So the last two days I’ve been stuck at home, unable to move more than just a few feet from the toilet, seeing as everything on the inside of me would much rather be out. I’m not sure I can recall a time in my life I’ve ever vomited so much. I know ya’ll really wanted to know that, but it has given me some time and I was watching MLB network this morning when a conversation about Phil Hughes came up that I found interesting. They mentioned that Phil would be going in for an MRI to rule out a circulatory cause of his recent loss in his velocity.
Of course, my nerdy brain thought more into it. And as much as I don’t like talking about the Yankees I think he is someone worth writing about.
If you don’t know, Hughes is a right handed starting pitcher for the New York Yankees. He was drafted in the first round out of high school in 2004 and made it up to the majors by 2007. He is well known for his nasty 1-7 curveball and has a 4 seam fastball that averages around 93 mph but can get up to 95-96 mph. Last year, his first full season as a regular starter, he went 18-8 with a 4.19 ERA.
During spring training this year, scouts began noticing a drop in his velocity. A drop in velocity is almost always the first sign of injury in a pitcher. Pain can also accompany a drop in velocity, however most pitchers are experiencing some sort of pain at any given time (they throw a ball overhead at over 90 mph) so it may be difficult for them to differentiate a new pain. Hughes continued to pitch into the start of the season where he went 0-1 with a 13.94 ERA in only 10 1/3 innings with a fastball that was only averaging 89 mph. Hughes problem? He complains that after just a few pitches his arm feels fatigued.
“The first few felt all right, and then there was nothing there,” Hughes said. “It’s sort of the feeling you get after 110, 115 pitches — I normally should feel that way. It’s way too soon.”
So yes something was wrong. Placed on the DL with “shoulder inflammation” Hughes was put on a strength and conditioning program. No MRI performed. According to Joe Girardi (yankees manager )
“Usually, if a guy says he has pain, you go for an MRI,” Yankees manager Joe Girardi said. “He just said he felt like it was dead and there wasn’t a lot coming out. We figured that maybe he needed to be built up. We put him on a program, and now that the program didn’t seem to work, we go get an MRI. He still says he’s not experiencing pain.”
There is this diagnosis in the baseball world called “dead arm.” The idea behind dead arm is that right after the ball is released (like in the picture) , when your elbow isnearly fully extended and the forearm is pronated there is a distraction force on the shoulder joint itself. There are ligaments and muscles in the posterior shoulder whose job are to apply a compressive force to oppose the distraction. However over time, these structures can become faulty and pitchers can have pain, loss of velocity of loss of control. These types of forces can also cause a tear in the labrum called a SLAP tear. Players at greatest risk for these types of injuries usually have a significant loss of internal rotation at their shoulder joint; deficits that should be picked up by pre season physicals.
Now Phil may or may not have a SLAP tear, only the MRI can really determine that. Usually this type of injury does also come with a lot of pain in the acceleration phase of throwing, however, I would not be surprised if he did. Because he isn’t having pain thought, there are other common things that could cause his symptoms. When a player complains merely of loss of velocity with no pain like Hughes is, I’m thinking a nerve injury or entrapment which can cause the weakness without the pain. Circulatory causes could also be the case, like Thoracic Outlet Syndrome, which means his brachial artery is getting caught somewhere. This could give him the sensation of fatigue without pain.
Either way I just wanted to write about this because I think its an important lesson. Guys like Phil Hughes don’t just lose 4 mph on their fastball at the start of the season because they need to get stronger. A drop in velocity like that should be a red flag that something else is going on.
Have a good day everyone,