Tagged: FP Santangelo

Spanning Is the New Santangeloing: A Brief Review of Washington Hit Streaks

There have been many impressive offensive feats performed in the last few weeks by the Washington Nationals in the midst of their hot streak, which now has them four and a half game out of the last Wild Card spot, currently held by the Cincinnati Reds. Arguably the most impressive of said feats is the 24 (and counting) game hit streak by center fielder Denard Span, which is good for fourth in Washington Nationals/Montreal Expos history, right behind just-retired Vladimir Guerrero and current teammate Ryan Zimmerman, and has propelled the Nats to a 19-7 record during the streak.   Here’s how Span’s streak looks:
 

Rk Strk Start End Games AB R H 2B 3B HR RBI SO BB SB CS BA OBP SLG OPS Tm
1 Denard Span 2013-08-17 2013-09-13 24 101 16 38 5 2 2 7 12 6 2 1 .376 .413 .525 .938 WSN
Provided by Baseball-Reference.com: View Play Index Tool Used Generated 9/14/2013.

 
Not too shabby, eh?   Now, let’s take a walk down (recent) memory lane and take a look at how Span’s production — batting average (BA) and on base plus slugging percentage (OPS) — during his hit streak compares to similar Nats (as in Washington, not Montreal – sorry Canada!) hitting streaks. Moving forward, I am only considering hit streaks of 15 games or more, courtesy of Adam LaRoche, Cristian Guzman, Span, Ian Desmond, HDIB? great Nick Johnson, and Zimmerman:
 
WSN 15+ Game Hit Streaks By BA and OPS
 
Not surprisingly, Span’s batting average is reasonably high, with his OPS reasonably low compared to his fellow Nats streakers, which makes sense, given Span’s lack of power and so-so (for a top of the order hitter) on base percentage. Fair enough.  
 
Something’s missing.  
 
I seem to recall an 18 game hitting streak in there somewhere, in the annals of Washingreal history.  
 
Ahh, yes, F.P. Santangelo told me many many times over the course of Span’s hitting streak once he had an 18-game hitting streak.  
 
Ribbing aside, let’s take a look at Nats 15+ game hitting streaks — along with Santangelo’s 18-gamer — again by batting average and OPS:  
 
WSN 15+ Game Hit Streaks By BA and OPS (and FP)
 
OK, cool — we see some interesting trends here, namely, these guys are going out of their minds not only with their batting averages, but their overall power. Now, let’s break down OPS into its constituent parts — on base percentage (OBP) and slugging percentage (SLG) and add that to AVG and OPS and then look at these streaks in comparison to each player’s career averages for these four stats, yes?  
 
Difference Between Hit Streak and Career AVG, OBP, SLG, and OPS
 
With this, we see that while Santangelo’s hitting streak was impressive, it is definitely the outlier in comparison to the other streaks; his streak production was in such great contrast to what he normally accomplished hitting-wise, even when compared to his fellow streakers. Conversely, Span’s hitting streak, as well as Johnson’s, more closely trend with their career averages.  
 
What does this mean? Probably nothing; while it would be easy to say that the differences between streak averages and career average is some reflection of each player’s inherent hitting talent, that is a bit of a slippery slope and something that the data as presented can’t really speak to. Variables such as opponent defense and even pitching match ups all cloud the data enough to not warrant too many brash statements made about the data here. What is interesting are Zimmerman’s streaks and how he went about each — while some were driven more by his ability to make contact and not much else, others were marked by his ability to generate runs with his swings.  
 
Taking one more step back historically, how does the Washingreal data compare to other teams?  
 
Let me tell you, with the help of Baseball Reference’s Play Index. Looking at the modern era — 1916 to current day — I provide below the number of 15 game or more hitting streaks for each organization. I then averaged them over the years of interest to give an idea how frequently over the franchise’s modern era a big hitting streak occurs:
 

Team Yrs 15+ H Streaks Strk/Yr
STL 93 170 1.83
BOS 94 170 1.81
DET 96 171 1.78
CLE 94 166 1.77
MIN 97 162 1.67
NYY 95 155 1.63
COL 20 31 1.55
TOR 36 54 1.5
BAL 96 142 1.48
SEA 35 49 1.4
TEX 52 72 1.38
LAD 97 132 1.36
MIA 20 27 1.35
SFG 96 127 1.32
CHC 96 125 1.3
OAK 97 125 1.29
CWS 97 123 1.27
CIN 97 121 1.25
LAA 52 63 1.21
ARI 15 18 1.2
KCR 43 51 1.19
ATL 93 109 1.17
MIL 44 51 1.16
PHI 97 111 1.14
WAS 42 42 1
HOU 51 50 0.98
SDP 44 43 0.98
NYM 51 42 0.82
TBR 15 8 0.53

 
Not that Span’s streak wasn’t impressive enough, but the data provided, especially the table above, confirms how special the streak is to the organization; these kinds of streaks, while seen more frequently in the last few years, thanks to Zimmerman, haven’t been a hallmark of Washingreal hitters, to say the least. Between that and the context of Span’s streak — in the middle of a wild card run in the waning days of the season — only adds to the enjoyment of the streak and its importance to the success of the Nats’ 2013 season.

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HDIB? Neuroscience Grand Rounds II: Thoracic Outlet Syndrome

For the 2013 St Louis Cardinals, there will be a mainstay of the pitching staff conspicuously missing from spring training, with news that starter Chris Carpenter will miss most, if not all, of the season, due to continued issues stemming from thoracic outlet syndrome. Symptoms such as numbness, tingling, and discoloration of his pitching hand arose during a brief pitching session, and prompted shutting him down to prevent further injury; less than a year removed from surgery, Carpenter’s return and recovery look to be a little more complicated and lengthier than what was originally hoped.

So what is this condition that limited Carpenter to 30.2 innings of regular and postseason baseball in 2012, and why does it threaten his 2013?

Well, as we have done once before, it’s time to pick up our lab coats out from the dry cleaners, and dust off our medical kits, and get down to brass tacks. For those curious, here’s my medical kit:

il_fullxfull.303128523

Top of the line stuff, no doubt.

For a pitcher, thoracic outlet syndrome (TOS) can be a devastating diagnosis, as it arises from a very complicated area of the body anatomically. Let’s take a somewhat simplified look at the area we’re talking about:

Picture-1

Broadly, the thoracic outlet is simply the area between the ribcage and collarbone, also known as the clavicle. As you can tell from the picture, this area is chock a block full of important things; muscles, arteries, veins, and important neural elements that comprise the brachial plexus, which is a complex of nerves that originate from the spinal cord. The nerves responsible for arm, forearm, and hand movement all arise from the brachial plexus; as you can tell, this is a very busy and crucial piece of anatomical and physiological real estate.

It is also a very small, crowded piece of real estate, which substantiates many of the problems encountered by those who suffer with TOS.

Let’s talk about those symptoms, and some possible causes shall we? Yes, we shall.

Much like our good friend Brandon McCarthy and his hematoma, folks who suffer from TOS do so at the hands of very particular process, seen across many different medical disciplines and disorders.

Smooshing. TOS is a transient smooshing disorder.

McCarthy’s smooshing was a bit more dangerous, since it arose from his brain swelling and smooshing into his cranium, a part of the anatomy without much give, shall we say. TOS is nonetheless a dangerous situation, as the pressure and swelling that arises from the initial injury or insult can cause smooshing, displacement, and compression of a number of critical structures in the already cramped thoracic outlet (the superior thoracic outlet, more specifically).

OK, so we have lots of anatomy, small space, smooshing- let’s dig a little deeper.

There is an initial insult – that’s fancy talk for a cause – that sparks the swelling and compression. Let’s talk about those for a second, kind and gentle readers impromptu medical residents.

You, with the Hello Kitty stethoscope, can you name some causes of TOS?

Nice list – yes, common causes of TOS include trauma arising from a car accident, a specific type of lung tumor called a Pancoast tumor, and any work that creates a repetitive motion and strain on the area, say, like pitching, swimming, or any other sort of over the head motions. Know it all medical residents who raise their hand over and over to answer questions are at risk of suffering from TOS. Not sayin’, just sayin’.

Also, people born with an extra cervical rib can have a predilection towards TOS, as the additional skeletal anatomy provides less of an outlet and square footage for the nerves and vasculature to course through.

We have cause… how about effect?

Symptomatically, TOS arises from what structure the smooshing affects, and can broken down into 3 categories: neurogenic, arterial, and venous. Regardless of the structures involved, pain is the most prominent symptom. From there, we can also see symptoms such as the ones Carpenter complained of, such as numbness and tingling, arising from nerve compression, skin that is discolored and cold to the touch, arising from poor circulation due to compressed arteries and veins, and muscle weakness.

OK, so let’s take these symptoms, and confirm that it truly is TOS – how would we do that?

Aside from your usual suspects, in the form of  imaging – x-rays, CT scan, or even a MRI – we can perform a costoclavicular maneuver, or be on the look out for Adson’s sign before we subject the patient to any undue insurance copays. However, these two methods aren’t very specific or sensitive, so some sort of x-ray, scan or even an electromyography (EMG) exam should be performed to confirm a diagnosis of TOS.

So our hypothetical diagnostic studies are back, and it’s TOS. Young residents, what do we do to treat it?

You, wearing glasses with no lenses with them, whatcha gonna do?

Start with physical therapy, then consider a surgical procedure called a first rib resection/scalenectomy, where a surgeon goes in, removes a rib, the scalene muscles, and any scar tissue that could be the compressive culprit, thereby, opening up the superior thoracic outlet, creating more space, and less smooshing opportunities?

In the immortal words of FP Santangelo – abso-LUTELY!

Let it also be known that cortisone and botox injections are other treatments that are less invasive, but may not completely resolve the underlying issue, but can give the patient a modicum of relief, enough to allow them to pursue physical therapy.

While time will tell whether Carpenter can overcome the nagging effects arising from his thoracic outlet syndrome, the prognosis looks fairly encouraging, as the vast majority of those who elect to get surgery enjoy symptom free lives post-operatively. However, there does exist a small population around 5% – who remain symptomatic after surgery, and require further interventions, be it additional surgery, or other non surgical options.

For those so inclined, you can read more about TOS here and here; it’s a small sample of what’s out there, but hey, Google is your friend.

As for our Cardinal friends, 2013 still looks to be a promising year, even without their pitching and emotional leader toeing the rubber. While it remains to be seen if this is the last of Carpenter’s career, let it be known that this Redbird’s wing is well on the mend.

Chris  Carpenter