Niese headed to Dr. in NY

[ashie62]

http://hardballtalk.nbcsports.com/2013/06/20/jon-niese-leaves-start-with-apparent-injury/

Funny that Terry told the WS Journal the previous tendinitis was not an issue...

[Edgy MD]

It's isn't until it is. It is until it isn't.

Congratulations to Shaun Markup, though, huh? Calling up Burke instead of a starter may keep the Marcsist in the rotation.

On the other hand the next best candidate to enter the rotation is Carlos Torres, and he's already on the team.

[Zvon]

Crap.
Mets place Jon Niese on DL with slight tear of rotator cuff:
http://www.cbssports.com/mlb/blog/eye-on-baseball/22499186

[ashie62]

Crap. Mets place Jon Niese on DL with slight tear of rotator cuff: http://www.cbssports.com/mlb/blog/eye-on-baseball/22499186

Surgery may not be necessary.

Its not like Niese hs been terribly effective anyway.

[Centerfield]

Wow, this is awful. Isn't a partially torn rotator cuff one of those things they say you can pitch with, or rehabilitate without surgery, but inevitably leads to surgery, being out for the season, then coming back but never being as effective as you were before it?

I feel like we've been down this road with the two Pedros (Astacio and Martinez).

[Benjamin Grimm]

Andrew Keh, New York Times wrote: John Ricco, the Mets� assistant general manager, said the tear was discovered through a magnetic resonance imaging exam on Friday, the day after Niese was pulled from a game because of discomfort around his shoulder. Niese, a 26-year-old left-hander, was placed on the disabled list. He will rest for two weeks and then have another M.R.I. exam, at which point the team doctors are expected to make a recommendation on whether surgery is necessary. The Mets hope a procedure will not be necessary. Rotator cuff injuries � shoulder ailments as a whole, really � are considered ominous. The rotator cuff refers to the muscles that move the shoulder; the tendons that connect the muscles to the bone are susceptible to tearing. For some athletes, surgery can be avoided if the surrounding muscles are strengthened to the point that they can compensate for the weakened tendon. Pitchers who resort to rotator cuff surgery generally require several months to return to game form. Ricco said the team doctors believe Niese�s partial tear could be small enough that surgery will not be needed. Furthermore, the doctors indicated that the tear could start to heal on its own. Ricco was unwilling to offer a best-case return date. �He�s going to rest for two weeks, and I�m not going to speculate beyond that,� he said. �We have a plan for the next couple of weeks, and we�ll see how that goes.� Niese missed a start earlier this month after he was found to have shoulder tendinitis. An M.R.I. administered on May 30 revealed no structural damage. After skipping one rotation turn, Niese came back to pitch twice before Thursday�s outing, when he said he began to experience pain again. According to Ricco, the current tear occurred sometime after the initial first test.

So it could start to heal on its own, and if it doesn't, they might be able to strengthen the surrounding muscles, so that he can pitch with the tear.

I don't know how likely either of those things are to actually happen, but it seems that that's what we need to be rooting for.

[Ceetar]

I played Google doctor a little after it was announced for some of the more recent cases. Two guys this year Both Chris Narveson and Roy Halladay had surgery.

Tommy Hanson was diagnosed in August 2011, didn't have surgery that I can find, but had has poor 2012 blamed on the rotator cuff.

Brandon Lyon had the diagnosis in April of 2011 and missed a month before returning for 3 games. He then developed biceps tendinitis and had surgery for that and the shoulder and missed the season. It's unclear whether the tendinitis was related, was based on adjusting his motion, or what not. It seems like surgery for that is rare, and Lyon's case was more of there just being too much wrong so let's go in and fix what we can.

So Dr. Ceetar sees a glimmer of hope, but someone smart has to make sure Niese isn't altering his delivery. If he is, it very likely could mean reduced velocity like Hanson, or other injuries like Lyon.


Now to the "why bother, the Mets suck" angle, which always bothers me. Guys want to pitch, they want to play, the team wants to win. You don't just wrap guys in a bubble until you can use them to fire the fatal shot. they might be rusted in the gun. But you don't want to go into the offseason with Niese as an unknown either. Sure, don't rush him back in a month, but you'd like to see him come back and pitch too.

[TransMonk]

Niese is young, we have a few more years invested in him and the team isn't winning any pennants this year. If there is a choice to be made, I say give him the surgery and have him as healthy as he can be for 2014 with as few question marks as possible.

I am very wary of this just working itself out. That type of situation NEVER works out for the Mets.

[Edgy MD]

The choice is certainly the player's, though teams may certinly push them one way or another.

If a choice is to made, I think, the pitcher with a few years on his contract typically gravitates toward reparative surgery, while a pitcher at the end of his contract looks to strengthen himself and pitch through it.

[Ceetar]

either way though, giving it the two weeks to see what it looks like seems like the smart "more information" avenue to take. Remove the stressor and see what happens. vis-a-vis healing. Worst case is you get into that murky "well, it seems better, let's give it another 2 weeks" cycle, but being able to NOT cut into a pitcher's shoulder always feels like a great idea.

[metirish]

Centerfield wrote: Wow, this is awful. Isn't a partially torn rotator cuff one of those things they say you can pitch with, or rehabilitate without surgery, but inevitably leads to surgery, being out for the season, then coming back but never being as effective as you were before it? I feel like we've been down this road with the two Pedros (Astacio and Martinez).

This

[ashie62]

They wait two weeks to see if the inflammation goes down and then cut...Out one year..