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Axford talks pitching, elbow injuries, Tommy John surgery

April 17, 2012

MILWAUKEE — Even as the workload of pitchers decreases, the injuries seem to be mounting with increasing frequency. Especially elbow injuries, and especially with closers.

That was the premise of a story written today by Tom Verducci for SI.com. As he sees it, the injury trends point to a need for rethinking the modern bullpen in which relievers — outside of a select group of long relief pitchers — are limited to single innings or at-bats in very specific situations.

Left-handed relievers often face strictly left-handed batters late in ballgames. Managers like Tony La Russa have no problem running out three different relievers for three batters in a single inning: right-hander to face righty at the plate, lefty versus lefty, and then back to the right side. Or vice versa.

The alarming thing is that while pitchers’ workloads are generally decreasing, the likelihood of injury seems to be on the rise. Just this week, Giants closer Brian Wilson went down with a season-ending elbow injury that will require his second Tommy John surgery.

Here are some of the statistics from Verducci’s story:

  • Sixty-six percent of 2011 Opening Day closers (20 of 30) are no longer closing for the same team 12 months later, with seven of them hurt.
  • Fifty percent of all starting pitchers will go on the DL every year, as well as 34 percent of all relievers, according to research by Stan Conte, director of medical services for the Los Angeles Dodgers. That bears repeating: half of all starting pitchers will break down this year. (“When I did the research,” Conte said, “I was so surprised I figured I must have done the math wrong.”)
  • Injuries last year cost clubs $487 million — or about $16 million per team. The bill since 2008 for players who can’t play is $1.9 billion.

As for guys like Wilson, going through the surgery a second time, 70 percent of relievers make it back while only one in 10 starters returns following a second operation and lengthy rehab.

A couple more stats from Verducci:

  • The past two seasons mark the first time since the save statistic became official in 1969 that nobody saved 25 games with 81 innings in back-to-back full seasons. Bailey, with the 2009 Athletics, is the only closer to do so in the past four years.
  • Over the previous five seasons, 53 closers saved 25 games at least once. Thirty-three of them, or 62 percent, no longer are closing.
  • Only five pitchers saved 25 games three times in the past five years and are still closing: Jose Valverde, Mariano Rivera, Jonathan Papelbon, Heath Bell and Joe Nathan

With all that in mind, I talked this afternoon with Brewers closer John Axford about the story and the injury trends, to assess his feelings and level of concern about the likelihood of injury and seemingly short lifespan of pitchers in his role.

Here’s what he had to say:

Do the injury trends worry you at all?

“No, not particularly. As far as injuries go, that happens to anybody, whether you’re a starter or reliever. I don’t think it matters whether you’re specified as a closer or not. As a pitcher in general I think you’re more susceptible to injury than a position player.”

“It’s nothing I think about every single day, that’s for sure.”

Do you ever think at all about the fact that as a closer you’re likely to have a short lifespan in the role?

“Some people do, some people don’t. It just depends on the trend and the people that they want to look at. Once again, it’s not something I really look at and think about too much.”

Did you ever talk to Trevor Hoffman about how he was able to last in the role so successfully for such a long time?

“Really, just his work ethic. Just watching him work day in and day out, you could just tell his determination and dedication every single day. I think that’s really what it takes.”

“Obviously for Trevor, too, it was a matter of San Diego. Him wanting to be there, taking an opportunity when he had it, and obviously the team wanting him to be there also. So if I’m given the opportunity to stay in Milwaukee, I obviously would love to do that. I think you have a better chance of staying with that same club than testing free agency and popping out everywhere as a closer. That doesn’t seem to go over quite as well. Unless you’re Papelbon, I guess.”

Would the likelihood of injuries make you more likely to want to sign early if offered an extension?

“I know how hard I work, I know the effort I put in every single day. I know my body and I know what it’s capable of. Same with the team. They’re pretty trustworthy and they’re pretty open to both sides. If I tell them I can’t pitch on a particular day, they know they won’t put me in. Even if I say I’m OK, sometimes Ron [Roenicke]’s going to say, ‘No, we’re going to give you a day off.’ If it’s early in the season, obviously, why not give a guy a break when he needs a break? And Ron and Kranny [pitching coach Rick Kranitz], they’re great about that. They’re great about making sure that the relievers and everybody has the time that they need.”

“So I don’t think I’m going to get overworked, and I know how hard I work. So I don’t feel like an ‘injury waiting to happen’ by any means.”

Another thing mentioned in the story is the setup of the bullpen and closers being limited to late-inning save situations, if it were up to you would you stick with that or pitch whenever high-leverage situations came up? Fifth-inning, sixth inning?

“I don’t really know. Maybe not that early. I think my mentality’s kind of made up now towards the end of the ballgame. I really enjoy that role. Obviously in 2010, I was in there in the eighth inning at times for some saves. So I got some two-inning saves, some four- and five-out saves. Those opportunities I think really kept me focused out there as well. Having the bullpen we have now, though, everything is really role-oriented… so there isn’t much that you need to do to deviate from that.”

Can you compare your arm now to what it was like before Tommy John surgery?

“The way the doctor described it was, it was a few pieces of string that’s now become a noose rope. I had what many people do not, which is a lack of a tendon in my wrist. So they used my hamstring. So it was thicker and stronger, and they looped it through four times. Generally it used to be two, then they started switching to three. They could do four really easily with me because I had such a prominent elbow bone, my bone sticks out prominently enough, so they looped it through four times. That’s why it sticks out even more now, unlike [the other] side, which just goes straight.”

“He said, as long as I continue to pitch in baseball and work the way you normally would and work hard,  I should never have another elbow problem again. And I haven’t. It’s been unbelievably strong since. Obviously it took a little longer to come back than I wanted because I was trying to figure out my arm path again. … But as far as the elbow is concerned, I’ve never had a problem with it since.”

Do you think there should be any concern in baseball in general about the increase in injuries despite the decrease in workload?

“Not to attack anyone’s work ethic, but it could be just a matter of how people are going about their work. If you’re doing a little too much throughout the year, that could affect it. If you’re not doing enough throughout the year, that could affect it. So many little things could affect an injury. Something small, something big.”

“The elbow is such a tough thing. Throwing a baseball is the most unnatural thing you can do in sports, other than serving a tennis ball. So it’s going to put a lot of strain on your elbow. You just have to take care of it. Certainly you have to understand and know of your body. If you’re putting too much strain on it outside of your throwing program and outside of the games, then obviously that’s not going to be good. But if you’re not doing enough to maintain your shoulder work and elbow work, then you’re going to hurt it then too.”

How well do you know BrianWilson and what did you think when you heard he would be having a second Tommy John surgery?

“We played together when I was in the Cape in 2002. But that was  the only time I ever met him. And that was just before he had his first Tommy John, and just before I had my first Tommy John.”

“It’s concerning because he had his in 2003 and that’s when I had mine too. So it’s interesting to think about. Obviously I don’t want to think about it too much because it’s the same timeframe for both of us. But it’s a tough break for him, tough break for the Giants.”