On Miguel Cabrera, Torn Biceps, and the Future

By Dr. Ankur Verma

 

Miguel Cabrera. (Keith Allison/Flickr).

In March 2014, Miguel Cabrera signed a professional sports record-setting eight year, $248 million extension with the Detroit Tigers.  Though there were whispers in a few corners about the potentially massive downside of this contract, the Tigers were still baseball royalty at the time and such concerns were somewhat brushed off given the team’s decade-long playoff contention.  However, those whispers grew to outright conversation as we witnessed the steep decline of one of Miggy’s contemporaries, Albert Pujols.

A little more than four years later—and a minimum of $162 million owed to him from 2019-23—the 35-year-old tore his left biceps on what began as a routine swing on a pitch from the Twins’ Jake Odorizzi.

 

 

He takes a pretty big cut at the pitch.  It’s hard to know when exactly in his swing he injured his biceps, but it appears the momentum of his body is at odds with his follow-through.  That should be the only time the word “momentum” is used in sports, by the way.

Cabrera left right after that pitch, had an MRI in-game, and it was announced that he would need season-ending biceps surgery.

When will Miguel Cabrera be back?

A search through ProSportsTransactions reveals a litany of biceps tendonitis injuries, fewer biceps surgeries, and even fewer actual biceps tears.  What’s more, most of the players listed are pitchers.

This makes sense.  There are two types of biceps tears: proximal and distal.

Proximal tears are the vast majority. Over 95% of biceps tears are at the proximal portion, where the tendon originates from the labrum of the shoulder.  As the tendon is associated with rotator cuff stability, it makes sense that pitchers are the greatest constituent of biceps issues.  When this attachment is torn, it is called a SLAP (superior labral anterior posterior) tear.  Players with biceps tendinitis or SLAP lesions usually undergo biceps tenodesis surgery where the biceps tendon is reattached from the shoulder to the humerus.

Most biceps tears are proximal, or near the shoulder. Cabrera’s tear, however, was at the distal end, or closer to the elbow. (CFCF).

There have been studies done on the return to play rate for players undergoing surgery for such lesions.  However, they have been largely inconclusive due to sample size concerns, with far fewer pitchers than positional players returning to play.  A quarter to a half of players, depending on the surgery, return in about a year.

But those are proximal lesions.  It has been reported that Cabrera’s tear is distal.  The mechanism of injury is usually due to a flexed arm being forced into an extension position, resulting in excessive eccentric tension.  If you look at the clip of the at-bat again, it does seem that Cabrera’s arm excessively extends at the tail end of the swing, though it’s hard to say if that’s when the tear actually occurred.

Patients tend to hear a “pop” when such an injury occurs, which is exactly what Tigers third baseman Nicholas Castellanos reported that Cabrera felt “on that swing”.

Full recovery, including rehab, after distal biceps surgery usually takes 3-4 months.  If that’s the case, it is clear why Cabrera has been declared out for the season and why we can expect him back in time for Spring Training in 2019.

What’s the track record for distal biceps tears?

Good question.  Like I mentioned, distal biceps injuries are rare.  As such, there is little precedent from which to draw from.

A search using ProSportsTransactions reveals biceps tears to position players such as Cameron Maybin and Chris Heisey.  It appears there are a few players missing in this search as it is known that Mo Vaughn and Michael Brantley also had biceps tears, as well.  Maybin’s and Brantley’s tears were of the proximal biceps, so we will not talk about them in this post.  Heisey tore his distal biceps tendon last year and treated it non-operatively.  Perhaps this isn’t a promising sign, but he has yet to play in the majors since the injury (he signed a deal with the Twins this past off-season, but couldn’t make it out of Spring Training after batting sub-.200).

We’ll turn our attention, then, to Vaughn.  This perfectly suits our purposes since, out of the above players, he is the closest match to Cabrera.  While Miggy has three inches and twenty pounds on Vaughn, they’re both first-baseman and, while very few match Cabrera’s offensive profile, Vaughn had a career OPS+ of 132 (including a six-year stretch of having an OPS+ between 139 and 153).  Cabrera’s career OPS+ is 151 thus far; out of the other players besides Vaughn, the closest career OPS+ is 114.

In addition, Vaughn ruptured his distal biceps prior to the 2001 season and it cost him the whole campaign.  At the time, he was 33-years-old, which gives him another similarity to the Tigers first-baseman.

Vaughn lasted for just two seasons after his biceps tear, retiring after 2003 because of arthritic knees.  However, much of Vaughn’s offensive game is predicated on power, which is not unlike Cabrera.  In addition, it’s worth noting that Vaughn’s injury was to his left biceps.  While this is the same as Cabrera, Vaughn was left-handed, meaning this was the top hand on his bat.  The top hand is generally considered the “power” hand of the swing.  How did Vaughn’s power numbers look before and after his injury?

Mo Vaughn Pre- and Post-Biceps Tear

 1991-200020022003
wOBA0.3920.3500.291
ISO0.2350.1970.139
wOBA- Weighted On-base Average
ISO- Isolated Power

 

Yeesh.  Looks like he fell off a cliff after the surgery, doesn’t it?

Well, not so fast.  Let’s take a look at the individual seasons leading up to the tear.

Mo Vaughn Individual Seasons

 19981999200020022003
wOBA.421.370.368.350.291
ISO.255.227.226.197.139
wOBA- Weighted On-base Average
ISO- Isolated Power

 

Vaughn had been declining for the three seasons leading up to the tear.  So it’s likely his drop in productivity after the surgery is likely age-related, especially since he was roughly the same player on his return as the season before.  He was also hampered by the aforementioned knee issues, which eventually led to his retirement.

With that said, how has Cabrera’s trend looked over the three seasons leading up to the injury?

Miguel Cabrera's Power Last 3 seasons

 2015201620172018 (until injury)
wOBA.413.399.313.360
ISO.196.247.149.149
wOBA- Weighted On-base Average
ISO- Isolated Power

 

On first glance it appears that Cabrera was suffering a decline before experiencing a bit of a bounce back this year.  However, as Fangraphs so elegantly pointed out, even though he has been hitting the ball harder, his launch angle continues to dip (it was almost half as much this year as the last three years).  So he’s not elevating the ball.  This is also reflected in his grounball percentage of 54.6%, which is the first time in his career he was over 50%.  And this was before the biceps tear.  Cabrera has been struggling with back and hamstrings injuries all year, and it appears that age and injuries have sapped his power and are finally transforming him into something more ordinary.

To be fair, we are also looking at Cabrera’s age-35 season.  Vaughn was done after his age-35 season, while Cabrera was still reasonably productive.  With that said, the Tigers are still saddled with over $30 million a year for the next five years.

He is showing age-related and injury-related (the two often go hand-in-hand) decline.

While there is some optimism because Vaughn essentially showed no year-to-year drop-off after his biceps surgery, if we likewise get the 2018 version of Cabrera in 2019, he is assuredly not worth his salary.  Such is the tariff for Mike Illitch’s extravagant spending to keep him as the face of the franchise when things were going well.  But perhaps more importantly for the rest of us, we will likely be witnesses to a once fearsome slugger trying desperately—but failing—to recapture the early days.

 

Thanks to baseball-reference and Fangraphs for statistics.  Thanks to Brukner and Khan’s Clinical Sports Medicine and Orthobullets for information.