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Playoff Health Preview: League Championship Series Could Be Decided by Health

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Playoff Health Preview: League Championship Series Could Be Decided by Health
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Teams don't always make it to this stage in the season by being healthy. The Dodgers and Red Sox have overcome more injuries than most teams, but they have been able to succeed because of depth, the emergence of new stars and the kind of "next man up" luck that occurs as the residue of design. The Cardinals and Tigers have been able to avoid the most costly injuries this season, but they have to contend with the fatigue and management that every other team does to stay that way.

With the help of Dr. Tim Kremchek, here's a look at the health situation for all four teams heading into the League Championship Series. You may not see the medical staffs much, or just glimpses of them in the dugout, but know that all four are big parts of why these teams are playing for pennants.

 

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Walt Hriniak would be proud.
Los Angeles Dodgers

Sue Falsone and her staff have never had a break. They started their season with injuries, and they'll end their season with injuries. What they've done is minimized the effect, though much of that has been bought along the way. 

While there's not more hours in a day just because it's playoff time, I asked Dr. Kremchek what teams do to get ready. "Many players have muscle injuries this time of year. Hamstring and lower back strains are the most common. During the playoffs, the players come in extra early and get stretched, warmed up and do a light exercise strengthening regimen. They will repeat this again after batting practice and be totally warmed up for the game. Often times, the trainers will bring them below in between innings and stretch again. During the season, they might get some time off, but not in the playoffs."

Yasiel Puig's emergence has wiped out the loss of Matt Kemp, but the medical staff has kept Clayton Kershaw productive despite last year's hip injury, as well as helping sort through the back end of the rotation and bullpen.

The Dodgers could get Andre Ethier back. His leg injury has made progress, making him available for the LCS. There's risk, especially in the early games, of setback. If they have to pull him from the roster, he'd be lost for the World Series, so look for them to be very cautious. It could limit pinch-hitting from Don Mattingly, though he didn't shorten his pen to compensate.

 

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St. Louis Cardinals

The Cardinals are a bunch of babies. I don't mean that as an insult at all. In fact, the Cards medical staff has been big advocates of a system where rehab and training is done to help players get back to primal motions. It's worked pretty well once again, as they're in the top third of teams in terms of injury stats like days and dollars lost. It may look strange, but ball clubs will do a lot of strange things if it means playing in October.

Their biggest success is keeping Babe Ruth—I mean, Carlos Beltran healthy. The Mets did the bulk of the work years back, keeping Beltran from needing microfracture surgery, but the Cards have certainly been able to maintain the knee well. His production in October is always a big factor.

The Cards do have a lot of young pitchers behind Adam Wainwright (who needs a good bit of maintenance on his repaired elbow.) Keeping them healthy and effective has been a challenge. Lance Lynn hit a wall last year, and that's informed not only his season, but those of Shelby Miller, Joe Kelly and Michael Wacha

I asked Dr. Kremcheck how he monitors young pitchers. "You always worry about younger pitchers getting out of their comfort zone. We have all learned that innings pitched become a problem in young pitchers, especially those that have thrown more than ever before. Add that to the pressure of the end of the season and the stress of the playoffs, and it makes this last month more than just innings pitched."

In game is even tougher. What things will Mike Matheny and the med staff look for? "The first thing you do is look for mechanical changes, a young pitcher will try to overthrow when he is tired and fatigued. He will keep his velocity but lose his command. When that happens, take him out." 

The Cards also face a tough decision on Allen Craig. Is his level better hurt than another player is healthy? These kinds of roster moves can make or break a team at this time of year, but John Mozeliak has experience with them, so he's likely to take a stronger lead for this playoff run than in the past, with Tony La Russa at the helm.

 

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Detroit Tigers

Fantasy players would describe the kind of roster construction used by the Tigers as "stars and scrubs." There's no scrubs on Kevin Rand's medical staff, as he's been able to keep this team largely healthy all year. It's a more mature team, but they have adjusted well to their minor injuries.

The biggest issue for the team is Miguel Cabrera. His hip/abdomen/groin issue may not be a sports hernia, but the effects are similar. Cabrera is not turning on the ball as well, evidenced by his homer in Game 5. He acted like it was going way out, but it was just a wallscraper. Running has also shown that it affects him, so the Red Sox may try to force him to move more if they can.

The Tigers will also have to focus on their starters. While Justin Verlander and Max Scherzer have been dominant, they've also gone deep into games, which makes their between start recovery even more key. Scherzer's use as a reliever shouldn't affect his availability at all. It was once common for a starter to relieve on their throw day, though it's new for Scherzer.

 

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Boston Red Sox

The Red Sox are one of the biggest turnaround stories in sports, but they've done it in spite of health rather than because of it. They tried to back out of Mike Napoli's deal because of a hip condition, only to have Napoli have a healthy and productive season. They worried that Dustin Pedroia's season was done due to a thumb injury, only to see him continue hitting without much in the way of treatment.

Even the pitching staff has been plagued by injury. John Farrell has lost Clay Buchholz for much of the season and Andrew Bailey for all of it, but unexpected players doing big things, like Koji Uehara and a deal for Jake Peavy, were able to get the team past those.

Their biggest issue in the playoffs is keeping Jacoby Ellsbury available. The soon to be free agent is doing nothing to show issue with his foot, running well in the outfield and on the bases. Once again, the injury's effect is significantly less than what we were led to believe. John Lackey has also had a solid return from his Tommy John surgery, though that's relatively standard.

The Sox and their "Duck Dynasty" look make it a bit deeper into October, a place this particular team hasn't been. Pedroia, David Ortiz and John Lester will have to really lead a younger team, as they continue to find their own way despite some medical bobbles along the way.

 

Timothy E. Kremchek, M.D. is in his 18th season as the Medical Director and Chief Orthopaedic Surgeon for the Cincinnati Reds. He began his practice in Orthopaedic Surgery and Sports Medicine in 1993 and has become a leader in the care of athletes across the country at Beacon Orthopaedics.

 

Will Carroll has been writing about sports injuries for 12 years. His work has appeared at SI.com, ESPN.com and is a three-time FSWA Award winner.

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