Nationals Baseball: Fister's elbow - to worry or not to worry

Thursday, March 13, 2014

Fister's elbow - to worry or not to worry

Today I read a blurb that was basically "Fister's throwing off flat ground! That's great news!" and I asked myself, how did I get here? This is not my beautiful Fister!

Taking a stroll through (mostly) the Post's ST blog here's the Fister timeline

2/22 : Fister pitches BP. Is "nasty".
2/24 : Practices hitting
3/02 : Starts vs Marlins , is "erratic" in two innings of work, "felt 50/50", has discomfort after game  
3/06 : Recieves MRI, shows "a little inflammation" and "no structural damage", will rest Williams says team not worried - if in season he'd go.
3/07 : Misses next start due to "elbow inflammation, no timetable for return other than "few days rest"
3/09 : Team states inflammation is on the way out. 
3/10 : Team schedules a "catch" for Fister for Tuesday the 11th.
3/11 : Fister plays catch.  Feels fine. Will stretch out from a further distance on Thursday the 13th. First mention of regular season start being affected, when they say plan is he'll be ready for his first turnFister says he'll be ready.
3/13 : Fister throws from distance on flat ground. Feels tight.

Elbow inflammation after your first real "competitive" experience is scary. They want to give him rest to heal him up. That makes sense. But prior to that first game he had months of rest. Is a week really going to help? Maybe it will, actually.  He probably wasn't icing and medicating over the offseason so the full frontal assault on the inflammation may keep it at bay. It doesn't look promising. He's missed two starts now. He felt tight after just an extended catch session. Signs point to an actual problem.

This wasn't an issue last year from what I can tell. No news, no decrease in velocity over last season.

Some elbow inflammations from Spring 2013 (no structural damage)  for comparison.
  • Zack Greinke missed a couple starts, had no discomfort on return, pushed him back for regular season start but otherwise fine. Though he did get an extra month "off" after first two starts, thanks to a broken collarbone. 
  • Matt Thornton was diagnosed real early (mid Feb), no issues on return, was pitching by end of that month.
  • Jenrry Mejia ended up needing no surgery but had a very lengthy rehab stint. Didn't start in majors until late July.  He had had previous surgery on his elbow a few years prior.
  • Frank Francisco was initially diagnosed with no structural damage. That became a flexor strain which became a flexor tear which kept him out until September. He had had elbow surgery just that previous December.
  • Scott Baker also had a long rehab not pitching until September. He was coming back from TJ surgery. 
There's comfort there and some concern. The comforting fact is the full season issues seemed to be tied to previous elbow surgeries, of which Fister had none. I can't feel comfortable drawing comparison to those guys. The concerning fact, though, is that the two that bounced back quickly had no issues once starting back up. It is certainly possible to have an non TJ related elbow issue without previous surgery, ask 2012 Drew Storen.(note there : also no structural damage at first. Then they said "Hey we might have noticed a floating body before!" Based on that and the Francisco bit above you can take "no structural damage" to be code for "He didn't have a massive tear needing immediate Tommy John surgery". That's it.)

This isn't exactly telling us much is it?  Everyone stay glued to Fister's bullpen session. If it goes well (assuming it goes at all) I wouldn't worry too much. He might miss his first start just because the timing is bad but inflammation does happen.  If it doesn't go well, I'd start preparing for a lengthy rehab.

Side note : Let's remember to thank your local beat reporter. Kilgore, Wagner, Zuckerman. It's because of the yeoman's work they put in day to day that we have these things to talk about around the Keurig.


Chinatown Express said...

Based on the Greinke example, the solution here is obvious.: We need Fister to bean Carlos Quentin and get him to charge the mound, stat. When do we play the Padres next? Or maybe he can just throw a baseball at Quentin on the street to induce a fight. Either way, we've got to break Fister's collarbone before his elbow explodes.

Harper said...

CXe - alternate plan - we nuke the planet and launch Fister's elbow into space. It's really the only way to be sure.

Chinatown Express said...

Any speculation on how the Joarkwiler(c) race is going? I am leaning more and more toward my darkhorse pick of Jordan in the five spot with Det in the pen, Roark optioned back. If Fister misses a start, I presume Jordan and Det get the 4 and 5 starts . . . which doesn't bode well for the Braves series.

Harper said...

my feeling is Detwiler has to lose it and Roark and Jordan have to win it to change the assumption of Det as #5. Right now he is losing, but no one is quite winning, though Jordan is kinda close. A bad outing by Det next and a very good one for Jordan and I'd put the race at neck and neck

(my opinion- forget Spring let Det start)

Nattydread said...

In other news, Boswell has an interesting article about....pitching injuries!

John C. said...

Am I worried about Fister's elbow? Not really. I acknowledge that there is some (less than 50%) chance that there is something serious going on, and that it's also quite possible that he makes 33 starts this season. I have too little data and no control over the situation so I just don't worry about it. Baseball is back and we're less than three weeks from Opening Day. Worry? I'm pumped!

Donald said...

This would be another mailbag topic, but is there any statistical evidence that players do better in their contract years? It might just be my impression, but it feels like they do better those years and worse in the first year of landing a big contract. If this is true, though, it might mean better years for LaRoche, Span and Soriano.

blovy8 said...

Yep, we should be worried about Fister. The track record for the medical staff is terrible in terms of diagnosing injuries, and I would always err on the side of it being worse than the company line. The next conspiracy theory will be that Dombrowski was dumping the guy before the odometer on his elbow flipped and now an overhaul is needed.

John C. said...

blovy8, as with all conspiracy theories, the "Dombroswki dumping Fister" theory has an obvious glaring problem. Even if you accept that Dombrowski was dumping Fister, he should have gotten more in exchange. For that reason it was a bad trade whatever happens with Fister.

John C. said...

To Donald's question about contract years, the basic answer is that even though most fans and pundits assume that there is a "contract year effect," studies haven't been able to document any effect at all.

KW said...

I just disagreed with John C. on Hairston on Todd's blog but will wholeheartedly second him here. I don't think Dombrowski knew anything. He was just desperate to dump salary and sign Nathan. And even if he *did* know something, he still could have gotten more for Fister - a lot more.

As for Fister's mileage, it's very low for someone his age, in terms of professional innings.

All in all, the Nats do need to be careful with Fister and feel no need to try to get him up to speed by the beginning of the season. They've got three parts from Joarkwiler from which to draw two starters if need be.

blovy8 said...

I'm more worried about Zim's shoulder soreness.