Ike Davis & the Culpability of the Mets Medical Staff

Nothing is set in stone, but Ike Davis has some torn cartilage and a bone bruise in his ankle that is not healing. He’ll face some more tests and try to run in three weeks, but if he can’t, he’ll be facing season-ending surgery. It’s possible that season-ending surgery will be of the bone-chilling microfracture variety. Let’s pause for a second until the cacophony of “snakebit” and “woe is us” coming from Queens dies down.

There, that’s better. It’s upsetting though, of course. And the one of the main complaints may have some merit. With this story so familiar in recent years, it does seem merited to wonder if the Mets medical staff is doing their jobs correctly. You could take the words “Ike Davis” out of this situation and slide in “Carlos Beltran” and only the joint in question would be any different.

It’s been well documented that the Mets have had injury problems. Over the last three years, only the Oakland A’s have lost more than the Mets’ 4423 days. And that number is almost three times the number of days the White Sox have lost to injury. Yes, there have been plenty of players on the training table at Citi Field.

But injuries happen. Healthy players run into healthy players, trip over bags, and get hit by pitches. There’s very little that can be done about the chaos of baseball. Well, there’s a little something that can be done. And the Mets’ staff did try to do that little something about this recently with a focus on “prevention and recovery” going into the 2010 season. The team still led the league in days lost to the DL in 2010, but they trimmed that damage from 1451 days lost in 2009 to 929 days lost in 2010. Progress!

But using ‘days lost’ as the measuring stick misses the fact that a veteran team will be more susceptible to injury. They were the fourth-oldest team in the NL in 2009, for example. And even young players like Angel Pagan and Jose Reyes can be injury-prone independent of their medical staff. Does it seem like perhaps ‘days lost once a player hits the DL’ is a better measure of the prowess of the medical staff? Injuries can happen in the run of play, but then how quickly the training staff gets their team back on the field at least provides us another entry point into the discussion.

Well, the Mets suffer there, too. Whether you go back three years or five years, the team has lost the second-most days per DL trip in the league. Only the Yankees have lost more days every time a player has gone down with an injury. Ike Davis and Carlos Beltran are part of a larger pattern. Once a Met has hit the DL over the past five years, they’ve averaged over 60 days gone.

Of course, this isn’t completely fair either. Just like a player might be prone to injury whether because of their age or physiology, they could be prone to longer recovery times for the same reasons. But we can’t let the staff off the hook, either. A major part of the recovery process is correctly identifying the problem from the get-go. In the case of Davis, Beltran, and David Wright, there have been new discoveries late in the game. Injuries have turned from sprained ankles into cartilage issues, and from back strains into stress fractures.

Mets GM Sandy Alderson has looked a little embarrassed during some his injury updates this year. Perhaps the next thing he can look into is the effectiveness of his own medical staff. That might ‘prevent’ some ‘recovery’ from embarrassment in the future.

Thanks to Jeff Zimmerman for providing the DL data for this piece.




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Graphs: Baseball, Roto, Beer, brats (OK, no graphs for that...yet), repeat. Follow him on Twitter @enosarris.


52 Responses to “Ike Davis & the Culpability of the Mets Medical Staff”

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  1. Kevin S. says:

    Jose Reyes was also misdiagnosed and rushed back, too. There was pressure on Wright and Church to come back too quickly from concussions. Injuries happen, and having a lot of injuries shouldn’t necessarily be blamed on the team. But when the injuries are consistently mis-diagnosed and recovery time is always rushed, a problem exists. The Mets are the anti-Suns.

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    • Derek says:

      Reyes was misdiagnosed……by the Dodgers team doctors. You can’t blame the Mets or their doctors for that.

      Not sure what the hell you’re talking about with Wright’s concussion. He came back in 15 games and was ready to go.

      Church definitely rushed to get back, but not really sure you can blame the medical staff for that when concussion symptoms are not something that are readily obvious upon examination. The player can easily downplay a headache to get back onto the field.

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      • JohnnyComeLately says:

        If Reyes was misdiagnosed by the Dodgers team doctors (and I have no idea what you’re talking about), then the Mets staff is still to blame as they should have made their own diagnosis.

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      • Evan_S says:

        Church’s concussion was made worse because right after it happened, they put him on a plane. Reyes’ oblique injury last season was mishandled with Jerry Manuel’s genius, “he’ll only bat right handed” strategy.

        And I still don’t know why the Mets wouldn’t immediately get a second opinion from their own doctors, regarding Reyes in 09.

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  2. I think what’s clear from the table above is we need to get MLB out of New York.

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    • Theodore says:

      Actually, we should move one or two of the perennially horrible teams around the League back to the New York area, which could easily support another team, and probably two.

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      • Brad Johnson says:
        FanGraphs Supporting Member

        Way to completely miss the point of that post…

        I agree matt. Clearly there’s something wrong with the air or the citiy’s aura or psychomantic emanations. Or something…

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  3. Greg says:

    Something is wrong here. The article says “Over the last three years, only the Oakland A’s have lost more than the Mets’ 4423 days.” Then goes on to say “The team still led the league in days lost to the DL in 2010, but they trimmed that damage from 1451 days lost in 2009 to 929 days lost in 2010. Progress!”

    Even if we’re including 2008 as part of that “last three years” statement, it seems impossible that the Mets have had nearly 2000 days lost in 2008 and 2011 combined.

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    • Jason B says:

      If they lost 1451 days in a single season, why would it be a stretch that they lost 2000 in a season and a half?

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  4. mcbrown says:

    The misdiagnosis of Ike’s injury is a serious indictment of the Mets’ medical team. This wouldn’t be acceptable in routine medical treatment that you or I might receive; for it to happen to a highly paid athlete with an alleged medical infrastructure in place designed specially to help the team protect its investment is beyond inexcusable. What is the point of having a dedicated medical team? Why not just tell the players to pick a doctor out of the phone book and take their chances? At least it would be cheaper.

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    • Derek says:

      There was no misdiagnosis, they knew the DAY AFTER Ike got injured that he had a bone bruise. ( http://sports.espn.go.com/new-york/mlb/news/story?id=6533216 ). What they did not know was said bone bruise would not heal from normal rest, like would happen in 99% of cases. The Mets just seem to have an amazing ability to have that 1% fall into their laps.

      Seriously, Fangraphs of all people should be better then writing crap like this.

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      • Eno Sarris says:
        FanGraphs Supporting Member

        There is no mention of cartilage issues at the beginning, and then there was most recently. And there was also talk from Ike himself that the boot was the wrong way to go because it hindered circulation. Both not good things.

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      • mcbrown says:

        I agreed with you, until the news of cartilage damage came out. Either they missed it, which is inexcusable, or their prescribed treatment caused it, which is inexcusable.

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      • mcbrown says:

        (meaning I agreed with Derek that it was just a bad bone bruise and thems the breaks)

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      • Derek says:

        He had an ankle sprain and a bone bruise, cartilage issues were pretty much a given. I don’t see that as a new development, sorry.

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      • Eno Sarris says:
        FanGraphs Supporting Member

        So nothing rings alarm bells with this statement?

        “Alderson admitted the decision to have Davis wear a boot during his rehab could have impaired his healing by limiting his circulation.

        “That’s another thing,” Davis said, “is I wore the boot for so long that my joint kind of was compressed the whole time and not a lot of movement in there to help out with inflammation and stuff.”

        Read more

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      • Eno Sarris says:
        FanGraphs Supporting Member

        Also, I’m not a doctor, but cartilage issues are not a given with a sprained ankle. A sprained ankle is a small tear of a ligament. Cartilage is different.

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      • Derek says:

        Unless the walking boot was applied improperly, it shouldn’t have hindered circulation. It’s not supposed to be applied so ridiculously tight that it would actually limit circulation to your foot. If that was in fact the case, then yes, perhaps they are partially responsible for the slow healing and it would be a little troublesome.

        But that seems more like a guesswork explanation as to try and explain why things are taking so long more then anything else.

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      • mcbrown says:

        I’m sorry, I just disagree. I get that even the best doctors make mistakes, but if the best the Mets’ staff can do is throw their hands up in the air and say “how were we supposed to know it wasn’t a vanilla bone bruise?” then what value are they adding? That’s the point – my GP can tell me the basic treatment for a vanilla bone bruise; these guys are supposed to do better than that.

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      • Darryl Strawberry Fields says:

        Sprains involve ligaments and tendons. Bone Bruise implies a bone issue. A cartiage issue is independent of the two. It could conceivably be missed on an MRI due to swelling, but if there was still enough swelling to cloud an MRI picture then the doctors should have ordered new MRI’s as the swelling decreased rather than let Davis extend his tie on the DL.

        Whether Davis returns this year or next is less a factor of how good the medical staff is than it is of how his body heals in this particular instance. BUT, if Ike misses time in next years spring training because surgery was delayed due to the medical staff failing to provide a clear MRI or order a follow up then they should all be fired! This is pro sports, people are often fired for things out of their control. Team isn’t hitting, fire the hitting coach. JJ is on the DL and Hanley is in lala land, treat the coach like shit till he leaves… So why not fire people who are actually doing their jobs poorly. There is no defense, if they are at all culpable in this situation and Davis isn’t 100% next spring they should all be fired and replaced. Preferably with Huston’s staff, they seem to know what they are doing from the graph provided.

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      • Derek says:

        Just to clarify, my point was more if the injury was significant enough to injure both ligament and bone, it would have been surprising if the cartilage in that same area came out unscathed. That’s a pretty significant injury. I’m not saying it’s the same injury or anything like that. I don’t believe that this cartilage damage was news to the Mets, even though they may had neglected to put it in the initial injury reports, believing (at the time) the other 2 injuries were the more severe ones.

        If anything, the key problem with the Mets and injuries (aside from some really poor luck) is probably mainly attributed to poor communication. They have a tendency it seems to initially label every injury “Day to Day” pending further evaluation, but such a designation seems to downplay the severity of every injury, and the timelines they always seem to put on their injuries usually seem overly optimistic at best. They should in the future put more realistic timelines on their injuries, or none at all.

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      • Chakrabs says:

        But it wasn’t normal rest. They stuck him in an aircast, had him walk around on it, and then try “baseball” activities after which they determined that he still had a bone bruise. Then they stuck him in a boot which now has resulted in cartilage damage.

        What these clowns should have done was immobilize that ankle in a boot in the first place for about a week or so and THEN go to the aircast and eventually walking on crutches. Instead they likely cost Ike Davis the season and have set back a very promising career.

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  5. Matt says:

    All I know is that if I ever get sent to the Hospital for Special Surgery, I’m leaving the city. I was really hoping Alderson would overhaul the medical staff, but that does not seem to have happened, and the team is still suffering as a result. I mean, with an asset as valuable as Ike, shouldn’t they have done a full evaluation instead of just labeling it a bone bruise? And then leaving his ankle in a boot that cuts off the blood flow, thereby worsening his cartilage issue? Some people say we have bad luck, but it seems like we create our own bad luck most of the time.

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    • Derek says:

      “The 2010 edition of “America’s Best Hospitals” by U.S. News and World Report ranked Hospital for Special Surgery as the #1 hospital in the country for orthopedics, as well as the nation’s third-best for rheumatology. Additionally, HSS was ranked #16 in neurology. HSS has been top-ranked by U.S. News and World Report for the 20th consecutive year. According to New York Magazine’s “Best Hospitals” issue, HSS is the best hospital in New York City’s tri-state area for knee surgery, spine surgery and hip replacement.”

      All available from Wikipedia (I know), but point being you’d be hard pressed to find better doctors in the country, nevermind in the local NYC area.

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      • Eno Sarris says:
        FanGraphs Supporting Member

        That the hospital has a good reputation and is in a good city for, generally, for medical care puzzles me. I don’t think the age of the team is the only explanation here though either.

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      • Chakrabs says:

        HSS has a gorgeous hospital and their doctors have impressive pedigrees. However, I am unimpressed by HSS, they rest on their laurels and have gotten complacent. I’d consider other places if I needed orthopedic procedures. Columbia or even better, NYU’s Hospital for Joint Disease would be atop my list.

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      • MG says:

        US News and World Report rankings are generally pretty crappy. New York Magazine’s are even worse. Essentially a glorified popularity contest.

        “Rating systems such as the US News & World Report’s “America’s Best Hospitals” and HealthGrades’ “Best Hospitals” generally fail to identify quality high-volume hospitals, with the exception of some oncologic surgeries. This finding was reported in an article published in the May issue of the Archives of Surgery”

        http://www.medscape.com/viewarticle/742875

        There are literally only a handful of useful and worthwhile publicly-reported quality measures that are worthwhile. One example is the NY state CABG ratings which is based on risk-adjusted clinical data (not claims/administrative data) from the Society of Thoracic Surgeons.

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  6. Telo says:

    When I clicked on the article I was excited for some real hard hitting evidence to embarrass the Mets, but this failed to deliver. An old team had a bunch of injuries. zzzzzzzz

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    • Eno Sarris says:
      FanGraphs Supporting Member

      That’s not all of it. They aren’t old this year. And when they were at their oldest, three NL teams were older.

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      • Telo says:

        Really my only beef is with the title. The word “culpability” got me excited for actual “proof”, or something remotely close. This is 1000 words on how the Mets have had more than average amount of injuries over the last 5 years.

        Corrected Title: The Mets have gotten hurt, a lot.

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      • Eno Sarris says:
        FanGraphs Supporting Member

        …and have stayed hurt, longer.

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      • Telo says:

        Which does not inculpablate anyone. It means dudes had bad injuries. These aren’t with doctors who heal broken legs with their mindgrapes. If you had 100 years of data that’d be one thing. This data is nowhere near significant

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    • Darryl Strawberry Fields says:

      Yeah the Mets are old, but their younger players are contributing major time on the DL. Ike, Wright, Jose. . . even Beltran wasn’t that old in baseball years when his knee problems started.

      Yes these athletes are obviously slower healing than other athletes, but there are too many coincidences for the Mets management not to hold the medical staff accountable. I wouldn’t be surprised if they replaced the MRI machine with a “Magic 8 Ball” to cut down operating costs. That certainly would explain a lot!

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  7. Zak says:

    When Alderson came in when of the first things he did was check the whole medical process out because he knew that this was a major Mets problem of the past. He did not make any large wholesale changes that I read about except for probably changing some small things behind the scenes. The Mets doctors work at what is regarded at one of the best hospitals in the county. I believe other sports teams in the are send their players to HSS and yet we don’t see a problem that the Mets seem have. Their is a disconnect somewhere but it doesn’t make much sense. The article also didn’t even mention how the Mets possibly made Davis’ injury worse by having him wear a boot for the last 3 weeks and then realizing yesterday that it probably slowed down the healing process. I don’t know if Sandy will do another re-evaluation of this upcoming off season but changes have to be made.

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  8. db says:

    The problem is that the Mets, being in the small rural village of Flushing, do not have access to leading doctors.

    On a separate note, I blame the weatherman for today’s rain that is delaying the game.

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    • Eno Sarris says:
      FanGraphs Supporting Member

      This, of course, is a good point. Even when slicing it down to days per DL stay, it’s still on the players and their actual injuries. But when you have some anecdotal evidence that at least three players in the past two years have been handled in a way that could have extended their stays on the DL, then it’s not quite the same as blaming the weatherman.

      Perhaps we could find the Mets’ players average DL stays for each injury type and then find that compared to the league average. If a Mets player stayed out longer for the same injuries then there might be a straighter line between cause and effect.

      i’m not trying to throw the doctors under the bus. I do think that days per DL stint does uncover another corner of the puzzle.

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      • quicksilver417 says:

        I feel like your “days on the DL” stat is not a reliable factor in determining the quality of medical staffs, especially since you picked it apart for half your article.

        On the other hand, being a Mets fan, I am very familiar with the mishandling of their medical staff with athletes over the years. Quite frankly it’s a matter or pride for these doctors they settle on a diagnosis and treatment and refuse to go back on it.

        It is up to the athletes (if they are smart) and/or the organization to provide second and third opinions because of this. This will allow for more comprehensive data that can be analyzed with more accuracy.

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  9. Sandy Kazmir says:

    They’re no Cleveland Browns.

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  10. Jon says:

    Anecdotally, it certainly seems like something is going very wrong in the Mets’ training room. When any other team says a player is going on the DL and is expected back in 15 days, I figure they will be. When I hear the same thing about a player on the Mets, I start to imagine what their lineup or rotation will look like presuming that player misses the rest of the season.

    Anyway, the one thing this article doesn’t cover is the differential impact of stays on the DL. Most teams’ regulars who mostly stay on the field, while the Mets’ stars seem to spend most of their time on the DL (or playing poorly because they’re hurt). Is this impression that the impact of the Mets’ injuries is outside the norm true?

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  11. TLD says:

    I’m not sure “days after DL” is the best way to look at it. Look at the Red Sox and what they’ve done to their players. Jacoby Ellsbury, Jed Lowrie, Mike Lowell, all misdiagnosed by the med staff in the interest of getting them on the field as fast as possible, it’s hurt the team more than it’s helped.

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  12. Choo says:

    The Mets medical staff should be commended for any diagnosis Ike Davis receives, regardless of minor details such as accuracy or even realism.

    When J.J. Putz landed at JFK for his Mets physical, a clown wearing a Shriner’s hat approached in a miniature car, pantomimed a 10-second physical, then gave him a balloon and sent him right back to Seattle.

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  13. Franco says:

    It’s tough to quantify how bad a medical staff is for a baseball team. I would’ve just gone the anecdote route for this article. The usage of Mejia last year alone would make most other teams laugh.

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  14. JMS says:

    I have a business relationship with the Hospital for Special Surgery that has twice afforded me the opportunity to speak with the Mets team doctor. He has basically said that while he makes correct diagnosis’, the Mets ignore what he says. There is tremendous circumstantial evidence to suggest that the Mets team doctors are not incompetent, as they are widely regarded as the finest orthopedists on the planet.The Mets training staff might be to blame but it has experienced huge turnover in the past couple. of years that should have rooted out any serious incompetence. I’m led to believe that it is bad luck compounded by Chinese style propaganda from Met management. .

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  15. Htpp says:

    You could replace “Mets” with “Nationals” throughout this post and most of it would still apply. Completely frustrating

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  16. David G says:

    After a number of questionable calls (Mo Vaughn was healthy; Vladimir Guerrero was not, etc.) I was sure a long time ago that the Mets could not win until they switched hospitals and they did…they switched from Hospital for Joint Disease/NYU (great hospital) to HSS (great hospital). So I was thinking the same thing, and it hasn’t made a difference. It’s clearly not the hospitals and I’m not sure it’s the same training staff supposedly not listening to the docs at HSS. Maybe it’s just bad luck.

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  17. SuperGrover says:

    Strawberry and Derrick have it right.It’s not the hospital or doctors,but Jeffrey wanting players on the field as soon as possible.

    Don’t think so well read this.”New York Mets chief operating officer Jeff Wilpon was apparently so displeased with his team for not seeking retribution against the Oakland Athletics for hitting Justin Turner in the first inning Thursday, he took action.

    Immediately after the series finale, which the Mets won 4-1 against the A’s at Citi Field, Wilpon scolded the team for not retaliating, two clubhouse witnesses told ESPNNewYork.com.

    He interferes with everything.

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  18. MDScotty says:

    Here’s the real story: meddlesome, stupid owners are micromanaging the health care of the teams. That’s right. The dumbest owners in baseball are pretending that they have medical degrees.

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