Jim Hendry's Plan #44
Before I get to what's going on with Aaron Heilman's knee, I've got a few odds and ends to mention.
I've figured out what the heck Cubs GM, Jim Hendry, is up to this offseason. In a nutshell, in an attempt to beef up the middle of the lineup he wanted to add one of the all time great sluggers to the Cub lineup. Unfortunately Hank Aaron is just about to turn 75 years old. So this great idea came to him in a dream...swap out Hanks (Blanco, Williamson) and accumulate Aarons (Miles, Heilman). Voilà, plan #44!
The newest acquisition (Aaron Heilman) grew up as a Cub fan. It seems that this is the first directive from Tom Ricketts, all new organizational members must be diehard fans.
On to Aaron Heilman's medical issues. I've not been able to find a precise diagnosis to his 2008 left knee ailment other than it being labeled tendonitis. This LINK goes to an article from Sept 12th, 2008 discussing what problems Heilman was dealing with last year.
Last night on WGN radio, David Kaplan interviewed Aaron Heilman and specifically asked him about his knee problems. All we got was "athlete speak." It does seem that they have a therapy treatment plan that was worked out for him to address his issues this offseason.
Kaplan: In terms of your knee. I'm reading an article on ESPN today, it said knee pain played a role in your 2008 struggles. Would you agree that your knee was a problem and how is it today?
AH: Right now it's great. I feel healthy, everything feels good. I struggled a bit early on in the season trying to figure out a routine that would work best for me. By the end of the year I had figured that out. It certainly took a lot longer than I thought it would and that I hoped it would. It certainly wasn't 'the' factor that caused me to have a year I wasn't particularly pleased with. When you are going through something like that, you're trying to figure it out, you're trying to do different things every day, you don't really quite have a routine because you're not sure how you're going to feel the next day, that can play a role into it. We've got all those issues hammered out. I'm looking forward to staying with a good program, staying healthy all year and just going out there and competing.
Tendonitis refers to inflammation of a tendon and there are several tendons around the knee. The largest two are the quadriceps tendon (which inserts into the patella/kneecap) and the patellar tendon (which goes from the patella to the tibia below the knee). Tendonitis of either one is common. There are also hamstrings (medial or lateral) and even the gastrocnemius which is more of a calf muscle but the tendons go behind and above the knee attaching to the femur.
My guess is it was a patellar tendonitis (aka Jumper's knee) as it's probably the most common of these conditions. In a pitcher, this would a significant problem for both push off or landing from a mound. Heilman played through it most of the season, meaning it was nagging but not incapacitating . It wasn't disclosed to the press until the 2nd week in September where there are multiple articles (see the link above for one of these) explaining why they hadn't used him as much in early September. Of course blowing 5 of 8 save opportunities might just be a better excuse to skip calling him from the pen.
I'm sure they had MRI imaging on him as that would be useful to rule additional conditions inside the knee that might make the tendonitis a secondary problem (like a torn meniscus). The treatment is the usual rest and non-steroidal anti-inflammatory medications, better shock absorption in shoes. Therapy includes stretching and controlled exercises also various heat modalities to the inflammed area. In a pitcher it's unlikely to resolve until enough rest can occur, which means the off-season.
He didn't have this in 2007 so I'd expect him to be OK in 2009. I saw that he did have right (his pitching elbow) tennis elbow surgery immediately after the season on 10-23-06. Tennis elbow (aka lateral epicondylitis) is an inflammation of the tendons responsible for wrist extension and originate just above the outside/lateral aspect of the elbow. It develops from repetitive resistance to wrist extension activities hence it's nickname, tennis elbow came from the added resistance of using a tennis racquet. Dr. David Altchek (he's quite a famous NYC Sports Orthopod, who did similar surgery on Carlos Delgado that same week) performed the surgery and although it's obviously unrelated to his knee issues, it is an example of a chronic tendonitis that rarely needs surgery but ultimately he needed it (and presumably got better from the surgery). His stats in 2006 (74 games, 3.62 ERA, 1.16 WHIP) were better than 2008 (78G, 5.21 ERA, 1.59 WHIP) so I guess it was the same nagging thing but he put up with it pretty well. He probably had a bunch of therapy, ultrasound/deep heat rxs and a few cortisone shots for it before the elbow surgery.
Patellar tendonitis can be chronic (which isn't all that common) and then the tendon can be surgically explored or consideration is occaisionally given to (ESWT) extracorporeal (ultrasonic) shockwave treatment, which is more often used to treat resistant plantar fascitis (arch inflammation). ESWT is not like ultrasound in a physical therapy center which is mostly a way of delivering deep heat to tissues. ESWT is more like what they use to break up kidney stones (lithotripsy). It actually traumatizes the tendon collagen and brings in new blood supply which then promotes healing of the damaged tissue.
Update: based on a nice pickup from reader ankeith15, it looks like Heilman did undergo ESWT treatment. This LINK from a mets.com archive on November 20th confirms his diagnosis was patellar tendonitis and goes on to say:
After a loss in September, Manuel disclosed that Heilman had pitched much of the season troubled by patellar tendinitis, a malady that affected his landing leg, restricted his conditioning and non-game throwing, and reduced the sharpness of his pitches. Heilman since has undergone a noninvasive ultrasound treatment that has reduced the pain in his knee.
ESWT was used off-label on Magglio Ordonez during his free agent year when he was diagnosed with avascular necrosis of the femoral condyle (dying bone in the knee due to damaged local blood supply). I think Mags had to go to Vienna, Austria to get that treatment as ESWT wasn't being used like that in the US then. Ordonez knee did recover apparently enough to hit .298 with 24 HR's and be the ALCS MVP with a memorable walk off 3 run homer to end that series.
A variant on such an example of surgical treatment of a chronic tendonitis was the chronic achilles tendonitis in Cliff Floyd who had surgery (also at the same hospital/same week that Heilman had surgery, but a different surgeon) on it the offseason before he signed with the Cubs.
Of course if you have HMO insurance, they just tell you to change shoes.
he subscribes to my twitter, he's beyond TCR. #yolo #swag
Whoops. Maddon must have been reading TCR (for his daily crunch) and got confused.
kuhl is a righty, not a lefty.
i think maddon might think kuhl is a lefty, too. i wonder what the reasoning is for baez leading off vs a rightie.
"trout's one of the best, and at this point should probably win over donaldson (and should have more MVPs in the past, too), but the defensive aspect of valuing WAR still needs more tweaking...imo."
that's from my 1st post. there's no suck involved in that. maybe with a few less posts about bullshit that point would have jumped out more.
crunch - you do know that, taking defense out of the equation, Trout has led the AL in wRC+ each of those years, right?
And, if you want to complain about position adjustment (which would be serious #crunchsplaining), he's been in the top 3 in the AL in WC (not park/league/position adjusted). And the only players ahead of him (if there were any players ahead of him) in any of those years have been DHs or 1B that play lousy defense.
But sure - Trout sucks (or at least isn't as good as WAR says). Because it factors in defense and position.
early tim tebow stuff rolling in...
ran a 6.7 60yd (above average)...shagging flies in RF and showed off a rather impressive arm a few times, but average-at best on most of his throws...hit a few over the fence (both fields), fouled or weak contact a few...he's got a touch of power
it'll be interesting to see who bites on this project, if anyone. he probably projected himself out of RF and into LF/1st because of his arm, but unless he can make that power work on a steady basis it'll be hard for him to play himself up anyone's system.
LHP Clayton Richard (released by the Cubs earlier this month) is pitching very well as a starting pitcher for the San Diego Padres and could be a good candidate to get traded to a contender looking for a veteran SP before tomorrow night's post-season roster eligibility deadline.
Because they released him, the Cubs are paying most of Richard's 2016 salary (the Cubs are on the hooks for $2M, minus the pro-rated portion of the MLB minimum salary that is paid by the Padres).
it is honestly awesome (for real) that anyone would even have a strong opinion on AZL playoffs. i guess if you invest enough time watching it, you want to see a fair/just playoff structure.
plus, the kids deserve it.
The AZL team with the best record over the course of the full 2016 AZL season and the only AZL team to play .600 ball (the AZL Dodgers) did not qualify for the AZL playoffs, and the AZL East Division team with the best record over the course of the full season (the AZL Athletics) did not qualify for the AZL playoffs, either.
That's because of the ridiculous "split season" schedule most of the minor leagues now play, a stupid system that rewards mediocrity at the expense of the worthy.
Despite good movement on his fastball, I think location kept him from getting Ks. Left some pitches up and away that got hammered up and away. Then of course Travis Wood gave up the 2-run double in the 7th, but both runs counted against Arrieta.
"i'm gonna make you my main squeeze one day, bro. save the date."
This level of discourse is #charming.
I would be having this discussion with anyone who (a) blathered on ad nauseum about the topic. (See, "Olt, Mike, not given an opportunity") or (b) responded directly to what I posted (which you did).
Have a nice day.
what would you do without me? aside from having your posting content here cut by 75%+?
i'm gonna make you my main squeeze one day, bro. save the date.
In this instance, yes, I care more about the result of this big thing that isn't really a big thing.
Fangraphs WAR #s include baserunning and Hamilton is elite at that. He leads in SBs with the 54 and and has an 87% rate which is really good. I'm sure once he gets on base he's able to take the extra base quite often too. Both those things will up his overall WAR value.
The differences between BR and FG WAR is pretty well documented online and thus If there are discrepancies it's fairly easy to figure out why. It's fairly well accepted that BR WAR is fine as a snapshot but FG is better at predicting future value.
i have no doubt at all you quit reading at that point. you're very enamored with outcomes without caring what it takes to get there.
the fact it's exploitable, especially without someone to cover the running game for him, as well it's evolution in how people are testing possible exploits is interesting to some people...to me...i'm some people...hurrah.
some people want to check the boxscore to see who won, some want to know how it went down.