ESPN the mag:  MLB injuries up, steroids to b

Do you ever wonder why half your favorite team-or fantasy lineup-is on the DL?

Well, the men who run baseball wonder too, about the sore rib cages, torn biceps and strained flexor tendons that are sidelining their stars at a record pace. In fact, they commission a tightly guarded annual report on the subject that confirms a huge spike in injuries. And while they still don't have any definitive explanations, there's a growing belief among insiders that steroids play a role in how often and how seriously players are breaking down.

Dollars and days lost to the disabled list have continued to climb. According to data obtained by The Magazine from the 2002 edition of MLB's injuries report, the Redbook, teams paid more than $1 billion to injured players from 1997 to 2001. That's double what they shelled out from 1992 to 1996.

Similarly, the number of players going on the DL zoomed from 260 in 1991 to 401 in 2001, a 54% increase. Doctors who have seen MLB's most recent data say the trend continues.

To try to determine why teams are losing so much to the DL, the authors of the report talked with club presidents, GMs and chief financial officers as well as doctors, trainers and strength coaches. They culled the list of explanations to a surprising few. Here's one: "This incentive [to make money] has motivated some players to look for ways to improve performance, possibly at the cost of good health ... The effects of improper nutrition, performance enhancement and steroids are impossible to measure, but are widely believed to be a contributing factor to injuries and subsequent DL time."

Both the players association and the league take a fairly blasé view of the steep rise in injuries. "The injury numbers are not amazing to me," says Gene Orza, No. 2 man at the union. "I think baseball is comfortable knowing what the reasons are." And the leagues think it's just a sign of what they see as changing times. "There is a different mind-set," says Frank Coonelly, MLB's chief labor counsel and the man designated to answer questions about the Redbook. "Back in the day, everyone in starting rotations pitched 300 innings a year. Today, pitchers are used in a way where some would claim they are babied."

Those are neanderthal positions, particularly in light of the fact that American Specialty Insurance of Roanoke, Ind., baseball's principal insurance company and compiler of the Redbook, says most injuries could be averted. The Redbook's authors divide injuries into "preventable," as when a team overuses a pitcher and he blows out his elbow, and "nonpreventable," such as a leg that is broken in a home plate collision. (These definitions have nothing to do with whether or not teams collect insurance on injured players; they're simply terms the Redbook uses to help MLB understand its data.) American Specialty says a staggering 71% of big league injuries are preventable.

MLB officials don't like to talk about the Redbook. They wouldn't give The Magazine a copy, or allow its authors to talk with us. More important, they feel no need to share its contents with the players association. "We care about the players as individuals," says Coonelly. "The people over at the union aren't getting hurt by playing baseball."

That kind of posturing has helped to keep MLB a day late and many dollars short in getting to the bottom of the DL explosion. "I am aware that the number of man-hours spent on the disabled list has grown considerably over the past several years," says Dr. Elliot Pellman, MLB's chief medical adviser since March 2003. "The question is why? The answer is, I don't know."

Nobody knows for sure, and that only fuels speculation about the use of performance enhancers. "Is it true that use of performance-enhancing drugs cannot be ruled out as a contributing factor in the rise of injuries? Yes," says Coonelly. "Do I believe that use of performance-enhancing drugs actually is a contributing factor? I don't know."

The union too is oddly uninterested. "The Redbook mentions three things with conditioning, right?" Orza says. "Nutrition, performance enhancement and steroids. Well, players are supposed to enhance their performance. You shouldn't enhance your performance illegally, but enhancing performance is not only not a bad thing, it's a good thing."

Baseball can point to everything from privacy issues to drug testing negotiations as hurdles to researching the steroid problem. But it shows little unified interest in looking into the root causes of injuries on even basic levels. For example, what percentage of 26-to-29-year-old lefthanders who throw 240 innings in a season develop elbow problems the following year? MLB doesn't know. Asked what evidence baseball has compiled on the relationship between innings pitched, pitch counts and player health, Coonelly says, "No such studies exist."

To outside observers, that makes no sense. "How much has MLB done to develop research about injuries? What's lower than zero?" asks Will Carroll, author of Saving the Pitcher: Preventing Pitching Injuries in Modern Baseball. "When it comes to sharing information, they're in the Stone Age."

Teams blow nearly one out of every seven payroll dollars on disabled players. But you could probably come up with half a dozen reasons for that off the top of your head. For example, you might suggest teams are losing more money to the DL year after year simply because they're paying players more. But the Redbook shows that payments to injured players are growing much faster than overall salaries, an increase of 114% vs. 59% from 1997 to 2001. Payments rise after adjusting for the number of teams, too, so expansion isn't to blame. Or you might think DL ranks are swelling because today's players have longer careers, and it would make sense that older players get hurt more often. In reality, though, younger and older players alike break down more frequently than in past seasons.

Or maybe you think it's economic incentives that are driving teams to shelve players more quickly, with doctors protecting high-priced athletes (and covering their own butts) by shutting them down at the first sign of trouble. That's an idea the union buys. "I think greater attention is being paid to players because they represent a greater investment every year," says Orza. "As salaries go up, clubs have a bigger stake in making sure players are taken care of."

While that may be true in specific cases, it doesn't explain why an injured player spends more time on the DL than he used to-an average of 68.4 days, up from 58.3 in 1997 and 55.9 in 1989. Those numbers indicate some serious bone-crushing going on, not just forward-thinking roster management. Many teams have traded artificial turf for grass. Some have installed state-of-the-art training and rehab facilities. A few have placed their pitchers on controlled pitch counts. And still the injuries mount. Does anyone know what's going on?

The people who study baseball injuries offer a few overlapping hypotheses. The first is that players are getting too big. When you bulk up, most of what you add is muscle, and sometimes your tendons and ligaments can't keep pace. This theory makes performance-enhancing drugs the 800-pound gorilla in the room. Many MLB insiders are concerned about their effects, but few speak openly and specifically about them. An exception is trainer Stan Conte of the Giants, one of a handful of teams whose medical staffs are intimately involved in their baseball decisions.

"It's important to talk about what the overall causes are," says Conte, who recently analyzed the 2003 Redbook. "The steroid issue is definitely one of those. The problem is, we don't really know what's being used and how it's being used." Conte hopes testing in both the majors and minors will alleviate that problem. But, he adds, "there is not just one cause. It's also pitch counts, players who want to play hurt. There's a multitude of factors, all of which have to be addressed separately if you're going to keep injuries down."

According to Conte, the newest Redbook shows it is primarily pitchers whose rate of injury continues to accelerate. The theory here is that managers are asking pitchers, who face more powerful hitters and throw more breaking balls than ever, to do too much work when their arms are tired. "Virtually every pitching injury is an overuse injury," says Dr. Glenn Fleisig, head of research at the American Sports Medicine Institute in Birmingham, Ala. "Even when a guy hears something pop in his arm, when surgeons go in, they usually find that tendons or ligaments have frayed and worn away." So much for being babied.

The commissioner's office has only recently turned its attention to these issues. Bud Selig created the medical advisory committee chaired by Pellman, and authorized it to spend up to $100,000 a year to support research projects. Yes, that's $200,000 less than the MLB minimum, but it's a start. "We want to fund superb research, and we want to see the results published in journals," says Pellman. The group recently gave out its first grant, though it hasn't disclosed how much and for what.

Pellman faces an uphill battle. MLB owners don't like helping each other if it means having to spend money. "In January 2003, we had a town meeting with representatives from about 25 MLB teams," says Fleisig. "I made a presentation where I said, 'Here are some numbers on injuries. You work for MLB. ASMI wants to step up and help.' And when I was done, the doctors and trainers all said, 'You're totally right, it's a big problem. But we don't work that way. We can try to drive something to prevent injuries through MLB, but we'd be better off coming to you on a team-by-team basis.' "

Only about one in four organizations uses the newest research or biomedical techniques to manage risk. That's great if you're a fan in Cleveland, where young pitchers Cliff Lee, C.C. Sabathia and Jake Westbrook all benefit from ASMI evaluations. Or San Francisco, where the medical staff reviews potential trades and draft choices as well as X-rays and lab results. Or New York, where George Steinbrenner funds private medical studies. But many clubs are still content to shovel players onto the DL without making much effort to find out why they're getting hurt. "For some teams, this is becoming an amazing advantage," says Carroll. "If Oakland and Toronto are reducing pitching injuries to near zero, they don't really want the other 28 teams getting their information."

Meanwhile, the union is in no hurry to help advance baseball's medical research frontier, though such advances will be difficult without that help. "We need to develop an injury surveillance system," Pellman says, "and for that, we need the cooperation of the players association."

You'd think the union would push harder for research that would help its members, but its disinterest serves as a blocking strategy for players worried that injury data could be used against them. "Anything that may reflect on a particular player's potential for injury could affect his salary or ability to sign with a team," says a member of MLB's medical advisory committee. "There's a lot of money and a lot of politics involved in releasing data about players."

Thing is, though, there are a lot of careers involved, too. And unless the owners, players and doctors find a way to work together to understand why so many injuries are occurring today, future stars will spend even more time off the field.

And we'll still all be wondering why.

unsubstantiated,unsupported bull

steroids are not a factor in baseball why do you continue to talk about this nonsense

if bud selig thinks it is  a factor i know it is not because he has no credibility

if bud selig thinks it is  a factor i know it is not because he has no credibility

Smazz may have something with that .................

If Bud Selig said it wasn't a factor, then Smazz would be agreeing with him

If Bud Selig said it wasn't a factor, then Smazz would be agreeing with him

But THEN he'd be wrong .............

Or, maybe it's because people are missing games over things like sneezes and fingernails.

fingernails become brittle from steroids   ;)

it hasn't rained in months in la

maybe it is because all of the people taking steroids

steroids might have thrown off the balance of life on the planet... or at least Barry's head has thrown off the gravitational forces in this solar system...  the apocolypse is near and it is baroids fault.

what is explanation for boston's collapse