There are known knowns. These are things we know that we know. There are known unknowns. That is to say, there are things that we now know we don’t know. But there are also unknown unknowns. These are things we do not know we don’t know.Which brings me to Stephen Strasburg's elbow. Did the Nationals "do everything they could to protect him and keep him from placing unusual stress on his arm" as Buster Olney and all right-thinking baseball insiders have said again and again?
The truth is, we don't have any idea. Pitching is one of the least understood areas of sports medicine. Talk to one pitching coach, and he'll tell you that Strasburg's problem was the "upside-down W." Talk to another and he'll say it was that he short-stepped on the front end. Talk to another and he'll tell you he didn't do enough long-toss, or that he threw too much in college, or that he didn't throw enough, or that his mechanics are perfect and just had bad genes.
After listening to all that, you realize that there are really only two camps when it comes to pitching injuries. People who don't know and know they don't know (see, me), and people who don't know but think they know (see Olney, Buster).
My problem is that Jim Riggleman could be the poster boy for the school of unknown unknowns. On blogger day last year, I asked him if he'd learned anything from Kerry Wood, and would he do anything differently. He said, "I never asked for him to come up, but once he was there we treated him like everybody else. [Pitchers] just get hurt. It was probably inevitable."
Then, during spring training, Mark Zuckerman captured this moment of clarity from Riggleman:
You know, anything that has to do with the mechanics of pitching, you know, I just, I'd be bluffing if I tried to tell you I knew what I was talking about. You know, the mechanics of pitching, you know, it makes sense to me when McCatty and pitchers explain what they're doing, but you know, I want him to be healthy, and I'm looking for results, so, you know, that's the main thing, and I'm sure if he feels there was a mechanical thing there that he was doing that he'll make the adjustment, and he'll do it otherwise next time he pitches.There are gobs of quotes like this from Riggleman, and they all basically come back to the same points: he doesn't know what he's talking about, but he's 100% sure it doesn't make any difference.
Now, again, based on what we could see from the outside, it seemed like they were careful. We know about pitch counts, they waited to bring him up... generally it looks like they were taking obvious steps to limit his workload and the stress on his arm.
That's all well and good. But pitch counts and innings limits are only two pieces of a big puzzle, and I just don't believe that a team run by a guy who says he knows bupkis about pitching mechanics (and doesn't seem to be aware why that's a problem) can be said to be doing "everything they could."
Going back to the "two camps of pitching theory," there's really a third camp. Those are the people who know they don't know, but they have ideas and they are trying to learn. Guys like Don Cooper of the Chicago White Sox (who has been widely misreported as having "predicted" Strasburg's injury--Cooper saw what he considered a red flag in Strasburg's "upside-down" arm action, but expressed worry, not a concrete prediction).
Cooper doesn't have the magic 8 ball or anything. But he was the pitching coach for this group, which says something. He and a lot of other thoughtful, smart baseball and medical people are working to advance the body of knowledge about pitching injuries, even if all they can do is reduce risk or delay injuries, rather than eliminate them altogether.
I just with the guy running my team was one of those smart, thoughtful people trying to learn.