Each year in the MLB Draft thousands of MLB hopefuls are evaluated by scouts on measures such as throwing, hitting, fielding, and with all the recent growth in baseball research and development much more. There is one lesser observed item that all teams look at, past and present injury history. Many players are left dumbfounded when they don’t get drafted. What they don’t realize is that their injury history may have played a huge role in that. The mlb orthopedic rating system helps organizations grade players based on their medical history to help them get a better idea of how a player will be able to contribute to their organization in the long term. This is how the medical evaluation process plays out.
The team physician will assign a grade to each potential draft pick with the hope that it can accurately predict the athlete’s longevity in professional baseball. The grades range from 1 to 5, with 1 being no orthopedic injury and 5 indicating “do not draft”. So yes, it is very likely some players are not drafted due to their injury history. The process typically looks like this, the medical staff evaluates a player based on the information they have available, the top 3 orthopedic surgeons on staff will each assign the player a grade from the scale, the 3 numbers are then averaged and passed to management to be included in the decision process when considering potential draft picks. The formal version of this rating system is typically only used by professional organizations but the same thought process is applied throughout the country on other levels.
Here are some examples of how the orthopedic rating system may be used. When asked to rate a prospect who recently underwent a UCL reconstruction 77% of respondents graded the player a moderate risk and if that prospect had pitched for a full year after reconstruction 73% of respondents graded him as a minimal risk. Thus, this player would be graded a lowly 2 on the scale which may not make a significant impact on his draft stock. When asked to evaluate a prospect with a UCL sprain who had not yet returned to pitching 52% of respondents graded them as a high risk. While UCL reconstruction has shown to have a great prognosis both with return to play and level of return to play, This isn’t the case for all common baseball injuries.
Any MRI of the shoulder in a baseball player will, more than likely, reveal some sort of abnormalities. A study done by Miniaci et al revealed that 79% of players with no shoulder symptoms at all, had positive MRI findings. When evaluating a player with a diagnosis of a type 2 SLAP tear (tear of the labrum of the shoulder) 64% of orthopedic surgeons graded them as a high risk. Likewise, when asked to evaluate a player that has undergone a surgical intervention for internal impingement of the shoulder 60% of respondents graded them as a high risk. It’s not hard to see that if an organization is deciding between a player with and without a surgical history of the shoulder, they may side with the later.
Overall, whenever experiencing a little bit of pain make sure you get it checked out by a qualified healthcare professional that regularly studies and deals with baseball athletes and don’t be so quick to run to the MRI machine (because 1. It can and will be used against you 2. It doesn’t always tell the true story). Most issues, if dealt with early enough, can be treated non-operatively and with better outcomes. Don’t be the guy that’s asking his coach or trainer about his elbow pain, do your homework, get healthy, reap the benefits.
If you think this is only possible at the elite levels of professional baseball, think again. This type of research and decision making may be even more in depth in the college levels because of the short amount of time you have at one school. While a professional organization may have unlimited resources to use for their players, NCAA programs typically have limited resources and must make the most of their time and scholarship allotment.