Buzzing on Yahoo Sports:

Red Sox's use of Toradol could put ex-trainer at odds with state law, industry guidelines

Jeff Passan
Yahoo Sports

A former Boston Red Sox athletic trainer regularly injected players with the powerful and controversial painkiller Toradol for six seasons, former Sox pitcher Curt Schilling and two other sources who independently witnessed the injections told Yahoo! Sports, possibly flouting state laws intended to prohibit trainers from administering such treatments.

Mike Reinold, an athletic trainer and physical therapist for the Red Sox who was fired after last season, used Toradol to treat players, mostly Boston's pitchers, Schilling and three other sources said. Toradol is a legal substance and isn't banned by Major League Baseball. The Massachusetts board of Allied Health Professionals, which regulates trainers in the state, has disciplined multiple trainers in recent years for injecting patients, regardless of the drug administered.

View gallery

.

Former Red Sox trainer Mike Reinold, left, was fired by the team after last season. (Getty Images)

"It is the board's position that athletic trainers are prohibited from using injectables," said Amie Breton, director of communications for the Massachusetts' Office of Consumer Affairs and Business Regulations.

Witnesses and the findings of a 2012 MLB investigation into Reinold concur that the 35-year-old injected players at home and road stadiums from 2006-11. MLB sent a league-wide memo March 8, 2012, strictly prohibiting trainers from injecting Toradol. While MLB's investigation focused on Reinold, sources said he was far from the only trainer administering Toradol.

"I had a Toradol shot almost every single game for the last 10 years of my career," Schilling told Yahoo! Sports. "It was never administered by a doctor at home or on the road. I didn't think it was wrong."

Though Schilling said Reinold never injected him with Toradol – he declined to say who did – the right-hander said he saw Reinold inject other players.

"Absolutely he did," Schilling said.

[Related: Red Sox reviewing Toradol policy]

Two other sources described the same scene as Schilling: Reinold and a player stashed away in a secluded area, away from the trainers' room, with Reinold jabbing a needle into a player's buttocks before a game.

Toradol is a stronger cousin of Advil and Aleve in the nonsteroidal anti-inflammatory drug (NSAID) family. Its popularity dates back longer than a decade despite doctors believing it can damage organs, and pitchers across baseball often use it both to dull arm pain before outings and prevent it during them.

More than 300 Toradol shots over his career taught Schilling their vitality. He said he experimented with different times of injection before settling on the optimal one: 5:25 p.m., exactly 100 minutes before a 7:05 start. Even though it's neither considered nor classified as a performance-enhancing drug, its ability to help pitchers perform isn't in doubt. Schilling remembers one particular game, a 2002 Sunday getaway day in Milwaukee with the Arizona Diamondbacks.

"I slept on a pillow wrong," he said. "I woke up at 5:30 [a.m.]. I couldn't move my head. I went to the ballpark at 6:30 for a 1:30 [p.m.] game. Worked for four hours on it. I literally couldn't move my head. I went to the bullpen and started throwing and I didn't think there was any way I could pitch.

"Then the Toradol kicked in. I threw a one-hitter and struck out 17."

Officials in Massachusetts have yet to launch an investigation into Reinold. The board would do so upon the filing of a formal complaint, Breton said.

People familiar with Reinold's practices told league investigators he injected players dating back to 2006, according to two sources who requested anonymity because they were not at liberty to talk publicly about the contents of the investigation.

In a statement to Yahoo! Sports, Reinold declined to address whether he injected players, citing "patient confidentiality and HIPAA requirements." He continued: "Every medical treatment I provided was under the direction, authority and knowledge of a team physician and appropriately documented. Any suggestion to the contrary would be false."

View gallery

.

Former Sox pitcher Curt Schilling said he often used Toradol in the last 10 years of his career. (AP)

During MLB's investigation, a number of people interviewed said Thomas Gill, the team's medical director, had not given Reinold such orders. Others interviewed backed Reinold's story. Three trainers who have worked with Gill in MLB, the NFL and the NHL told Yahoo! Sports he never instructed them to perform any types of injections. When reached by phone, Gill declined comment.

The league's investigation ended in August with little fallout beyond the written prohibition of trainers injecting Toradol. Investigators concluded Reinold had injected players during his tenure with Boston, sources familiar with the investigation said, but the conflicting stories about responsibility and in-fighting among the team's medical staff prompted the league to close the investigation without discipline.

"At the conclusion of an investigation and against the backdrop of the new industry directive, we reached a set of specific understandings with the Red Sox about how they would operate going forward," Rob Manfred, MLB's executive VP of economics and league affairs, told Yahoo! Sports.

[Also: Full speed ahead for Josh Hamilton, new-look Angels]

Following the 2011 season, when the Red Sox considered changes to their medical staff after a September collapse, at least one team employee informed owners Larry Lucchino and John Henry, along with general manager Ben Cherington, that Reinold had injected players at home and on the road and may have broken laws in doing so.

The Red Sox moved Reinold from head trainer to lead physical therapist between the 2011 and '12 seasons amid an overhaul of the staff that included the elimination of Gill's position and the firing of assistant trainer Greg Barajas, physical therapist Scott Waugh and strength-and-conditioning coach Dave Page. Though Reinold was not retained after last season, Cherington said the team is still in discussions with him about a consulting role.

"Every team in baseball is trying to put together the best medical staff we can," Cherington said. "Every year we review that like we do our scouting staff and player development staff and every part of our operation. That's what we're all trying to do. If there are practices going on that we come to see as inadvisable, we stop those. In this particular case, this is not a question of someone using an illegal substance. It's a question of how it was administered. And we made a change. We have at all times complied with MLB's directives on the use of Toradol.

"Mike is a talented physical therapist who worked very hard for the Red Sox for a number of years and was part of teams that had a lot of success. He's got an expertise in the area of pitching and care of pitching, and there's no doubt he'll continue to work with Major League Baseball players and players of all ages for years to come."

Lucchino and Henry declined comment through a Red Sox spokesman. Barajas and Waugh declined comment when reached by Yahoo! Sports. Page did not return multiple phone messages.

Massachusetts athletic trainers' rules and regulations are broad and don't address injections specifically. The closest thing to a hard-and-fast statute is Rule 4.02(2), which reads: "The athletic trainer, except in life-threatening emergencies and when no physician or dentist is available, advises an athlete that he is not a physician or dentist and that an athletic trainer renders athletic training services only under the direction of physician or dentist."

As defined by the state, "athletic training services" include "appropriate preventative and supportive devices, temporary splinting and bracing, physical modalities of heat, cold, massage, water, electric stimulation, sound, exercise and exercise equipment under the discretion of a physician."

[Also: Terry Francona had front-row seat to Michael Jordan's baseball experiment]

Whether Reinold's actions were simply unethical or more could determine the future of his state licensure and national certification by the Board of Certification of athletic trainers. One possible gray area of the law exists if Reinold can prove he was acting under physician's orders when administering these injections – particularly under Massachusetts state law 243 CMR 2.07(4) that says of doctors: "A full licensee may permit a skilled professional or non-professional assistant to perform services in a manner consistent with accepted medical standards and appropriate to the assistant's skill."

When asked whether he holds credentials allowing him to inject, Reinold declined comment. He is licensed as a certified athletic trainer and physical therapist through Dec. 7, according to Massachusetts state records, and the standard curricula for both do not include injections.

"I don't think we're allowed to administer any injections as an athletic trainer," said Dr. Deb Swanton, chair of the athletic training program at Endicott College in Beverly, Mass. "We might be able to do it in an emergency situation if someone is having an allergic reaction. We don't teach that to our students. It's not under our purview as practicing clinicians. I don't think that's a gray area. And I don't think a doctor would order that."

View gallery

.

Josh Beckett is among the players said to have used Toradol while with the Red Sox. (Getty Images)

Reinold's rise in the Red Sox organization was facilitated by former Red Sox GM Theo Epstein, who hired him as an assistant athletic trainer before the 2006 season. Reinold, who received a doctorate in physical therapy, also studied at the American Sports Medicine Institute, the renowned medical facility, research lab and think tank run by Dr. James Andrews. Peers regard Reinold as an expert on biomechanics and the academic side of training.

Reinold ingratiated himself with some players, particularly younger pitchers. Following the 2009 season, the Red Sox let go of head trainer Paul Lessard, a 12-year veteran who immediately joined the Cincinnati Reds, and then promoted Reinold. Over the next two seasons, his relationship with a number of veteran players worsened to the point they refused treatment from Reinold, three sources said, and the quality of Red Sox's conditioning came into question following the 2011 implosion.

By then, Red Sox pitchers were taking Toradol shots before a majority of starts, two sources said. Jon Lester admitted to reporters Monday that he frequently used it, as did starter Josh Beckett. Phillies closer Jonathan Papelbon told ESPNBoston.com he used it for years with the Red Sox.

The risks are abundant, according to doctors. Toradol use can cause excessive internal bleeding as well as damage to the kidneys and liver, and by allowing a trainer to inject players, the Red Sox may have opened themselves up to potential litigation in the future.

"I imagine there would be some culpability for the ballclub," said Leamor Kahanov, the chair of Indiana State's Department of Applied Medicine and Rehabilitation and an athletic trainer who helped write a paper on proper protocols for trainers dispensing medication. "If they didn't let go of [Reinold] for that kind of breach, it surprises me and it's unfortunate."

Red Sox pitcher Clay Buchholz was hospitalized last season with bleeding in his esophagus, an injury he told reporters might be due to his Toradol usage. Armond Armstead, a former USC football player, alleged in a lawsuit against the school that Toradol led to his heart attack. Former NFL players filed a class-action suit against the league alleging Toradol use left them more prone to concussions.

[Also: Emotional Felix Hernandez receives King's welcome from Mariners staffers]

Still, enough athletes consider the side effects worth risking that baseball faces a sport-wide conundrum: Teams, according to two sources, have issued league-wide emails saying their physicians will not inject Toradol to visiting players, which puts the onus – and pressure – on trainers to placate those who insist on a shot. Some teams use only the oral version of Toradol, which also comes in pill form. Other teams refuse to prescribe Toradol for players. A number of teams have retained physicians in each road city to serve as a proxy, though three trainers told Yahoo! Sports that players, unaware of legal or ethical consequences, still put immense pressure on trainers to provide medication.

One longtime trainer, whose colleague lost his job because he injected a player, outlined multiple scenarios in which trainers feel pressure to administer drugs. Because team physicians are not full-time employees, they often show up to stadiums too late for Toradol's analgesic properties to kick in before a start. Throughout the sport, doctors, trainers and executives wonder why with payrolls creeping past $200 million not one team has hired a physician in a full-time role, the sort of move that, while costly, could mitigate such conflicts.

The Red Sox continue to review their Toradol policy, Cherington said, noting that only doctors provided injections during the 2012 season.

"We'll come to a conclusion on that during spring training," he said. "I don't think banning it would be the appropriate measure. This is a legal substance a physician has the right to prescribe."

The league's 2012 investigation wasn't its first into Reinold. In 2008, as he was rehabbing an injury that would end his career, Schilling said Reinold suggested he consider taking performance-enhancing drugs to recover. Schilling told manager Terry Francona and Epstein, who reported the story to MLB.

Though officials have tried to discredit Schilling's story since he first told it last week, Schilling maintains he has no reason to fabricate the incident. Schilling said he didn't tell investigators the entire truth because Beckett and others liked Reinold and, as a player on his way out of the game, he did not want to upset the clubhouse.

[Baseball 2013 from Yahoo! Fantasy Sports: Join a league today!]

League officials including Dan Mullin, head of the league's Department of Investigations, and Dan Halem, MLB's general counsel, interviewed Schilling with union leader Michael Weiner present. During the interview, Schilling recanted his story and said he had taken Reinold's suggestion that he use performance-enhancing drugs out of context.

"I gave Reinold a free pass," Schilling said. "I didn't want to disrupt them trying to win a championship."

Fantasy baseball video from Yahoo! Sports:

Other popular content on Yahoo! Sports:
Memorable encounters with Michael Jordan that helped build his legend
Olympic 'Blade Runner' Oscar Pistorius charged with murder
How much stock should you put in reports of RG3's return?

Sign up for Yahoo Fantasy Basketball
View Comments (1043)