30 September 2013

Making the Orioles a Champion in 2014: Center Field

This post is part of the Making the Orioles a Champion in 2014 Series.  Below you will find links to the other articles.  We will do our best to make sure the links go live with each new update.
C | 1B | 2B (1, 2) | 3B | SS | LF | CF | RF | DH | Bench | SP (1, 2) | RHRP | LHRP | Conclusion 

So, as we are all well aware, the Orioles did not make the playoffs. (Cue sad Robert Andino.) After being ridiculously fortunate in close games in 2012, the 2013 Orioles finished with a plethora of one-run and late-inning losses, which is a shame, especially since they were close to that second Wild Card spot for much of the season. Then again, considering that before 2012 the Orioles hadn't won more than 79 games in a single season since 1997, and also how unexpected and exhilarating the 2012 Orioles' 93-69 record and playoff adventure were, it's hard to complain too much about an above .500 record (85-77, to be exact) in baseball's best division. Unless, of course, the Orioles end up going another 14 seasons until their next postseason trip.

The Orioles still have a solid core of players, so it's important not to panic. (Is anyone panicking? No? OK, good.) But what do the Orioles need to do in the offseason to get back to the playoffs? The Camden Depot staff has some ideas, and Jon, Joe, Stuart, Nate, and I will be examining each part of the team (by position) throughout October to review how the Orioles performed this past season and explore ways in which they can improve heading into 2014.

I'll kick off the discussion by talking about center field and Adam Jones.

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Looking Back

In May of 2012, the Orioles signed Jones to a six-year, $85.5 million contract extension. He went on to have the best season of his career, and he was a key part in helping the O's get to the playoffs. The first year of his deal started in 2013 (for $8.5 million), and while he wasn't quite as good as the year before, he certainly didn't make anyone regret the team signing him to a lucrative extension.

In 160 games in 2013, Jones hit .285/.318/.493 (.350 wOBA). His 33 home runs were a career high. Of all qualified MLB center fielders, Jones's wOBA was fifth, behind Mike Trout, Shin-Soo Choo, Andrew McCutchen, and Carlos Gomez -- pretty good company. More or less, though, Jones did what he's been doing for the past few seasons: hit for a pretty good average, an average on-base percentage, and lots of power (especially for a center fielder). Only Trout, McCutchen, and Gomez (again, out of all center fielders) had higher slugging percentages than Jones's .493.

But a typical Jones season at the plate also includes lots of swinging at pitches out of the zone and, unsurprisingly, not many walks. Jones's 3.6 BB% was slightly worse than his walk percentage in 2010 (3.7%), though he's never been able to draw walks consistently (highest = 6.9% in 2009). Jones is not a patient hitter, and he attacked more pitches this year than any other. He swung at 58.1% of all pitches this year (career average just below 55%), and he chased nearly 45% of pitches outside the strikezone (career average around 41%). He swung early and often; sometimes it worked, and sometimes it didn't. It would likely work out better for him if he were a little more selective, and maybe that's something he'll improve on as he gets older. But, at least for right now, Jones is a 28-year-old power hitter who, just about every time he steps to the plate, is thinking about hitting the ball out of the ballpark. He'd much rather swing the bat than walk, and an opposing pitcher has to work pretty hard to throw him four balls out of the zone that he won't swing at. But, hey, that's Adam Jones, and that offensive strategy, while frustrating at times, is working out well for him so far.

Defensively, Jones may have been marginally better in 2013. Per FanGraphs, his -5.8 UZR was his best since 2010, though that's obviously still below average. Per Baseball-Reference's Baseball Info Solutions' defensive runs saved above average, Jones finished at -3, which, again, is below average but is also his best since 2009 (+2). He also committed just two errors in 2013 after having eight of them each in the past two seasons. Error totals are not a good indicator of defensive skills, and maybe those numbers means Jones's range took a step back this past season. He can still make flashy plays, but he doesn't always make more routine plays that you think he'd be able to. (All of which, for what it's worth, has nothing to do with him blowing bubbles.)

Moving Forward

Jones has five years and $77 million left on his contract, as discussed above, so he's not going anywhere. And considering he's only 28, his deal seems more than fair. He's not the best center fielder in the game, but he's still relatively young, hits for average and power, and is a bit below average defensively in center field. He's a big part of why the Orioles were sixth in the majors in runs scored. The Orioles still look wise for signing him to that extension during the 2012 season.

If things go south for the O's in the next few years -- really, really south -- it's not out of the question that Jones's name would come up in trade talks. It wouldn't be the first time something like that happened. It's extremely unlikely, but anything is possible. It doesn't hurt that Jones's contract is movable right now -- unlike, say, B.J. Upton's. Still, the O's don't have any strong center field prospects who are close to the majors, and they even got rid of two of their best outfield prospects this past season when they shipped L.J. Hoes to Houston and Xavier Avery to Seattle.

Free Agent Options

To repeat: Adam Jones is not going anywhere. The Orioles are not in rebuilding mode, and Jones is a huge part of the revival of this organization. There aren't many strong center field free agents, though someone like Jacoby Ellsbury would give the top of the O's lineup a huge boost. But signing Ellsbury would cost a lot of money, and it's unlikely the O's spend that kind of money on a single player. Ellsbury would help the O's more defensively in center field than Jones, but signing someone to replace Jones in center just isn't going to happen right now. Maybe that could happen at some point down the road, if the talk of moving Jones to a corner outfield position intensifies, but not right now. And if you believe in any kind of team chemistry issue, that likely wouldn't go over well, anyway. That shouldn't be an overriding factor when it comes to improving a team, but it's still worth considering.

Jones in 2014

Barring injury, Jones will be the team's opening day center fielder in 2014. No surprises here. O's fans should continue to look forward to lots of extra-base hits from Jones. Just don't get your hopes up for better plate discipline.

25 September 2013

Manny Machado's Knee Injury: Diagnosis, Treatment, and Future Prospects

"When you hear hoofbeats, think of horses, not zebras."

One of the more famous and memorable sound bites from the medical field, the above quote comes from a former University of Maryland School of Medicine physician, Dr. Theodore Woodward. It was a catchy warning he used to advise his young trainees on the pitfalls of thinking of the exotic instead of the commonplace when looking to diagnose patients.

In some ways, the knee injury Manny Machado sustained was the hypothetical zebra Woodward warned his fellow practitioners against labeling, in place of the more frequently seen horse. It isn't often this way, but for Machado, it really was a zebra, and that is a relief.

As reported earlier today, Machado sustained a tear of his left medial patellofemoral ligament (MPFL) and not either the anterior cruciate ligament, medial collateral ligament, or meniscus, which was originally feared by many and more commonly seen injuries. While the diagnosis is still a significant injury, it is one that is exceptionally rare in baseball, and brings with it a treatment protocol and recovery period that don't typically include surgery or a lengthy rehabilitation. While not seen as frequently as the horses, this zebra of a diagnosis is pretty encouraging and one that should have Machado ready for 2014 spring training without having to go under the knife.

With collective sighs of relieved breathed with the less daunting diagnosis finally divulged, let's turn our attention to what exactly is at hand for Machado and further discuss the MPFL tear and the prognosis. While we previously discussed some general knee anatomy yesterday here at Camden Depot, with the exam results in, we can finally get down to brass tacks and discuss specifics.


  
Image courtesy of musculoskeletalnetwork.com
As seen in the image, the MPFL runs in an east-west fashion across the medial portion of the knee between the medial border of the patella and the distal portion of the femur at the adductor tubercle; this is immediately superior to the femoral attachment of the MCL. Its primary function is to prevent the lateral migration of patella, providing 50%-80% of the restraining force to lateral patella dislocation. Simply put, the MPFL prevents the patella, or kneecap, from being dislocated outward.

For Machado, this MPFL diagnosis is one that makes sense, especially when his previous injury history is considered, in particular, the left patella subluxation injury he suffered in 2011 while at Class A Delmarva. A subluxation of the patella occurs when the patella is pulled towards the outside of the knee and out of the groove in the femur that it rests on -- called the trochlea -- causing pain and instability of the knee. Often, it can lead to a more severe patellar dislocation and is commonly seen with large valgus external rotation forces on the knee. With patellar subluxation and dislocations also comes increased rates of MPFL ruptures, with rates quoted as high as 90% to 100%*. 

While there have been instances of success with an immediate surgical repair of the MPFL, especially in the professional athlete and in patients with recurrent patella dislocations, surgery does not appear to be indicated in Machado's case. Considering a number of studies looking at surgical versus non-surgical treatment route success rates have show no difference in outcome, the more conservative, physical therapy oriented route that looks to strengthen the muscles in the area, in particular, the quadriceps, and restoring hamstring flexibility is one perfectly suited for Machado, and a return to action, pain and injury free, come spring training.

Overall, the injury to Machado could have been much worse and one where the horse you're expecting isn't as welcome as the zebra you aren't. 



*Reference: Dines, JS, Altchek, DW, Andrews, JR, ElAttrache, NS, Wilk, KE, Yocum, LA. (2012) Sports Medicine of Baseball: Philadelphia, PA.


24 September 2013

A Brief Overview of Manny Machado's Knee Injury

Third baseman Manny Machado exited Monday's game against the Tampa Bay Rays in the seventh inning after stepping awkwardly while rounding first base after singling off of Rays reliever Jake McGee and sustaining what can conservatively be called a significant knee injury. At the time of writing, Machado had an x-ray, but was awaiting other tests and examinations to be performed once the team returned to Baltimore before the type and severity of injury that was sustained could finally be determined.

While the exact injury or injuries that have befallen the All-Star still remain conjecture, we can still take a closer look at the processes involved and the anatomy of the knee and establish a baseline of knowledge that can provide a clearer picture of what the near future might possibly hold for the third baseman.

Judging from the video of the injury, Machado's foot caught the corner of first base awkwardly, forcing his knee to buckle inward and creating excessive valgus force and rotation upon the knee joint while his foot remained planted:


A head on look at the bones of the knee joint and valgus rotation. Courtesy of annals.org

Upon sustaining the injury, Machado was then questioned by the medical staff; questions in this type of acute setting usually revolve around what the mechanism of injury was, whether a 'pop' was heard or felt, and where the pain arises from primarily. At this point, a quick examination, limited to palpating the knee for areas of tenderness or crunching sensation - called crepitation - and an assessment of ligament health and stability are performed in order to rule out more severe injuries, such as dislocations or fractures. From there, the limb is immobilized.

Diagnostic imaging, especially x-ray, is then performed to provide additional information such as joint alignment, fracture, or bone chips. MRI studies can also be performed once immediate swelling has subsided, allowing an exceptionally accurate picture of the disease and injury processes at play. MRI images are especially helpful in confirming injuries in ligaments and cartilage.

With respect to the anatomy of the knee and knowing Machado's knee buckled medially (inward), what could possibly be at risk?

Image courtesy of athleticadvisor.com
MENISCUS

The mensicus is the c-shaped, cartilagenous part of the knee that provides cushioning for the tibia and femur bones, while also assisting in the even transmission of weight across the femur - tibia interface. It also provides some nutritional and lubrication support of the knee. It is often torn when twisted or turning quickly, with the knee bent and the lower leg firmly planted. These are some of the more common lower body athletic injuries seen and are often accompanied by a tear of the anterior cruciate ligament.


ANTERIOR CRUCIATE LIGAMENT

The anterior cruciate ligament (ACL) is primarily responsible for keeping the femur and tibia bound together, preventing anterior translation of the tibia. It also assists in preventing significant varus or vagus stress of the knee; in simpler terms, the ACL prevents too much knock knee or bow legging stresses put on the knee and is one the knee's primary stabilizers. While ACL injury isn't as seen as frequently in baseball as compared to other sports, such as football, it does still occur, particularly when the mechanism of injury arises from a quick turn, sudden stop, or misstep.


MEDIAL COLLATERAL LIGAMENT

The medial collateral ligament (MCL) is the most commonly injured knee ligament, typically in the form of a sprain. It is the primary stabilizer against valgus (inward) stresses of the knee. It is unique in it having two components - static and dynamic. The static component is made up of the superficial and deep MCL and the posterior oblique ligament, while the dynamic portion of the MCL complex is comprised of aspects of the semimembranosus and vastus medialis muscles of the hamstring and quadriceps muscle groups, respectively.

While there are a number of other features of this region of the knee, the ones discussed here are the major players and the ones at greatest risk for injury during baseball competition. It will still be a few more days before the extent and complexity of Machado's injury will be known, but the potential for one or many of the anatomical features of the medial aspect of the knee discussed here to have been implicated in his injury is high. Once a confirmed diagnosis is provided, a more concise discussion of not only the anatomy at risk but also treatment and rehabilitation plans and timelines can be divulged and discussed.


Do the Orioles Hitters Have a Home Run Problem?


Yesterday, Steve Melewski of MASN wrote about the Orioles recent problems on offense.  These problems aren’t all that recent though.  Since the beginning of September they’ve only averaged 3.7 runs per game while hitting .228/.286/.372 (AVG/OBP/SLG) as a team.  One of the problems that Melewski states is that the Orioles have been struggling on offense because they’re too one-dimensional.  The problem according to Melewski is that, “the Orioles are too reliant on the home run and they need more variety from their offense”.  

He’s not ENTIRELY wrong, but scoring runs via home runs should never be a problem.  Every year, you’ll hear about a team who hits too many home runs, and this year it’s the Orioles.  This isn’t the first time this has been said about the 2013 Orioles, but the rhetoric has picked up as the Orioles continued to fight for a playoff spot, while their offense has endured its worst month of the season.  

Melewski goes through some offensive statistics, comparing this year’s team with the playoff team from 2012, and as he shows, the 2013 offense is basically better than last year’s version in essentially every category, except for on-base percentage.  And that is the real issue.  What follows certainly isn’t groundbreaking analysis.  I’ve highlighted where the Orioles are specifically located on each graph, along with the Red Sox and Cardinals.



As you can tell (and probably already knew), a high OBP correlates better to scoring runs than hitting home runs, as evidenced by the corresponding R2 values (the closer to 1, the better the correlation).  The Orioles appear to be enough of an outlier in the second graph that they should consider themselves lucky to have scored the 5th most runs in the majors. If Baltimore’s runs scored correlated approximately with their OBP (according to this model), they should have scored right around 600 runs, which would give them a Pythagorean win-loss record of 69-86.  These correlations change slightly from year to year, but the underlying fact remains the same, as you can see from a sample of correlations from previous years.


The fact that Orioles hit a lot of home runs isn’t the reason that their offense has gone cold.  The reason is that they don’t consistently get on base (.311 OBP compared to a league average OBP of .318).  If more of Baltimore’s home runs had been hit with men on base, you could bet that relying too much on the home run would not be considered a problem.