2012 Reds

RG3 and Joey Votto

Could someone please forward this article to the Reds’ organization? It makes the case, citing numerous examples, for taking the decision out of the player’s hands when it comes to returning after an injury. The Reds owner, GM, Manager and Medical Staff should carefully read this paragraph, in particular:

“The emotional need of wanting to play and being a star always overtakes making a good decision,” said Sharon Stoll, a sports ethics professor at the University of Idaho. “You’d like to think an athlete as intelligent as Robert Griffin III would be able to make that decision. But your humanness prevents you from making that decision. That’s why you need a community of medical authorities to step in and say, ‘No, you’re not [playing].’ The athletes themselves, they can’t do it. There’s too much emotional tie-in.”

We’ll never know how the Reds’ season would have turned out if Joey Votto had received an MRI on June 29 to determine the full extent of his knee injury. Instead, he was allowed to play on it until July 16, including starting at first base for the NL in the All-Star Game. Did he worsen his injury during that time, prolonging his recovery or causing permanent damage? We don’t know.

The Reds played well in Votto’s absence. He returned to the lineup on September 5. The team won the NL Central and were very close to winning the NLCS. Not a bad outcome, overall.

On the other hand, the date of Votto’s final home run in 2012 was June 24.

37 thoughts on “RG3 and Joey Votto

  1. Votto’s knee is the biggest question heading into spring training in my mind – even bigger than whether or not the Missile can move into the rotation. The fact that Votto himself said that the knee is still not 100% as late as Redsfest is a HUGE concern.

    I still shake my head at the way the Reds dealt with the issue from the moment he slid into third base in SF.

  2. Given how much the team has invested in Votto, I would think it to make long-run economic sense to take such decisions out of his hands. While it is his body, there is a lot of money riding on his body’s ability to remain able to play baseball at a very high level. This may sound like callous reasoning, but I can see no other way to take the emotion out of this.

  3. @Drew Mac: Curt Schilling makes a similar point in the article. He says how the organization behaves should depend somewhat on the stage of the player’s career, with more risk taken for older players. RG3 is 22 years old. Schilling was toward the end of his career when his situation arose. Votto is sort of in the middle of that, but as you point out, the Reds are hoping he has more than $200 million of production ahead of him.

  4. I don’t understand why it would be so hard to make the team policy be one of, if a player leaves the game with an injury, or is obviously showing the signs of an injury, have the trainer and/or the team physicians check him out. If it’s a “policy” that everybody would have to adhere to, it lets the player off the hook from having to appear “weak” or “un-macho” in trying to play through it. … I’d rather have a player say later that “I told you it was nothing,” and be proven right, than learn that it was more serious but the medical staff never got an early chance to find out.

    I’ve been curious to hear whether Votto needed any more work done on the knee so far this offseason, and hoping no news is good news.

  5. If you try to play through an injury and end up hurting the team because you can’t do your job, then you are not macho.

    I can’t believe more players aren’t concerned about the dangers of permanent injury (and lessened production, and shortened careers) by playing on something that is hurt. I’ve never once considered a player “more of a man” for playing hurt. Typically, the player can’t do his job and drags the team down, and still, he’s lauded for “grinding.” I don’t understand it and never will.

  6. What I want to hear is the manager or doctor saying that this player is too injured to play, whether he believes he is or not. If Joey Votto says he’s fine and willing to play, how many people would be excited about removing him because he was overruled by somebody else, whether that be Dusty, the team doctor, or team trainer? Probably not many. That’s pretty disrespectful to the athlete, treating him like a little baby who has been overruled by a controlling mother rather than a free-thinking adult and a professional.

    Vegastypo would like to have a player say “I told you it was nothing” but most fans don’t want to see a key player held out of games for nothing.

    All injury aren’t as dramatic as a bone breaking in two and I don’t think that some fans recognize that. Frequently people get second opinions of diagnoses. Players can play through many aches and pains and I think it’s up to them to determine how they feel.

    I think a lot of fans have a mistaken impression that Joey Votto really struggled after his return from the DL. After all, only his homerun totals (or lack thereof) are mentioned. He hit .343 with a .527 OBP in 67 ABs in September! He hit .318 with a .500 OBP in the NLDS! Now he has had MONTHS to rehab and recover. He was hitting just fine after his return, and he’s had time to recover his power. If his power does NOT return he’s still likely to have a Joe Mauer-type season.

  7. @redsfanman: Easy now, easy … You take me out of context. Of course I’d rather a player not miss time at all if he is deemed uninjured. If that means a player misses ONE game while being checked out, so be it. But I don’t think fans are going to begrudge a team for trying to protect a player — especially a star player, but anybody — from further injury. (And frankly, if it’s the health of a player, I don’t really care what the fans think.) As it is, Dusty doesn’t mind giving a guy a day off once in a while anyway. But I don’t think that getting checked out by the team doc means a player is going to miss much time (unless he gets sent home from a road trip, obviously).

    If Joey Votto says he’s fine, it stops there? You wouldn’t want a doctor to check him out? I guess we agree to disagree. If a team sees enough of an issue that it thinks a player should be checked out, and the player won’t go, I think it’s the player who is acting like a baby.

  8. @vegastypo: I didn’t mean to take you out of context but if a player thinks he’s fine it’s silly to override him unless there’s a real concern. When Joey Votto injured his knee he was examined by trainers who apparently didn’t find a major problem. They are professionals and experts with more inside knowledge than any of us have. In my opinion dragging him to the hospital over his objection would be pretty disrespectful if he turned out to be fine. I hope he’s learned from this to take aches and pains a little more seriously.

    You “don’t think fans are going to begrudge a team for trying to protect a player – especially a star player – from further injury”? What about Stephen Strasburg? Lots of Nationals fans wanted people in the organization fired for shutting him down early. Doctors shut him down for passing an arbitrary line and it was wildly unpopular and controversial. Shutting Joey Votto down when he insists that he’s able to play would probably be received similarly badly.

  9. @redsfanman:

    Again, you’re changing the context on me. Strasburg is a bit of a different animal. The risk there was that he COULD GET INJURED if he pitches further based on his health history. Our discussion today began with a case where there is some sort of current issue and figuring out how to proceed with it. My point is the same. I think management, teammates and fans would be perfectly willing to sacrifice a game if it meant sizing up a current injury correctly. If we disagree, so be it.

    You kinda make my point for me when you say “unless there’s a real concern.” Of course, nobody is suggesting running Votto or anybody else to the ICU unit with a paper cut. But if the team thinks there’s a real concern, that should be enough.

  10. But Votto was not the same hitter when he returned…his slugging, which in April/May/June was .500/.600/.677, was .448 in September. He was not driving the ball like he had been upon his return.

    I said it at the time, I’ll say it again now, I think the Reds handling of the Votto injury was absolutely horrible. From medical staff to management to Joey himself…and as Steve says, we’ll never know what might have happened if it had been handled differently.

  11. Votto wasn’t the same hitter after his return but he remained a great hitter with a .343 average and .527 OBP in September. Maybe for him that is sub-standard but for most guys that is spectacular. The Reds wanted Joey Votto’s bat in the lineup if he was capable of playing and I don’t blame them for it.

    When people place value on homeruns and slugging percentage I’m curious about what people here think about Joe Mauer. Career .323 average, .405 OBP, .468 slugging percentage (vs .316/.415/.553 for Votto). He’s a different hitter than Joey Votto but I don’t think he’s significantly worse as a hitter. If Votto’s homerun totals vanish (although that seems unlikely to me) I think they’re left with another Joe Mauer, which is still great.

  12. @redsfanman: You can seriously claim that if the result of the management of Joey Votto’s knee is that he goes from a player who hits 30+ HR to one that hits 5 per year that it’s nothing to criticize? Seems like you’re just going out of your way to be on the other side of the argument.

    All I’m hoping is that the Reds be aggressive at trying to find out if their players are, in fact, injured. Anyone watching Votto play after the injury could tell – immediately – something was wrong with him. It’s not a matter of disrespecting him (and if it does, big deal), it’s just that the organization should have a more aggressive policy of insisting on MRIs and other diagnostic techniques. That way everyone, including the player, can find out how hurt he really is.

    Again, this isn’t about a disagreement over whether Votto should have played or not. It’s a disagreement about whether the Reds did enough, soon enough, to find out IF he was injured. And if the result of their passivity is that Votto’s recovery time was significantly extended or he was permanently injured, then it was a horrible mistake.

    I’m sure the medical staff took a look at him. But they didn’t do an MRI. So their basis of how hurt he was depended on him answering questions like “Does this hurt?” and “Is this tender?” etc. Then he comes in the next day and says “It feels better.” or “I’m OK.” It’s exactly the point of this article that this process is inherently unreliable.

    You’ve got to be the only person on the planet, including Votto, who would be OK with him being a singles hitter the rest of his career.

  13. Votto without power is a glorified SeAn Casey. Better eye/ strike zone discipline; slightly better at making contact. Nothing wrong with that except it is not what a team pays $22M or whatever the 10 year average annual salary of his deal is.

  14. All players play “hurt”, pretty much all the time – that is a given of Baseball. What we’re really talking about is playing “injured”, and even then it is “injured enough to affect a player’s career.” And there we’re talking highly subjective judgements.

    Despite Steve Mancuso’s assertion, I doubt the Reds’ medical staff merely relied upon Joey’s self-reported pain. I expect they also evaluated range of motion, strength of the joint and other factors, likely including the sound of the knee as it was manipulated.

    It is entirely possible that the medical staff made a competent and reasonable diagnosis that was nonetheless wrong. Stuff happens, you know? Reds ripped Foster for not “playing hard” when he was making the sound judgement that a flyout in June wasn’t reason for him to be on the injury list for two months. As much as I loved Freel, I used to cringe watching him dive for a soft liner which could have been played on the bounce rather than letting it go through for a triple. Balancing when to play injured or “hard” is probably the hardest part of playing MLB.

    • It is entirely possible that the medical staff made a competent and reasonable diagnosis that was nonetheless wrong.Stuff happens, you know?

      Which is the exact reason that they have those fancy MRI machines to tell you when you may be wrong. An incorrect, reasonable diagnosis might be excusable with a back up utility infielder. It is an outrage with the face of the franchise who the team has committed millions upon millions of dollars to over the next decade.

      Steve is exactly right – this conversation really has nothing at all to do with playing hurt vs. playing injured. It is all about the gross incompetence of not having the MRI done immediately in SF and the questionable care he has received since the injury.

      I truly fear that we are looking at another surgery or at least stint on the DL early this season for Joey. If he’s still not at 100%, which is what he said just a few weeks ago, then there is something still wrong inside that knee.

  15. this is such an easy question. There is absolutely no justification for not having an MRI after the game in SF. Any potential joint issue on your franchise players are worth a MRI if for no reason other than the ounce of prevention. What player could reasonably object to an MRI?

    And as a Reds and Skins fan, this conversation makes me nauseated.

    • @Steve Mancuso: I didn’t say that I want Joey Votto to be a singles hitter for the rest of his career, but I think you should recognize that even in his condition in September he was still a darn good hitter. After months off to rest and rehab he’s probably gotten better, not worse. I think you’re taking it way overboard by implying that this is some sort of career changing injury. Guilty until proven innocent, I guess… or in this case injured until proven healed. I guess it’s clear that you won’t be confident in his ability to hit anymore until you see some numbers from spring training.

      this is such an easy question.There is absolutely no justification for not having an MRI after the game in SF.Any potential joint issue on your franchise players are worth a MRI if for no reason other than the ounce of prevention.What player could reasonably object to an MRI?

      A player who doesn’t believe that he’s sustained an injury might object. He might resent being taken in for thorough examinations after insisting that he’ll be fine.

      Start to teach the players that reporting any ache or pain will get them shipped to the hospital for an MRI whether they like it or not will likely make them less forthcoming with trainers and doctors, in my opinion. Similarly a reputation for turning clients in to the police isn’t going to build trust in a counselor. Making people feel that the go-to guy (in this case the doctor or trainer) is out to get them and that their own opinion doesn’t matter, that’s not the way to go. But oh well.

  16. @RES: Great post by RES by the way. I agree with RES that playing hurt vs playing injured is subjective – I don’t know where some people think they draw some arbitrary line. The players get sore at various times in the season. HERE you are playing with pain, but beyond HERE you are injured. Where’s that line? If Joey Votto stubs his toe and insists he’s okay do you pull out a copy of his contract, wave it in his face, and force him into an MRI? Apparently some say yes.

  17. As another way to put it, I think doctors and trainers should treat players with respect, treat them like people, treat them like adults. Don’t start looking at the players as slaves, machines, children, or some tool owned by the organization because of a piece of paper. Unfortunately that’s what some fans want – Votto signed a contract to play baseball and some people want him forced to have an MRI whether he wants it or not – after all he signed his life and free will away to the Reds. It’s odd.

  18. I got a note from my friend The Lurker. (He lurks here, but doesn’t post.) He’s also a radiologist in his spare time. With his permission, here is a portion of what he had to say …

    “What is the big deal about getting an MRI? It takes about 30 minutes to perform. No sedation. Usually painless (if no contrast is injected). People are usually not taken kicking and screaming into the MRI suite. This does not violate a player’s dignity. Any potential knee, ankle, foot, hand, wrist, shoulder, hip, or elbow injury (or potential muscle tear) needs an MRI.”

  19. Letting a player determine his own injury is nothing but disaster. I wonder why a player who just signed one of the biggest deals in baseball would want to play through pain and prove himself? A couple 200 million reasons.

    You let a player say “I’m fine” and get his media/fan bonus points. Of course he gets input into his treatment, like anybody. It’s management’s job to take the heat… like the Strasburg example. People went ape because they wanted to win. They’d also go ape if he hurt himself and missed a season. Shoot, people might give the manager a reputation as an “arm killer.” That’s happened to someone before right? :D Fans, as a general rule, are emotion based. What they want is completly irrelevant when it comes to assessing injury. If making some fans annoyed is the cost of protecting the team’s assets, then so be it.

    As in the Votto case specifically… all circumstantial evidence points towards a huge goof by the team.

  20. Explain it all you like, the Reds medical staff has a history of botching diagnosis. If it was just Votto I’d give them a pass. But factor in Madson, Massett, Phillips, et al, you have to start wondering about their process of diagnosing the seriousness of injuries. Or they’re lying. It has nothing to do with being emotional about it. By the time Votto’s injury happened we had already lost faith with the medical team. Votto was just the last straw.

    “I feel fine” should get an automatic reply of “That’s good, but we’re not going to take any chances.” Simple as that. It’s just common sense. To be contrary to that is just… well just silly. (Pardon, I don’t mean to offend.)

    • “I feel fine” should get an automatic reply of “That’s good, but we’re not going to take any chances.” Simple as that.

      Short and sweet. Like it.

  21. Maybe some one who follows this site works in the medical field and can weigh in on the following. As I recall the Reds said Votto did not initially get an MRI because the swelling would have made it useless and that by time the swelling had subsided, Votto was saying he was fine and ready to work his way back into the line up. So, is it accurate that swelling blocks the effectiveness of an MRI?

    Personally I agree with the folks above who say the whole issue is about having protocols and following them regardless of what the player self reports or doesn’t. Look at the situation with Masset for example. Any number of former pitcher types were saying in 2011 that he was throwing like a guy with a shoulder issue. Masset himself continued to deny that he had any physical issue. Then the situation unfolded in 2012 and at length lo and behold he ended up having a shoulder issue which required surgery.

    • I got a note from my friend The Lurker. (He lurks here, but doesn’t post.) He’s also a radiologist in his spare time. With his permission, here is a portion of what he had to say …

      “What is the big deal about getting an MRI? It takes about 30 minutes to perform. No sedation. Usually painless (if no contrast is injected). People are usually not taken kicking and screaming into the MRI suite. This does not violate a player’s dignity. Any potential knee, ankle, foot, hand, wrist, shoulder, hip, or elbow injury (or potential muscle tear) needs an MRI.”

      I’ve also had MRIs. Several of them on my head (although related jokes aside I’m fine). They put you inside a buzzing tube where you have to remain motionless for an extended period of time. It may be painless but it definitely isn’t comfortable either. It’s not like sitting on the sofa watching TV. It is probably worse if you have to drive to or from a place to get an MRI when you don’t believe that you are injured.

      @OhioJim:
      I’ve also heard that swelling is detrimental to the image and it is best to wait for the swelling to go down before diagnosing or treating a problem. That’s stuff for people on the Reds’ medical staff to understand and for Reds fans to complain about.

      Some guys are hampered for years (Rolen’s shoulder, Masset, Bray) but it’s silly to blame that on bad medical care. The Reds are really careful with helping people to rehab from diagnosed injuries. Getting paranoid about and thoroughly examining every bruise to players is a whole different issue. Diagnosing vs Rehabbing.

      The Reds have doctors, remember that they are under no obligations to tell fans anything. In fact they’re not allowed to by law. That is frequently misinterpreted as the doctors not knowing what’s going on. Remember when Joey Votto missed time with an Inner Ear Infection? That incident showed the commitment to keeping fans informed about medical details. The details are none of our business and they’ll make something up to shut people up.

  22. I don’t want to be that guy that blames Dusty for everything (yes I do), but when BP was clearly INJURED at the beginning of the year, Dusty point blank told him that he used to play through injuries and you need to learn to do the same thing, as he continued to trot him out there to the detriment of the team. A lesson learned for Joey.

  23. Powerful article from Washington Post writer Sally Jenkins on RG3 and Shanahan. Here’s a great paragraph. Replace the word Shanahan with Baker, the word Griffin with Votto, and the words “accuracy fell from 70 percent to 50 percent” with “power swing and fielding dexterity disappeared and he limped when running the bases”:

    “There isn’t a coach on the planet who doesn’t obsess over knees, who doesn’t know exactly what stresses them, and who can’t diagram a knee. They all understand how playing with an injury alters movement, and creates complications and potential chain reactions. It’s hard to believe that Shanahan didn’t understand exactly what was going on when Griffin’s accuracy fell from 70 percent to 50 percent — that he couldn’t plant properly on that knee.”

  24. Regarding the MRI, it is possible that an MRI may not have done any good in the early stages of Votto’s injury. An MRI can’t see much when there is too much swelling in the area to be imaged. Of course, the other side of that coin is if it was so swollen that an MRI couldn’t be performed, Votto probably shouldn’t have been playing.

    The other thing to consider is that MRIs are generally pricey. It’s why insurance companies hate it when orthos order them too often. Yes, we are talking about a $200-milliion player and a baseball team with millions in revenue, but the expense does matter.

    • Regarding the MRI, it is possible that an MRI may not have done any good in the early stages of Votto’s injury. An MRI can’t see much when there is too much swelling in the area to be imaged. Of course, the other side of that coin is if it was so swollen that an MRI couldn’t be performed, Votto probably shouldn’t have been playing.

      The other thing to consider is that MRIs are generally pricey. It’s why insurance companies hate it when orthos order them too often. Yes, we are talking about a $200-milliion player and a baseball team with millions in revenue, but the expense does matter.

      The most expensive thing this franchise has ever paid for and you think that the cost of an MRI was a consideration? Gawd, I hope now. This would be the perfect example of “penny-wise/pound foolish”.

  25. @Bill Lack: I can’t disagree with you there. The expense, especially in hindsight is a drop in the bucket compared to a lingering injury to your franchise player.

    This kind of stuff happens throughout the sports world however. It does at times seem as if it happens to the Reds more than other teams. Is that bad luck or the medical staff? Dr. Kremcheck is considered an outstanding ortho and lots of professional athletes, even from other teams, come to him for second opinions or even to perform surgeries. I personally don’t like him as MY ortho but that was more a matter of feeling he was a bad fit for me and not that he was a bad doctor.

    I think Reds fans got really cynical when in came to injuries in the wake of all the injuries that plagued Ken Griffey Jr. while he was here. I think it’s made many of us a little too eager to believe the medical staff is incompentent.

    For the record, I do think the Reds blew it in the Votto case but can see some of the reasoning for how/why it happened.

  26. @zab1983: Although I feel the Reds medical staff made a mistake, we have no way of knowing that allowing Votto to play made his injury worse. It’s certainly possible that it did but it’s just as possible that IF, and notice that’s a big “IF”; if the injury is somthing that lingers with Votto, it could be the initial injury that had the lasting impact. In other words, IF Votto is never the same, never forgiving the Reds FO is extreme when there is no way of knowing that his playing made things worse. The reason to be angry with the Reds FO would be the delay in having the surgery done and the impacts the injury had on Votto towards the end of last season and during 2013.

    All that said, I’d be very surprised if Votto was “never the same” due to this injury.

  27. The talk about Votto and his knee injury last year has merit. But in all honesty, I think Votto re-injured his knee more severely on that Sunday night game against the Cards right after the All-Star break. Late in the game, 8th inning I believe, Votto fouled the ball off his foot and landed very awkwardly. The way he twisted around and landed looked very much like it caused further injury to Votto’s knee. He grimmaced badly as he got up. You could tell then he was hurt more. If you can find it and access it, look at the re-play of that pitch and I think you will see what I mean. I don’t fault the Reds management or their medical staff for what happened to Votto.

  28. It makes perfect sense that Votto was unable to hit for power when he returned. I have also had the same surgery on my right knee (when I played I was a right-handed batter). When you are recovering from this surgery your lateral movements are restricted making it difficult to drive off of your back foot (Votto had surgery on his left knee). Anyone who knows how to swing a bat knows the back foot is where your power comes from. Votto returned from his surgery rather quickly; having all winter off to recover and regain his strength he should be okay. It took me about 6 months to return to full strength and I’m not getting near as good of treatment as what he did. I’m no doctor, but I have experienced the same surgery as what he has. A meniscus tear is pretty minor, he should be okay for 2013.

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