THE BIG HURT: Health scores that don't tell the whole story

BaseballHQ's health scores do a very good job of identifying health risk. Here’s a synopsis of the 2019 results by health grade (based on the 1,205 players identified in the 2019 Straight Draft Guide):

Health Score Breakdown

Grade  % IL Trips  Avg IL Days
=====  ==========  ===========
  A        42%         10.2
  B        71%         14.9
  C        66%         16.1
  D        63%         20.1
  F        81%         25.6

Health scores didn’t perfectly predict the odds of hitting the IL, though if we group them, 47% of players with A or B health scores hit the IL in 2019, while 72% of players with C, D, or F health scores hit the IL. Health scores did predict quite well, however, the average days on the IL. And if we just look at the extreme ends, players with an F health score were almost twice as likely to hit the IL, with average time missed that was 2.5 times as much as players with an A health score.

Health scores are based on the number of IL days a player has had over the past five years. They are simple and effective, but there are some players whose health scores don’t accurately assess their risk. These could be situations where a player was often hurt but didn’t hit the IL, or where they were injured too late in the season to accumulate a lot of IL days. In some cases, the injuries are unlikely to repeat, even though they may have caused a player to miss a lot of time.

Here, we’ll discuss a collection of players whose health scores don’t truly represent their risk levels (with one exception):

Players whose risk is higher than health score suggests

Brandon Kintzler (RHP, MIA, A health) isn’t being drafted all that highly despite being the presumptive closer for the Marlins. His pedestrian skills are the likely reason, but there’s also an extensive injury history to consider. He’s hit the IL in five of the past eight seasons, including a trip in 2019 for pectoral inflammation. Most of the IL trips were short, though he did miss three months in 2015 for knee tendinitis. He’s also 35, an age at which declines can be quick. He’s not an extreme risk, but he’s also not a safe pick.

Jeff McNeil (2B/OF, NYM, A health) broke his wrist the last week of September, an injury that likely would have cost him eight weeks of the regular season. Given that it’s a trauma injury (he was hit by a pitch), it’s not as much of a worry as a soft-tissue injury might have been, but it’s still a factor that needs to be considered. If the broken wrist was factored in, he’d probably be a C health, which does raise his risk some.

Christian Yelich (OF, MIL, A health) fouled a ball off his kneecap in September, an injury that would have cost him several months on the IL had it occurred earlier. That alone would have pushed him to a C health score. However, that was really a freak injury and probably shouldn’t be held against him. The greater concern is that he’s had a series of back issues over the past several seasons. None have kept him out for more than a few games, so there’s no IL record to follow, but they are a concern. It appears that he knows how to manage his health, but as he ages, he may be less able to manage. It’s not a serious concern yet, but you need to consider the risk when drafting him.

Nelson Cruz (DH, MIN) has an A health, but he’s also 39 years old, and his health score doesn’t reflect that anywhere. Now, he’s been remarkably durable and his skills don’t seem to have declined as he’s aged (1.031 OPS in 2019? Seriously?). The risk here isn’t that he suddenly loses the ability to pound the ball—it’s that he sustains an injury and has difficulty recovering due to his age, or that the loss of flexibility or athleticism leads to an injury. We’re not suggesting you avoid him, especially since he’s currently being drafted four rounds beyond his projection, but definitely factor his risk into your roster construction.

Everything we said above applies to Justin Verlander (RHP, HOU) as well. Given the lack of reliable elite starters, you’re probably tempted to ignore the age risk here, but that doesn’t make it go away. Personally, we’re more willing to take a chance that Max Scherzer (RHP, WAS; neck injury, 2019) has corrected his delivery or that Walker Buehler (RHP, LA) can continue his rise to stardom than risk a Top 20 pick on Verlander. He has a B health score, so he’s low risk aside from age; if you do select him, just be aware of the risk.

Note: Verlander had been diagnosed with a mild lat strain in his upper back. We swear we wrote the above passage before that injury was announced. Not to harp too much, but this is the kind of thing an aging pitcher can experience. For now, it's a minor injury with a likely return by May, but these kinds of injuries be slow to heal.

We hate to dump on Chris Sale (LHP, BOS), but his mystery ailment from 2019 is very concerning. He does carry a D health score, but we don’t think that fully captures his risk. We were completely out on him coming into draft season, and his recent diagnosis of a flexor strain has cemented that opinion. We note one NFBC draft where he went in the 16th round. If that happens to you, sure, take the chance. But his overall ADP, even since his current injury was announced, is in the 4th round, and that’s much, much too high.

Players whose risk isn’t as bad as their health score suggests

Julio Urias (LHP, LA) is two years removed from the shoulder surgery that gave him his F health score. He avoided any time on the IL in 2019, and the Dodgers did an admirable job of bringing him back slowly. You can be concerned about his PT with the way the team handles pitchers, but don’t be too concerned about his health grade.

Frankie Montas (RHP, OAK) is being dinged for the 116 days he missed in 2016 for a rib resection. This is not an injury that is likely to recur, and he’s far enough removed from it that any secondary effects would have shown by now. His 80-game PED suspension in 2019 adds to his risk—it’s not the performance effect as much as the possibility of another positive test—but health-wise, he’s very low-risk.

David Price (LHP, LA) had elbow issues in 2017, was healthy in 2018, then had some wrist and elbow issues in 2019. That adds up to an F health. However, the cyst in his wrist was an oddity and not predictive of future health. He also had tendinitis in 2019, but that was minor and could have been an effect of the nerve issues he was facing. His 2017 issues are another concern, though that particular issue has not recurred. The Dodgers are very good at managing injuries and workloads, so there’s hope that Price can meet or exceed his innings projection.

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  For more information about the terms used in this article, see our Glossary Primer.