Labrum injury – bad timing

Wow, you're right...awful timing.  Not much you can do other than get it checked out and see what they say.  It's obviously not working for him as it is so "playing thru it" to get thru the showcase/tourneys/etc this summer is not a likely scenario....and the potential for doing more damage if you don't know what the problem is is also there.  There's no easy answer....I guess if it's me, I'd get it looked at as soon as possible and if needbe, adjust the summer accordingly.  If he's been talking to coaches once you know the diagnosis just be upfront with them and keep them updated.  Good luck!

I wouldn't worry about missing anything!  I would worry about getting him healthy.  If he gets healthy, he'll have plenty of time to show off.  Fall of Sr. Year is a great time.  If he gets right by Fall, he can go to the Arizona Fall Classic which is a great event for kids to be recruited from.

Ryan got hurt 1st of June, after Jr. year.  (Meniscus)  Since they operated and repaired the Meniscus, he missed the entire summer.  He played football in the Fall, so he didn't showcase, and this put him in a bad place.  Ultimately though, he went JC, and now he is a starter at the D-1 level.  

The key is to be safe and get healthy.  It will work out.

Thanks Buckeye and Ryno. You guys are always on it!

Yes, my sons both went through similar issues their rising Senior summers. 

IMHO, get the MRI done. And get to an ortho doc who truly understands throwing athletes. I’d go to the Andrews Institute in Pensacola. 

Once that is done, you’ll understand appropriate next steps. 

As far as recruiting a 2019 player at his stage in the recruiting timeline and projected level of college play/interest, I would skip the tournament play.  If he is able to perform this summer, college recruiting for him will solely be about getting seen by the coaches and admissions reps from the colleges on his vetted list of schools.  Tournament play, in my experience, won’t help that. Showcases that his colleges attend and campus visits/interviews are more important. 

Good luck!

Always get an MRI, dont listen to the docs and the initial assessment, especially when this isnt about a HS player who is done playing. I cant tell you how many times i hear mis-diagnoses before MRIs.

I hope he is not hurt and gets back to 100% in no time...keep us in the loop on the MRI results and update on his rehab.

Shoveit4Ks posted:

Always get an MRI, dont listen to the docs and the initial assessment, especially when this isnt about a HS player who is done playing. I cant tell you how many times i hear mis-diagnoses before MRIs.

I hope he is not hurt and gets back to 100% in no time...keep us in the loop on the MRI results and update on his rehab.

+1

Shoveit4Ks posted:

Always get an MRI, dont listen to the docs and the initial assessment, especially when this isnt about a HS player who is done playing. I cant tell you how many times i hear mis-diagnoses before MRIs.

Thanks Shoveit! So how does this work exactly - arrange for an MRI on our own and get a doc to read it or insist with your existing specialist that an MRI is performed?

Some insurance companies these days have protocols ( in your sons case xrays and meds) so Just tell the doctor you want him to have an MRI. End of discussion on that one as his protocol didn't work. If there is nothing serious, hopefully, he can prescribe therapy.

In our experience if you show up back in the office saying we did the treatment you prescribed but it still hurts,  you'll get the MRI.  But if you gotta pay you gotta pay.

I'm curious - did your son continue to play after warming up hurt, or did he stop?

Also, does he do band work?  People who know more than me recommend band work for throwing athletes, not just pitchers, especially if they have had a hint of shoulder trouble.  They also recommend staying away from certain lifts.  It may be helpful to see a PT who can help your son with workout routines  that don't stress his shoulder.

JCG posted:

In our experience if you show up back in the office saying we did the treatment you prescribed but it still hurts,  you'll get the MRI.  But if you gotta pay you gotta pay.

I'm curious - did your son continue to play after warming up hurt, or did he stop?

Also, does he do band work?  People who know more than me recommend band work for throwing athletes, not just pitchers, especially if they have had a hint of shoulder trouble.  They also recommend staying away from certain lifts.  It may be helpful to see a PT who can help your son with workout routines  that don't stress his shoulder.

Thanks for the response JCG.

I don't think the MRI will be a problem. We've got several avenues for that as Mrs. Tequila works in the medical field and has a lot of contacts. I just didn't really know the sequence of events i.e. can you just "carry" an MRI to a specialist and tell them this is what we've got.

He stopped throwing after warm-up with the exception of playing catcher in a benefit slow-pitch softball game later in the afternoon where he was basically just lobbing or under-handing the ball back to the pitcher.

He's not been doing band work but that is on the agenda and he's got a personal trainer that will be putting together a warm-up program for him to incorporate this. He also has a regular lifting regimen but nothing overhead to date. I've got a lot of faith in his trainer as he has a very good reputation locally, has been in the business a long time, and is a former division 2 catcher.

Sounds like you have great resources. Just to clarify by PT  I meant physical therapist.  Nothing wrong with a good trainer, esp former athlete, but their training isn't the same.

Oh absolutely agree on the PT thing. If that's the case, I know we'd rather get that going sooner than later. Thanks again!

Unless I missed it his expected level to be recruited hasn't been mentioned. Since it’s leading into senior year I'm guessing anywhere from mid major to top D3. There are multiple avenues to make baseball work out. All it takes is a kid who wants it badly enough. Due to timing what could be lost is using baseball to get into a college he may otherwise not been accepted. My son had two injuries post junior year. He was out from Saturday afternoon of the first travel tournament through two weeks before senior season. It worked out for him academically and athletically. Good luck.

Don't feel alone.  It happens to far more than you think.  It is never a good time for an injury, always costs something but eventually happens to all who stay in it for any length of time (usually more than one) and play hard enough.  

Whatever the diagnosis, use resources to see the right type of medical help in a timely manner, follow any PT to a tee and do not rush him back until healthy enough.  

My son was in a similar situation (2016). Pain in shoulder after summer of sophomore year. Getting a lot of interest from college coaches (calling HS coach and inquiring) after couple of showcases. Ends up missing entire junior year of HS baseball. Even though he was not 100% he did a couple of showcases in summer before senior year. He hit well enough to get some attention and was contacted late summer by D3 college coach that would have been a great fit but did not get through admissions. He had another coach from an academic D3 call him after the HS season but son had already committed to one of his dream schools for the academics. D3's will recruit late into the his senior year of HS so there is still time. He needs to get healthy! My sons arm was never the same but good enough to be recruited.   

RJM posted:

Unless i missed it his expected level to be recruited hasn't been mentioned. Since it’s leading into senior year I'm guessing anywhere from mid major to top D3. There are multiple avenues to make baseball work out. All it takes is a kid who wants it badly enough. Due to timing what could be lost is using baseball to get into a college he may otherwise not been accepted. My son had two injuries post junior year. He was out from Saturday afternoon of the first travel tournament through two weeks before senior season. It worked out for him academically and athletically. Good luck.

 

I sort of tacked on towards the end of my OP that my son is targeting–and has had some interest from–higher academic D2 and D3 schools, though no offers have come his way. Thanks for the input and luck!

This happened to my son a couple of weeks ago. Pain was on back shoulder. I brought him for a sports massage on his shoulder and visit to chiropractor. They both worked extensively on area & showed him pre / post stretching techniques. Worked out for him .

Everything will be okay. Worst case scenario he misses out on some recruiting over the summer and has to work twice as hard to be seen when he is healthy.

i know the school I ended up committing to in high school hadn’t seen me until winter of my senior year. Large mid major school. Ended up not working out and signed with a junior college over the summer.  Spots are always open somewhere. I would definitely recommend the juco route if playing d1 is the ultimate goal.

im in a similar situation right now. Draft interest , tommy john after my junior year at d1. Come back for senior season, more scouts come and watch, end up with a concussion and knee injury limiting me to only hitting and jogging the bases. Hit a 390 foot single off the wall Thursday...

Good news is, I had a good friend go in for labrum surgery, turns out the labrum was in tact and his pain was alleviated by cleaning out the surrounding area and only a month of recovery.

best of wishes

I guess y'all are A-OK with people showing up at your office making demands too, huh? 

Looks like you have great answers above. I can tell you from personal experience that the MRI should be first as we were part of a misdiagnosis.

tequila, my son tore his PCL at the end of his high school baseball season during his junior year. At the time it seemed like the end of the world. In retrospect, everything worked out great. His situation changed from being a "borderline" D1 recruit, to a sought after D3 recruit.

Assuming that your son will be rehabbing for a while, be sure to ask the ortho about hitting. If he's cleared to DH, he can still show his athleticism this summer at tournaments.

Does your son play a fall sport? If not, the fall is huge for D3 recruiting.

Health insurance companies have a variety of protocols for this type of injury. Find out about yours asap. They may require a certain number of PT sessions before authorizing an MRI.

Start with the best sports/baseball ortho in your area. They write the script for the MRI. Request a MRI disk regardless of where it's performed. You may want to take it somewhere else for another reading later. In my experience, radiologists and orthos usually read them differently.

I would not agree to a shoulder surgery without getting at least one other expert opinion. In your case, you could  probably drive to Andrews Institute in Gulf Breeze FL.

IMO, you would be making a mistake to allow him to rush himself back into competition just to be seen by a school or just to compete this summer. The timing is unfortunate, but with HA D3s the summer is not as critical as many other categories. Young bodies have an amazing ability to heal, but they do need the proper amount of time off.

Best of luck to your son.

Thanks again to everyone for their responses and advice! We've got an MRI scheduled for this Wednesday but are having to reschedule due to an AP exam conflict. It may be as early as tomorrow morning and we'll get a reading by a reputable sports ortho specialist hopefully that same day, or the next. I'll update here for those who might be interested. Never know when our experience might help someone in the future!

Similar story to Midatlanticdad.  Son was an Ivy, Patriot, NESCAC type player.  Son partially tore his UCL during the last game of the high school season his junior year.  Rest, PT, more rest and he still couldn't throw.  Missed all tournaments and showcases that summer except one.  He still couldn't throw, but wanted to go to Headfirst in August.  He went there as an outfielder since he could hit without pain.  Didn't do the defensive showcase portion, but did everything else including playing in the games.  Ended up on Coach Decker from Trinity College's team one game.  Double, triple and the only play he got in CF was a long running catch on a ball hit over his head for the third out so he didn't have to make a throw.

He ended up having TJ surgery in October of his Senior year.  All D1 interest dried up, but every D3 that was recruiting him still wanted him even after he told them about the surgery.  He only DHed his Senior year of High School, but was fully recovered when he showed up at Trinity that fall and had a nice career there. 

Thanks for your son's story 1ST&3RD. That's a really nice outcome and, coincidentally, Trinity College is on my son's radar for his HF camp at the end of June if he's ready. Like your son, that would probably be the one showcase we would choose not to miss even if all other plans fell through. Might be a little more difficult since my son essentially plays catcher only, and considers his defensive skills the stronger of his recruiting tools, but I think we'd make it work somehow.

As a little update, we had a second opinion yesterday and it was in alignment with the initial assessment which was a shoulder impingement. He got a steroid shot, prescription nsaids, and had his first PT appointment today. He's also got an MRI scheduled for tomorrow for what hopefully amounts to peace of mind. If all is correct, and goes well, we're cautiously optimistic that he may be able to resume throwing in 2-3 weeks based on feedback from the doctor as to his progress. Thanks again for your story!

Please do report back on the MRI and the assessment from the reputable sports ortho.  As others have hinted or stated, too many have been down this road too many times.  I suspect several here can be more specific with their experiences once that info and diagnosis comes to the front.

Hi Folks,
A couple of you have requested that I provide updates to my son’s injury status for potential future benefit in the unfortunate case that anyone finds themselves in a similar situation. I’ve received so many great pieces of advice and knowledge in my short time here that I feel privileged to provide some of my own whenever possible, so here goes. We’ve got a few things working so I’ll attempt to organize/summarize:

Orthopedic doctor assessment
⦁    Original diagnosis was shoulder impingement
⦁    Performed x-ray
⦁    Prescribed oral steroid pack
⦁    After no real improvement in two weeks of not throwing, we got a second opinion/assessment, which generally agreed with the first
⦁    Performed another x-ray
⦁    Gave steroid shot in shoulder
⦁    Prescribed NSAIDs
⦁    Advised to seriously limit throwing
⦁    Suggested MRI/Arthrogram
⦁    Prescribed PT

MRI/Arthrogram
⦁    We ordered this on our own through another doctor that we know and trust
⦁    Without going into too much detail, the impression from the MRI was “Scarring along he posterior labral capsular junction with blunting of the posterior labrum without a definite labral tear, likely related to overuse. Mild tendinosis and articular surface fraying along the conjoint tendon. Remainder of the cuff is intact.” The net of this is no throwing for a while and continue PT.
⦁    We’ve also got a family friend in SoCal who is a fairly well-known orthopedic surgeon that we have asked to review the reading and imagery but we don’t suspect much change in diagnosis.

Physical Therapy
⦁    Working with a well-known facility in our area and with a therapist who my son has worked with on two previous occasions for other issues.
⦁    Therapist thinks he will fully heal and recover and they are working to modify/strengthen the impacted areas of motion so as to not have the issue repeat. This will likely go on throughout the summer.

Summer schedule
⦁    Summer team coach consulted MRI results with his trainer from the D3 college where he coaches and he advised shutting down throwing during this process, so that is what he’s done. With six tournaments on the schedule, my son will DH in probably all but the last one (or two), which is mid-July if the healing process goes well.
Four showcases on the schedule:
⦁    Local baseball training facility sponsored – already cancelled
⦁    PBR Top Prospects Games – requested cancellation
⦁    Headfirst West 2 session (end of June) – will likely push this out to the October session in Phoenix
⦁    The Complete Showcase (8/11) – should be ok for this one (fingers crossed)

Needless to say, Tequila Jr. is very frustrated but I think he understands the importance of healing and re-preparing the right way. He has been hitting the gym hard with his trainer (and on his own) with exercises that will not impact his shoulder, getting plenty of decent calories, icing, taking his anti-inflammatories, started band work, and is going to try to concentrate on hitting and defensive aspects that don’t involve throwing (blocking, footwork, transfer, receiving). You never know; there could be a silver lining to all of this in that his development could be significantly further along by the time he is able to showcase. As others here have pointed out, with him targeting higher academic D2 & D3 schools, there should still be plenty of recruiting time.

I hope all of this helps someone in any way. Thanks again to everyone for the feedback and encouragement!

Good luck to Tequila Jr. during rehab.

I'm curious about one thing - does he play other positions? I'm wondering if taking a few buckets of flies and/or grounders every week might be another good summer activity.

He hasn't really played any significant amount at any other position - a little RF a few years ago - but his summer coach talked about putting him over at 1B and letting him figure it out. I don't want to watch if that happens

Stuff does happen, and  players are players.  We know 2 guys who are currently playing 1B on D1 teams and killing it, but neither played the position before as far as I know.  And a C on my son's team found himself playing RF this season despite never playing OF in the big field.

Hey Tequila,

My perspective is totally the "Holiday Inn" variety so take with a grain of salt.  But when you were describing the symptoms earlier, it screamed of what I have seen with too many players.  And then, when you provided the diagnosis that included some version of frayed labrum, that was exactly what I expected to hear.  

I'm sure there are varying degrees and types of frayed labrum injury.  But, I have seen it happen too often... get prescribed with shut down or rest along with PT and re-examine.  Then, quite often, surgical repair was eventually necessary.  Meanwhile, several months to a year of time were wasted with the initial efforts of shut down and PT.  It seems to be the common protocol.  So, please keep doing what you are doing utilizing second opinions and seeing specialists so that you can get him on the road to recovery in a reasonable timeframe.  I was very hesitant to throw this out as I don't want to send fear of surgery when it may not be necessary but I don't want to see another player lose unnecessary time.  

Thanks Cabbagedad! We're not too afraid of the "S-word" and I think you're right about varying degrees of fraying. Fortunately, most can supposedly heal in time but surgery for clean up of scar tissue, etc. is not nearly as recovery intensive as full-on cuff repair from what I can gather. As a minor correction to your mention of "frayed labrum," it's not the labrum that is frayed but the Infraspinatus, which is a tendon. Evidently tendons can heal, unless there is a  but the labrum, eh... not so much.

I mentioned earlier an orthopedic surgeon in southern California that we know. Well, I got his feedback a few minutes ago and he said basically that it doesn’t look like something to panic over. He said if one of the Padre catchers had this then his coach would be working with him to at least slightly alter his throwing motion. Otherwise resting the shoulder is about all you can do. But even a slight change in his throwing motion should help keep this from hanging around or coming back. He has worked with the Padres for years, has seen many many cases when it comes to shoulders, and has been amazed at some of the comebacks he's seen from worse than this.

We hope it doesn't come to surgery and wasted time, and nobody we talked to has suggested that at this time, but it was mentioned as an option down the road if rest and PT fail to correct it. Thanks again!

Cool, you guys are on top of it !!!

UPDATE (for those interested in following this thrilling tale):  As we begin week three of throwing shutdown, the boy is pretty miserable and frustrated.

On his summer team, he’s DH’d in five games over two tournaments, totaling 11 ABs. He says he’s learning from them but the games are typically over before he gets to apply it. With them allowing a DH and an EH in these, most kids only get to the plate twice per game. He took a step back this past weekend and decided we should re-evaluate the benefits of remaining on the “showcase” team and I think he’s pretty close to having made the decision to break with that and focus on skill and strength development. Legion is also an option for live ABs, and would result in a similar number but keep us close to home which would pretty much eliminate travel expenses.

He’s doing PT twice a week and can still feel pain when he makes certain movements so we’re definitely not there yet. I think at six weeks (essentially a month from now) we’re going to let him try some light throwing. His ortho doc says that if he can gradually return without much pain then he should be good to go.

He sent emails to all the college coaches he’s been communicating with informing them of his schedule changes. We were able to move most of the camps he had to dates in August and beyond so hopefully he’ll be ready to go by then - better late than never. Response has been positive so far from these guys about options for fall camps/visits, etc. We were pretty torn on how to approach the details in the email so we consulted with his summer coach, who is also the pitching coach for a local D3, and he gave us some ideas on how to frame it up without going into specifics about an injury. More along the lines an explanation of rest and conditioning being the focus.

I’m sticking to the positive thought that this may end up having a silver lining. He seems to be adding lbs. of muscle daily. He’s also working on his hitting daily and, after having not seeing him practice in a while, I noticed the sound and velocity, just off the tee in the back yard yesterday, were remarkably different. He had me feed him two buckets out of the machine yesterday just receiving (he’s a catcher) and wanted me to leave ite up so that it would be easier for us to do this throughout the coming weeks. He worked with his hitting coach once last week and has sessions set up with his catching coach back-to-back days this week (and wants to continue this pattern - if my finances can hold up!).

This is all pretty good stuff in my mind and I’m just along for the ride at this point. Thanks to everyone for channeling any healing vibes . More updates to come….

My 2019 is in a similar situation. Fall of Junior year breaks hand during Hurricane Harvey with surgery. Comes back for Junior HS season to find out he had an elbow issue. Misses entire Jr season. 2 weeks into summer of rising senior year was having an issue with left inner thigh. MRI showed a hip impingement called FAI. Now doing PT for 8 weeks and hoping by Fall will be able to pick something up late. Never had any health issues until this year. Crazy

My 2019 LHP is also in a similar situation.   He had a posterior internal impingement in his throwing shoulder last fall.   He had the MRI w/ arthrogram, had steriod injection, did PT, etc.....    Nothing remarkable on MRI.. no tears.  We even had his biomechanics analyzed by a pro.       Long story short he missed most of his Junior year HS season due to setbacks during his return to throwing program.  It was a much SLOWER process than we anticipated.  He played OF a little toward the end of his junior year.    However as he tried to return to the mound for this summer, he ended up with more shoulder pain and was dx'd w/ bicep tendonitis.    Ortho shut him down again to let it cool off.   He is currently doing PT 2x per week and started 8 week return to throwing program again.   Returning to the mound will take longer as Ortho & PT want to ramp up his mound throwing much slower.    I understand why.  But it is so frustrating!!!    He is a rising senior afterall.   UGH!    We planned to do Headfirst in August, but I am not sure he will be outfield ready by then.     We are hoping he will be ready to play in the fall and are planning accordingly.   He is an academic kid as well. 

Tequila, your post was helpful for those of us going through a similar issue so thank-you for posting.

MountainMomof4 posted:

Tequila, your post was helpful for those of us going through a similar issue so thank-you for posting.

  

Hi MountainMom and thanks for your son's story. Eerily similar I must say. My son is just over four weeks of not throwing and tested it out a couple of days ago. He said it was weak and sore but no sharp pain so I think it's going to be a few more weeks before he can really try it out.

I know what you mean about the frustration and my son is definitely feeling it. One of our biggest challenges has been cancellation/re-arrangement of plans for the summer and his keeping all the coaches up to date of where he is or isn't going to be. It's looking like just about everything for my son will be moved to the fall including doing the HF camp in Phoenix in October. We can only do what we can do and hope to find the right fit, even late in the game.

Good luck to your son in his recovery and keep me posted on how it's going!

It's been a couple of months since my last update to this thread so here goes. WARNING: This may be a little bit of a downer in the midst of all the fantastic news of commitments so read at your own peril .

2019 shoulder impingement rehab has continued with PT, band work, strength/agility/mobility, hitting, and position specific training. His throwing has ramped up to five days a week with max distance at 120ft and max effort at 80% (but not those together). He came home yesterday after throwing and the look on his face told me all I needed to know. He's feeling pain but his physical therapist has assured him this is normal. Still, it crushed me to see it so obviously on his face that he thinks this may not ever go away. I'm trying to be optimistic for him as it has only been two months and "results may vary" on recovery in these cases but, as a parent, I hate seeing him down like that. He doesn't really have the luxury of time in his favor and he's trying to be ready for a few chances in front of some coaches he's been communicating with by mid-September though October. I think he's frustrated because it's hard to sharpen up throwing to bags, for example, when you can't actually make a throw at the effort that it will need to be. It's hard to get better at baseball without actually playing baseball and I think he's feeling that pressure right now, especially with activity all around him from teammates and other kids he knows. He told me the other day that he feels like it's been so long since he's played, and it has. Longer than he's ever gone without playing.

Someone mentioned way back in the thread that, to paraphrase, he might end up at surgery anyway. With a 12-16 week recovery for this type of surgery it would effectively be January before he could get up to full speed so we're not going down that path as it would likely be the end of baseball for him, and I don't think he's ready for that.

We will continue down the path we're on with him and hope for the best. To say that this has been disappointing to him would be a gross understatement and we're just trying to be supportive along the way. The road is uphill even if he's 100% by mid-September but he's fairly confident in the decisions he's made i.e. doesn't want to play badly enough to sit out a year or take the JuCo route. Not hating on JuCos either, he's just interested in a high academic college experience that doesn't involve transferring mid-way through.

I'll try to update in another month or so. I suspect the water will be much less muddy by that time as college applications will be being filled out, and financial aid estimated, along with continued assessment of pain and progress.

I am sincerely happy for all those who have secured commitments and have no intention of overshadowing that with this post. The process is different for everyone and there are things to be learned from all journeys. I'm hoping that updates to my son's might help others who may experience any similarity of ups and downs.

I feel your pain.  Going through a similar experince with my 2019 MIF.  Broke his wrist during sophommore HS season and missed entire travel season rising Junior year.  Son had not yet showcased as we were "waiting for something to show".  Came back with a moster Highschool season this past year led conference in batting average and extra basehits.  Had some nice success at WWBA and WIlson tournament.   Was planning on doing a couple top showcases but then hurt tendon in his wrist sliding, completely unrelated to last years break and out 6 weeks.  Had a few D1's wanting one last look and hes' been out last 4 weeks with at least 2 more to go, and currently playing football with a cast.  It looks like D1 options are not likley with his timeline.  The positives is he has been offered a spot at many very good D3 baseball schools, but that's not what he wants.  At this point it looks like Juco is his preferred rout "betting on himself" as he wants the D1 experience.

Best of luck to your son, it's a long lonely road back from injury.