Atlanta Braves reliever Jose Ramirez injury unanswered questions
By Fred Owens
If he’s hurt why was he pitching?
I’ve written about the complexity of shoulder injuries several times; it can be a career ending issue if it requires surgery. While the first TJ surgery produces about a 93% success rate, shoulder surgeries – aside from debridements (cleaning out miscellaneous flotsam) – produce success rates in the 30-40 percent range.
Tightness in the shoulder generally relates to the posterior-inferior GH joint capsule.
"The tightness of the posterior capsule and the muscle tendon unit . . .(limits) internal joint rotation. . .leads to . . .internal rotation deficit. . .) may compromise the . . . ligament (IGHL), and increase the risk for impingement symptoms during throwing . ."
According to a study led by Dr. Jobe, tightness causes malpositioning and can lead to impingement. In simple terms the shoulder hurts so the thrower moves the arm to a position where it doesn’t hurt. The rotator cuff gets squeezed between skeletal parts of the joint and rotator cuff damage may occur.
This 2017 video narrated by Dr Nabil. Ebraheim explains the details.
It would seem that the prudent thing to do when a pitcher says his shoulder feels tight, would be to send him to the DL before it becomes serious.
Who if anyone made a mistake
As Ramirez tells it he did the right things, reported the problem and implicitly did what was asked. Yet he remained active and made seven appearances in the first 19 days of the season.
Pitching through shoulder pain (not soreness, pain) is serious enough to warrant asking if Brian Snitker and company knew and if so, why he was pitching?
I can’t imagine the medical staff or Brian Snitker ignoring a player’s assertion that his shoulder wasn’t right. I can however understand why a journeyman reliever who sees other relievers come and go (Josh Ravin for Miguel Socolovich today)would hesitate to be completely forthright.