St Louis Cardinals Team Health Report: 2013 Injury Risk for Every Starter

Will Carroll@injuryexpertSports Injuries Lead WriterMarch 4, 2013

St Louis Cardinals Team Health Report: 2013 Injury Risk for Every Starter

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    Will Carroll has produced an annual Team Health Report for each MLB team for 12 years. The report gives risk ratings for every player in the expected starting lineup and starting rotation, plus two relievers. A proprietary formula sets a baseline according to a player's age and position. It is adjusted by 12 factors, including injury history, team history and expected workload.

    This risk rating is classified into three tiers—red (high risk), yellow (medium risk) and green (lower risk). It should be used as a guideline and is about probability, not prediction. To learn more about how the Team Health Reports are devised, click on this article

    2012 Ranking: 10th best of 30 teams in DL days and dollars lost

    Biggest Injury: Chris Carpenter, $22 million (single largest injury cost in MLB) lost value

    Head Athletic Trainer: Greg Hauck

    Figuring out who to credit and blame for injury stats is difficult. Does a healthy pitching staff mean that the medical staff kept them healthy and handled their recovery? Does it mean that the front office signed or drafted good pitchers? Did the development staff bring a number of guys up and give the staff depth in addition to strength?

    The St. Louis Cardinals had the end of an era come with a bit of a rolling end point. Tony La Russa is a year gone, Greg Hauck has led the medical staff for a couple of years and with Dave Duncan officially gone, it's fully to a new era. That lack of a clean break makes it tougher to give the credit or to separate how much of La Russa was Duncan, who was responsible for so many great pitchers over their time together.

    The fully new staff starts with an anchor attached. Chris Carpenter informed the team that he wasn't going to be able to go at the start of the season. In the last year of his deal, he'll tack on 180 days of DL time and $10.5 million to the injury stats. This points to one of the problems with injury stats: They don't always happen in the year where they have to be accounted for, but there's not a better way available. 

    Carpenter's absence puts more pressure on Jaime Garcia, coming back from an injury himself, and the young guys at the back of the rotation. We got a good indication of how Mike Matheny will deal with that last year, and it was a positive.

    The biggest injury situation in the field is Matt Holliday. His lingering back issues threaten to derail both his power and speed with four more years left on his big contract. If the medical staff can't get Holliday to take his health seriously at the start of the season, before things start to build up, they'll find themselves in the same situation as they did last year, perhaps much sooner.

    The success the staff had with Carlos Beltran in his first year with the team gives some hope for how they could deal with Holliday, this year and beyond. The team allowed Beltran to play in a style that recalled his peak, despite a knee problem that seemed to have him severely limited. The team even acknowledges that it pushed him a bit further last year than it had hoped despite the success.

    There's a lot of threads to put together and again, figuring out how to account for all of it will be impossible from the outside. As long as the Cardinals win, anything else will be secondary.

    Click ahead for the Cardinals. Here are links to all the teams' reports.


    Will Carroll is the Lead Writer for Sports Medicine at Bleacher Report. He has written about sports injuries and related topics for 12 years. His column is called "the industry standard" by Hall of Famer Peter Gammons.  

C Yadier Molina (GREEN)

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    If there is a perfect modern catcher, it's Yadier Molina. He's not fast, but he does everything else at the highest level. He raised his game to fill some of the gap that his friend Albert Pujols left and there's no reason to think that will change. 

    A large part of his value is his durability, which in part is a reflection of his competitive spirit. Yadier wanted to be the best Molina around, and after he did that, he wanted to be the best catcher. On top of the durability is a good foundation based on the sheer number of at-bats he gets over a normal catcher. 

    There's a cost to catching, in foul tip bruises and bent fingers. Molina could do with a better backup, especially as he ages. For now, he's clearly the best player, a guy who you can figure will play in at least 150 games, and there's no reason to think he can't. Now if we could just clone him.

1B Allen Craig (RED)

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    Allen Craig isn't Joey Votto, but he had a similar situation with his knee. Craig had a major setback in his recovery, costing him the first month of the season. Once he was back, he ended up with wrist and hamstring issues. He limped through the season to the tune of 120 games, a stunning level in retrospect. 

    Given the production that he gave the team while injured, a healthy Craig should be even better. .300/25/100 is well within reach, and there might be even more in a healthy season. The Cardinals let Lance Berkman go and didn't put anyone behind Craig this offseason. That's both a nice statement of confidence and an acknowledgement of their flexibility with players like Matt Carpenter and Ty Wigginton.

2B Daniel Descalso (GREEN)

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    Daniel Descalso took the utility job and turned it into a platoon job. He turned that into a starting job and with this spring, the job is his to hold. Matt Carpenter stepped up to the utility role, though he's going to be very stretched defensively if forced to play 2B. 

    The pressure on Descalso comes from below, where Kolten Wong is progressing as expected. The worst case is that Descalso gets Pipped due to a minor injury and finds himself back in the utility role. That's not that bad, given the flexibility of this roster. The green rating reflects both the lack of significant injury history and that value floor.

SS Rafael Furcal (RED)

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    Rafael Furcal avoided Tommy John surgery, but whether the elbow will hold up to the load of a season remains to be seen. The Cards are bringing him back slowly and seem willing to go with Pete Kozma as much as needed. Add in Furcal's age and history of back problems, and this is one that could go badly in a number of ways.

    Furcal was showing more speed than he has in a while last season, so if the back problems are really under control, there's some upside here. It's just very, very risky and borderline speculative.

3B David Freese (YELLOW)

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    David Freese is well known, but he's not really a star, at least not yet. He can hit, he can field, he has a nice smile—yes, that matters too if you're building a ballclub. The skill that Freese lacks is health, and it's one that simply can't be taught.

    Or can it? A player can't change his DNA, but he can get smarter about style, about preparation and about conditioning. No one questions Freese's work ethic or baseball smarts, but he's going to have to figure out how or even if he can keep himself healthy so that all those other skills stay on the field.

    Last season's numbers may well be his high point and he might be a 120- to 140-game player. That's not a bad thing; it's Scott Rolen's career without the early peak, and the Cardinals would gladly take that.

LF Matt Holliday (RED)

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    Matt Holliday fought through a number of injuries and has good numbers, but the back injury that kept him out of the NLCS is the worst sign that Holliday is degrading. He's a max-effort guy with football size and immense skill, but he's ended up his own worst enemy in ways. Instead of learning how to dial it back a notch and play more, his answer is to work hard and dive more, and it ends up making nagging injuries worse.

    The back problem is lingering now and any sort of chronic problem is likely to start sapping his power. With several years left on his contract, he'll end up a maintenance case. That's not a bad thing, given the success they had with an even tougher case in Carlos Beltran. Holliday is going to have to refocus some of his work toward keeping his body not in shape, but functional. The production is still there if he doesn't fall apart.


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    Jon Jay has a career line that The System just looks at and stares. It's really singular and combined with his injury history, it just doesn't know what to do with it. The System is smart, but in ways, it seems dumb unless you understand risk. Unknowns, singular events and things that don't appear to follow normal logic are risks. It doesn't like something unpredictable. 

    Jay is unpredictable, but productive. His 2012 looks good, but muddled by injury. His 2011 looks great. If the truth lies somewhere in between, he's a very solid outfielder in a good lineup with both upside and downside. The fact is that I don't know, you don't know and The System certainly doesn't know. Coming in just below the red threshold shouldn't be a negative with all the risks.

RF Carlos Beltran (RED)

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    That Carlos Beltran is playing at all is a testament not just to the Cards med staff, but to the Mets and Giants as well. It looked at one point like Beltran was definitely headed for microfracture surgery, a place where baseball players don't seem to come back from. (Yes, that makes no sense. Even in small numbers, baseball players should have fewer demands on the knees than football or basketball players.) 

    Instead, Beltran is playing at or near his normal level, playing many more games than expected, and even playing solid defense. The worry is that he fatigued near the midpoint of the season, lost a ton of power and was generally overexposed. The Cardinals want him to play less next year, spotting in more rest and keeping him close to 135 games than the 151 of 2012. He's likely to be a better player in that scenario.

    He's one bad step, one sprinkler head, one quirky slide from being right back where he was a couple years ago, so the risk is definitely there, and due to the knee being the story, his age is usually ignored. If Beltran gets through the season healthy, the Cardinals medical staff shouldn't win an award, they should lead seminars. 

SP Adam Wainwright (GREEN)

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    Last year, there were major questions about a curveball pitcher like Adam Wainwright coming back from Tommy John surgery. Since the proprioception of the release point is even more key to a big curve like Wainwright's, the thought was that it might take him longer to get that back. Instead, it appears that the proprioception it takes to make that pitch normally allowed him to get it back quicker and maybe better. 

    Wainwright answered every question, becoming the staff ace by deed and by default. Chris Carpenter missed almost all of last season and will again this year. Wainwright had a rough start, by his standards, and did have some fatigue down the stretch, but he still showed enough that he and his new elbow figure to be the top of the Cards rotation this year and a few more. 

    He's not as young as most think (31 years old), but his case makes for a good counterpoint to the Stephen Strasburg saga. Somewhere between the two is the middle path of objective data that every team in the big leagues is ignoring right now.

SP Jake Westbrook (GREEN)

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    Jake Westbrook had a Westbrook year, again. He doesn't fool anyone with his stuff, but he keeps his team in the game. One of the tenets of the La Russa style is that even if he didn't have someone great in the four or five slot, he always had someone like a Westbrook who could keep his team in games and give the offense a shot to win it. Five days out of five, 162 games a year, La Russa might not have the best pitcher, but the best pitcher doesn't always win.

    Westbrook should be able to do it at least once more. There's nothing dominant and barely deceptive, and with the Cards' regular defensive experiments, Westbrook isn't the kind of pitcher that should succeed with this kind of team. It works out somehow, even now with La Russa gone. 

    There are some issues, like a mild oblique strain at the end of the season that does seem to indicate some fatigue. He's nearing the end of the Tommy John "honeymoon," so there's that as well, though he was never a big risk the first time around. Expect similar numbers, similar velocity and that a lot of people won't understand how a guy like Westbrook has been doing it for years when all the other pitchers on the team have so much better stuff.

SP Jaime Garcia (RED)

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    The next time someone says that nothing good ever comes from a visit to Dr. James Andrews, mention Jaime Garcia. He saw four different surgeons about his shoulder issue and Andrews was the only one who thought he could rehab through it. I'm not going against Dr. Andrews by saying Garcia is risky. He is, clearly, but if he'd had the surgery, he wouldn't be risky at all. He would have missed the season.

    The best-case scenario is that the rehab worked and Garcia comes back with the same good stuff he had prior to the shoulder injury. The worst case is that he breaks down early in the spring. In between, we get the likelihood that he won't make it through the season unscathed or without some shutdowns, but if the Cards can get some production in between, anything like 20 solid starts, its a clear win for the team and the medical staff. 

    At 26, Garcia is young enough that you might think a big free-agent contract is in the near future, but with a bad rotator cuff and a Tommy John surgery in his medical file, you'll understand why pitchers ask for long-term deals when they can get them. The risk is huge, but so's the reward.

SP Lance Lynn (RED)

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    Though innings increases have been scientifically challenged, and this challenge is reflected in this year's ratings, it's the anecdotal evidence of guys like Lance Lynn that has kept the theory of innings increases in effect for better than a decade. Even to the point of it being a large basis for the Stephen Strasburg shutdown. Lynn hit a wall at the 140-inning mark, just over 30 from his previous season's total. 

    He wasn't hurt, just ineffective and a trip to the pen lightened the load, but kept him effective enough to bring back in the playoffs when he was needed. Lynn should make a step up from there, but with Chris Carpenter out, the idea that he would do anything but start was vanquished.

    Lynn showed up to camp down a significant amount of weight, which for almost anyone is a big positive and certainly shows a commitment. Then again, even small things can have a huge cascade effect, so we'll only know in retrospect and anecdote how this affected him. If he has a big year, building on his 18-win season and becomes a Cy Young contender, we'll see a lot of skinny pitchers next year and a lot more team-hired chefs. If not, well, guys will stay chunky.

    For Lynn, the combination of age, the workload from last year and the expected workload from this year puts him into the red. I'd certainly take the risk if he looks solid in the early stages of camp.

SP Shelby Miller (RED)

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    Shelby Miller is by acclimation the future ace of the Cards, and many fans think the top prospect will be mentioned with Adam Wainwright the way that Chris Carpenter was for the better part of the last decade. Miller's good and has great stuff and makeup, but The System doesn't care about things like Minor League Pitcher of the Year or Baseball America rankings. 

    Like the Cardinals, The System is from Missouri and says "show me." Miller has but a handful of major league innings and will now, due to Chris Carpenter's injury, likely start the season in the rotation. Going from 13 to 200 innings is going to be a task for any 22-year-old pitcher and one the Cards are smart enough not to push.

    The Cards have pitching depth and could give Miller a rotation turn off every couple times through, letting Trevor Rosenthal or Fernando Salas take a turn and some of the load. Keeping Miller healthy through the season is yet another test for this Cards medical staff, not to mention the new pitching coach.

RP Mitchell Boggs (YELLOW)

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    Mitchell Boggs picked up velocity when he went from fringy starter to setup man. He excels in the role and seems to relish it without pining for the saves. The workload isn't helping a chronic bad back, with a bulging disk really wearing on him at the end of the season. If season-over-season fatigue is playing a part here, Boggs is in for a much bigger fall than what the yellow rating indicates.

    The fact that we know is that a relief inning isn't physiologically the same as a starter inning. The leverage concept shows that the situation is important, but we don't have enough physiological data to come up with a real answer, and the proxies that have been built like Leverage Index (LI) don't provide enough of a framework to translate, even on a general basis. The person or team that figures out the true workload cost of an out will jump to the head of the line for the Nobel Prize for baseball. 

CL Jason Motte (GREEN)

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    Next time someone calls Tony La Russa a genius, remind them that La Russa fought tooth and nail to keep using Ryan Franklin over Jason Motte. Not once, but for a long time. Even geniuses make mistakes and that's definitely one on La Russa. Motte has pure closer stuff and the crazy-like-a-fox closer stuff down. He even has the wacky beard and demeanor that seem to come with the job.

    Put all that aside. What you have is a good pitcher with good stuff who doesn't buckle under a pressure situation. The ninth really isn't that much harder than the eighth or seventh, but in a game where role and superstition is taken very seriously, it shouldn't surprise anyone that there's something of a closer placebo effect—if they think the last three outs are harder, they are. And they do.