One of the most informative panels at the MIT Sloan Sports Analytics Conference in Boston this past weekend was one called "Staying on the Field: Injury Analytics." This panel focused on all sports and the way injuries are measured, treated and talked about. There were some great insights for all sports, but I wanted to touch on two separate issues that came up regarding baseball during the panel.
The prevelance of injuries in MLB
Stan Conte is the Vice President of Medical Services for the Los Angeles Dodgers and gave us all some pretty interesting stats about injury prevalence in the major leagues. Perhaps the most shocking was that 50.3% of starting pitchers end up hurt at some point in a year, with the average Disabled List stint being 65.3 days. If that sounds extreme, how many teams can you think of that had three 30-start pitchers? Beyond that, the numbers are increasing since 2007, the first year in which the current drug testing protocol existed.
Conte wasn’t outright suggesting the link between performance enhancing drugs and injuries, but it’s difficult to see a decline up to Point X and an increase since and not make that jump. In addition, I was under the vague impression that injuries were probably decreasing, at least slightly, as we learned more and more about injury detection, prevention and rehabilitation. I was wrong, according to Conte’s numbers.
All of that begs the question: why aren’t we studying injuries with more fervor? I’m sure teams and doctors are, but the issue with sport is that, as Dr. Peter Wehling put it, you can’t do double-blind studies in sports. That is, you can kind of only test things as the injuries come up, since you’re not afforded volunteers and you can’t give some patients a placebo to test for a method’s efficacy.
While there has been some great preliminary research by names like Jeff Zimmerman and our own Jon Roegele, as well as Conte’s studies and the research of other teams, we still don’t know much about injury detection and prevention. We know that age, service time, body mass, handedness, role, velocity changes and more can all play a part, but we’re not that close to an accurate predictive methodology. Injuries are very much a "known unknown," in the sense that we know we don’t know much about them, despite the best efforts of some very smart and motivated people.
And there’s certainly an economic reason to study it further – last year, Conte estimates that salary paid to injured players and salary paid to the players who replaced them reached $600M. The marginal value of five wins, for comparison, may be worth just $10M, but teams are spending the equivalent of a four-to-five-win player just on injuries each season.
It actually makes for the odd case where it may benefit teams to merge their efforts – after all, injuries are costing everyone a tonne, and I think people would agree that less injuries is better for the game. At the same time, an edge is an edge, and I doubt very much Conte, for example, would share the injury knowledge he has with the San Francisco Giants.
Overall, it’s great that we have independent people trying to track incidences of injury and what may cause them or signal them. If someone figures any of this out with any reliability, they probably stand to make some good money.
Concussions and the man-up culture of sport
John Brenkus of Sport Science was also on the panel and gave a great presentation on concussions in football. I actually began thinking about it in terms of hockey first, since I’ve suffered a few concussions playing, but the conversation did get to baseball eventually. MLB has done a nice job trying to take steps towards concussion awareness, especially with the introduction of a shorter, seven-day disabled list for head injuries that prevents teams from making sub-optimal decisions facing a two-week DL constraint.
But there’s a lot more that teams and players should be doing to protect the heads of players. The standard batting helmet, for example, is apparently tested on 60MPH balls, and the ones that can withstand 100MPH (allegedly) are clunky and make David Wright look like Gazoo. Conte used the example of Mike Matheny behind the plate, as well, and told an anecdote about Matheny thinking blackouts behind the plate from foul tips were normal. Catchers take dozens of small-impact shots and become susceptible to Second Impact Syndrome, where an initial concussion doesn’t heal and a second strike causes further damage (think of tapping an egg that is already cracked).
The issue of pitchers also came up, with Brenkus giving this terrifying example: With a 90MPH pitch and a 120MPH hit-ball velocity, a pitcher has 0.3 seconds to react to a comebacker. It takes the brain 0.1 seconds to register light and another 0.15 seconds for the brain to send a signal, leaving the body just 0.05 seconds to react. That is scary. And it’s why, especially after Brendan McCarthy’s incident last year, baseball people have been experimenting with a Kevlar-layered liner in hats for pitchers. If this sounds silly, Conte indicated he’s spoke to pitchers who would try it, which would have been a laughable suggestion five years ago (his words).
Stephania Bell of ESPN also noted that it’s a pretty important issue for society to consider as a whole. Professional knowledge and protocol tends to trickle down to the youth level, meaning changes in MLB can create change for young players who are perhaps even more at risk. Brenkus added that the human brain isn’t developed until the age of 23, meaning that players from tea-ball all the way to the Major Leagues are at a higher risk than we all want to believe. The brain is an incredibly complex and difficult-to-measure part of a human body and should be treated with the utmost care at all levels of sport.
A final discussion from the panel, related to the Matheny story, focused on the "man up" attitude in sports. Conte indicated that players study the baseline concussion tests so they can answer capably, which is a pretty serious issue though I’m skeptical of how true that is. Brenkus used the example of the UFC, where any knockout is followed by a mandatory 90-day medical suspension, illustrating that even the most "tough guy" sport there is treats concussions seriously. While a 90-day DL stint is probably overkill, I do have one suggestion for MLB to aid their concussion handling:
If a player is suspected to have suffered a concussion, via collision, bad slide, hit by a pitch, comebacker or what have you, allow him to be taken out of the game to be evaluated with the option to substitute him back into the game if he passes the requisite tests. While there would be some (minor) risk of the system being abused, it’s one way of encouraging players and managers to be honest and forthcoming about head injuries without making huge on-field sacrifices to be safe.