Hughes headed for MRI tomorrow

Maxwell walks off in Scranton win
Yanks can't get anything on offense, drop to Sox 2-0

Update (11:41pm): Via Chad Jennings, Hughes did pass all of the strength tests with the doctor(s) today, so that’s encouraging.

Original Post (10:30pm): Following tonight’s loss to the White Sox, manager Joe Girardi told reporters that Phil Hughes will undergo an MRI tomorrow “just to see what’s going on.” Why they didn’t bother to do this when he first went on the disabled list, I don’t know. Hughes experienced a setback during today’s bullpen session, as the right-hander simply said that his arm felt dead after ten or so pitches. Hopefully the MRI comes back clean, but I really wouldn’t be surprised if it didn’t.

email
Maxwell walks off in Scranton win
Yanks can't get anything on offense, drop to Sox 2-0
  • Steve

    I’ve not been high on him in awhile and his coming into camp overweight really annoyed me, but you don’t ever want to see any pitcher go through this. I think it was absolutely inexcuseable that the Yankees didn’t send him for a precautionary MRI. Michael Kay has said that they don’t do that unless their pitcher complains of pain because all pitchers are going to have some sort of inflammation or whatever, but in this case – how can you take the chance? This could be Phil’s career we’re talking about; can you imagine if the Yankees potentially aggravated an injury and made it worse to the point where he needs surgery? The Yankees will move on no matter what he does or doesn’t do in his career, but an athlete basically gets one crack at a career.

    This is Joe’s quote: “It’s just to see what’s going on,” Girardi said.

    Really? They couldn’t have done that a few weeks ago? Just to see what was going on?

    • adeelmd

      My point exactly. This isn’t how you manage your 80 year old grandmother, how can the yankees be excused for such poor management of one of their prized players?

      • YanksFan77

        Let me clarify, so you’re saying you can be relatively lax if your 80 year old grandmother shows medical problems?

        • adeelmd

          No I am saying the opposite, that you wouldn’t want this to happen to your grandmother, so why would they let this happen to their pitcher?

          • YanksFan77

            Glad I clarified that, cause I read it the other way. I hope one day, everyone can get equally excellent health care, whether you’re a construction worker, an 80 year old grandmother, or a 24 year old MLB starting pitcher.

            • MannyGeee

              for the record, i would not take my mother in for an MRi… I would tell her to rub some dirt on it and walk it off.

              jus sayin

            • fire levine

              You can get that already. As long as you pay for it.

  • bonestock94

    I just hope its not the shoulder. Anything but that seems surmountable most of the time.

    • ROBTEN

      I have to say, the version of the story on MLB.com has me a bit worried:

      “Hughes has been on the disabled list since April 15 with inflammation in his right shoulder”

      “Hughes further compared the feeling in his shoulder with the numbness that sets in after being punched.”

      http://mlb.mlb.com/news/articl.....8;c_id=mlb

      I don’t recall the Yankees saying anything about the shoulder before, much less inflammation in the shoulder being the cause of the problem. (When they talked about putting him on anti-inflammatory meds,I thought it was reported as precautionary.) This, combined with the fact that Hughes seems to be putting the problem in his shoulder, rather than his arm, is certainly troubling. Hopefully, it’s nothing that extended rest can’t cure.

      • bonestock94

        It’s nothing short of a disaster if it’s the shoulder. A big prospect with high hopes having a career-threatening injury is REALLY bad. Hopefully my gloom and doom is unwarranted.

      • http://www.secondavenuesagas.com Benjamin Kabak

        I believe — but am not 100 percent sure — that right shoulder inflammation is the medical “excuse.” Dead arm isn’t a reason for the DL. So the team can report right shoulder inflammation. It could also be right shoulder inflammation.

        • Mike HC

          haha

        • Gonzo

          Weren’t you adamant that the Yankees ran tests before deciding yo send him down then sending him to the DL. Did you mean imaging tests or just range of motion tests?

          Not trying to be a d*ck, just wondering if they only did your standard, “were does it hurt?” tests instead of more in depth tests.

          • http://riveraveblues.com Benjamin Kabak

            From the sound of it, I guess they just did the old “does this hurt?” and range of motion tests. I guessed wrong.

  • mop982

    They didn’t get A-Rod an MRI when he had stiffness in his hip in 2008.
    Is there a good reason to skip out on an MRI?
    They’ve got the money to cover the costs and have enough invested in these guys to at worst waste a few hours of their time.

    • CP

      With ARod, I’m not sure why they would skip an MRI. With Hughes it’s not clear that they would have known where to look. Saying take an MRI sounds easy, but it’s not as simple as that. You have to have an idea of where to look, and if you don’t you’re going to see damage because basically every pitcher has damage, but it won’t necessarily be the cause of the problem or even a real injury.

      • Gonzo

        Then how will they know where to look now?

        • CP

          I don’t know, but it sounds like this is different than his earlier assertion that he felt fine and just couldn’t throw quite as hard.

          • Gonzo

            Ughhh. Well in a worst case scenario, the Nats can pay for his rehab at least

      • Mike HC

        I think it is more just the culture of professional sports. These guys are getting paid millions of dollars to go out there and pitch. Injury, no injury, I’m not sure these teams really give a crap to be honest. As long as you are moderately effective enough to take the mound, you can figure out your injuries in the off season. I think the Yanks were hoping for Hughes to have the ability to power through the season, but the longer it took, the less hope they had. And if he wasn’t taking the mound anyway anytime soon, might as well figure out what the hell is wrong.

        • Gonzo

          Like me with my car. Run it ’til the wheels fall off.

    • MannyGeee

      their HMO doesn’t cover all these MRIs…

      somewhere, Sarah Palin is smiling and blaming Phil Hughes’ shoulder on Obamacare…

  • Steve

    I keep thinking about how things have turned out with him and it’s always tinged with some sadness. I honestly don’t blame the Yankees; IMO, the course of a player’s career is determined by his own abilities (or lack thereof), his work ethic, etc……..However, if the results of the MRI are bad, then the Yankees had better change the way they do things because there are other kids in the system who depend on the team to take care of them. I hope it’s not too late for Phil.

  • Mocha Joe

    What they’ve done to this poor kid is a travesty. But we’ve seen it before with Wang and Joba. A little known fact is that since Andy Pettitte we have not developed one quality starting pitcher that has lasted in the major leagues. They just don’t know what they’re doing when it comes to pitchers.

    • The Big City of Dreams

      I don’t think they don’t know what they’re doing but it seems like they don’t have a good grasp on transitioning starters from the minors to the big league. No I don’t expect them to be perfect but so far the big 3 has been a mixed bag

      • adeelmd

        I think they are practicing medicine in the 1950’s

        • The Big City of Dreams

          lol brutal

      • Gonzo

        It could be they are too wimpy in increasing pitches pitches and/or IP’d in the minors then get too aggressive when they are in the majors.

        It doesn’t make sense. Major league innings are way more stressful than minor league innings. A player’s biggest jump should be in the minors when it’s less stressful not the majors, no?

        • adeelmd

          Well it’s also like if you have a headache, and don’t take aspirin; and the headache doesn’t go away. Or like if you are a diabetic and don’t take your insulin and try to “eat” your way through it.

          If your arm hurts, and your velocity is not there; you get imaging. There is no excuse imho.

        • The Big City of Dreams

          “A player’s biggest jump should be in the minors when it’s less stressful not the majors, no?”

          It makes sense to me now if someone has a different opinion I have no problem hearing that side of the argument.

          • adeelmd

            The part about the minors I completely agree with. I think that was because the yankees had no pitching and had to promote him. My argument is simply that if you are going to take that risk and add that pressure, maybe you should think about being overly cautious and get an mri (and shelving him) at the first sign of trouble, rather than let him start a few games, then go on the dl, and only after he couldn’t do a bullpen session— well by then you’ve probably already torn what could’ve healed no?

            • The Big City of Dreams

              I understand where you’re coming from. It’s better to get it checked out when it originally popped up.

              Hughes velocity has been done since he reported to camp and it stayed that way all the way through. I’m surprised no one at least raised an eyebrow.

              • The Big City of Dreams

                hughes’*

                down*

  • adeelmd

    I freakin do blame the yankees. As a radiologist, an MRI is not a big deal. There are virtually no side effects, radiation concerns, and what not. I am around the magnets all day, and see all sorts of people get imaged for absolutely nothing (ie you know what’s wrong before people even get into the machine). A shoulder MRI is a simple 30 minute procedure, done around the clock all over the country.

    I remember first reading about Hughes decreased velocity while on call, Ironically sitting next to an MRI machine that was unoccupied at the time. Honestly, the only side effect of an MRI would be the $1,000 it would cost (assuming you didn’t go for contrast). But it would be enough to look at the rotator cuff, look at the tendons and bursa. You could even do another mri of the elbow to look for any swelling there (wasting another 20 minutes of the Hughes precious time).

    All I am saying is that if anyone of you went to a DR complaining of pain, you would first get an x-ray. If x-rays were negative you would get an MRI. Your physicial rehab would be based on the MRI results. This isn’t even a best case scenario, this is standard of care (meaning you would get this workup even if you didn’t have any insurance).

    Regardless of whether or not an MRI is positive or not, this is borderline malpractice. If the MRI shows something (anything really) than it would be outright malpractice. Physicians have been sued for much less.

    • CP

      But what if you go to a doctor and just say that you can’t throw quite as hard as normal – only about 97% of your previous ability, but with full range of motion, no pain and no obvious weakness?

      • Mike HC

        It doesn’t take Sherlock Holmes to start at his right shoulder and elbow, and if that comes up empty, work from there. I wouldn’t avoid sending him for an MRI just because you are not 100% of where to start.

        • Rookie

          I agree with adeelmd and Mike HC. It shouldn’t take a Sherlock Holmes…

      • adeelmd

        If you were an 80 year old grandmother, no. But if you were a construction worker and it was interfering with your ability to work (aka a pitcher with decreased velocity) then it is definitely a concern. When was the last time his velocity was this poor? I don’t remember it ever being this bad. And he has never said he didn’t have pain… they just said “all pitchers have pain” type of bs. Well pain after throwing 100 pitches at 96 mph is different then pain after four innings of 88 mph fastballs.

    • Ed

      All I am saying is that if anyone of you went to a DR complaining of pain, you would first get an x-ray. If x-rays were negative you would get an MRI.

      But he didn’t complain of pain. He’s only complained that he felt weak. He’s still able to throw a baseball in the high 80s/low 90s, so realistically he probably still has more arm strength than any of us do.

      If the MRI shows something (anything really) than it would be outright malpractice.

      Of course it’s going to show something. By the time you get to your 30s or so, the average guy has tears in his rotator cuffs large enough to show in an MRI. If you look at pitchers, anyone that’s been around for a few years will have tears. Likewise, if you look at a pitcher’s elbow, you’ll find ligament tears.

      • adeelmd

        You can’t say for sure what would show up. Sure there would be tears, but of what and what grade? While there might not be enough data out there to predict with 100% certainty when a tear will seriously hamper velocity and mechanics there are certain pathologies that can and should shelve pitchers immediately. What if all there is some fluid in the joint capsule? Drain, rest, maybe some corticosteroids and your good to go. But pitch and that fluid will grind against your labrum like sandpaper.

    • Snake Plissken

      how about blood clotting, will that show up in an MRI or do they have to do a doppler ultrasound ?

      Rick Sutcliffe mentioned David Cone/JR Richard and their dead arm issues which were based on thrombosis.

  • Rookie

    Aside from the 80+ inning jump in 2010, has anyone looked at his progression in innings from the minors on up?

    I haven’t bothered to check the numbers. But a poster on SOSH’s Yankee Discussion says it’s been as follows:

    Year Age IP
    2005 19 86.1
    2006 20 146
    2007 21 110.1
    2008 22 69.2
    2009 23 105.1
    2010 24 176.1

    And he says that it’s hard to be too shocked about a pitcher with this progression in innings having arm issues.

    If these numbers are correct (and again I didn’t check ‘em) I would definitely agree.

  • Rookie

    And another poster there added:

    “It’s actually a bigger jump because of the postseason. 111.1 innings total in ’09, 191.1 last year, so an 80 inning increase. If this is the problem, boy, they saw it coming a mile away and still mishandled it.”

  • adeelmd

    Instead of shelving pitchers when they have pitched “x” amount of innings and what not, wouldn’t it be more scientific to mr their shoulders after they have huge innings increases, prophylactically to see if there is increased stress on a particular muscle or tendon?

    I am thinking Hughes, Strasburg, Volquez just off the top of my head of people that are so important, and the money/side effects involved so miniscule, that you could even make the case for preventive imaging.

    • S

      Strasburg didn’t even pitch 110 innings (the year prior in college he threw 101) and even then he never threw more than 90 pitches in a start. The only way the Nats could have been more careful is if they had someone throw in Strasburgs place.

      • adeelmd

        True, my point is that they did everything including the kitchen sink, and he still got injured. If he was so valuable, maybe a $1000 mri after a few starts could have seen some grade 1 or 2 tendinitis and shelved him for the time being.

        Preventive MRI is not anything real, and this is all the physician scientist in me talking. I have seen incidental cancers pop up on trauma patients, suspected rotator cuff disease turn out to be mild bursitis. What if an MLB team got shoulder mri of their starting pitchers before spring training… could it help prevent a future injury? You won’t know until you actually go out and do it.

        What I meant with strasburg and Volquez was that the current system isn’t working for anyone really.

  • S

    I think there is some things we tend to forget:

    it takes a ton of trial and error to develop good starting pitching, for every one that is developed there are 6 arms that failed. The Yankees have only been doing this for like 5 years.

    With that said, I do think one issue with the young starters going down do to injuries lies in how these guys are brought up. Every Yankee pitching prospect has been brought up do to necessity, not readiness. The fact the team had nothing before Phil, Joba, and IPK and so they had to be thrown in before they were ready and the team had to come up with so many crazy rules and limitations on the fly to try and continue the development process in a stressful surrounding.

    I hope Hughes will be fine (I am cautiously optimistic that he won’t need surgery; just a few months of rest and rehab, conditioning) and I also feel that the curse of the big 3 won’t be repeated, due to the AAA rotation possessing several arms that have been gradually throwing innings for years and are now at the point where they could easily go 180+ innings without limits. With the exception of Brackman, none have more upside than that of a mid to backend starters, but they can eat innings, and allow the B’s something the big 3 never had….

    time

    • The Big City of Dreams

      Hopefully the B’s have time to grow but I can’t help but think the same mistakes will be made again. Sooner or later whether it’s this season or early next season the calls to bring the kids up will be loud at the first sign of trouble.

  • ND Mike

    I saw that Mark Feinsand’s article said he’s going for a full body scan to look for something like an aneurysm. That’s scary shit right there, baseball concerns aside I hope that whatever they find isn’t affect-the rest-of-your-life serious.

  • Gonzo

    Good news finally. Or semi-good news.

  • Rookie

    There’s another fascinating post on the Sons of Sam Horn Yankee discussion forum by Sampo Gida that I thought some of you might find interesting. It breaks down the innings pitched year by year for Hughes, Lester, Buchholz, Doubront, and Joba at age 19, 20, 21, 22, 23, and 24.

    And several things jump out from the numbers. First, the jump in innings pitched at first glance appear to be just as drastic for Lester as Hughes, if not more so — and not a whole lot less drastic for Buchholz. But the poster points out (quite astutely, I think) that it didn’t seem to hurt Lester and Buchholz, whereas it did seem to take its toll on Hughes, Doubront, and Joba — perhaps (the poster writes) because Lester and Buchholz weren’t moved back and forth from starter to bullpen, whereas the other three were. And he suggests that perhaps that takes a nasty toll on a young arm.

    This makes a lot of sense to me given the tendency for high level closers to flame out quickly.

    One other difference which the poster doesn’t point out, but which jumps out at me, is that Lester and Buchholz didn’t pitch more than 106 innings before age 21, whereas Hughes and Doubront pitched 146 and 129 innings respectively at age 20 — years in which they added 60 and 52 innings, respectively, from their age 19 seasons. I gather from the table that Joba was still in college at age 20. However, I recall that he was injured during his final year in college — which I have to imagine was much more likely than not the result of his usage pattern by his college coach.

    Again, take the numbers and speculation for whatever it might be worth. I just found it fascinating and thought you guys might, too. Again, all credit for the preceding analysis should go to Sampo Gida on the SOSH Yankee forum.

    • The Big City of Dreams

      That was an interesting read that shed some light on the situation.

  • Rookie

    Hopefully, it was clear (although I didn’t state it specifically) that my last point was that perhaps pitching too many innings at too young an age, separate and apart from any increase from year to year, could be very stressful on a young pitcher’s arm. The small sample size of pitchers looked at, of course, suggests that it’s not a conclusive argument, just interesting and that it may even explain some things or at least be the basis for some interesting discussion.

  • Monteroisdinero

    And if the MRI is normal (which I predict), then what? Finished at 24? Can it happen? Of course it can.

    My solution then would be to send Phil to Dr. Fred Garcia, renowned guru for pitchers who can’t throw a fb over 88mph. With Fred’s new “learn how to throw effective junk in 6 weeks”, Phil will return to us by the asb ready to go. Changeups, slow curves, splitter/sinkers and an occasional “keep em honest” 86-87mph fastball.

    Results vary (Javy).