesting that because pitching is “unnatural,” that’s why Niese is injured, and no other reason? And further, that every single pitcher in baseball will become injured to the point of needing surgery, and there’s absolutely no way to prevent it?

      Further curious: did you listen to either this podcast, or the one previous?

      • argonbunnies March 20, 2014 at 6:52 pm
        Overhand throwing certainly isn’t unnatural from the perspective of evolutionary advantage (some academics claim that it’s why women find broad shoulders attractive in men), but using every muscle in your body to propel a round thing 90+ mph off a hill… well, it wouldn’t shock me if that was unnatural in some way.

        At the same time, I don’t see how the “unnatural” claim is productive. It’s nothing but an excuse for not trying hard enough, and an attempt to deflect blame. Us humans find ways to make all sorts of unnatural things safe and sustainable. “There’s only so much you can do” rings hollow when we can do a friggin’ LOT.

        • argonbunnies March 20, 2014 at 6:53 pm
          Oops, meant that as a reply to OM, not JJ. Oh well, whatever, same topic…
  2. DanB March 20, 2014 at 10:51 am
    give a rock to a caveman and tell him to kill that deer. i would guess he doesn’t throw it underhand. Throwing overhand would be the more natural throw. Of course he might not throw it 120 times over three hours.
    • Joe Janish March 20, 2014 at 12:12 pm
      Good point. Though, he MIGHT have to throw a hundred or so rocks before killing something. Certainly, he’d want to practice, to hone his aim, so that he doesn’t waste so many rocks.

      🙂

      • argonbunnies March 20, 2014 at 6:38 pm
        Oh man, not the Conservation of Rocks Fallacy again.
      • DaveSchneck March 20, 2014 at 10:03 pm
        Joe,
        Due to the constant badgering by his mate to stop throwing rocks after 100 throws (in order to be healthy enough to perform other chores around the cave), the prehistoric caveman was motivated to develop the slingshot, as well as fermented beverages.
  3. DanB March 20, 2014 at 6:19 pm
    Hey Joe, I am (surprise!) tired of talking about why our shortstop position sucks. What about a good ole baseball post about Collin’s idea (actually Russo) of pitchers bating 8th? At first I didn’t like it because it gives the pitcher 18 more ABs per year. But then I realize a pitcher only gets two to three ABs anyway before they get pitch hit for. ?It would be the pinch hitters getting 18 more ABs per year. I actually like the idea of the pinch hitters getting more ABs rather then the typical eight place hitter, especially since it will be in ttone late innings. And this is before we debate whether it would give DW more RBI opportunities. Anyone?
  4. argonbunnies March 21, 2014 at 4:34 am
    Help me think happy thoughts!

    Sorry to go off-topic, but every time I think Mets, I get all negative. What are some positive developments this spring? Here’s what I can think of:

    • Although Jeurys Familia still misses the target by 2 feet occasionally, he has been throwing enough strikes to be effective. His fastball down has been getting lots of weak grounders.

    Wilmer Flores has not looked awful in the field. He’s not quick, but his long limbs, solid reads, and willingness to dive, add up to give him more range than expected. His arm looks good enough for SS to me. If nothing else, this probably keeps the Mets from giving up too much for Nick Franklin.

    Eric Campbell looks like excellent insurance in case Josh Satin struggles or gets hurt.

    Bobby Parnell‘s recovery from spinal surgery has proceeded fairly smoothly.

    Montero and Plawecki looked roughly as advertised (as opposed to the frequent prospect overhype).

    David Wright still looks awesome at the plate, and Juan Lagares still looks awesome in the field.

    • DaveSchneck March 21, 2014 at 8:53 am
      Argon,
      Good point. Amongst the annual spring training dysfunction at Met camp, the positives you note should not be overlooked. This is precisely why Alderson needs to get off his keester and improve the 25. This squad will not be favored in the NL east regardless of the moves he makes, but the opportunity does exist. The Nats look like the class of the division, but they have a rookie manager and underachieved last year. The Braves are vulnerable even after signing Santana. The Phillies are somewhat in flux, and the Marlins are flush with young talent but starting from far back. The Mets have many ifs, but also the chance to take a big step. The GM and owner should not leave them shorthanded, as they have done in recent years past.
      • argonbunnies March 22, 2014 at 12:43 am
        I liked watching Medlen pitch and I feel for the guy, but at the same time the Mets’ path did just get a lot easier with the Braves’ injuries.

        If the Mets projected as even a .500 team, then “a few things break right and we compete for the playoffs” would be realistic. I think it’s already too late for that — even adding Drew would probably push our expected wins to only 76 — but I’m going to see if I can look at positives a little longer before returning to overall hopelessness.

        Anyone else see anything good?