Neshek's Injury Misdiagnosed
by natetheskate on May 6, 2010 7:32 AM EDT
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PrintEdit by Jesse: Thanks to natetheskate for posting this. Please see below the jump for an explanation, and a quote from Neshek himself. Gotta love you some Neshek!
There's been a lot of speculation & uncertainty about Pat Neshek lately but luckily Pat is a class act to his fans and goes directly to them with info. Here's Pat's Facebook status from about an hour ago: "Had an MRI, Went to a Hand Specialist, found pain was coming from my palm and not my finger like intially diagnosed. Can't wait to be back pitching."
Sounds like it's been pretty frustrating for Pat. Someone mentioned on his wall that Jim Souhan and Patrick Reusse were saying he's in the doghouse with Gardy, and that sort of set him off:
"Yeah it's been a drag on me. Here's what's going on. I injured my finger about 3 weeks ago, got a cortisone shot in the finger and told to rest for a week. The pain never went away but my finger felt a little better. During the entire time throwing I have not felt that well out there playing catch (painful to grip and release the ball) and in games. I pitched with pain since the initial diagnosis said that it would go away and throwing a baseball would help it. Well, 3 weeks have passed and I'm still having trouble gripping a ball. I went in for an MRI and to a hand specialist and learned that I was misdiagnosed. My pain was coming from near the palm of my hand where my middle finger in my palm...called a pulley tendon. The best thing to help it is a direct injection of cortisone, rest, not to stretch it or use it doing things that put stress on it. To get a cortisone injection I need to wait at least 4 weeks after my last one. I had my last one 3 weeks ago. I'm not happy with anything that has gone on especially when it could have been taken care off 3 weeks ago and was told the wrong info. For me I'm not going to risk tearing a finger, I want this to be healed ASAP and I want to pitch ASAP. You have to understand the press really doesn't understand what is really going on other than what they read or what they hear and they need to have something to talk about. My number one priority is to get this feeling fine and pitch...I don't care where I pitch Twins, AAA, AA, A whatever because I know when I'm healthy I will be getting guys out, But as for right now I'm hurting and need to get this feeling normal. That's where I'm at right now, as far as the guys in the media they have no clue, Gardy & I are on the same page, we had a miscommunication in Cleveland but are on the same page and both agree the #1 thing is to get healthy and pitch."
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Gardy's position
Before I get to my position, let me just say that I like Pat a lot, and it stinks that he was misdiagnosed. When was the last time the Twins medical staff diagnosed anything correctly? I can’t recall. They seem to always be proven wrong by specialists weeks or months after their initial diagnosis. The the treatment (or lack thereof) they perspective after their diagnosis often makes the problem worse, not better. So it sucks for Pat. I get that.
But Gardy has a point. After the first Cortisone shot, Pat reported that he felt better and that he could get back to pitching. That wasn’t entirely true. The finger felt better, but he was having trouble gripping a ball, which would seem to affect how well he could perform. All he said was that he felt better. He never said he didn’t quite feel right.
Anyway, Gardy thought he was better and put him into a game in a key situation when we’re trying to win a ballgame against our main division rival. Pat obviously couldn’t grip the ball well enough to control it, walking two batters on nine pitches way out of the zone. Those two batters ended up scoring the tying and winning runs. Based on his performance, Gardy wanted to send him down to work on his control. Only then did Pat reveal his hand wasn’t right. Gardy got pissed because he was mislead into thinking that Pat was OK to pitch when he wasn’t, and we lost a ballgame because of it.
If Pat had told Gardy or Andy or Stelly or the medical staff that he was having trouble gripping a ball, they would never have activated him from the DL and they would never have put him in a key situation. If I’m Gardy, I’m pissed that he was not completely open about the injury and it cost us a ballgame.
"You're thinking too much. Just have fun." -- Bennie "The Jet" Rodriguez in Sandlot
Sure, but at the same time, if you're an athlete you want to get out there and pitch.
You don’t want to be seen as “the guy who refused to pitch because his finger hurt”. That’s not cool, either. I don’t blame Pat for this. If it felt a bit better, and he was under the assumption that it would get better with time (while pitching, no less), then this is exactly what you expect a professional to do. It’s hard to blame a guy for wanting to do his part.
I agree
I’m not taking sides or blaming. I just understand Gardy’s position. I also wonder why Stelly didn’t say something. Presumably, if he’s not throwing it over the plate in the bullpen, you don’t let him go out there. You could tell from his first pitch that something was not right. Everything went up and in to the right hander—drastically. As a fan, I was saying out loud after his outing, “Why did he tell them he’s OK if this is the best he can do with his hand problem?”
One other thing: I’m sure it was not Pat’s intention, but the way he communicated this made it sound greedy. The difference between being on the major league DL and in AAA is like $1000 a day.
It’s a similar situation to Perkins. In that case, they optioned him anyway. At least they had the decency to keep him up here, send him to a hand specialist and get the thing resolved. Aside from the medical staff, the Twins treated him with more respect than some organizations might have. They certainly treated him with more respect than they did with Perkins.
"You're thinking too much. Just have fun." -- Bennie "The Jet" Rodriguez in Sandlot
Salary
According to Pat, his salary’s the same in the minors or on the DL: " I also can’t stand the morons saying I’m milking this…not sure what I’m milking…my paycheck is the same if I go to the minors, get optioned to the minors, get released, the exact same. I think being hurt is the worst thing that can happen to me, I don’t know why someone would say they are hurt if they weren’t."
Do you want to know the terrifying truth, or do you want to see me sock a few dingers?
Is there a pay difference?
I was thinking the same thing as you when I saw the initial story about him wanting to go on the DL instead of taking an option, but then I realized that he is in his first arbitration year, and I was under the impression that contracts after “serfdom” are guaranteed major league deals. Anyone know for sure?
"There are only two things that are infinite, the universe and human stupidity, and I'm not sure about the former." - Albert Einstein
Apparently natetheskate knows
"There are only two things that are infinite, the universe and human stupidity, and I'm not sure about the former." - Albert Einstein
Well we're not morons
And we don’t know whether he gets a cut in pay if he’s optioned. So how are casual fans supposed to understand? Calling us morons doesn’t help.
"You're thinking too much. Just have fun." -- Bennie "The Jet" Rodriguez in Sandlot
you do realize that nate is just quoting Neshek right?
by montanatwinsfan on May 6, 2010 12:20 PM EDT up reply actions
Yes, I was refering to Neshek calling us morons
Maybe he meant the media (Souhan and Reusse). But you have to admit, it sure sounds like he’s saying that anyone who doesn’t know how major league salaries work is a moron.
"You're thinking too much. Just have fun." -- Bennie "The Jet" Rodriguez in Sandlot
I didn't read it like that at all.
Of course this is where the problem is: EVERYTHING is open to interpretation. I took “morons” to mean “uninformed people who jump to conclusions”. Either way I feel like it’s a non-issue.
I think it's my fault for quoting him out of context
When he said morons he was referring to certain people in the media. I didn’t want to quote everything he said because even though his FB page is pretty public you still have to accept him as a friend to view it. I don’t want to get him in trouble, but I think he is being perfectly reasonable and, again, a class act for going straight to the fans. He will add anyone who asks to be his friend, so you can get the straight story from him. Until you do though, please give him the benefit of the doubt because I’m selectively quoting him.
Do you want to know the terrifying truth, or do you want to see me sock a few dingers?
It's not really similar to Perkins' situation.
Perkins kept his mouth shut, didn’t he? Neshek was honest about it and they misdiagnosed him.
explanation
Maybe he didn’t want to be the “my finger hurts” mollycoddle, but “I can’t grip the ball” is an excuse that no one should argue with. Neshek handled this one poorly.
Yeah, I agree.
My guess is that he downplayed it because he didn’t want anyone thinking it was connected to the TJ. He’s waited a really long time to be pitching again and didn’t want to miss a minute.
But he still kinda screwed this up. I’m hoping it’s true that he and Gardy are fine now. The last thing we need is personality conflicts.
http://www.realityfish.com
It sounds like he and Gardy have worked it out.
I hope they have.
But again—I’m not sure how he screwed this up, if he was going off the doctor’s recommendation.
Twins partly to blame
If he said it felt fine, that was wrong. You need to communicate clearly so the manager can make an informed decision. But if you look at the lambasting Perkins took from the manager and GM just for acknowledging that a lingering injury was affecting his performance, you’d be gun shy about making what could look like excuses.
And did he say it was fine? Not that I’ve heard. He just said it was improving.
They told him the problem was his finger. They put cortisone in his finger. And his finger felt better. Not all the way better; just getting better. But I highly doubt he told anyone it was all the way better. Which apparently was true, because the finger was never actually injured.
They also told him that he should try to pitch through the pain if he could, because pitching would actually help his injury heal. So he did what they asked, and pitched through pain. What’s he supposed to do? Complain and refuse?
The problem wasn’t that he did what he was told. The problem is that what he was told to do was wrong. If there’s a victim here, it’s Neshek.
If he’s in the doghouse for not complaining enough, and Perkins is in the doghouse for complaining too much, then you’re going to have some very confused ball players out there, who are justifiably afraid to tell their manager what’s really going on.
lambaste?
lam·baste /læmˈbeɪst, -ˈbæst/
–verb (used with object),-bast·ed, -bast·ing. Informal.
1.to beat or whip severely.
2.to reprimand or berate harshly; censure; excoriate.
Perkins was not “lambasted,” unless I missed it. Questioned, perhaps. Fact is, if Perkins was a better pitcher they would overlook his quirks, but he’s not, so he’s in AAA until he can be traded.
He only handled it poorly if he knew he'd been misdiagnosed.
The doctors told him it would get better. If the doctors thought he needed time off, they would have told him so. Blaming Neshek for acting on the medical diagnosis is expecting Pat to know that he was misdiagnosed, which really isn’t possible. There’s a big difference between trying to play through something, and handling it poorly, and if what Neshek has said about all this is true then it’s not really a thin line between the two.
I blame him
for trying to pitch when he couldn’t grip the ball, not telling anyone, sucking, and then saying he shouldn’t have pitched because he couldn’t grip the ball.
It is not a big deal, but it is a bigger deal because Neshek is a blogger so the public is aware of his every bowel movement.
But he did tell someone.
He told the doctors. If they say he’ll be fine, what do you expect him to do? Complain more? Because that’s what Perkins did, and that wasn’t too popular, either.
And no, it’s not a big deal, but there’s really no basis to blame Neshek here. Just the doctors.
public media
This is beyond a minor thing that will be forgotten by June, but I think it says more about the public media tools such as blogs and twitter than anything else. Neshek is fond of putting himself before the public, and now he must prepare to reap the whirlwind.
He said his finger was good enough to pitch, it wasn't
I can understand not wanting to seem like you’re injury prone, especially in this organization. There’s a long list of guys who were demonized for having injury issues. The medical staff tends to blame the player when they screw up. The most recent one is Morales. But I can think of 10 cases off the top of my head. Even Joe Mauer got the third degree on his knee problem.
But if you can’t grip the ball, and therefor pitch effectively, just say so before you have an epic fail in an important game. Also, we could have had Slama the whole time he was injured but not on the DL.
"You're thinking too much. Just have fun." -- Bennie "The Jet" Rodriguez in Sandlot
I don't know, the doctors said it was good enough to pitch
And that pitching was good for it. The Twins staff presumably was watching him pitch and evaluating whether it made any sense to put him out there. They should have had some responsibility to look at results and say “you’re just not ready.” And I’m sure Neshek didn’t think it was an automatic disaster for him to pitch that day. Ballplayers often go out there at less than 100%.
-1
Better that he kept his mouth shut and let the media decide if he’s being a greedy, secretive fool or a crybaby wimp?
And he obviously didn’t know the results would be that bad in Cleveland. Should every pitcher who performed badly have told the manager they shouldn’t have been put in since they should have known they didn’t have good enough stuff to get it done?
+1
He was told his finger was fine and no structural damage.
If he didn’t pitch despite being cleared we would be hearing rumors of how he is wussy and can’t pitch through pain.
by clutterheart on May 6, 2010 10:22 AM EDT up reply actions
how about this
Tell the manager: “I can’t grip the ball.” Which was obvious when he came in the game.
I think Gardy and Andy’s beef with Perkins and Neshek is that they wait until AFTER they pitch to say they are injured.
And I think we learn when we are about 10 that we know our bodies better than the old sawbones.
you are making the assumption
that because it was obvious when he came into the game, it was also obvious before he came into the game.
I also don’t think you’ve proven that Gardy has a beef with Neshek. According to Neshek there is no issue between them.
frankly, given how very very little about the situation is known, its troubling the detail to which some people want to over analyze it and crucify Neshek over it.
Nobody is crucifying Neshek
He’s drawing attention to himself by trying to clear the air. All we’re doing is saying his perspective isn’t the only source of truth here.
"You're thinking too much. Just have fun." -- Bennie "The Jet" Rodriguez in Sandlot
Yeah this is what kills me.
How many times have we had to hear this—that the training staff screwed something up? Mistakes are made…but this often?
+1
Maybe with the new stadium revenues we could hire out some people from the Mayo Clinic….
The one constant through all the years, Ray, has been baseball. America has rolled by like an army of steamrollers. It has been erased like a blackboard, rebuilt and erased again. But baseball has marked the time. ~ Terence Mann
by John Veldhuis on May 6, 2010 11:02 AM EDT up reply actions
I'm not a doctor but it seems like they shoud know what they are doing
and I think it’s fair for us fans to question whether that’s the case or not.
For what I’ve read though the Twins are not the only team that screws up in the department. It sounds like the Mets have an even worse team looking over their players
"For the parents of a Little Leaguer, a baseball game is simply a nervous breakdown divided into innings."
— Earl Wilson
It's funny because Twins players consult the Mets' team doctor
I think Nathan did.
"You're thinking too much. Just have fun." -- Bennie "The Jet" Rodriguez in Sandlot
I don't see that as a huge deal
It was the Mets’ team doctor who did Nathan’s Tommy John surgery, but I don’t see that as a huge deal – there simply aren’t a lot of surgeons in the country who do that procedure, and baseball teams are obviously going to spring for the best, most experienced surgeons, so the same few guys do pretty much everyone’s. It’d be more of an insult if players were seeing other doctors for more minor issues; I don’t know whether that’s the case or not.
"There are only two things that are infinite, the universe and human stupidity, and I'm not sure about the former." - Albert Einstein
+1
I don’t see how people can denegrade the Twins’ medical staff unless they have a lot more specific information and have a lot more medical training. The anecdotal “this person is hurt so the medical staff sucks” thing is silly.
It’s one of those things where you only notice the failures, and it’s very difficult to compare the Twins’ staff to any other with any sort of perspective.
I can cite you chapter and verse
But it would take too long. Put it this way: Almost every major injury the team has suffered followed this script:
1. Medical staff says it’s “No big deal”
2. Player told to “rest for a few days and test the injured limb”
3. Player still experiences symptoms
4. Medical staff prescribes rehab
5. Player has setback during rehab and is shut down
6. Medical staff sends him for an MRI
7. MRI discloses structural damage
8. Medical staff recommends rehab
9. Player has setback after a couple of weeks of rehab
10. Medical staff shuts down rehab
11. Player goes for second opinion
12. Second opinion recommends surgery
13. Player gets surgery and eventually recovers.
Steps 1-11 typically take 3 to 6 months, which are just wasted time. And we’re not talking about fringe players or minor injuries: Joe Mauer, Francisco Liriano, and Pat Neshek are just three players whose injury woes followed that pattern.
I’m pleased they sent Mauer for an MRI so soon. I’m also pleased they now have an ultrasound machine on site at Target Field. So apparently they are not so quick to dismiss injuries.
But even in Spring Training, the first thing out of Gardy’s mouth was “The medical staff said it’s no big deal.” And that same medical staff recommended rehab after the MRI. Nathan took it upon himself to get surgery because he didn’t want to risk 6 months of wasted time on the DL.
"You're thinking too much. Just have fun." -- Bennie "The Jet" Rodriguez in Sandlot
Yep
I was thinking of Neshek and Liriano as well – Neshek might’ve been able to come back last year had he gotten his surgery early in 2008, when the injury happened, instead of trying the initially-prescribed “rest and rehab” and delaying the surgery for several months.
It would be interesting to know how often this happens to other teams… Like ben2 said, we seize on this because we see it happen to our team, but it could be a more common situation than we think.
I’m reminded here of Rany Jazayerli, the Royals blogger – last year, he wrote a scathing indictment of the Royals’ training staff based on the horrible injury problems they’d had. I was thinking he may have had some data backing him up, but I don’t recall that for sure.
"There are only two things that are infinite, the universe and human stupidity, and I'm not sure about the former." - Albert Einstein
We don’t know how often rest is prescribed and it DOES work but we never hear about it.
The script above was probably for dramatic effect, but it’s exactly what I’m talking about. We don’t know what’s going on in the doctor’s office. I know a similar point could be used to shut down pretty much any discussion on here, but it’s especially relevant when you’re talking about something as complicated as sports medicine. We get a lot of information these days, but nowhere near enough to make any reasonable claim about whether a medical staff is inept.
And I don’t quite remember the Nathan thing the same way. I remember it being a foregone conclusion that surgury was going to be required, but Nathan wanted to rest a few weeks on the outside chance he’d be able to pitch without surgery.
It's a matter of public record
The burden of proof is on you to prove me wrong.
"You're thinking too much. Just have fun." -- Bennie "The Jet" Rodriguez in Sandlot
It’s a matter of public record that the Twins’ medical staff is inept?
My burden? You go around saying that someone is bad at their job, I say I don’t think you’re in a position to make any kind of informed judgement on that, and I have to prove they know what they’re doing? I guess I can’t do that.
If you’re talking about the Nathan thing, he talked about it here. He was clearly on the same page as the Twins.
It's a matter of public record that the scenario I outline above has happend several times in the last 10 years
What I mean by a matter of public record is reading the new stories in chronological order. In the first news story, Gardy was quoted as stating, “Nobody thinks this is a big deal.” They did send him for an MRI quicker than they have in the past. But they told him after looking at the MRI that he should consider the rehab option. The other doctors he consulted recommended surgery. It was his choice, and he eventually chose surgery. The article you refer to is his perspective after he chose surgery.
I never said they were inept. They have an approach that doesn’t seem to work very well. The main problem is they think surgery is a last resort for all injuries. This is their stated medical philosophy. It doesn’t work for structural damage. For structural damage, surgery should be the preferred option because it gets players back on the field the quickest. This has been proven over and over throughout the league.
"You're thinking too much. Just have fun." -- Bennie "The Jet" Rodriguez in Sandlot
Blackburn
Apparently rest worked fine for Blackburn
For now
I still don’t get why they didn’t take the spur out in the offseason. Bone spurs cause friction in the joint, increasing the likelihood of future ligament damage (basically what happened to Nathan). They have known he has a spur for the past year and they didn’t take the offseason to get it out of there.
"You're thinking too much. Just have fun." -- Bennie "The Jet" Rodriguez in Sandlot
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