Skip to main content

I would appreciate some feedback from any parent whose son has had shoulder injuries and/or surgery. My son is a soon to be 16 year old h.s. sophomore lefty pitcher, who is passionate about baseball, and wants to pitch in college.

Sometime last April, he was pitching for his 9th grade team and doing quite well. In the fifth inning, his shoulder hurt and he took himself out of the game. I believe that he then spoke with the Trainer, but it may have been after his shoulder was again sore the next time he pitched. In any event, she thought that the soreness would go away after some rest. It did not.

During the summer, he was not able to pitch, but did not have soreness that I know of when he played first base or outfield. In late August, he tried pitching and his shoulder hurt. I took him to a doctor who has much experience with shoulders and ballplayers. The doctor believed that my son had a torn labrum, and sent him to get an MRI. The MRI came back negative for a torn labrum, and the doctor then prescribed physical therapy for his rotator cuff. For the remainder of August, September, October, and part of December, we drove thirty minutes before school to receive physical therapy at a facility operated by a big league trainer. He also was quite diligent in performing rehabilitative exercises each evening. In December, he began long toss at precisely the distance and number of throws suggested. He worked with two pitching coaches to refine his form so as to minimize the strain on his shoulder and maximize his effectiveness this spring. He also took swings in a batting cage many weekends.

In late January, my son again got pain in his shoulder when pitching. He was crushed. As the first doctor was on vacation I took him to another well regarded orthopedic physician. The second doctor believed that it was still tendonitis of the rotator cuff and since that time we have been going to PT two mornings a week, and my son has added additional exercises to his nightly routine. Last week the PT suggested that he had a torn labrum, as he still has pain. We went back to the second doctor who suggested an 85% likelihood that it was not a torn labrum. Speaking by phone, the first doctor was apparently 100% certain that it is. Surgery was scheduled for Friday morning, and later cancelled by me in order to give the second doctor's more conservative treatment of a cortisone shot a chance. The second doctor thought my son would be able to attend tryouts on Monday. Finally, my son was examined again by the first doctor on Thursday, and he remains certain that my son has a torn labrum and needs surgery.

At this point, I'm hoping to get the two doctors to speak with one another. I'm also considering getting a third opinion, since the two we've gotten are at odds. We would be willing to fly to Alabama, if that well known facility really is superior. Any advice? Who is the best doctor out there? Must a labrum tear (if he has one) be treated surgically? How long is the recovery? Can he still be an effective pitcher? It isn't cancer, but it does break my heart because he has worked so hard.
Original Post

Replies sorted oldest to newest

I am not understanding why you would rush into surgery if there was no tear found or even if there was a tear found. Did anyone suggest a second MRI? I would insist on a second MRI and think long and hard before proceeding. It is very hard to detect and multiple opinions are needed or exploratory surgery. Maybe for the remainder of the year, play position player only.

The problem with shoulder surgery, is that it is not always successful, read the articles. Some people think that this surgery will be cureall to the problem. Your son is still very young. If it were mine, I would not rush into anything at this time.
Just my opinion.

http://www.slate.com/id/2100895/

http://www.hopkinsmedicine.org/orthopedicsurgery/labrumtear.html
Last edited by TPM
PP,

Jon Conway is highly regarded also and 'Andrews Trained'.

Dr. John Evert Conway
Specialties
Orthopedic Surgery, Sports Medicine
Location
-800 5th Avenue, Fort Worth, Texas (TX)
Years in Profession: 23
Gender: Male

No doubt going to Alabama to see the leader in research would get some answers but before you make the trip I would call them and find out if there are any disciples that they have trained and are practicing closer to home.

I have visited with players who have had labrum surgery by Conway and I hear he does good work. Not all surgeons are created equal...that's why it's called practicing medicine not perfecting.
Don't continue dealing with the dueling doctors..get a third opinion. If he actually has a tear, there's a chance rehab can overcome it, but reality is that he will probably need surgery. What's puzzling is that he was scheduled for surgery when the two of them couldn't decide if he actually had a tear or not..you don't do exploratory arthroscopic shoulder surgery just for the heck of it on the odd chance that you may find a problem.

My son's experience...he was a RHP throwing 87 as a HS soph. Beginning his Junior season, his velocity suddenly dropped to 80-83. He said he was fine, no problems...continued through his SR season, throwing 83-85. D1 schools that had been watching him backed off, because they thought something was wrong, even though they couldn't put a finger on it, and he signed with a JUCO. All this time he was saying he was ok...reality is he was pitching for one of the better HS teams in the state, he wanted a shot at a state title, and he refused to say his shoulder was killing him...and other than his velocity drop, he did a remarkable job covering it up. Right before reporting to JUCO, he hurt it longtossing, to the point he couldn't even play catch.

His JUCO team sent him to the team Dr., and they spent his Fall and most of his Spring trying to rehab him with therapy. They finally scheduled surgery on him...without doing any kind of imaging, just to look for a problem. I got rather upset, to say the least, cancelled the surgery, and brought him home to a good Sports Med MD. His initial physical exam, the Dr. diagnosed labral tear, and scheduled an MRI. MRI showed significant labral tearing...he had arthroscopic surgery...once they were in fixing the labrum, they found rotater cuff tears that didn't show up on the MRI. That was June 2003. He rehabbed that Summer and Fall, and finally got on the hill Spring 2004 once the weather warmed up. He ran into a lot of problems with shoulder/bicep tendenitis that year and the next. Two seasons of JUCO later, he's now with a D1 team as a redshirt Jr., throwing with no pain, living in the mid to high 80's, touching 90.

He went through a lot of pain with the rehab and the recovery, and a lot of hard work. Players have a very good chance of being better than ever after Tommy John surgery, but there are no guarantees with labral/rotater cuff surgery. The success rate is much lower.

Hope your son turns out ok. Definitely see a reputable third MD before going on a fishing expedition inside his shoulder.
TigerPawMom, thank you for the link to the Hopkins article. I had not seen that one. Please be certain that I am not rushing him to surgery. Quite the contrary, I may be delaying the inevitable, as his physical therapy since August has not cured his problem he's had since April.

CoachDad, we are in Massachusetts. I am willing to travel, to get this right.

2seamer, I am very happy to hear of your son's perserverence and success. He must be a hard worker. The MRI (actually called an MRA when dye injected) did not show a labrum tear. According to the Johns Hopkins article provided by TigerPawMom, the MRI may not show a tear. I am going to ask about the new C-T scan that may reveal more. Gimages, he did have an x-ray, and Doc 2 said his growth plate looked ok. In fact the only good news to come out of this saga was that at 6'1" he is not done growing.

Thank you all for your responses. Please keep them coming, especially if your son had a similar experience, or if you know whether it is worth it to make a pilgrimage to Birmingham.
proudpapa,
I am sure that you are doing what you can, which is wonderful and you will take all of the info and make the right decision. Seems to me that maybe the only way to tell is through exporatory surgery.
According to my understanding, tears not always are a problem, but where the tear is. Not sure if that is correct. I would suspect if you looked int many pitchers shoulder, you would see something going on.
If he is not done growing would they still do surgery? I am curious as to the answer, let us know.
We've been through a couple of shoulder surgeries with our sons, one with Dr. Conway in Ft. Worth and the other by a leading specialist at Stanford. While I'm far from an expert, I have learned a few things.

1. It's hard to see everything that's going on in the shoulder in an MRI. Sometimes you need exploratory arthroscopic surgery, but that's usually a last resort when pain still persists after treatment.

2. If money and distance are not a concern, see a specialist that has a strong track record of treating pro baseball players. Retaining the range of motion required to throw a baseball requires specialized skills and experience.

3. Use a good PT with pro player experience and a record for success.

4. Don't loose hope. Our oldest had a torn labrum repaired and actually throws harder now than before.
Last edited by TxMom
proudpapa - Let me start by saying you have received alot of good info here. I have been down this road with my son who is now a freshmen in college. I am not going to get into details of how it happened or the road we took. But I will say it was practically identical to your son's process that he's been through. This will be a hard road for your son and he will have to make many sacrifices in the coming year and you as a father will as well. Let me explain something here - TIME is a factor, WHY because my son, like yours, had a dream to play college ball and as a sophomore(when he was injured) was coming upon that so important season.... The summer of his junior year - SHOWCASE SEASON. It was in October of his junior year when the decision was made to have an arthroscopic procedure on his arm. TXMOM is 100% right when she said mri's do not show everything going on in the arm. Which worked to my sons favor. He was scoped and DR. David DINES (REMEMBER THAT NAME) found a tear in the supraspinatus. Which he stated would have never healed on its own in the area it was in. My son missed pitching in the rotation his junior year of school ball(a sacrifice he needed to make) but he was able to play 1st base though. He had many dedicated hours of rehab and was able to get that arm good enough to participate in many summer showcases and DO WELL in-fact. He was honored to have twenty or more colleges recruiting him. It brings tears to my eyes of happiness and joy every time I see him on the field just knowing he got his DREAM. Please support your son and have patience with him as it is a difficult journey he will have to take and he will not be able to do it without his family behind him !

Here is the info on the surgeon we used
: DR DAVID DINES - GREAT NECK LONG ISLAND, NY. 516 - 482 1037 said to be one of the best in the Northeast-- if not the best- period. He has done shoulder work on some of biggest name athletes. Pitchers / tennis professionals / Yankees - METS PITCHERS John Franco for one ! So please he is only hours from you. Call the office and set up a meeting to see him with the mri reports. He is a great MAN i can wright a book on this but i will stop here. PROUDPAPA please pm me with your phone number if you would like we can talk further.
WHICH ALL THE BEST TO YOUR SON. HE WILL DO FINE clap
Proudpapa.....gosh.....you have gotten some good advise here..... Growing up in Massachusetts....Mass General was the best....have you checked out Doctors/Specialists there yet? I have a sister working there over 20 years now.....if you want...I'll check with her and see if she has any referrals.....just send me a PM. You want the best....and it would be good if you could find a Doctor closer.....especially with follow up visits, etc.....
Last edited by LadyNmom
2 Seamer, I would llve to hear what if any conditioning your son did prior to the injury. Please be as honest as possible. I'm not suggesting you wont be but the brutal facts will help a lot. I'm also not suggesting that conditioning will eliminate trouble. I just want to help my boys as much as possible.

Proud papa....there's alot of info here. Good luck and keep us in the info loop please.

Razor
Daughter had exact same issues. An MRI with and ARTHROGRAM (where dye is injected into the shoulder to see if there is a tear in the labrum). MRI as read by radiologist, showed a tear. Surgery revealed NO TEAR! SO while in there the surgeon 'tightened up' the shoulder. She is now throwing 3 months later. I wish I had requested another opinion, surgery may have been avoided. The KEY was REHAB. We went with a former Major LEague trainer. He knew exactly what she needed to do to get back on the field. GO WITH YOUR GUT. Dont allow the surgery until you are sure that is the answer. Great PT may be the way to go. Good Luck
Son also had labrum tear - we interviewed five doctors in New York City to find best for us.

Dr. David Dines was highly recommended, lovely and very thorough - was MD for tennis tour.

Dr. Andrew Rokito at NY Hospital for Joint Diseases also wonderful - was Mets doctor at time.

a doctor at Hospital for Special Surgery who specialized in shoulder surgery - can't remember his name - it started with a W - but didn't relate well to son.

a doctor at Beth Israel Hospital in Nichols group specializing in shoulders...we didn't know hospital well so chose elsewhere.

Dr. David Altchek at Hospital for Special Surgery was our ultimate choice - we knew the hospital well; many, many people kept recommending him. He was easy to talk to and seemed to understand baseball players injuries, the young man's psyche, the toll taken on player's body in college sports, understood the rehab problems while in college, and he also was Mets doctor at one time as well as tennis tour MD.

My son had different prognosis from different doctors - basically all felt his labrum needed repair although some doctors wanted to do a little more fixing than others. All answers kept coming back to Altchek.
Surgery went very well. Recovery was slow for first month - pretty depressing for son not to be able to do anything - no driving - right arm in sling for one month before real rehab began (this was done in July when he was accustomed to busy baseball schedule).

Major rehab began when he got back to school - but rehab done three times a week at physical therapy center off campus - interestingly, college offerings in this area not as good.

He tried to play in March, but still had some pain so basically took off the season. Was ready to play by May for summer ball. Arm felt much stronger, and throw to second was much stronger than before.

For my son, rehab was slow and he may have come back too soon. Doctors had told him rehab would take a good year, and he rushed his return (with a little encouragement from others around him).

Every rehab is on a different schedule, though and I've heard of players having a much faster rehab.
Last edited by NY MOM
To each and every respondent to my post, thank you. We have decided to go ahead with surgery, with the original doctor, who has performed this surgery on pro ballplayers. The good news is that my son's extensive physical therapy should make his recovery quicker. Let's hope.

Now we are contemplating his repeating his sophomore year at another school. Not sure if that's nuts, or if it is smart and increases his chances of playing college ball. Any thoughts?
My son had surgery on March 28, 2006. It was performed by Dr. Joseph Chase at St. Elizabeth's Hospital in Boston. Dr. Chase has performed the surgery hundreds of times, and believes that many times the injury is not properly diagnosed, in that a rotator cuff injury may be secondary to the primary injury of a torn labrum.

COACHDAD and TXMom are correct: A tear is not always visible on an MRI. Sure enough, when the doctor operated, he found a tear in the supraspinatus, which he stated would not have healed on its own. (Just like COACHDAD.)

Since that time, my son has been extremely diligent with his physical therapy. He treats with a former Red Sox trainer recommended by the surgeon (who also used to work with the Sox).

He also worked out all summer under the supervision of a trainer (in a group, and skipping anything that could harm his shoulder). Last week, he threw a baseball for the first time, lobbing it thirty feet about forty times on three days under the supervision of the PT. He will continue to throw with the PT two times per week, and will also work out with a trainer at the same facility two times per week, with an emphasis on baseball specific drills.

When he is able, and after consulting with the doctor and the therapist, he will work with a pitching coach I found through this forum, Brad Miller, to further correct his arm slot and other mechanics, so as to avoid further injury.

The truth is, we've heard more stories of failure than success, and we are very happy to hear of COACHDAD's son's successful return.

Another truth is, my son has not yet had the level of success that many of your boys likely have. He is 16, 6'1", 180lbs., throws and bats lefty, and is a very hard worker who works very hard and is quite coachable. He was making considerable progress before his injury, but had only gotten as far as his 9th grade team and 15 year old AAU. If heart and work were all that mattered, he'd go very far.

Having missed his sophomore and summer seasons, we want him to be in the best possible position next spring, and for junior year summer showcases. It will be one year since his surgery, and he should be at full strength.
If he is not, he'd like to repeat his junior year at another school.

What are your thoughts? Advice? Please know that the advice we have received so far has been excellent, and appreciated.
My son underwent surgery for a labrum tear 6/28/05. Did all the work, including rehab all summer,fall, winter. When he was finally able to throw a ball (not off a mound) we took him to his regular pitching coach who worked mechanics (arm slot, balance, etc.) Has not yet gotten back to his former self but that was partly due to a h.s. coach who had no confidence in his "post surgery" shoulder. Pitched sporadically over summer but still has a long way before getting back his control. He is now at a D-3 school and we're hoping he makes the team and gets some decent training that he wasn't able to get in the year since his surgery. I think once your son gets the green light to throw off of a mound is PRACTICE. Re-learning to throw with control - not necessarily velocity - upon his return to the mound will be key. Velocity will come.

Good luck to him!! I know that road is a tough one - sometimes I think harder for us to watch than it is for them to go through.
We had a player who had labrum surgery, and keep in mind all operations are not the same,. He missed his junior year on the mound and came back 10 months later to pitch in the fall of his senior year

He had a great senior year and summer season and is not at Northeastern as a freshman pitcher.

BUT he worked hard and did all the right things pertaining to PT
Last edited by TRhit
13 weeks today out of surgery to fix my torn labrum. It has definitely been a battle so far and i am only a part of the way through. Everything has gone very well with my therapy according to schedule. My surgery was performed by Dr. Girhidar Burra in Naperville, Illinois..he is a product of Dr. Andrews and has been great. I agree, the next thing after getting a good doctor would be getting the right PT. I had a great one back home until I came to school and now with things being new it is going to take a while for the trust factor to kick in. It does make me a little nervous that I don't know him but I suppose we'll see how things go. I have been dying to throw or hit again but not for another couple months. Should be good for the season as long as everything goes to plan..I can't wait..
It's been over thirteen months since my son had surgery for his torn labrum. He has worked exceptionally hard at his rehabilitation, at improving his core strength, and at improving his mechanics. The pitching coach that he has been going to (Thanks for the referral, TRhit) is impressed and mildly surprised at his progress, and believes that he now needs innings. Son is a high school junior, 6'1", 190 lbs and still growing, throws and bats left, and made his high school varsity team as an outfielder. (Seems there's always a big, slow guy who can croke the ball playing first, and son wasn't ready to pitch during tryouts.) Since the team only uses two starting pitchers and one reliever, and one of the starters will be a top draft pick in June and the other is going D1 next year, son asked coach if he could pitch a few innings of JV game. He pitched for the first time in two years two weeks ago, throwing 38 pitches over three innings, no hits, no runs, one walk, seven Ks, two errors, and two runners picked off first base. Varsity coach indicated this week that the JV coach doesn't have any more innings for son to pitch, and it seems unlikely son will get varsity pitching opportunity before next year. The team plays only fifteen seven inning games.

Son throws two and four seam fastballs well, change-up is decent and improving, and is just developing a pretty good curve. His speed has gone from about 68 mph eleven months after surgery, to between 76 and 78 at thirteen months. Pitching coach doesn't want him to focus on speed yet, but expects velocity to continue to improve.

So while his pitching is improving and he throws without any pain or problem, and in fact will be a better pitcher as a result of the injury and resultant dedicated focus on rehabilitation, strength training and conditioning, and improved mechanics, the fact remains that he is entering the summer between his junior and senior years having pitched a total of three JV innings, and no varsity. He was unable to play last summer due to his surgery, and the summer before that couldn't pitch due to his shoulder pain.

We're still considering whether he should repeat his junior year at a different school, which would allow him two more school years to improve his grades (SAT score was 1990, grades B minus to C at very challenging school), give him two summers and two varsity seasons to pitch competitively and gain experience(no rules against), and two summers to attend showcases. Otherwise he will have to have a great showcase in August, when he should be peaking, to get noticed.

Any thoughts, suggestions or experiences to share?
I certainly don't agree that a labral tear means the end of a pitching career. What we've found is that it requires dedication to improved mechanics (since mechanical flaws likely contributed to the tear), a very serious commitment to physical therapy and conditioning, a strong desire to pitch, and more time than anticipated, for successful recovery from SLAP surgery.

It's been a very long and often discouraging road for my son. As the name I've chosen makes clear, I'm very proud of my son, whose tenacity in spite of adversity will serve him well in life.

He believed that he was ready to pitch in May, over thirteen months after surgery. But he failed to make his Legion team as a pitcher, and did not look great in tryouts. His velocity was only in the low 70's, and his control mediocre. He landed with another Legion team, and got some limited innings.

He kept working to get bigger and stronger, and to improve his pitching. He attended a couple of showcases that struck us as simply moneymakers for the organizers, and was getting discouraged. In August, he pitched two scoreless innings against pretty good talent at a showcase, and was clocked at 79 mph. Like that good golf shot that gets you back on the course, he and I had a little boost of encouragement.

He also began to long toss regularly. By December, he could throw 80 or 81 mph. He has developed four good pitches, and at least in the gym, has good control.

He is hoping for a great senior season. He's applied to quite a few D3 colleges, where we think he could have both academic and athletic success. He's 6'2" and 195 lbs., a good student, and a great kid. We've not done much to market him to prospective college coaches, but will be sending out emails to the coaches at schools where he's applied.

I'm very hopeful that all of his hard work will pay off in successful senior and summer baseball seasons. I believe that he will be a real find for some college baseball program, and that he will be a much stronger and better pitcher due to all that he has been through, including the labral tear.

In any case, he is a better person for what he has gone through as a result of that tear.
I would not do any shoulder or elbow with anyone other than Andrews. There isn't anything he hasn't seen. A very keen eye for shoulder injuries including any number of tears, partial tears, wearing, stress reactions (foolers), and a host and plethera and any other adjectives to describe the sheer numbers of injuries he has seen. Do yourself a favor and schedule him and no one else! You CAN get into his clinic for evaluation. He makes a point to see EVERYONE, no matter what his load is. He is just simply amazing and worth the trip & money (although the money is comparable to anywhere else because he does not rip people off).
Last edited by switchitter
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.
Last edited by P&CMom
P&CMOM

Great move on your sons part to ask those questions

We talk alot about the "miracle" surgeries but what works for one does not work for another all the time

I recall mine and it was not a sports caused injury--I was walking my Lab on a snowny night and slipped and fell on my left shoulder---OUCH-- went to the hospital for exrays etal---to my orthopedic guy the next day and he tells me he thinks it is just the rotator cuff but xrays were still cloudy from the blood--MRI was not even clear-- we schedule surgery, artho-- but three hours later I come off the table ---he had to open me up because of all the damage they found initially---he had prepared me for the worst so I was fine with it

The key is to ask questions-- and trust your surgeon---they can scope and always cut if they have to after seeing the damage--pictures do not always tell the entire story

I also a few years later had a impingement in my right shoulder---my arm could not raise above the shoulder level--he scoped and shaved ---9 months later not better---one massive shot of cortisone made it heal and it is fine now---every persons body reacts differently


Always get a number of opinions and have a doctor that will listen to you---you know your body better than anyone
quote:
Originally posted by TRhit:
one massive shot of cortisone made it heal and it is fine now


A massive shot of cortisone. How many milliliters did they shoot in there? The cortisone does not have healing powers. It simply helps with the imflamation in the area. Sometimes they work, sometimes they don't. Sometimes the relief can be temporary. Sometimes they can last a lifetime. However, they possess no healing qualities whatsoever.
Last edited by Ennis Lyons
Ennis,
With an inflammed joint that prevents playing or movement, a shot of cortisone can relieve the inflammation and allow movement/playing. Would that not be a healing of the joint inflammation?

As a veteran of many cortisone shots, I have had them take me from unable to game ready in days...very impressive results for me, but as you say, doesn't work everytime and results can vary.
My son is a senior in high school this year. In February of 2007 he felt a pain in his right throwing shoulder while doing a light bullpen session. He stopped throwing and we went to see an orthopedic doctor the next day. The doctor said that he should have an MRI with dye injected, which he did. The MRI was interpreted as showing a posterior labrum tear. The doctor recommended trying physical therapy first before surgery. A second opinion yielded the same result. My son did not throw at all for six weeks but still played as a DH and had no pain batting. He could not throw a ball even ten feet. He began throwing left handed and did therapy five days a week. After the six weeks was up he began light throwing for about two weeks and then announced to us that all was well and pitched as a closer for the last part of the season. His velocity was greater then before the injury (maybe due to the throwing specific therapy). He closed five games and pitched a total of 10 innings. His control was good as he struck out 19 batters and walked 4. He sits around 86-88 and maxs at 90-92. You would think that I would be pleased with the way things worked out. My problem is that I am worried that the labrum tear has not healed. From what I read the labrum has a poor blood supply and a tear will not heal without surgery.If this is true if he continues to throw harder it may cause a more serious tear that could end his baseball life. He has signed a letter of intent with a D-1 school. How do you know if the shoulder is truly healthy again? Is no pain the indicator? Is it possibly that a lot of pitchers have torn labruns but have no pain and don't have pain as a symptom until they really injure it seriously. Any thoughts?
quote:
Originally posted by CPLZ:
Ennis,
With an inflammed joint that prevents playing or movement, a shot of cortisone can relieve the inflammation and allow movement/playing. Would that not be a healing of the joint inflammation?

As a veteran of many cortisone shots, I have had them take me from unable to game ready in days...very impressive results for me, but as you say, doesn't work everytime and results can vary.


Ripped this off a website as their explainatin says it better than I do. I just look at cortisone as an anti-inflammatory (not to be taken in the buttocks). It's makes you feel better, that much is for sure.

What is cortisone?

Cortisone is a type of steroid that is produced naturally by a gland in your body called the adrenal gland. Cortisone is released from the adrenal gland when your body is under stress. Natural cortisone is released into the blood stream and is relatively short-acting.
Injectable cortisone is synthetically produced and has many different trade names (e.g. Celestone, Kenalog, etc.), but is a close derivative of your body's own product. The most significant differences are that synthetic cortisone is not injected into the blood stream, but into a particular area of inflammation. Also, the synthetic cortisone is designed to act more potently and for a longer period of time (days instead of minutes).

How does the cortisone injection help?

Cortisone is a powerful anti-inflammatory medication. Cortisone is not a pain relieving medication, it only treats the inflammation. When pain is decreased from cortisone it is because the inflammation is diminished. By injecting the cortisone into a particular area of inflammation, very high concentrations of the medication can be given while keeping potential side-effects to a minimum. Cortisone injections usually work within a few days, and the effects can last up to several weeks.
Last edited by Ennis Lyons
This outstanding thread has been re-opened for business. The troublemaker has been dealt with and the associated posts removed.

To get back on topic, P&CMom's post was outstanding. She is one of the very best writers we have here on the hsbbweb imho and it was nice she took the time to document her family's experience. All the posts in this thread have contributed nicely to a very serious topic - thanks.
We received word two days ago that the kid who was supposed to be the starting catcher has a torn labrum and will require surgery. Season starts on Feb 10th; he is out for the season. The injury happened during football, not sure if he saw a doctor or not, but I do know he has been going to PT for a couple of months with no results. I do know he never sat out a football game and I didn’t even know he was hurt. His parents brought him in for an MRI last week and it showed a tear. I cannot imagine the disappointment this kid feels as this was to be his first season as a starter. Hopefully the surgery will be a success and he can come back for his senior year next year. If anyone has any suggestions on a surgeon in Louisiana, I would be happy to pass the info on to the parents.
The parents should do everything they can possibly do to have the surgery performed by Dr Andrews in Birmingham.
Labrum repairs are not only difficult to diagnose, they are equally difficult to repair. When you combine those issues, and some others, with the need for a repair that will provide a player the best chance to resume playing baseball, you need the very best. I would strongly recommend Dr Andrews to maximize that young man's chances.
Hi proudpapa,

I was just catching up on reading the HHBBW and saw your question. I did not try to read through everyone's responses but can relate what I saw with a couple of kids my son played with.

In a very similar situation to yours the kid actually had bone spears in the shoulder that did not show up until they went in with a scope and looked around in the shoulder area. The procedure was not very traumatic and the kid was good as new in no time.

Another kid I knew had stretched ligaments or tendons that appeared as pain in the back and the shoulder. They were ready to go to some extreme measures until one doctor finally suggested he work with a physical therapist and once everything started to tighten up the pain disappeared.
Just a quick update......my son had the MRI this week. We see the ortho on this coming Tuesday (1/15). Will keep you posted.
He is still continuing with physical therapy at this time, increasing his range of motion, little to no pain at all, but at this point has not yet resumed throwing.
His therapist used to work in the Mets organization. He told us he is close to begin light throwing. One of our biggest concerns/frustrations is this is his SR season.........we'll see how it plays out.
Last edited by jbbaseball
quote:
Originally posted by jbbaseball:
Just a quick update......my son had the MRI this week. We see the ortho on this coming Tuesday (1/15). Will keep you posted.
He is still continuing with physical therapy at this time, increasing his range of motion, little to no pain at all, but at this point has not yet resumed throwing.
His therapist used to work in the Mets organization. He told us he is close to begin light throwing. One of our biggest concerns/frustrations is this is his SR season.........we'll see how it plays out.


he needs to take it REAL slow, regardless of what the rehab people say and doctors. Don't let him go too fast with his recovery. It will be regretted by everyone involved. Ruining an arm stops participation in the sport. cool off ANY pitching for a long, long time.
quote:
Originally posted by jbbaseball:
Just a quick update......my son had the MRI this week. We see the ortho on this coming Tuesday (1/15). Will keep you posted.
He is still continuing with physical therapy at this time, increasing his range of motion, little to no pain at all, but at this point has not yet resumed throwing.
His therapist used to work in the Mets organization. He told us he is close to begin light throwing. One of our biggest concerns/frustrations is this is his SR season.........we'll see how it plays out.


While I understand the desire to have your son healthy and ready to play his senior year, the information in your posts leads me to think the therapist is, at this time, providing optimism without the critical information to do so.
Medically, it is very difficult to tell the difference between bursitis/impingement and a labral tear. At times, both are involved.
To be quite candid, based on our son's experience, I would be very reluctant to rely on the diagnosis of the therapist, even one who has been at the MLB level.
The only way to know if your son has a labral tear/impingement or both, is the MRI which will be reported tomorrow. That should provide the guidance you need to make the next steps and decisions on care and rehab. I hope it goes well tomorrow.
Until the MRI results are known, I would not let the trainer, or the improvement with PT and without throwing, influence your thinking on his care or on throwing.
Last edited by infielddad
Louisiana09,

Dr. Andrews has a spectacular new facility in Gulf Breeze, Florida...The Andrews Institute. My son had Bankhart repair about 12 weeks ago for a torn labrum. I believe they just opened last March.
Our experience: son severely dislocated his arm a week before his senior season was to begin. We saw an excellent doctor; reports didnt show a tear. Son was determined to do aggressive therapy and be able to play, if even a portion of his senior season. After 8 weeks, he finally got to play (ss/pitcher), but was recommended to only pitch since he injured his non-throwing arm while diving for a ball at SS. The third to the last game of season, he threw a no-hitter and had a good end to his high school career. In JUCO, was the starting SS and had an excellent freshman year. But during, the first fall game of this season (OCT. 07) he dove back to 1B on a pick off.....and dislocated again. MRI -labral tear. Surgery scheduled w/ Dr. Andrews.
He has taken a medical redshirt this spring soph yr at JUCO. After 12 weeks, he's healing great...and waiting on the o.k. to begin some light weight training. It has been very tough, emotionally, to handle; a lot of kids are determined to keep it going...and will just keep getting back up.
jbbaseball,
First all, I truly wish for the best for your son.
It sounds to me like you are doing all the right things.
Getting the right information and getting the second opinion is exactly the right approach.
Taking a portion of your post, the rehab of no throwing for 6 months isn't anything I have heard/read about or experienced with our son. The ability to begin throwing post surgery is an estimate based on range of motion and strength, and medical oversight.
The more normal time to begin throwing is 3-4 months with good recovery/PT and strengthening. The throwing rehab program itself is 8-12 weeks, also if all goes well.
With regard to the "playing cannot make it worse," I can tell you our son did hear that. Personally, I have my doubts.
As you know, a MIF is going to be making throws from various positions, many of them off balance. He will also be diving for balls with his arm extended.
While it may or may not be true that "throwing" alone won't make it worse, that isn't baseball the way our son's play it.
In effect, playing this season is a question of how much pain your son can endure and the extent of clicking/catching/instability he may experience.
Playing with a labral tear is as much mental as it is physical. You need to know that in advance.
In my view, it also requires a coach who truly can help deal with both and who can help your son fundamentally in the field so that he, to the extent possible, he reduces the stress on his shoulder. I cannot underestimate for you the mental component of this situation.
With all that said, it is very difficult having your son assured that "playing won't make it worse" and hearing, after the surgery, "that was worse than the MRI showed."
As you might be able to tell, we have some experience and our son is a MIF.
Please don't hesitate to PM if you would like to discuss more privately.
I am really hoping for the best for your son.
He is lucky to have your helping him.
Infielddad gives good advice.
My son just informed me of a shoulder problem a couple days ago. He noticed it while playing summer laegue. Very mild pinch feeling in right front and side of shoulder. It goes away after a few warm up throws.
This is the 1st time that he has had a problem and blames it on poor workouts in summer ball. It is the 1st time he has ever not worked out all year. It is mainle a stiff feeling. I made him tell the trainer and he is on Anti inflamatory drugs and heat/cold compresses.
He has no loss of motion or any pain. I want him to get an MRI but the trainer feels it is a minor issue. Not sure I buy that. I have a call out to his doctor who deals with this on a regular basis.
Son didn't complain but mentioned it when I asked how his arm felt as I routinely do. No panic as far as I am concerned at this point but he may have to shut down and rehab for a while. I did some reaserch and this site was helpful.

http://shoulderpaininfo.com/shoulderImpingement.html
jbbaseball--playing may not make it worse, but by playing, your son risks another injury---which may sideline him for a longer period of time.

My son, also a middle infielder, tore his labrum at the beginning of the season in his junior year of high school. We didn't know that it was torn, only that it hurt. But because he didn't want to lose his starting shortstop position, he "played through the pain"...which developed into elbow tendinitis. And then he couldn't play. The doctor didn't want to do the surgery right away, but suggested that he rehab it; sometimes the rehab prevented surgery. But the way, the two MRI (a regular one and one with the contrast dye) were inconclusive, as they often are. The doctor, being an understanding White Sox team doctor, allowed him to stay in the game and allowed him to hit--as the eh or dh. After not playing for a while, he finally got his swing back, was hitting the ball very well and then oops--he got hit in the wrist, which broke both bones. Bummer. This delayed the shoulder rehab leading to the surgery, but it was finally done in mid September. The doctor promised that he would be ready to play in the spring.

Until the rehab in October was delayed because his wrist hurt and continued to be swollen. So off we go to the hand specialist, who very conservatively wanted to rehab what turned out to be torn cartilage (torn when the pitch broke his wrist bones) before considering surgery. Which was determined to be necessary in February--and it was performed on the morning of his high school try-outs in his senior year. Another bummer.

So although playing may not make his shoulder worse, it may keep him out longer with a more serious injury. Freaky as it may be.

Good luck with best wishes to your son. Feel free to pm me to talk about this....I really do feel your pain and dilemma.
Last edited by play baseball
Where were all of you for my son in 2000 with a torn labrum? I only wish I knew about all of you. What great advise everyone has.

My son was a great athlete but unforturnally we were sent to a local surgeon who operated (twice on the right shoulder and once on the left throughout his HS years) and his baseball/football career was shot for any college hopes. He could still hit but throwing was out of the question.

My advise to anyone with a labrial tear, go to someone who will work with athletes. When we told the doctor that he was the HS quarterback and HS catcher at age 15 he laughed at us. What a hard lesson to learn about the right doctor Frown Please make sure you do not go to the first surgeon you see and also make sure he understands that your son still wants to throw the ball. When we asked that question he gave us a smirk and said "sure with his son someday".

We made a huge mistake and can't take it back. He was only 15 and never had a chance to play college ball. The good thing out of all of this though, he is now in Medical School and is saying he is going to be a orthopedic surgeon. Never to let this happen to any of his patients Smile
quote:
Originally posted by floridamom404:
Where were all of you for my son in 2000 with a torn labrum? I only wish I knew about all of you. What great advise everyone has.

My son was a great athlete but unforturnally we were sent to a local surgeon who operated (twice on the right shoulder and once on the left throughout his HS years) and his baseball/football career was shot for any college hopes. He could still hit but throwing was out of the question.

My advise to anyone with a labrial tear, go to someone who will work with athletes. When we told the doctor that he was the HS quarterback and HS catcher at age 15 he laughed at us. What a hard lesson to learn about the right doctor Frown Please make sure you do not go to the first surgeon you see and also make sure he understands that your son still wants to throw the ball. When we asked that question he gave us a smirk and said "sure with his son someday".

We made a huge mistake and can't take it back. He was only 15 and never had a chance to play college ball. The good thing out of all of this though, he is now in Medical School and is saying he is going to be a orthopedic surgeon. Never to let this happen to any of his patients Smile


We all would appreciate it if you could tell us the name of the surgeon. Not to berate the surgeon but to understand what his qualifications are/were. Perhaps he is much more experienced with these type of things now. Some orthopeadic docs will talk of wear and tear damage in a shoulder for example but mention nothing specific and say wow, he shouldn't be throwing.
I was reading on another site about two pitchers who were top recruits out of high school in 2006. Both had shoulder surgery before they even threw a pitch in college. From the post I read, one is going to miss his second year of college baseball trying to recover and the other is no longer playing.
Last weekend I was talking with a 3rd year medical student who intends to specialize in Sports Medicine.
He is doing experiments on shoulder function/repair using animal models.
His view is the shoulder is, perhaps, the single most complicated joint for medical repair. Even more so when you put it through the rigors of playing baseball at a highly competitive level.
I make this post because we often hear about the successes of TJ surgery. We tend not to hear as much about the results with shoulders. That is because there aren't nearly as many successes.
For anyone who's son is diagnosed with labral, rotator cuff or other shoulder conditions, including something as "simple" as bursitis, it is important to realize there really isn't anything simple about the shoulder and how it needs to function to play baseball.
For any parent or player, finding the best is my best recommendation. The measure of the best isn't how many times they have done the procedure, it isn't if they are a "team" doctor, it is how many times have they done it on someone who plays baseball, and the player was able to recover and resume playing.
Last edited by infielddad
I honestly don't see how a torn labrum could heal itself without surgical help. At least a badly torn one. My son is 6 weeks out from surgery with tears in the front and in the back. Seeing the video of his surgery, with the labrum "flapping in the breeze" so to speak, I can't see how anything short of what they did would fix that.

He was hurt in the third game of football season and had his shoulder dislocate 3 to 4 times each and every game for the remainder of the season. Crazy kid didn't want to let his teammates down! Luckily it was his left shoulder and he is a righty, so we are now just working the strength back into that arm, in preparation of getting him back on the mound, and able to lift his arm safely to catch a ball.

He had the contrast MRI and both tears were evident, I don't think there were any surprises when they got in there. They put anchors into the two tears and tightened him back up. The doc tried to pop it out at his 6 wk check up Monday and I thought the kid was going to come up off the table swinging it hurt so badly.....but doc was happy that it was nice and tight. BTW you can check out Youtube for videos posted of torn labrum repairs and you can see exactly what you will be getting with surgery.

Best of luck to all having to deal with this. We would have rather not forked out the money and time, not to mention the discomfort to him by having to do the surgery, but there was simply no choice in the matter. He was broken and he had to be put back together. Scary thing about it all, is that he is planning on playing football again next fall! Eek If only I had that crystal ball to know if that is going to be a horrible idea or not. Makes me sick at my stomach to think about....going to go throw up now!
quote:
We would have rather not forked out the money and time, not to mention the discomfort to him by having to do the surgery, but there was simply no choice in the matter.


Although the monetary cost of the surgery and the subsequent lengthy rehab can be great, in my experience it pales in comparison to the pain that you son has--not just the physical pain, but the emotional pain, too. The emotional pain can be just as great as the physical pain. Let's face it, there is no "good" time for surgery, and sometimes it must take place at absolutely the worst time for your son. There isn't much more pain for a parent to endure than to witness the incredible pain of your child.

My heart goes out to anyone who has to endure this...along with prayers.
Last edited by play baseball
You are so right about that! He is sitting out his first varsity season, and (((may))) have a chance to come in during the last couple of weeks. He goes to every practice, workout, and game and watches his teammates play baseball. Not only is that torture to have to watch, and not participate, but it is just plain boring watching other people take batting practice for 3 hours at a pop. He is doing his best to keep a good attitude and support his teammates, but it is difficult, especially for a 15 year old who just wants to play!

On a good note, he had a great therapy session yesterday....the second hard core one. His therapist was very psyched at how loose his arm had gotten with just a couple of days out of the sling and working it out. He can lift it a little bit over his head without too-too much effort. At this rate I totally foresee him being ready in 6 more weeks to get out on the field. He should start to throw bullpen in 3-4 weeks, so the throwing arm should be back up to speed as well as the recovering glove hand. Now we just hope that the doc agrees that he is ready!

A good surgeon is very important, but equally if not more important is finding a PT guy or gal who knows what they are doing and works regularly with athletes. We are very lucky to have both!
If this were a discussion about TJ, surgery, it would be fine to comment on coming back stronger and better.
However, I don't feel that is at all correct when it comes to shoulders with labral and/or rotator cuff surgery.
For shoulders, the post surgery recovery is tedious, lengthy, and, unfortunately, very unpredictable. It is so unpredictable, especially for pitchers, that you love to hear the stories of those who succeed.
Most of us don't hear the stories of those who are not able to get back and be able to have a shoulder that withstands the rigors of high school, college and professional baseball. For shoulder surgery, that is much more common even with great post surgical PT and player dedication that is remarkable.
When it comes to shoulders and surgery, the results cannot be equated with TJ, when predicting the future.
if you are lifting weight (curling) and monsterous pain hits your forearm and then thereafter the pain from the elbow (lateral epicondyle) to top of forearm muscle is in pain and hard to straighten out for weeks on end. Will this heal naturally or will it require surgury to reattach the muscle/ligament/tendon back onto the outside elbow bone? just curious?

for example, if the elbow (bone - outside) hits a door jam while walking through and you feel immediate pain, this is another example of the pain involved. Hard to lift using the injured arm. Pushing on something produces no pain at all. But pulling something back up with palms down (not up) produces major forearm pain.

Add Reply

×
×
×
×
Link copied to your clipboard.
×