Santana--Shoulder Surgery, Out For The Season

[bmfc1]

�An MRI at the Hospital for Special Surgery in Manhattan yesterday revealed that Mets pitcher Johan Santana has suffered a tear of the anterior capsule of the left shoulder. The injury is located on the front and bottom part of the shoulder close to the pectoral muscle, resulting in discomfort radiating through both the pectoral muscle and shoulder. Santana will undergo surgery in the near future and we anticipate he will be able to resume throwing in the spring.�

[Guest Edgy DC]

Bloody amazing.

[TransMonk]

That's a surgery for each year he's been a Met.

Cripes.

[Guest attgig]

damnit! we need an ace for the playoff push! ... oh wait.. right.

[Guest LeiterWagnerFasterStrongr]

Well, there's your regular starter's slot for Gee.

That it's shoulder surgery is worrisome.

[Ceetar]

LeiterWagnerFasterStrongr wrote: Well, there's your regular starter's slot for Gee. That it's shoulder surgery is worrisome.

It sounds fairly minor, but I guess you never really know. Certainly won't help him build up arm strength/velocity or fight off atrophy.

[Benjamin Grimm]

Carlos Beltran is advising him to wait until January to have the surgery.

[bmfc1]

Good tweet:

craigcalcaterra

Worst part of Johan's surgery: you just know Beltran, Perez and Castillo won't visit him in the hospital.

[Guest Edgy DC]

It does sound relatively minor --- more about the pec than the the shoulder.

But what do I know?

[Ceetar]

Edgy DC wrote: It does sound relatively minor --- more about the pec than the the shoulder. But what do I know?

I'm sure we'll hear all the pseudo-doctors tell us soon. I think the major question is when he starts throwing normally again. and can start building up the muscles and such.

[dgwphotography]

bmfc1 wrote: we anticipate he will be able to resume throwing in the spring.

Why do I not believe this at all?

[Frayed Knot]

'Spring' is kind of a broad term.
Early February is 'Spring Training'. But mid-June is also still 'Spring'

[metirish]

Fuck's sake .......Louis won't bear to look at him when he's all bandaged up.

[Ceetar]

Frayed Knot wrote: 'Spring' is kind of a broad term. Early February is 'Spring Training'. But mid-June is also still 'Spring'

There's a "Spring" every year too.

[Guest Edgy DC]

I don't have a problem believing he'll be throwing in the spring. We just have to be prepared for the reality that one more surgery combined with one more year pushes our man that much further down the road of effectiveness.

But this is certainly not what I'm holding over the Mets heads. Starting pitching isn't what got them into this mess, even as they've been forced to dump two cogs in the unit early on.

[Guest themetfairy]

It's only a flesh wound....

[G-Fafif]

bmfc1 wrote: �... and we anticipate he will be able to resume throwing in the spring.�

Diagnosis from Dr. Chauncey Gardener.

[metirish]

Brian Cashman is a genius.

[Guest themetfairy]

G-Fafif wrote: bmfc1 wrote: �... and we anticipate he will be able to resume throwing in the spring.� Diagnosis from Dr. Chauncey Gardener.

LOL

[ashie62]

Two arm surgeries for Johan. This one after a year of declining velocity. He'll be back but I'm not expecting 200 innings next year.

[Ceetar]

Ashie62 wrote: Two arm surgeries for Johan. This one after a year of declining velocity. He'll be back but I'm not expecting 200 innings next year.

I think the declining velocity is directly related to the surgery actually. was hoping the extra year removed would be benificial, but sounds like not so much.

[Guest John Cougar Lunchbucket]

LeiterWagnerFasterStrongr wrote: That it's shoulder surgery is worrisome.

Yup.

[batmagadanleadoff]

From Adam Rubin:

Santana did not second-guess the Mets' handling of the situation, even though the wrong injury -- a pectoral strain -- originally was announced.

But was it ever a pectoral strain? Did both the Mets and Santana know all along that the pitcher injured his shoulder and not his pec?

From the Wall Street Journal:

Now, according to the team, Mr. Santana has a tear of the anterior capsule of his left shoulder, an injury revealed earlier this week during an MRI at the Hospital for Special Surgery in Manhattan. Mr. Santana had last pitched on Sept. 2 in Atlanta, and anyone who was in the visiting clubhouse at Turner Field that night could see this coming. Manager Jerry Manuel, pitching coach Dan Warthen and Mr. Santana each had offered a different explanation for what had caused Mr. Santana to leave that game after five innings. The principals couldn't get their stories straight. Mr. Santana said he felt tightness in his left pectoral muscle but "felt fine" after seeing a team trainer. Mr. Warthen, characteristically blunt, said that Mr. Santana's shoulder "wasn't right" and that a doctor had examined him. And Mr. Manuel, in addressing the matter with reporters after the game, needed prompting from a team spokesman. "Arm or chest?" Mr. Manuel asked. "Chest," the spokesman replied. "The chest? Really?" Mr. Manuel said. "I don't know the anatomy very well."

More from Rubin:

"I don't know. I don't really know," Santana said about the timeline for his return during a news conference to discuss what has been diagnosed as a tear of the anterior capsule of his left shoulder, which will require surgery. "This is something that I was told is going to take time. I just have to wait and see. I think the most important thing is to be ready to be 100 percent whether it's April, whether it's May, July, October. Who knows? Time will tell."

Of course, I have no idea when Santana will return. He hasn't even undergone surgery yet. But I'm ignoring the team's expectations for an April return from Santana because the team's priority is to sell tickets -- not to keep us fans accurately apprised. I wouldn't expect ownership to publically concede that Santana's recovery might, for example, take up to 12 months even if that was the most accurate prognosis: the team's decision not to pursue expensive free-agent talent for the 2011 season coupled with an admission that Santana might miss half of next season or more would likely erode next year's season ticket base. The Mets (and every other team) would rather mislead if they believed that honesty would hurt their gate.

Edited September 10, 2010 by Guest

[ashie62]

From Adam Rubin: Santana did not second-guess the Mets' handling of the situation, even though the wrong injury -- a pectoral strain -- originally was announced. But was it ever a pectoral strain? Did the Mets know all along that Santana injured his shoulder and not his pec? From the Wall Street Journal: Now, according to the team, Mr. Santana has a tear of the anterior capsule of his left shoulder, an injury revealed earlier this week during an MRI at the Hospital for Special Surgery in Manhattan. Mr. Santana had last pitched on Sept. 2 in Atlanta, and anyone who was in the visiting clubhouse at Turner Field that night could see this coming. Manager Jerry Manuel, pitching coach Dan Warthen and Mr. Santana each had offered a different explanation for what had caused Mr. Santana to leave that game after five innings. The principals couldn't get their stories straight. Mr. Santana said he felt tightness in his left pectoral muscle but "felt fine" after seeing a team trainer. Mr. Warthen, characteristically blunt, said that Mr. Santana's shoulder "wasn't right" and that a doctor had examined him. And Mr. Manuel, in addressing the matter with reporters after the game, needed prompting from a team spokesman. "Arm or chest?" Mr. Manuel asked. "Chest," the spokesman replied. "The chest? Really?" Mr. Manuel said. "I don't know the anatomy very well." More from Rubin: "I don't know. I don't really know," Santana said about the timeline for his return during a news conference to discuss what has been diagnosed as a tear of the anterior capsule of his left shoulder, which will require surgery. "This is something that I was told is going to take time. I just have to wait and see. I think the most important thing is to be ready to be 100 percent whether it's April, whether it's May, July, October. Who knows? Time will tell." Of course, I have no idea when Santana will return. He hasn't even undergone surgery yet. But I'm ignoring the team's expectations for an April return from Santana because the team's priority is to sell tickets -- not to keep us fans accurately apprised. I wouldn't expect ownership to publically concede that Santana's recovery might, for example, take up to 12 months even if that was the most accurate prognosis: the team's decision not to pursue expensive free-agent talent for the 2011 season coupled with an admission that Santana might miss half of next season or more would likely erode next year's season ticket base. The Mets (and every other team) would rather mislead if they believed that honesty would hurt their gate.

This is frightening to me. I think I am having a "Strasburg Attack"

[Guest Edgy DC]

Mets current rotaton came into this season with 52 victories among them.

Pelfrey: 28
Dickey: 22
Niese: 2
Mejia: 0
Gee: 0

Plus number six Pat Misch had three career victories going into this season and hasn't yet won this year.

[Ceetar]

I don't know where I read it, but from what I was lead to understand, one of the _symptoms_ of this torn capsule is pain/discomfort in the pectoral muscles. _everyone_ was correct in what they were talking about, this wasn't some underhanded sneaky "Let's not tell anyone what's going on and mislead everyone" it was simply different parts of the same thing.

[MFS62]

His return may take longer than as has been reported.
From Adam Rubin's ESPN blog:

Dr. Jonathan Glashow, an orthopedic surgeon and co-chief of sports medicine at New York�s Mount Sinai Medical Center, who formerly worked as a New York Rangers team doctor, offered his insights on anterior capsule tears. That�s the injury that Johan Santana will require surgery to repair. Glashow believes Santana may have difficulty going full throttle at the beginning of next season, even under the best-case scenario. And if doctors find rotator cuff damage when they go inside, the prognosis gets significantly worse. What are the main points to make about anterior capsule tears? �You can kind of think of the anterior capsule as the front ligaments of the shoulder. The ligaments are just really thickenings of the capsule. And it sounds like from what I�ve just briefly read about this, the ligaments are stretched. I don�t know if he�s got a damaged labrum. The big distinction here, and the important distinction, is whether the rotator cuff is involved. If it�s simply the capsule, plus or minus the labrum to a small degree, his return is much more predictable and quick. If his cuff is damaged more than they think -- and you may say, 'Well, they have an MRI,' but MRIs are less than perfect -- then I think there�s a big question mark whether he comes back at the same level and how long it takes him to come back. Some MRIs are better than others. And even in the best-case scenario, it�s never until you look inside that you know exactly. The question is not going to be fully answered until somebody looks in there and says, �Hey, his cuff is fine. Great. It�s maybe five or six months.� Or, if it�s more of a cuff issue, that�s a significantly longer problem and less predictable.� How does this happen? �It�s not so uncommon in my experience. It�s an overload injury. It�s the repetitive throwing that causes that rip in the capsule as opposed to one dramatic episode like a fall on an outstretched arm that may cause a dislocation and a big labral tear. It�s probably a repetitive thing that happens due to the constant forces on the shoulder -- wear and tear with some accentuations by recent throwing. The distinction whether it�s just capsule, or whether it�s capsule and labrum, I don�t think that makes a big difference. The big difference comes in how much of the cuff is involved. If the cuff is not really involved, quicker rehab, more predictable. If the cuff is involved, slower and less predictable. And then there�s the degrees of that. Age is a little bit against him. He�s been throwing now for how many years at 31? That puts a lot of wear on the cuff and on the labrum. But if he gets it early enough, which it looks like they�re doing and they fix it, it�s not unheard of that he comes back in six months. I think before six months is going to be tough.� And six months to begin throwing? Or in competitive games? �Six months to throwing a ball. I think that�s the short side. That�s optimistic. That�s if it�s a minor capsular tear where they can sew it back, it�s a quick rehab and everything goes right -- no glitches. I think six months is very optimistic. I think the likelihood is greater than that. It could be up to two years. Certain shoulders take 18 to 24 months to mature, especially those with larger rotator cuff issues. But that does not seem like the case here. But he�s got a lot of wear and tear on his shoulder. I�m sure. All pitchers at his level have some damage to the cuff. And then when you shut down the shoulder for a little while, rehab is a big deal. For every couple of months it�s shut down, it takes a couple to three months to bring it back. So the rehab is going to be a really important part of his game -- that he�s doing the exact right rehab so he doesn�t let everything else atrophy, so when he starts to go out to throw, things that were not repaired are not shut down and come back quicker. There are a lot of question marks here. But certainly this season he�s out. I wouldn�t count on him being great for the beginning of next season. It could be theoretically nine, 10 months out, which would put him into early to the middle of the season next year. It�s not unreasonable to expect, if it�s a better scenario going inside and he does all the right rehab, that he comes back potentially at the same level. But it�s hard to predict. I�d rather have somebody who is younger and doesn�t have as many miles on his shoulder.� BIOGRAPHY: Dr. JONATHAN GLASHOW is an orthopedic surgeon and co-chief of sports medicine at New York�s Mount Sinai Medical Center and has been in private practice for 18 years. He specializes exclusively in shoulder and knee injuries including advanced arthroscopic all-inside ACL reconstruction, double-row suture bridge rotator cuff repairs, as well as state of the art techniques to repair labral, meniscal and condral injuries. Dr. Glashow acted as a medical media consultant for ESPN Sports and was a frequent guest on their morning sport commentary �Cold Pizza.� His guest appearances on news broadcasts include CBS World News Tonight and most recently on CNN Evening News with John Roberts for his expertise on the usage of platelet-rich plasma (PRP) injections for expediting the healing process of certain injuries. After receiving his medical degree from Cornell University Medical College, Dr. Glashow completed his residency at Lenox Hill Hospital in Orthopedic Surgery. He went on to earn subspecialty fellowship training in sports medicine and arthroscopic surgery at the Southern California Orthopedic Institute/UCLA in Los Angeles, followed by a traveling Shoulder Fellowship in London, Ontario, Canada, and the University of Texas at San Antonio.

Oy!
Later

[ashie62]

Oh dear Lord.

[Guest Edgy DC]

"I think there�s a big question mark whether he comes back at the same level and how long it takes him to come back."

It comes down to that. I think we're all there at this point. This will be an adventurous offseason. After shopping for (most probably) a new manager and (less probably) a new GM, they have very big question marks in Santana, Bay, and Beltran --- their three highest paid players.

Enjoy it.

[DocTee]

Glashow repaired my knee in 1995 and it has not caused me any problems since. If he can fix me, Johan should be no problem!