I'm sorry if this post runs long, but we have learned a lot by going through this process twice, and, it would be terrific if our experience could somehow benefit another parent's child.
We have two sons (Pitcher and Catcher) who have had surgery with Dr. Andrews in Alabama. Pitcher is a first year college pitcher - had his surgery last June. Catcher is a high school sophomore - had surgery in October. We consulted great doctors here, in the DC metro area, before seeing Dr. Andrews and saw Dr. Andrews at the request of Pitcher's pitching coach (an ex pro player).
Both sons had MRI W/Wout contrast (arthorogram?) Results were not specific.
-With Pitcher - Dr. Andrews gave him the option of physical therapy to see if it would relieve the pain. He opted for the surgery (anxious to be rehabbed in time for College spring season) Surgery showed Labrum peeled away - needed an anchor. Pitcher is now pain free throwing at 80% It was a very emotional experience (found out he need surgery the week of graduation and was really looking forward to playing in college).
Proudpapa is right, it is not cancer or any other life threatening disease, but it still hurt to see our son's dreams potentially go up in smoke. The first thing that we told ourselves, and him, was that this was a challenge that he could either try to come back from (potentially stronger) or could allow it to take his dreams away without a fight. He chose to fight. We also reminded ourselves and him that, although it felt life shattering, it was NOT life threatening and it helped to put baseball in perspective (we have a friend whose son was diagnosed three days before his high school graduation with a usually fatal bone cancer).
Pitcher worked, worked , worked at physical therapy, followed the protocol to a "T", without pushing (although he was antsy and would liked to have cheated it, at least a little bit). He thinks that he should be able to play this season and will sit down with the coach to discuss whether he should play or red shirt. Pitcher feels stronger than he did before the surgery. He had lost some velocity when he was in pain and had lost a little bit of control (pain can be the cause of change in mechanics, muscle strength, not to mention the psychological effects on the head of a pitcher (or any player, for that matter).
Catcher has had shoulder problems since he was 10 (overuse issues). The doctors here, after YEARS of physical therapy, at different times (which he was religious about doing), upon the last exam, said there was extensive damage, needed to do surgery, did not even want an MRI. We insisted on the MRI. When the report came back, the Dr. called and said that the damage was not as extensive as he thought and that it would only take minor surgery.
When Catcher saw Dr. Andrews, Dr. Andrews said that he doesn't like to do surgery on players that young (15). Based on the non specific MRI findings, and one exam, not knowing what the arm looked like through the whole process, if Catcher were Dr. Andrews son, he would have him do another course of physical therapy and come back in several months. Dr. Andrews left the room to let us discuss it.
Catcher said that the arm really felt different this time, that he had been doing physical therapy as directed, shut down when directed, for as long as directed, and that if there really was something wrong with his shoulder, he would rather have it fixed earlier, rather than later so he could possibly play his HS season and be ready to start showcases the summer before his junior year. These were CATCHER"S thoughts, not mine. I was very conflicted. I knew that he was in genuine pain, had been following drs orders, but I trusted Dr. Andrews and did not want to see my son go under the knife, if not necessary.
When Dr Andrews came back into the room, CATCHER asked Dr. Andrews if he could start the surgery, but, if he went in and found nothing wrong, could he close him back up? (Yes) Would the exploratory surgery cause damage if there was no pre-existing cause for surgery? (Some, but not much) Would the physical therapy that he would have to do after exploratory surgery be any longer or different than the physical therapy Dr. Andrews would recommend with no surgery? (Same)
CATCHER told Dr. Andrews that he thought that there was really something wrong and different about his shoulder and that he would like to do the exploratory surgery. Dr. Andrews said that Catcher knew his body better than Dr. Andrews did and scheduled the surgery.
When Dr. Andrew went in, he found the labrum was frayed, the rotator cuff was frayed, and the fraying was starting to impinge the movement of the joint. He cleaned it up (shaved off the frayed part). Catcher has been doing physical therapy. While his recovery has not been as critical as Pitcher's (with an anchor or sutures, they want to make sure that they have had a chance to attach properly before they return to any kind of activity), we are not sure if he will be able to play ball this spring.
Catcher has been in chronic pain since he was 10. He is a little bit afraid that the surgery won't make a difference. He is not sure that he wants to play any more. We have encouraged him to complete his rehab and see how he feels then. Don't know whether this is just an indication that he is tired of baseball, or just tired of being in pain.
Some of the things that we have learned:
-MRI's often do not give a clear and accurate reading of the condition. Often, it is not until the surgeon gets in to the shoulder, that he knows what is going on. (I would be wary of a surgeon who spoke in terms of absolutes - either positives or negatives.)
-Different EXCELLENT Drs can disagree on how to proceed.
-Your son knows his own body better than any one else - even you.
-Go to a surgeon who works on baseball shoulders (or at least athlete's shoulders). The Dr. here wanted to tighten up Pitcher's capsul (I think). I was told by the pitching coach and by Dr. Andrews that they would do as little as possible to the shoulder to get him back to playing health. He was probably born with some laxity in the capsul and shoulder and that was probably what helped him to have a "live" arm. Although tightening things up on the average person would probably be the right thing to do, doing more than necessary on an athlete can limit range of motion and cause more scar tissue than necessary.
-If you don't do the surgery, the arm will not fall off. Pitcher and catcher were both told that they could continue to play. Granted, neither if them were very effective as they were, and both were worried about causing more damage. You probably wouldn't do more harm by doing further rehab, you just won't advance the ball if there is a labral tear that is affecting the motion.
-I think Dr. Andrew walks on water. He really understands the athlete's mindset. He is honest and frank, but very positive. He in no way ever pushed for surgery with either son. His staff and the hospital have the procedures down to a science. Sons were treated on same day a major league players (Pujoles, Sanchez, and others) and NFL players and WWF star (Cena), and treated with same attention and respect that they received. His office scheduled an appointment faster than I could get from a local doctor!
-Follow up rehab with a good physical therapist is critical, as is following the protocol for return to activity. You can have the best surgeon in the world, but if the work isn't put into proper rehab, you probably shouldn't bother going through the surgery.
-There is no "one size fits all" solution. Don't rush into anything and take time to figure out what feels right for your situation.
Proudpapa - congrats to you and your son. It sounds as if he is going through this with a great deal of tenacity and character. Good luck to him. Our Pitcher is at a great academic DIII with great baseball. The coaches have not only been great, they have been protective. He probably was never meant to play DI, but he did have some DI interest. I can't help but think that if he had gone DI, there was a good chance that he would have felt pressure (even if only self imposed) to produce as a first year.
Best wishes to all the players out there suffering from injury. Work hard, try not to be discouraged, and try to keep things in perspective.