Why Players Play Through Injury

DENVER, CO: Starting pitcher Jorge De La Rosa #29 of the Colorado Rockies is removed from the game by manager Jim Tracy #4 in the sixth inning against the Arizona Diamondbacks at Coors Field in Denver, Colorado. De La Rosa earned the win as the Rockies defeated the Diamondbacks 3-1. (Photo by Doug Pensinger/Getty Images)

We don't want players to play through injury because doing that worsens the injury and diminishes performance. Of course, in reality, it's not nearly that simple.

If I wanted, I could make this a really short feature. Baseball players play through injury because baseball players are athletes and athletes play sports and male athletes who play sports are jocks and according to jock culture a real man is supposed to tough it out. Suck it up, no quit, pain is just a state of mind and so on and so on. Of course that's a big reason why baseball players play through injury. They don't want to be thought less of, and if they sat when something hurt, they'd be thought less of.

But that isn't it. That doesn't tell the whole story. See, in theory, this is an easy situation to figure out. A lot of writers, myself included, have gone on record as saying they don't support guys playing through injury. Playing through discomfort, sure, but there's a difference between normal discomfort and pain from an injury. Players presumably know the difference most of the time. By playing through an injury, not only does a player risk hurting himself worse; he performs worse, which directly makes the team worse. There usually isn't a benefit to sucking it up.

In theory. But of course, reality is more complicated. If playing through injury always made the injury worse, and always made the performance worse, players wouldn't do it. Over time they would just know not to. What we find is that that isn't the case.

Wednesday morning brought this article on Jorge de la Rosa, a starter for the Rockies who is rehabbing from Tommy John surgery. At the beginning of the article, it's revealed that de la Rosa experienced pain in his elbow in his second start of the season. The pain didn't go away. Yet de la Rosa kept it hidden, and he made another eight starts. Eight more starts, all through injury. Finally, he had to come out in his tenth start because the coaching staff figured something was wrong, but de la Rosa lied to them about it even then. The extent of his injury was discovered shortly thereafter. His season was done.

Reading that, I was prepared to come online and take de la Rosa to task, using him as just the latest example of detrimental stubbornness. But then I looked at the numbers. Jorge de la Rosa was basically hurt for his entire 2011. Maybe not in his first start, but in all subsequent starts. Let's compare his 2011 to his 2010:

2010: 93.4 mile-per-hour average fastball velocity
2011:
92.7

2010: 4.22 ERA
2011:
3.51

2010: 22.2 percent strikeouts
2011:
21.2

2010: 10.0 percent walks
2011:
9.0

2010: 3.0 percent home runs
2011:
1.6

Jorge de la Rosa started ten games in 2011 before going on the shelf. We can conclude that he was injured in nine of them. Yet he performed as well as he did the season before, if not even better. He was hurting when he threw, but he was still getting the job done. Why make that stop? Why own up to a secret if the secret doesn't seem to be holding you back?

Additionally, there's this note, from later in the article:

Fortunately, the Rockies do not believe De La Rosa's insistence on pitching through the pain did any permanent damage.

Jorge de la Rosa felt pain in his elbow. Unusual, significant pain. He didn't tell anybody and he continued to pitch. He pitched well until he couldn't pitch anymore, and the belief is that he didn't make his injury worse. Cases like this one serve to encourage players to tough it out. Okay, something hurts. It hurts in a weird way. Maybe it won't matter. Let's see if it matters.

Also on Wednesday, Carlos Guillen signed with the Seattle Mariners. In 2001, Guillen played pretty much the entire season through undiagnosed tuberculosis. That sounds bad already. It gets worse. Guillen didn't tell any coaches. He didn't tell anyone on the medical staff. He felt worse and worse every day, but he was determined to keep playing. He did tell some of his teammates what was going on. Here's something from reliever Jose Paniagua:

Pitcher Jose Paniagua said Guillen had been sick for about three months and had told him he suspected the blood he was losing was from his lungs, and not his nose.

Terrifying, right? Pretty severe, right? We're talking about suspected lung blood. Guillen didn't say anything. His teammates didn't say anything. Guillen hit better in the second half than he did in the first half. He batted .439 in September before he finally went to the hospital and learned the nature of his malady.

Maybe Guillen would've piped up sooner if his performance was suffering. Statistically, his performance wasn't suffering, and he remained the regular shortstop until he was hospitalized at the end of September. He returned half a month later to play in the ALCS. In the long run, he was fine.

If playing through injury guaranteed worse injury and worse performance, players wouldn't do it. At the very least, they wouldn't do it nearly so often. But there aren't those guarantees. Cases like these two and several others show that you can play through injury and be more or less fine until you are not.

Which is dangerous. Because, of course, there are many more cases where playing through injury does lead to worse injury and worse performance. That's what we all want to avoid. But this isn't as simple as we want it to be. Athletes face pressure to remain in the lineup as often as they can, and in the event of true pain, they don't necessarily face guaranteed negative consequences. It's regrettable when a player plays through injury and makes things worse. But it's understandable why a player would do it.

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