Jeremy Mand - Under the Knife's Will Carroll on Met's injuries

As retold by Jeremy Mand:

On Friday, May 27^th, I had the pleasure of interviewing Will Carroll of Under the Knife. Will is an award winning sports writer, and spent significant time covering sports injuries for nearly two decades. He has worked for esteemed outlets such as Baseball Prospectus, ESPN, Football Outsiders, and Bleacher Report. I spoke to Will about the injury epidemic plaguing major league baseball in 2021, and specifically the unprecedented amount of injuries on the Mets roster. 

Question: Why is it that there are more injuries this year than most other years?

Will Carroll: This season is just strange. I honestly don’t know. Anyone can have a bad year, and luck certainly plats a part in this, but with that said when you look at multiple years, 3-5 year slides, that is where luck doesn’t play a part. At certain times, results (in terms of injuries) of (certain teams) have consistently been on the lower end. It gets worse as the league gets worse, amplifying what’s already bad. More injuries that don’t work out and I don’t know why, but I don’t think (this year) is a fluke. 

Question: Are injuries random, or can they actually be prevented?

Will Carroll: You have to look at a couple of things with injuries. They happen within ranges. For example in the NFL, there are between 27-45 ACL tears in any given year. This has been the case 99.9% of the time; and the same happens with UCL tears and subsequent Tommy John surgery. The studies have shown that while there has been random occurrence, it has not been random distribution. Meaning some teams are having these injuries occur more than others. As far as prevention, you have to look at whether the injury is traumatic or accidental, whether there is a pre-condition. For ACL tears, has the knee broken down over time, and is the (the ACL tear) the last straw?  

You can study the player and adjust for those situations; you can also look at the mechanics, there are certain movements which can put more stress on the body. One way some teams are preventing is just to test more; I think there are 3 teams now that use a portable ultrasound which connects to an Iphone, called a butterfly, and they could take a look at the ligament after every inning. I don’t think any do that - pretty extreme - but just having it there is a plus.

There is also a bio-mechanics component to this as well; a pitcher like Noah Syndegaard, do you know the stress on his shoulder, on his back, on his legs, that kind of information you can do a lot with. 

Question: So what you’re saying is that it’s not one pitch that causes a UCL tear?

Will Carroll: No, it’s not one pitch, it’s a compilation of events and stressors. 

Question: Why is it that injuries are hitting the Mets in particular so hard?

Will Carroll: A little bit of everything. Trainers have only so many man-hours to work on players. The physical therapists – there are only so many hours in the day. So if you’ve got a Noah Syndergaard, if he’s with the major league club, the trainers will work on him, and that’s going to take X hours; if a guy is coming back from hamstrings (such as Conforto, McNeil, and Carrasco) there are so many things you got to do, with regards to preventative work. 

There are many different pre- and post-game treatments, such as massages, strength and conditioning, that the eventually the training staff runs out of time. A lot of times, because of the lack of man-hours available to the training staff it can become a bit of a death spiral, the athletic trainers can’t keep up, and you get more injuries, more people in the training room, and then with the lack of the preventive work, that can lead to more injuries, and I think that is a possible reason the Mets have dealt with what they have. 

Question: Ben Zauzmer, the Mets Director of Analytics, said the Mets consider “injury prediction, prevention and recovery to be the game’s most exploitable inefficiency,” do you agree with that?

Will Carroll: I completely agree with that; there are few remaining asymmetric advantages, and if you fix that, that is significant. I believe that there are studies that show if you can reduce injuries by 10% there is a corresponding 25% advantage in terms of WAR. We’ve been able to see instances where this has been capitalized on—Look at the Rays from 2006-2007, they had massive injuries, and then they got serious about it. 

They got the best people in the business, including Dr. James Andrews, to rebuild their system (for handling injuries) and they have had great results ever since. They had a 5 year stretch without a Tommy John Surgery. The Milwaukee Brewers as well, also had a 5 year stretch without a Tommy John Surgery. This also encourages players to work with training staffs, because they trust what they (the team’s medical staff) is selling. When you lose trust, things can go south pretty quickly. 

Question: The Mets fanbase has come to distrust the Mets' communication around injuries, and are always disappointed when a timeline is different than what is expected; how should teams communicate about injuries to their fans?

Will Carroll: Joe Girardi came out the other day and basically told reporters that he no longer is going to share injury information with reporters. (Quote from Girardi: "I'm not going to share anything -- who's available, who's not available -- because I think it's somewhat unfair to us....there's a distinct advantage to the other manager if I tell you guy's a wrist is hurt" - not attributed. to Will Carroll); now this might become a situation with (sports) gambling if information is not shared, or if he was openly lying. You don't want to be caught up in a Black Sox  type scandal. 

Other than that there is no value in lying to the fans. We've seen in the NFL, the Kansas City Chiefs send out their head trainer, Rick Burkholder, comes out each week and is open and honest. He'll tell reporters what the injury is, what a surgery entails (if a player has surgery), how long it will take to heal. For example, with Dontari Poe, Burkholder came out each week, shared information about the injury and recovery, and you know what, boom, virtually everything he said is how it happened; the Chiefs are very good at communicating with their fans. 

The Mets are not horrible about communicating their injuries; they should be better than they are, but you can't blame Rojas. He is not a medical professional, why should we expect them to understand the nuances of a Tommy John rehab? 

What teams' need to do is trust their fans -- there may not be a more passionate fanbase than the Mets, they deserve to know the best information available.