I ain't a Dr, I just play one on the internet

Lot of chat on the 'net regarding 'precedents' for Erik Bedard's return.  At first glance, these 'precedents' leave a very clear impression:  don't expect anything from Bedard in 2010.

We went through this with respect to the strength of Richie Sexson's shoulder.  The medical consensus :- ) in cyber-Seattle was that it was not reasonable to expect Sexson to return at full strength. 

The surgeons' consensus was that it was reasonable to expect this, and on that basis, the M's gave Sexson a contract that presumed full health.  The fact is that the surgeons' consensus, and the M's $45m, were not taken seriously by the blog-o-sphere, which went on to do its own analysis of Sexson's prognosis.

I thought that we'd put this in the past, the idea that you and I can bounce around the net, find a few 'case studies' and come to some sort of educated medical guess.  We cannot!


=== Have At It, dept. ===

There's nothing wrong with going, hey, some pitchers return from rotator-cuff surgery and some don't.  That's baseball chat.

The problemo comes when we start to believe that our 'educated medical guesses' would be taken seriously by scientists in the field.  We're chatting, is all.  If we keep that straight, there's no harm done.

Let's not get back into the whole Richie Sexson "my best medical guess is..." winter.  The first one was plenty 'nuff for me.  :- )


=== Pop Science dept. ===

G-Money could speak to this better than me, but if you as a patient were in the office of the chief of orthopedic surgery at the UW ... and offered him these five "case studies" :- \ I think he'd nod, take them out of your hand, swing his hand over to the wastebasket, and release...

A surgeon, as opposed to a cyber-Doctor like myself, would ask questions like,

  • How similar were these injuries to Bedard's?
  • Were they 20% or 60% tears?
  • Of which part of the rotator cuff structure? ('Rotator cuff' refers to the entire structure of muscles and tendons supporting the shoulder.)
  • Who were the surgeons and precisely how did they repair the injuries? How good were they at the procedures they attempted?

The chief of surgery (a/k/a "the truth" here) wouldn't be the slightest interested in the opinion of his residents, much less in the opinions of laymen.

Dr. Lewis Yocum is familar with 100's or 1,000's of these cases, not with five of them. His prognosis is the relevant one -- not the one we can guesstimate with a half-hour trip around the internet.

Don't mean to be overly harsh, but a little knowledge is a dangerous thing. In this case the armchair medical opinions do not help our understanding.  Again, chat is fine, but let's keep in clear focus how overwhelmed our tiny medical understanding is by the complexity of the problem.


=== Dr's Prognosis, dept. ===

My own $0.02 is on the way that Erik Bedard, specifically, throws his 2-pitch arsenal.

It says here that there are few moving parts in Erik Bedard's "game," and those moving parts are relatively less dependent on arm strength.

A shoulder, better or worse, isn't going to affect the way Bedard snaps off his hellish curve ball. 

That's (1) my take on pitching mechanics, FWIW, and that take was (2) borne out by Bedard's June-July 2009.  Bedard threw slashing curve balls with a trashed shoulder because he throws his hook with his wrist and fingers, and because his motion is so centrifugal (he gets his back and hips into the pitch).


Now, it could be that Erik Bedard never gets his fastball velocity above 86 mph again.  That is the scenario under which Bedard's shoulder ruins his career, IMHO.

The likelihood of that?  Very low.  Matt Clement's career didn't implode because he could never throw 85 again.  It imploded because his fastball, slider, and control were mushy, and his particular game didn't work that way.

Bedard could lose some command, sure.  He could come back with an 89 fastball and mediocre command of it -- plus a gamebreaking curve ball.  Then he wouldn't be a superstar; he'd just be a very good pitcher.

My opinion could be wrong -- but my opinion is based on pitching mechanics and technique, not on my purported knowledge of the muscles and tendons in the human shoulder.


=== Follow the Smart Money, dept. ===

Very interesting that the A's gave Sheets $10-$13m after pitching 0 innings in 2009. 

Interesting also that the M's gave Bedard $1.5 to $8.0m for his 2010 performance.  You might easily conclude that the market for Bedard was soft, but we have to remember also that Bedard gave his agent clear direction to sign with Seattle, which was free to pay Bedard (more or less) whatever it wanted to.  Zduriencik then filled in the blanks with numbers that were awfully attractive to the M's.

If you want inferences about what the pitchers will do this season, probably the best place to look would be at the way the investors (the M's, Rangers, and A's) are betting.

What's your take? Have the Mariners been cautiously optimistic here, have they been pessimistic, have they been quietly all smiles about the situation, or what? 

That's as good an inference as any, as to where Bedard's 2010 is at.


Dr D


glmuskie's picture

Z was on KIRO today.   He described the doctors' reaction to Bedard's comeback as very surprised, and 'way ahead of schedule'.
Shannon asked him , what doesn that mean, if he's not throwing?  How do they know?
And Z said, well he's down in Arizona and he is in fact throwing off level ground.  (Rob Johnson confirmed this in a later interview).  The doctors evaluate strength, flexibility, range of motion, those sorts of factors, and based on that he is significantly ahead of where they would expect on the 10-12 month typical recovery time for this surgery.
He also said that he expects Bedard to be back 'way before' the trading deadline.

glmuskie's picture

Was very impressed listening to the KIRO Hot Sove show (or whatever it is they are calling it) tonight.  They apparently take a 'stat of the week' and have Tony Blengino describe it.  Tonight it was BABIP.  Tony's description, and how it can be used and misused, was great and informative.  In particular, he described how BABIP has (IIRC) twice as much variation for batters as it does for pitchers, indicating how much more control batters have over it than pitchers.  Which is probably obvious to all y'all, but for me I had never heard it quantified and explained this way.  Pretty pow'ful good information coming from the bubblegum homer station.  Educated fans make better fans who demand excellence from their teams.  Kudos to them.


Given the market for Sheets, Harden, and Bedard (as reflected in the salaries they received), most teams do not think Bedard is going to pitch much this year, or at least not at his previously established level.
The only alternative view of the situation is that Bedard was so predisposed to coming to Seattle that no other team really had the capacity to drive up the price.
While I agree that the doctors know better than the uneducated masses, medicine is still a black art as much as a science populated by people predisposed to overvalue their worth.  Who among us hasn't had to endure the self-important arrogance of an MD?  
To summarize, its a good deal for the M's but I don't buy that Sheets and Harden are legitimate comparisons... and the variance in salary that the three received indicates that MLB teams don't see them as equivalent risks either.
The possibility exists that the M's are working with better information than any other team and therefore are able to better assess the risk.  Here's hoping that's the case!


I think one of the key points to Bedard is this ... his injury "likely" (IMO - from a chatty, non-scientific perspective), is a result of pushing too hard.  In previous reviews of Bedard, my opinion is that he gets hurt simply because he continues pushing AFTER mortals, (like you, me, and ye olde media machine), would've been sitting back in the whirlpool sipping Bacardi and adjusting the 40 pound ice pack.  I think it likely that a little LESS ego might well have shortened Bedard's DL time -- but this wasn't going to happen.  Why?  Because the very press that were whining about him being a wuss pushed him even further to take chances.
That said -- this injury could EASILY be the harbinger of a miraculous turn-around.  As Doc has noted - Bedard is a gamer -- and if he's pushing, it's because he KNOWS that doing so improves 'something'.  But, coming off surgery, and being a year older - and having TWO aces in front of you -- for the first time in ages, the pressure is OFF Bedard to perform miracles.  And, because of the surgery, instead of pushing, that little nagging voice of doubt in the back of the mind may allow Bedard to NOT exceed manufacturer's specifications - and actually stay healthy.
Go and look at Nolan Ryan's career.  He *NEVER* "learned" control.  But, he got better as he aged - I believe - because he simply lost the ABILITY to be as wild as he was for the first 15 years of his career.  He lost just enough "throwing" ability -- that ultimately, he gained more "pitching" ability. 
Bedard is a different case.  He's already got mad control skills.  But, having watched Maddux out-pitch Smoltz (and every other mid-90s hurler the Braves found for 20 years), I can say with confidence that VELOCITY is without a doubt the single most overrated pitching stat in baseball.  If Bedard loses a little speed - but in doing so adds even the tiniest smidge of control to his arsenal ... well, I for one think a 1.90 ERA season isn't implausible -- given the park and defense he's got going for him.  No -- that isn't a projection -- that's the OMG miracle upside -- but one that fewer than a dozen pitchers in the game today possess.

glmuskie's picture

So, I'm guessing your an MD then?  : )
Calling modern medicine a 'black art' seems a wee bit of a stretch, considering the ridiculous amount of real science being done, extended life spans, diseases eradicated, etc. etc.  And personally, no, I've never had to endure the self-important arrogance of an MD.  I've heard they can get full of themselves.  But you know, there are jerks in every walk of life.  : )
It seems clear that the M's were in fact privy to inside information w/r/t assesing the progress of his rehab.  We'll probably never know if or how many other teams wanted to talk with his doctors, or actually did.  If I was a GM looking for pitching I'd put a call in to his agent to see if I could talk with his doctor...
Sheets and Harden are IMO good comparisons to Bedard; they have a similar level of ability to Bedard.  But they are ready to pitch now, Bedard is just starting to throw.  So ya, Bedard gets less and his contract is mostly incentive-based.


You're forgetting an important factor in why Bedard can't get the deal that Sheets and Harden got.  Sheets and Harden are healthy NOW...Bedard won't be healthy until at least May.  Even if most teams expect Bedard to pitch about as well as the other two guys, it's harder to justify taking that gamble on a guy who isn't going to start out the season healthy.

misterjonez's picture

Anyone running a league with an opening this year?  I haven't played since that once in the 14 team AL-Only group, but I've been interested in trying it out again.  My personal life shouldn't be nearly as hectic this time around :(

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