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a brief history of mark mulder's shoulder

let's begin in the present day --- st louis post-dispatch, june 24, 2006:

Lefthander Mark Mulder will be shelved at least through the All-Star break and probably longer after an MRI on Friday found that he has been pitching with a shoulder impingement, inflammation of the rotator cuff and slight fraying of the labrum.

Head trainer Barry Weinberg said Mulder is expected to recover without surgery but refrained from estimating when he might next pitch. Mulder will not pick up a ball for at least another week and is scheduled to be re-examined by Paletta next Friday during the club's home stand.

"It's not good news because he's missing time," Weinberg said. "But identifying it is important. It's not a situation where it's an operative condition. It's one we can treat conservatively" with rest and anti-inflammatory medication.

ahh, conservative treatment; where have we heard that one before? the cardinals lead the league in "conservative" treatment; they're the most careful, cautious guardians of ballplayer health in the whole major leagues.

let mark mulder serve as an example -- a case study in how conservative treatment can prevent a minor problem from flaring up into something major. . . . .

mulder's saga dates back to may 3, the day he left the team in houston and returned to st louis to see team doctor george paletta. matt leach picks up the story:

Mark Mulder returned to St. Louis to have his back examined by Dr. George Paletta on Wednesday. Mulder, who had felt some back discomfort in recent starts, was cleared by Paletta to continue pitching. He is expected to make his regularly scheduled start against Dontrelle Willis and the Marlins on Saturday at Dolphins Stadium.
whew, sigh of relief. but the following day, will carroll suggested at baseball prospectus that mulder's sore back was nothing at all to dismiss lightly -- and that his problems might be only beginning:
When you hear reports that Mark Mulder had gone back to St. Louis for an exam, that's not good. . . . . Knowing that it's not a structural problem is a plus, yet leaves Dave Duncan to do the hard part. Does Mulder miss a start to try and heal up, maybe even head to the DL to make sure, or does he go out and pitch through it, hoping that the training staff has a good enough handle on him to not let it get back into the pain/spasm cycle?
mulder's manager, coaches, and training staff -- conservative lot that they are -- chose option B: pitch through it. mind you, mulder's next turn was in florida, vs the woeful florida marlins -- an 8-21 club at the time. the cardinals were carrying 13 pitchers; maybe they could've squeaked by with a bullpen game? for that matter, they might have sat mulder down and turned to a pitcher named reyes, down at memphis. with two open dates in the subsequent 10 days, the cards could have held mulder out for three weeks at the cost of only one missed start -- in may. against a last-place team.

but mulder kept pitching.

he tossed quality starts in his next four games and won three of them, but he was laboring; only once did he go more than 6 1/3 innings (he exceeded that total 4 times in his first 6 starts). on may 28, at san diego, the first sign of real trouble surfaced: mulder gave up three homers and 8 runs in the span of 10 batters, blowing a 6-2 lead and sending st louis on its way to a 10-8 defeat. after mulder's next start, a 2d successive pummeling (at home vs chicago), some guy calling himself "no dribble" (a tobacco juice ref'nce, perhaps) posted the following keen observations at bernie miklasz' chat room:

I was watching the game today from my living room and paying particular attention to Mulder's apparent mechanics, especially his arm speed and arm slot. . . . . Mulder's arm slot changed too many times to count, like he was looking for a comfortable and successful angle to deliver the ball. Even watching on TV with the camera angle, it was pretty obvious--no consistency at all. I assume that's what was going on--he was trying to find his "groove."

But the thing that troubles me is that his arm speed was really slow--too many times lagging behind the rest of his body when delivering the ball, which would contribute to the number of pitches that were up in the zone. I remember he's had back issues this season, which can really screw up your mechanics. It's not uncommon for a pitcher who has back issues to alter his motion to compensate, which unfortunately often puts unusual strain on the arm--the shoulder especially--and creates a secondary injury, which at least in part, looked to be the case today with the slow arm speed.

with hindsight, it's pretty clear that "no dribble" knew whereof he spoke. and i more than half-suspect "no dribble" wasn't just your average game-of-the-week-watching schmuck; sounds like a pretty knowledgeable guy with a well-honed sense of what to look for.

whoever this guy is, he knew then what we all know now: mulder's shoulder was unsound. duncan, la russa, weisberg, jocketty -- somebody had to have seen what "no dribble" saw and reached the same conclusions. we can guess that they did, because two days later, on june 6, mulder's health status came into question --- as noted right here, in this post:

here's an interesting item: the official site lists marquis as friday's starter; that should be mulder's turn. the starter for saturday is named as "to be determined." i wonder what's up. mulder's back, you'll recall, flared up on him in april. maybe he's hurt.

Update [2006-6-6 11:36:9 by lboros]: they've updated the site as of 10:30 a.m. CDT -- mulder is now listed as saturday's starter, meaning he's going on 7 days' rest. marquis remains listed as friday's starter, which means he essentially is hop-frogging mulder in the rotation.

somewhere in the organization, there were doubts about mulder's ability to take his normal turn. in the end, he did take it -- and got killed, yielding 6 runs in 3 innings at milwaukee.

reyes continued to mow 'em down at memphis.

after mulder's next start, a 5-inning slog (9 hits, 4 runs, 2 homers) vs the pirates, duncan offered this upbeat assessment: "It's a step forward. As long as he keeps making steps forward, he'll get back to where we need him to be."

and then came the comiskey collapse, after which la russa explained:

"Since we need him so much, I'm going to decide to remember he has been improving. When you're pitching great, sometimes you have a stinker. Today was a stinker."

Asked if he wondered if the pending free agent is physically diminished, La Russa said, "There's no reason why he would hide it."

Pitching coach Dave Duncan believes Mulder to be sound physically but admitted he feels "borderline helpless" in addressing the pitcher's current woes. "We've tried just about everything I can think of," he said.

La Russa described some of the lefthander's side sessions as "electric," and like Duncan, he struggles to account for his inability to translate his side sessions to games.

either these guys were lying -- the same thing duncan indignantly accused ozzie guillen of the day after the mulder debacle -- or they missed something that a fan (if that's who he was) diagnosed from a TV screen and described to a tee in a chat room.

i don't think tony and dave missed anything. i think they knew mulder was hurt but thought that he could grit it out, just as they thought rolen could grit out his sore shoulder last season. i think they kept sending mulder out there, impaired, because -- to quote la russa from directly above -- "we need him so much." they needed him so much that they decided to pretend he wasn't hurt; they decided to pretend that mulder had been improving and that his side sessions had been electric.

they kept sending him out there, and all along they had reyes available down in memphis.

it doesn't really matter whether you agree that their handling of mulder has been fundamentally dishonest. if the mistake was an honest one, so much the worse: it means tony and dave were the last ones to see what had become plain to fans, reporters, and ev'yone else. if it was an honest mistake, then it was also a grossly incompetent one; and these two men have had too much success for me to believe they were guilty of such.

i can believe, though, that they would take a reckless chance with a player's health and then plead ignorance when it backfires.

all of this might have been avoided if the cardinals had applied (ahem) conservative treatment in may, when mulder's back problem becamde serious enough to require an emergency trip to the team doctor. the shoulder almost surely got hurt as a result of mulder's pitching through the back pain; as "no dribble" described, mulder likely favored the back, changed his delivery, and put more stress on the joint. those compensatory measures worked for a few starts, but they ultimately turned a manageable problem -- back pain -- into a far more serious injury to mulder's pitching arm.

could any of this have been foreseen? am i just 2d-guessing here? no, i'm not just 2d-guessing. on may 8 i outlined a plan to leverage two off-days in mid-may into a 14-day respite for mulder, while keeping ev'ybody else on normal rest:

this might [be] an opportune time to let mulder skip a couple of starts and rest his back. so happens his next turn falls on the same day anthony reyes is due to pitch. if they'd call anthony up and let him take that turn for st louis instead of memphis, they could get both mulder and ponson [whose elbow problems had already begun to surface -- ed.] some extra rest. voila:
8 v colo
9 v colo
10 v colo
11 open 12 v ari
13 v ari
14 v ari
15 open 16 v nym
17 v nym
18 v nym
19 at kc
20 at kc
21 at kc

ponson would get 10 days off between starts; mulder (the more important pitcher) would get 14; and reyes could get another taste of the bigs -- pitching at home, against a team that's not well equipped to exploit reyes' hr vulnerability (arizona ranks 10th in the league in homers). it's just an option; i doubt the cardinals will take it. and maybe it isn't necessary; maybe mulder's back is coming along. i just figure, why push it when you don't have to?

i'm not dredging this up to show what a smart guy i am; i'm merely saying the team had options. the cardinals chose a different option -- and then stubbornly stuck with it for six weeks, until they'd run their #2 starter into the ground.

whatever the outcome for mark mulder going forward, la russa and duncan will have to answer for it.