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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.
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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

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