BOSTON, MA - MAY 09:  Carson Smith #39 of the Boston Red Sox looks on in the seventh inning during the game against the Oakland Athletics at Fenway Park on May 9, 2016 in Boston, Massachusetts.  (Photo by Adam Glanzman/Getty Images)

BOSTON, MA – MAY 09: Carson Smith #39 of the Boston Red Sox looks on in the seventh inning during the game against the Oakland Athletics at Fenway Park on May 9, 2016 in Boston, Massachusetts. (Photo by Adam Glanzman/Getty Images)

The Red Sox medical staff has continued to hold a cloud of mistrust with fans as the team continues to suffer from injuries and have disagreements with players over diagnosis. That is exacerbated when the team signs players who barely pitch a game in Boston before being injured or pitching as if they were injured. Think all the way back to John Lackey in his first year here. Before his first regular season pitch he was dealing with elbow issues and before long he was facing surgery. He came out the other end much the pitcher the Red Sox expected, but should they have seen it coming?

The Sox are now facing a similar but even quicker scenario with reliever Carson Smith who is out for at least a year to 18 months with Tommy John surgery after only facing 11 batters as a Red Sox pitcher. His elbow was an issue as early as spring training and the team allowed him to go on the DL and hope rest would fix it. He admitted upon returning he was still dealing with some discomfort and after three games he’s been shut down to undergo Tommy John surgery,

Was there any sign he was headed for injury or could the medical staff have predicted this was coming? Some analysis of injuries has shown that pitchers who throw a lot of pitches with high torque on the arm like Curveballs and Sliders lead to elbow problems. Think of Rich Hill who threw 40 percent curves. Smith throws 45 percent sliders and the rest are changeups and sinkers. This might not be the reason he got injured, but it had to be considered a risk.

The next warning sign is his velocity chart. In 2015 Smith pitched his first full MLB season and it showed in his velocity. He started the season averaging 93 mph on his sinker, 89-90 mph on his change and 85 mph on his slider. By the end of the season his sinker had lost 2 mph, his change was down 4 mph and his slider was down a single mile per hour. Perhaps he was just tiring as the season dragged on, but it is a red flag all the same.

He also showed some change in his release point according to Brooks baseball with a more than half an inch movement during August and September on the horizontal plane from where it was earlier in the season. It was back to normal in his final appearance of the season, which means he was either correcting it or trying to pitch through some pain.

Smith is still under Red Sox control for a long time, but losing him so soon is a big blow to their 2016 season and while he could be back pitching very well in 2017 it won’t be until later into the year. That said there were some warning signs that Smith would be an injury risk and with Koji Uehara already an aging option into the back of the pen that Smith was supposed to aid this year it looks like this injury could put the pen into the high risk area. Even with the injury the Red Sox might have made this move since Wade Miley wasn’t going to find a spot to pitch on this team, but would the Red Sox do it know if they knew he would be gone for a full year so soon?