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.