Labrum Injury for Pitchers

I have no input on the surgery, but regarding the scholarship- it depends on the program. See what the coach has to say, they may keep everything as-is, especially if he can be ready to go when he gets on campus.

I know a 23' RHP Mid-D1 commit, who tore his ACL in October of his HS Senior year. They kept his scholarship. He missed all of the HS season & summer ball, but got to 100% just before heading off to college. He's there now participating fully in the Fall program. 10.7 months puts your son on a similar timeline.

My son's best friend had that surgery I think in March or April of 2023. Missed the end of his senior year of baseball but pitched for the Pioneer league this summer. I think he's still not feeling like he completely has his command back, but did pretty well overall.

I don't have any advice, but I just wanted to say I'm so sorry this has happened to your son.  Missing senior HS year is heartbreaking, whatever happens after that.

Shoulder injuries are rough, esp for a pitcher.  

If you search this site for "labrum" you'll find lots of threads on the topic. Unfortunately, more sad stories than success stories. I'll pm you some names if you want to try to contact people privately. My son stopped pitching after senior year of high school bc he didn't love pitching enough to put all of his eggs in that basket. He played 1B in college and put up with the pain while throwing.

Have you ruled out stem cell and/or prp? I think the Andrews Institute "Non-surgical Sports Medicine" group performs those procedures.

https://community.hsbaseballwe.../labrum-tear-and-prp

@MidAtlanticDad posted:

If you search this site for "labrum" you'll find lots of threads on the topic. Unfortunately, more sad stories than success stories. I'll pm you some names if you want to try to contact people privately. My son stopped pitching after senior year of high school bc he didn't love pitching enough to put all of his eggs in that basket. He played 1B in college and put up with the pain while throwing.

Have you ruled out stem cell and/or prp? I think the Andrews Institute "Non-surgical Sports Medicine" group performs those procedures.

https://community.hsbaseballwe.../labrum-tear-and-prp

We actually haven't seen the surgeon yet.   The diagnosis was made by a radiologist reading the MRI and a Sports Medicine Physician (non-surgeon).  They both recommended surgery "if he is ever going to pitch again."  We don't have all of the options presented yet.   My son is heart broken about missing his senior, but I believe his biggest worry is that his D1 commitment is going to be dropped, and that he may not ever return to full pitching strength.  It is really weighing on him emotionally.   

@Ster posted:

We actually haven't seen the surgeon yet.   The diagnosis was made by a radiologist reading the MRI and a Sports Medicine Physician (non-surgeon).  They both recommended surgery "if he is ever going to pitch again."  We don't have all of the options presented yet.   My son is heart broken about missing his senior, but I believe his biggest worry is that his D1 commitment is going to be dropped, and that he may not ever return to full pitching strength.  It is really weighing on him emotionally.   

I would definitely get a second opinion. On more than one occasion I've seen the ortho that my kids go to disagree with their own radiologist's report.

I'd also recommend a sports ortho that did their fellowship or trained at some point at ASMI.

Get a second opinion from a shoulder specialist who deals with pitchers.  Preferably an MLB team doctor or ASMI affiliated.  The recovery rate on labrum is very low but if you have a tear you want it to be a SLAP tear. 

My son had a shoulder injury.  First doctor told us it was labrum.  Second doctor said it was clavicle osteolysis and third doctor agreed.  After recovery he injured it again.  First doctor suspected labrum and we took him to an MLB team doctor and it was a torn muscle.  What I learned in this process from talking to doctors is that labrum surgery is greatly overprescribed.

My son's teammate had the surgery fall of senior year.  Was throwing 94 again by spring of Freshman year and playing well. As far as I know he was still on scholarship.  He played 3 years and signed as an UDFA in July.  Another teammate in hs had a slap tear in early May of senior year.  He was still drafted in the second round, but the team chose to do PRP instead of surgery.  I think they sent him to the Dominican for treatment.  He is 4 1/2 years out and had still not recovered to what he was in hs.  We have made a similar mistake in the past of trying to bandaid instead of just fix due to downtime and I would recommend getting a few opinions and then just doing it.  Hopefully the coach will keep him on scholarship, but ultimately that's one of the things you can't control.

@d-mac posted:

Get a second opinion from a shoulder specialist who deals with pitchers.  Preferably an MLB team doctor or ASMI affiliated.  The recovery rate on labrum is very low but if you have a tear you want it to be a SLAP tear.

My son had a shoulder injury.  First doctor told us it was labrum.  Second doctor said it was clavicle osteolysis and third doctor agreed.  After recovery he injured it again.  First doctor suspected labrum and we took him to an MLB team doctor and it was a torn muscle.  What I learned in this process from talking to doctors is that labrum surgery is greatly overprescribed.

Yes, the surgeon that he is scheduled to see has completed fellowship with sports related shoulder injuries and was previously the team physician for the New York Mets.   He only performs shoulder procedures.   I think that his pedigree is good, and will give us competent advice.   He sees this surgeon within the next week.   I feel more confident of his impression than the advice we have received from the radiologist and Sports Medicine physician.   

Actually the sports medicine physician was a little surprised by the MRI results.   He spent 40 minutes examining my son's arm, range of motion, ultrasound, x-rays etc... and could never reproduce the pain.   The only time my son had pain was when he would long toss past 150-200 feet.   He hasn't pitched from a mound in months and had no pain pitching then.   I think that the physician was surprised that the MRI showed a tear when my son hasn't had any significant pain with normal motion and light tossing.   

Some (probably many) will completely disagree with this this, but my son stopped long tossing about a year and a half ago. He didn't have any pain, but he started a new throwing program and he couldn't do long toss and the program at the same time. The results were so good he never went back to long toss. If he's playing IF he will get out to 120-130 while warming up, but most of the time he's pitching and doesn't go past 90. If your son has pain when he gets to the further distances I would just not go to the further distances. Randy Sullivan from the Florida Baseball Armory talks about this often. Some players respond very well to long toss, others don't. Some players do well with weighted balls, some blow out their elbow. In his words, "you need the hardware to match up with the software".

@Ster posted:

Yes, the surgeon that he is scheduled to see has completed fellowship with sports related shoulder injuries and was previously the team physician for the New York Mets.   He only performs shoulder procedures.   I think that his pedigree is good, and will give us competent advice.   He sees this surgeon within the next week.   I feel more confident of his impression than the advice we have received from the radiologist and Sports Medicine physician.   

Actually the sports medicine physician was a little surprised by the MRI results.   He spent 40 minutes examining my son's arm, range of motion, ultrasound, x-rays etc... and could never reproduce the pain.   The only time my son had pain was when he would long toss past 150-200 feet.   He hasn't pitched from a mound in months and had no pain pitching then.   I think that the physician was surprised that the MRI showed a tear when my son hasn't had any significant pain with normal motion and light tossing.   

Speak with the surgeon and make sure you share the second paragraph.  MRIs are not perfect, and range of motion tests are pretty good indicators of what is going on/potential problems to explore.  We worked through a shoulder issue for my son last year.  MRI did not show a tear, but shoulder specialist (MLB team affiliated) said it is often hard to know until you get in there but surgery should be a last case option.  He also shared that a high percentage of professional pitchers (yes, I recognize your son is in HS) have some sort of tear in their shoulder.  It then comes down to strategies to manage the pain.  Rest, PT, altering throwing plan led to improvement for my son and he became pain free.

As to your scholarship question, before committing we specifically asked the head coach what happens if an injury occurs in HS or College.  He said, once you commit we are committed to you and that doesn't change your scholarship.  Sure, they could go back on their word, but I have seen other commits to this school have serious injuries and the program followed through for them (including guidance on care/facilities/specialists/etc.).  I agree with the earlier comment that the coaches want you to be in a spot to perform once you are on campus, so a HS injury is unlikely to change much assuming you are taking steps to get healthy.

Interesting article yesterday from Top Velocity, https://www.topvelocity.net/20...a-torn-rotator-cuff/

Just thought I would give  you guys an update.   First, I appreciate all of your input and advice.   

The MRI demonstrated a SLAP tear 11 o'clock to 1 o'clock.   Both Sports medicine doctors that have performed an evaluation reached the same conclusion.  I also had two other Orthopedic docs I know evaluate his chart and they were also in agreement that surgery is recommended.   The general thought is that if he were simply a high school pitcher wanting to push through to finish his high school baseball career then they would recommend rehab and PT for four or five months and then try to tough it out on the high school mound.   However, with him having opportunities for D1 experience they all suggested have the surgery, spend 11 months rehab and strength training and be ready for Freshman season.   Both physicians that have evaluated my son feel confident that a return to pitching performance is high.

Now, as I mentioned earlier, my son is currently committed to a low, mid-major D1 program.   This past week we had a zoom meeting with the coaching staff and informed them of everything that has happened, onset of pain, limitations, diagnosis, treatment plan etc....   Our fear was that they would inform us that they couldn't risk continuing with his commitment, and were going to pull his offer.   I was comfortable and expecting that to happen and prepared to start looking at other options.   However, the coaching staff had a different perspective.   

They said that nothing changes as far as their commitment to my son joining their program.   They are saddened to hear that my son is going to miss his Senior season of baseball, but they stated that he has had plenty of mound time (didn't need to prove himself to them) and they think that spending a spring and summer with controlled rehab and development would be better than him logging 90 more innings with his high school team on the pitching mound.   They do want their preferred Ortho surgeon to look at the MRI, and want their team trainers to have some input with his rehab process.  Unless their trusted surgeon says that my son will never pitch again, they are going to continue with his scholarship and roster position as planned.   

I can't be more pleased and impressed with the response and feedback that we have received from his school.  It would have been much easier for them to cut my son loose, and use the nearly full scholarship on a transfer portal pitcher, but they believe that my son has real impact potential for their program and understand that injuries are part of the game.   Thank you for all of your concerns and prayers.