Shoulder Injuries Are Serious Business

Been There Done That

Since 2010 the league’s seen 213 different pitchers placed on the DL in 296 total shoulder related listings. Every year three to five pitchers make two visits or more.  During the same time period 194 different pitchers were placed on the DL in 271 total listings for elbow related issues.

In 2014 a total of 47 pitchers hit the DL for some kind of shoulder injury and four of those made two visits within the year.

Being Young Helps . . . but just a little

Since all pitchers are carrying injured shoulders they get used to an aches and pains along with occasional stiffness and soreness. They are also competitors who want the ball and – being guys – are reluctant to give in to a little pain and hate the idea of going to the team doc.

Rangers’ team physician Dr. Keith Meister says they’ll come when they are in pain but, “. . .one man’s soreness is another man’s pain.”  Players also know that unlike TJ surgery which has a 90+% successful return rate, there is no fix to a shoulder with anywhere near that success rate. Of the 31 pitchers who’ve had shoulder surgery since 2009 11 are active, 9 are out of baseball, 8 are in the minors and 3 have retired.  Some have retired rather than have surgery as well.

Disabled list data compiled from Baseball Heat maps and Pro Sports Transactions.

So worry and/or pessimism about Minor’s shoulder issue is justified but it isn’t all gloom and doom. If a pitcher is astute enough to recognize that what he’s feeling isn’t a normal ache early on, there are things that can be done to pull back from the edge.

Treatment

The first thing is of course pitcher should stop throwing and hitters should stop swinging the bat. Pain is nature’s way tell you to rest.  Resting the shoulder – along with medications that reduce inflammation – helps the it return to something resembling normal . If the inflammation is severe enough, injections can help speed the process up. Continuing to stress the shoulder before it has had enough time to recover will make things worse.

An MRI can give some insight into the level of damage; a contrast MRI provides the best current method of looking for soft tissue damage. Teams will sometimes hesitate to order the contrast MRI because of the extra recovery time needed due to the use of dye. We saw this when Brian McCann’s shoulder was falling apart in 2012.

We’ll just clean it out

Cleaning out a shoulder sounds simple enough but it is a surgery albeit limited access surgery. A clean out doesn’t actually fix anything. Instead they go in and remove floating debris; bits of rotator cuff that have worn off and are now hanging around causing inflammation. They may also scrape bits off the cuff that are about to become floaters – it’s called  debriding.

The body resents anything poking around inside of it even if the intention is good, so recovery isn’t instantaneous.  Before they go in the surgeon explains that if he sees a bone spur or something else that requires repair he’s going to go ahead and do that because even the best MRI can’t see what’s really going on.