Miguel Cabrera has been playing during the 2017 season with back and hip issues that have conspired to all but gut a superstar’s offense during the Tigers’ worst year of baseball since 2003.
The decision to play has been Cabrera’s, the Tigers say, even as doctors and a training staff have evaluated and treated him on each game day.
Cabrera on Sunday was diagnosed with two herniated disks in his back. He first hurt his back during the late-winter World Baseball Classic when he represented Venezuela. But he believed the situation was bearable, that it would improve, and that he could function with the kind of ongoing pain and treatment athletes often accept as part of their life, particularly as they advance in age.
Cabrera, who turned 34 in April, has seen a dramatic fall in 2017: a .249 batting average compared with his .317 career average; 16 home runs from an average season of 34 homers; and, most starkly, a .728 OPS when Cabrera’s 15-year mean has been .948.
“We’ve asked him, on numerous occasions, to do more diagnostics,” said Al Avila, the Tigers’ general manager, responding to questions about why it took so long for the discs to be revealed. “He has turned down those overtures. You can’t make a player do something he doesn’t want to do.”
The disk herniations were discovered when Cabrera agreed last week to an early MRI as part of the annual “exit physical” when players’ conditions are evaluated ahead of offseason conditioning and rehab programs. Players also are given a complete physical when they report for spring camp, or if they are injured or disabled during the season.
But they have the right to decline MRIs or more comprehensive in-season exams, just as they have a right to tell superiors they’re able to play and prefer to play, which has been Cabrera’s steady insistence in 2017.
He is, in fact, with the team this week, determined to finish the season, as the Tigers wrap up their 2017 season during a road series against the Twins and Royals.
The Tigers say Cabrera’s decision is not inviting undue risk and is not a matter of an athlete opting for dangerous additional games.
Cabrera was not in the lineup again Tuesday. Manager Brad Ausmus said the club was arranging to get a second opinion on the MRI results from a back specialist.
“If you do MRIs on people of his age group, 40 percent will have bulging disks with no back pain,” said Kevin Rand, the Tigers’ director of medical services and head athletic trainer, who said Cabrera’s spring physical indicated nothing alarming.
“Obviously, during the season he was having issues with his lower back and hip. But he wanted to wait until the end of the season was over to do something more thorough. We took the opportunity (last week) to say, let’s just do them now.”
Rand was adamant that Cabrera’s situation is not career-threatening. He said there was no sense from the Tigers medical team, which includes orthopedic surgeon Stephen Lemos, that Cabrera will require surgery.
“Do I think he’ll recover?” Rand asked. “Absolutely. If we put him on a good program this winter, you’ll see Miguel back to who he was.”
The Tigers have a broad medical team monitoring players and their health: Rand, as well as two assistant medical trainers; a fulltime physical therapist; and a three-person orthopedic team, with either of three doctors – Lemos, Michael Freehill, and Kyle Anderson – on hand for each home game.
“This has not been misdiagnosed,” said Avila, explaining that extensive medical oversight is routine on a big-league level. “They (the public) don’t always understand how it goes on a day-to-day basis.
“But we have our medical staff in there every day, every game. A player comes in and says: I can play. Often, he’ll get a treatment. That’s what trainers are there for: To enable them to perform if they can.”
Avila agreed with Rand that the diagnosis of a herniated disc perhaps sounded worse than medical reality.
“It doesn’t mean you can’t play,” Avila said. “There are a lot of different levels there. It’s not like he blew it out.
“People have played with herniated disks in all sports for years. And they’ve taken treatment for it through the years. Omar Infante (former Tigers second baseman) played with back issues like that his whole career.”
Rand said a player’s view ultimately matters most.
“The fact of the matter is,” he said, “if a player tells you he’s OK and can play, you’re going to listen to him.”
Cabrera’s ability to play with pain is regarded by the Tigers as exceptional and has precedent, both astonishing and sobering.
Following the 2014 season, after he had played the entire year with a painful right ankle, Cabrera had surgery to remove bone spurs. Doctors then discovered he also had been playing with a stress fracture in his right ankle.
A year earlier, he had surgery to repair a sports hernia that all but disabled his lower body as the Tigers saw their postseason crumble during the ALCS series against Boston.
Cabrera nonetheless won his second consecutive American League Most Valuable Player award in 2014 as well as his third batting championship.
“People don’t like guys who complain about aches and pain and can’t play,” Avila said. “Well, Cabrera is the exact opposite.”
Rand said deeper postseason evaluations should make clearer to what extent the back and hip problems are interrelated or separate conditions.
“That’s what we’re trying to determine,” he said. “But we’ll put him on a program designed to work his core, as we did during the season, and sometimes that has proven to be really good.
“We’ve seen a lot of players as they transition through their careers have a year like this. That happens. And they have to adjust conditioning programs.
“Miguel has a lot of pride,” Rand said. “You’ll see that he’ll really attack things this offseason. And I think he’ll fully return.”
Cabrera is under contract with the Tigers through at least 2023. He will be paid, at minimum, $184 million.