History shows good and bad of labrum surgery
Posted by: Chad Jennings - Posted in Misc on Apr 26, 2012 
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As you start digging around the Internet for information about torn labrums, there’s one line that’s cited time and time again. It comes from Will Carroll’s 2004 story for Slate, and it puts the worst-case scenario into a rather harsh perspective:
“If pitchers with torn labrums were horses,” Carroll wrote. “They’d be destroyed.”
As you might have guessed, the worst-case scenario for Michael Pineda is pretty bad. It’s not dead-horse bad, but it’s bad. Ever wonder what happened to Jason Schmidt? He had a torn labrum. So did Erik Bedard.
The best-case scenario, though, is pretty good. Chris Carpenter had a torn labrum in 2002 and won a Cy Young award three years later. Curt Schilling had a slight labrum tear in 1995 and came back for the best years of his career.
Some pitchers can come back from this, but not all of them.
“(Pineda) does have youth on his side, I will say that,” Joe Girardi said. “He doesn’t have a ton of mileage in his arm as a younger player, so I think that bodes well for him. None of us are ever really going to know until we get to that point.”
I’m far from an expert on this sort of thing, but there’s plenty of recommended reading out there.
If you’re looking for the nuts and bolts of the labrum and the surgery, read Carroll’s story from Slate. If you want to see the inside of a shoulder, check out Schilling’s blog, where he documented his second labrum surgery in 2008. When Bedard had his surgery two years ago, Larry Stone looked at a few past cases of labrum surgery. A few years before that, Dave van Dyck in Chicago also wrote about past cases of torn labrums. For Pineda, there’s good news and bad news about his long-term potential, and like Girardi said, we won’t know anything until we get to that point.
Nick,
I’ve heard rumors that blake was the villain in “Marathon Man”, and Bronx, he used NO novacaine.
He kept on saying “Bidding on Yu Darvish… is it safe?”
tomingeorgia April 26th, 2012 at 3:04 pm
Nick,
I’ve heard rumors that blake was the villain in “Marathon Man”, and Bronx, he used NO novacaine
********
Yes – but is it safe?
I wonder how much of a factor the skill of a surgeon plays in the outcome.
Rich in NJ April 26th, 2012 at 3:07 pm
I wonder how much of a factor the skill of a surgeon plays in the outcome.
———————-
Anyone can cook a steak – takes someone who knows what they’re doing to make it worth eating though.
OK, Chip, then we need to know how many of these operations this surgeon has done, and what his success rate is.
I’m still blown away by the fact that Pineda and his agent insisted on using the Mets team physician.
The fact that he came into camp heavy and out of shape in the most important year of his career indicates a lack of dedication. So why should we be led to believe his rehab will be taken seriously. Its time to grow up and put things into perspective.
i can’t read anything else about this injury. makes me upset and sad.
Cash did all he could. the Yankee doctors did all they could as well.
very bad luck. nothing could have been done a few months ago.
MaineYankee, I read your post on the previous thread.
While I’m happy for you about the clean test and hopeful that your back improves and you quit smoking and enjoy more time with your family, you sound like a prime candidate to be sent to Montero Purity Camp, because it’s clear your priorities are all messed up if you put those parochial concerns ahead of being upset about the trade.
RESIGN CASH RESIGN!!
It seems the list of orthopedic surgeons trusted by MLB teams is pretty short, and they’re probably all multimillionaires by now. Whos best at labra (-ums) is another question.
Another factor to consider in reading these articles, 2004 was a lifetime ago in the world of medicine. Hopefully some of the horror stories are no longer relevant.
Who did Chris Carpenters’?
CMW had labrum surgery twice I believe.
Pville April 26th, 2012 at 3:14 pm
Another factor to consider in reading these articles, 2004 was a lifetime ago in the world of medicine. Hopefully some of the horror stories are no longer relevant.
****************************************************************
Last night on Baseball Tonight Mark Mulder(he had the same injury) explained that Tommy John surgeries these days are second nature to doctors.
Mark said that shoulder surgeries are far more complex and doctors are still learning about
the shoulder area. I think, I think Mark said there is a 20% chance a pitcher will not recover from torn labrum surgery.
Based on what Mark said last night, that makes me concerned about the likelihood of Pineda’s recovery.
Nick,
Montero Purity Camp has been renamed. It’s now “Young Pitcher Avoidance Reorientation Studies.” Attendance is required, and enforced.
hardwired7 April 26th, 2012 at 3:11 pm
I’m still blown away by the fact that Pineda and his agent insisted on using the Mets team physician.
———————-
I’ll say this again isn;t the problem with the Mets based on the belief they went against the doctor’s recommendation.
Doctor:He needs to go on the DL and work his way back
Mets: Give him a few days off and then send him back out there.
Nick in SF April 26th, 2012 at 3:12 pm
MaineYankee, I read your post on the previous thread.
While I’m happy for you about the clean test and hopeful that your back improves and you quit smoking and enjoy more time with your family, you sound like a prime candidate to be sent to Montero Purity Camp, because it’s clear your priorities are all messed up if you put those parochial concerns ahead of being upset about the trade.
——————————————————————
Thanks Nick.
I’ll give it some serious consideration.
“I wonder how much of a factor the skill of a surgeon plays in the outcome.”
Very good question Rich. My brother & I were talking about this yesterday. It’s something that’s not really discussed all that much. Everyone assumes that just because a doctor is used by an MLB team that he is good- is it fair to assume that? Obviously James Andrews is known to be excellent, but other than that, who are these guys? How good are they? You need a certain knowledge/skill level to make it to where they are for sure, but overall it is an interesting topic to think about.
Rich in NJ April 26th, 2012 at 3:11 pm
OK, Chip, then we need to know how many of these operations this surgeon has done, and what his success rate is.
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Ahmed is one of the best guys in the country I believe.
Altchek did Posada’s shoulder surgery in 08.
Rich, here’s some info on Dr. Christopher Ahmed:
http://vesta.cumc.columbia.edu.....?id=ortho4
-repost-
Look, Cashman pre-empted this whole discussion by admitting the trade was a big risk when it was made – it was the potential for injury (much more likely for a young pitcher) vs. success. Whether he was coerced into making this trade (or something like it) by Mini-Me Boss we may never know. He knows the fanbase isn’t stupid.
I was in the camp of not trading Montero unless it was for an established ace (at least that was the line we had previously been fed). Strategically, it made no sense. The $189 mil magic number (and let’s be real here, it’s not set in stone by any means b/c we all know s**t happens) caused Cashman (& probably others within the organization) to jump the gun with Montero.
What was the rush exactly? No place for him? Give me a break. He couldn’t catch 50-60 games & DH another 50-60? How was that going to disrupt the entire team? Say Montero’s upside is Posada (who was also not known as a defensive catcher)? Are you going to sour on his defense that easily as a means to get rid of him? You’ve got Martin, Girardi, Pena, etc. to mentor this kid, with Romine (& others in the low minors) waiting in the wings. What was the rush? You have multiple pitching prospects in AAA, why are you looking at an “inexpensive potential future ace” instead of a more established one that’s not in that “injury matrix”?
You’ve got an aging offense, and look – the Yankees are disrupting their whole team over one guy – and its ARod (gotta leave that DH spot warm for him for the next 5 years, you know) plus any other potential impact bats are at least 2-3 years away. I think the point of many people’s frustration (mine at least) was that it was a flawed strategy from the beginning, and the organization basically outsmarted themselves trying to stay under “the magic $189 million”. And guess what, don’t be shocked if that now gets tossed out the window as well.
“Ahmed is one of the best guys in the country I believe.”
That would be encouraging. If Pineda ever returns to being what they thought he would be, Ahmed could become a celebrity-surgeon, like Andrews or Jobe.
My luck, if I never need the surgery, Ahmed will be out of my network.
I still don’t get how Montero wouldn’t have had a position on a team where we managed to find room for Jones and Ibanez… the same player, basically.
If we didn’t have room for the kid to DH, why did we have to pay two other guys to fill out that role?
It’s just flawed logic, even if it was the context in which they made the trade. People are making it seem like Montero was a SS that we weren’t going to get in the line-up until after 2014 instead of coming up as a catcher after our All-Star offensive catcher just retired. If you can find ABs for Nunez, Chavez, Ibanez, AND Jones….. I’m pretty sure they could’ve given the kid a few. And not spent an extra million+ on some of those players. Since we’re so cost conscious, I would think that’d be important.
Even if you assume Arod will be the DH in two season…. that still two season from now.
It’s not just the immediate result of the surgery that’s important but the longer term prognosis, and that is not so great.
Most guys seem to have issues following on.
Again, the list of surgeons used at the top echelons of sports is pretty short. Who’s the guy in Colorado who did ARod’s hip? Does he do shoulders, or is that a subspecialty?
Let’s hope with this new thread, cooler heads will prevail.
The Pineda mess aside, the Yankees seem to get out of the gate slow every year. If Pettite can give them someting, I think we’re still in pretty good shape with starting pitching. The bats will pick it back up again.
Since I’ve been coming to this blog ( about 4 years ), we always have this angst in April.
Thanks, Chip. Anyone who went to NYU can’t be all bad.
theREALkevin April 26th, 2012 at 3:20 pm
“I wonder how much of a factor the skill of a surgeon plays in the outcome.”
Very good question Rich. My brother & I were talking about this yesterday. It’s something that’s not really discussed all that much. Everyone assumes that just because a doctor is used by an MLB team that he is good- is it fair to assume that? Obviously James Andrews is known to be excellent, but other than that, who are these guys? How good are they? You need a certain knowledge/skill level to make it to where they are for sure, but overall it is an interesting topic to think about.
———————————————————————
They are just mad scientists in a lab using these guys as guinea pigs.
The guy who did A-Rod’s hip only works on Centaurs.
MTU April 26th, 2012 at 3:23 pm
It’s not just the immediate result of the surgery that’s important but the longer term prognosis, and that is not so great.
Most guys seem to have issues following on.
——————–
Given how cautious the Yankees are when it comes to pitchers in general I’m sure that they will wrap Pineda in bubble wrap and Styrofoam popcorn until he is 100% rehabbed.
April angst brings May pranks?
(pending thinking up an actual -gnst rhyme)
Nunez is a worse all around player than Montero but the Yankees seem to have found a routine to get him lots of at bats!
According to that Will Carroll article, Pineda has a 3% chance of regaining his previous form?
Did I read that correctly?
Maybe Pineda should have one of those mystery surgeries that Colon had
Maine-
I was sorry to read about all of your troubles but glad to hear the results are good.
Hiked with a gal from Maine yesterday.
I told her about you.
who’s on suicide watch???
Jerkface April 26th, 2012 at 3:27 pm
Nunez is a worse all around player than Montero but the Yankees seem to have found a routine to get him lots of at bats!
——————
Nunez is capable of playing in the field – he may not do so well all the time, but he’s at least capable.
Given that the Yankees demoted Cervelli in favor of Stewart to improve defense behind the plate I find it hard to believe there was ever a shot that Montero was going to get time back there.
jackamir April 26th, 2012 at 3:12 pm
The fact that he came into camp heavy and out of shape in the most important year of his career indicates a lack of dedication. So why should we be led to believe his rehab will be taken seriously. Its time to grow up and put things into perspective.
———————————————–
Players can get a kick in the backside and become dedicated to conditioning. When they are young they can feel indestructible and they can get a wake up call when they hit a wall. Look at Shilling. He was a decent pitcher that became dominant after Clemens gave him a kick in the pants. I think Pettitte also benefited from that Clemens attitude (minus the PEDs).
“According to that Will Carroll article, Pineda has a 3% chance of regaining his previous form?”
Right, but that was in 2004 (a long time ago in a medical context as someone suggested).
So has the technique improved, and has any research/review discovered what contributes to having a successful outcome?
Chip-
What I really meant was in the years following.
The 5 year outlook.
Sorry I did not make that clear.
“According to that Will Carroll article, Pineda has a 3% chance of regaining his previous form?’
No, once he finishes his shoulder rehab, he’ll have to go to the fat farm to lose at least 3% of his form.
MTU April 26th, 2012 at 3:28 pm
Maine-
I was sorry to read about all of your troubles but glad to hear the results are good.
Hiked with a gal from Maine yesterday.
I told her about you.
————————————————————
Thanks.
I have a good support group, starting from above.
Where does she live?
“who’s on suicide watch???”
If you know something, you have a duty to come forward.
Bronx Jeers April 26th, 2012 at 3:28 pm
According to that Will Carroll article, Pineda has a 3% chance of regaining his previous form?
Did I read that correctly?
———————–
No you didn’t.
What the Carroll article says is that as of 2004 3% of major league hurlers had recovered from the surgery.
That was almost a decade ago – lots of changes have been made in the medicine and rehabilitation since then.
Rich-
There was interesting article posted yesterday about a Dr. named Romeo (no. Not that romeo) who is
working on a new technique that might show promise.
It is not generally available as of yet as far as I could tell.
You might try googling it if you are interested.
Nunez is capable of playing in the field – he may not do so well all the time, but he’s at least capable.
–
Montero can catch as well as Nunez can field and throw.
I have made it a life-long goal to stay away from men or women with knives. Broken hip made it unavoidable. The Frau mad every effort to find the best around, a career military doctor who has had a lot of practice patching guys up. After a little more than a year, I’m still feeling it, but that’s not a surprise after three score and eight. I hope a big healthy 23-year-old gets over it a lot quicker than I. Godspeed, Michael.
Who cares ? ? ? Once the MD’s who are trained and qualified open him up and fix it they will give the prognosis going forward, good, bad or otherwise.
It is what it is……………………………………..
MTU
This?
http://articles.chicagotribune.....overy-time
MTU
I told her about you.
—————————————————————-
Is that good or bad?
maine-
You’re welcome.
She lives out here now but was originally from the Bangor area.
She was familiar with Cadillac Mtn.
Called it a hill.
She mentioned the name of the tallest mtn. in Maine but I already forgot what it was.
We also talked about the White mtns. as we both had hiked them.
Rich-
that’s the one.
Rich in NJ April 26th, 2012 at 3:32 pm
“who’s on suicide watch???”
If you know something, you have a duty to come forward.
———————————————————————
Proceed with caution.
:
MTU
Then an enterprising reporter should ask Ahmed about it, maybe Pineda’s agent as well.
My labrum is fine.
It’s just the rest of me that needs a workout.
I’ll be back in a while.
MTU,
Mt. Katahdin, Northern terminus of the Appalachian Trail.
By the way, has Randy made an appearance ?
He wasn’t around this AM.
COOL – I just traded mason williams for carl crawford.. props to me!!!
#mri’smeannothing#
Thanks Tom.
That wouldn’t even be a hill out here.
MTU
This is it.
http://en.wikipedia.org/wiki/Mt._Katahdin
Nunez can’t handle routine balls hit straight at him but he’s considered by some on here to be the heir to Jeter’s throne… meanwhile, Montero might have below to average defensive skills and we don’t trust him to back up a plus-defensive catcher?
Worse than being mad at science, this is.
MTU April 26th, 2012 at 3:43 pm
By the way, has Randy made an appearance ?
He wasn’t around this AM.
—————————————————————-
Probably he’s out trying to dig up some dirt on Cashman so he can bury him.
MTU April 26th, 2012 at 3:43 pm
By the way, has Randy made an appearance ?
He wasn’t around this AM.
———————
Randy is probably taking everything in, reading the articles on what’s in store for MP, and formulating his ideas. He won’t gloat about Pineda being serious hurt but he’ll slice in half the FO and posters on here
Maine-
Thanks to you as well.
I told her you were a dairy farmer and where you were from.
I think she thought she might have known you by your buisness.
I don’t think she did though.
See. Not everyone from Maine thinks all we have are rocks and piles of sand out here.
what nickname do u think girardi will give to saltalamacchia once i trade gary sanchez for him?
#yacan’tstopme#
It’s just bad luck. It happens.
I received a fantasy baseball trade offer—-they wanted me to give them Mike Napoli in exchange for Carl Crawford.
Obviously, they live in a vacuum. Or they think that I do.
MTU,
There are some tough routes up Mt. Katahdin, and it has claimed quite a few lives of rash climbers. I climbed it long ago by one of the milder routes, and that was enough for me. Not like climbing a pinnacle at Bryce, but still enough for me.
“…but he’ll slice in half the FO and posters on here”
If he does it with his usual acumen, I think they and we will survive.
Tom-
I found the White’s of NH challenging at the time.
Saw these little ladies yesterday :
https://picasaweb.google.com/109721757058432487394/TaylorCreekDeer?authkey=Gv1sRgCOCCl_fI38agogE#
Enjoy. I’ll be back a little later.
Rays walk-off homer, sweep Angels.
@the fakecashman April 26th, 2012 at 3:43 pm
COOL – I just traded mason williams for carl crawford.. props to me!!!
#mri’smeannothing#
____________________________________________
Its a shame that precious forum space gets wasted on such bad humor
MTU,
I have more deer in my back yard right this instant, but they’re not mulies.
Shame Spencer April 26th, 2012 at 3:46 pm
Nunez can’t handle routine balls hit straight at him but he’s considered by some on here to be the heir to Jeter’s throne… meanwhile, Montero might have below to average defensive skills and we don’t trust him to back up a plus-defensive catcher?
Worse than being mad at science, this is.
********************************************************************
Despite his faults on D, I still have a lot of faith in Nunez. He very well could be the SS of the future. There is nothing holding him back from improving his defense. Cano was able to improve year after year with a lot of hard work, so I have faith Nunez will also improve his defense.
I would never compare Nunez or any other young player on the Yankees roster to a future HOF like Jeter or Mo or ARod. That is so unfair and clearly setting someone up to be disappointed.
tomingeorgia April 26th, 2012 at 3:51 pm
MTU,
There are some tough routes up Mt. Katahdin, and it has claimed quite a few lives of rash climbers. I climbed it long ago by one of the milder routes, and that was enough for me. Not like climbing a pinnacle at Bryce, but still enough for me.
—————————————————————————-
I’ve never been up it but all 3 of my kids have.
I think they all have crossed knifes edge.
I live near the White Mountains of NH. The Presidential Range all are over 5,000 footers. They are not “hills” by any means. Alot of people tackle these mountains unprepared and get lost. Weather can be unpredictable too. Of course, Mt Washington is the tallest.
MTU April 26th, 2012 at 3:48 pm
Maine-
Thanks to you as well.
I told her you were a dairy farmer and where you were from.
I think she thought she might have known you by your buisness.
I don’t think she did though.
See. Not everyone from Maine thinks all we have are rocks and piles of sand out here
——————————————————————————————
Ask Chad for my e-mail so I can tell if I know who she is.
NYY fan in NH April 26th, 2012 at 4:07 pm
I live near the White Mountains of NH. The Presidential Range all are over 5,000 footers. They are not “hills” by any means. Alot of people tackle these mountains unprepared and get lost. Weather can be unpredictable too. Of course, Mt Washington is the tallest.
————————————————————————
I can see Mt. Washington from my place. Especially when it’s all white.
I’m about 50 miles from Conway.
Let me make sure I have this straight. So the guy Brian Cashman traded for was healthy, even though he was clearly never right from the word, go.
Okay… Got it.
Next time, pull on my other leg. It plays Jingle Bells!
MTU
Let me rephrase that so it doesn’t sound so stupid.
I would like to see if I know who she is so if you get my e-mail from Chad we can discuss it.
This is all we need to know:
“We’re being cautiously optimistic,” Dr. Ahmad said. “One of the nice features of his injury is that his rotator cuff is not injured as part of this. His rotator cuff looked very, very good. When the rotator cuff is damaged as part of the injury problem, that has a much worse prognosis and influences velocity and ability to pitch. His rotator cuff looks great and this is isolated to his labrum, and that’s why we feel more optimistic about him having a good result.”
Nothing to worry about right now. We can worry about it in a year. The Yankees will protect Michael and make sure he does the appropriate amount of rehabbing. I’m sure of it.
One thing I think is weird about Ahmad is that he’s the head physician for over 20 sports teams. I have no idea if this affects his ability to oversee the Yankees but I would think the Yankees would have someone with less obligations.
Atlchek, like many of the other othropedic surgeons at HSS, work at their practice and deal with one professional team in the NY metro area.
Not sure what to make of it but I do think it’s interesting. Anyway, based on personal experience I’d trust the othropedic surgeons at HSS over anyone so I’m glad Pineda requested Atlchek.
“Despite his faults on D, I still have a lot of faith in Nunez. He very well could be the SS of the future. There is nothing holding him back from improving his defense. Cano was able to improve year after year with a lot of hard work, so I have faith Nunez will also improve his defense.”
Which is why I find it so funny that while Nunez is looked at as having potential Montero is looked at like a bear wearing a catcher’s mask.
“I would never compare Nunez or any other young player on the Yankees roster to a future HOF like Jeter or Mo or ARod. That is so unfair and clearly setting someone up to be disappointed.”
I wasn’t. I was merely putting Nunez in the same category as Montero: A young, thus far unproven commodity.
Was Ahmad seen talking in hushed tones on his cell phone when he gave Pineda the go-ahead to pitch before the extended spring training debacle?
Was the word “chowda” overheard?
Is anything on the line for the Knicks tonight?
Nick
Is anything on the line for the Knicks tonight?
——————————————————————-
Maybe if they take foul shots.
Is anything on the line for the Knicks tonight?
——
Not that it matters much but 7th/8th seed still in the air.
I’m going to chalk that one up to the back pain.
Get better, MaineYankee. We’re all pulling for you.
MTU and Jacksquat-
Thanks for posting the article on Dr Romeo’s technique of biceps tenodesis, or removing the attachment of the biceps tendon from the inside of the capsule and implanting it outside. Interesting concept, but it might need more of a track record before it becomes the TJ of shoulder surgeries for a torn labrum. It looks like Dr Andrews has also tried the technique.
Hoping when they actually scope the shoulder that the labral tear is minimal and the rotator cuff is intact.
Jim Bowden just said that he would have asked for a saline enhanced MRI before trading for Pineda and that Dr. Andrews always told him that a reguakr MRI is nearly useless …..
Thanks, LGY.
Have you settled up with Pat M? How many Ritter Sports exactly do you owe him, if not?
He owes 5 to me. I owe 5 to Patrick. Nobody owes anything to you and Patrick owes nothing to anybody.
I’ll trade my steak dinner for everyones Ritter bars.
blake April 26th, 2012 at 4:42 pm
Jim Bowden just said that he would have asked for a saline enhanced MRI before trading for Pineda and that Dr. Andrews always told him that a reguakr MRI is nearly useless …..
——————————————-
Motherf*ck.
Nick in SF April 26th, 2012 at 4:02 pm
Rays walk-off homer, sweep Angels.
~
‘t was a beautiful thing
Any thoughts on looking for another starter outside of the organization, or just wait until we see what Pettitte does and what happens with Hughes and Garcia in their next 3 start?
FA Roy Oswalt ?
Bret Myers might be available, but currently is closing?
Right now the Yankees have:
Sabathia starting to come around
Kuroda alternating between very good outings and not so good outings
Nova who has been consistent
Hughes whose outings are getting shorter
Garcia whose outings are worse each time out
Phelps who looked like a good 4 pitch starter, but has been hittable his last two outings
Nick in SF April 26th, 2012 at 4:40 pm
I’m going to chalk that one up to the back pain.
Get better, MaineYankee. We’re all pulling for you.
———————————————————-
I thought that was pretty good.
I guess I have to go to the good humor school of SF in order to improve.
Unlike that phantom steak dinner, these Ritter Sports will be paid off, or at least the ones tha Pat M. and I owe. LGY’s too, hopefully.
The question is, should a bunch of people send Ritter Sports to each other or should Person A just pay off Person D?
The Ritter Sport company votes for each bet being paid off discretely.
Nick
I think the Knicks are planning to rest some of their players so I’d be careful betting on them tonight even though they are playing the lowly Bobcats.
Pat told me to hold off on sending the Ritters because it looks like our Swish/Vernon Wells bet will almost assuredly end in my favor.
blake April 26th, 2012 at 4:42 pm
Jim Bowden just said that he would have asked for a saline enhanced MRI before trading for Pineda and that Dr. Andrews always told him that a reguakr MRI is nearly useless …..
————————————————————————-
I guess Cashman was rappelling down a building when that info was passed out.
LGY
I think the Knicks can send out their third string and beat them.
blake April 26th, 2012 at 4:42 pm
Jim Bowden just said that he would have asked for a saline enhanced MRI before trading for Pineda and that Dr. Andrews always told him that a reguakr MRI is nearly useless …..
——————————————-
Wonderful
He also said that the player can refuse…..because they don’t like to get the dye injected but he said when he was a GM he always asked and if they refused then it would depend on how badly he wanted the player whether he would make the deal……he said to trade Montero he definitely would have asked and he would guess that the Iinjury started in Seattle and got worse in ST
Maine Yankee..Are you near Lake Umbegog ? ( probably spelled wrong ). Used to camp up there.
Maine-
Just have Chad shoot me your e-mail.
YT-
Jack and Rich actually put the article up but thanks anyway.
I wonder how Dr. Andrews did before CAT or MRI, or is he old enough to remember only X-rays?
blake April 26th, 2012 at 4:42 pm
Jim Bowden just said that he would have asked for a saline enhanced MRI before trading for Pineda and that Dr. Andrews always told him that a reguakr MRI is nearly useless …..
__
All it can show are hot spots, at best. It can’t distinguish between inflammation and small tears.
blake April 26th, 2012 at 4:42 pm
Jim Bowden just said that he would have asked for a saline enhanced MRI before trading for Pineda and that Dr. Andrews always told him that a reguakr MRI is nearly useless …..
————————————————————————-
I guess Cashman was rappelling down a building when that info was passed out.
Or busy thinking with the little head
He also said that the player can refuse…..because they don’t like to get the dye injected but he said when he was a GM he always asked and if they refused then it would depend on how badly he wanted the player whether he would make the deal……he said to trade Montero he definitely would have asked and he would guess that the Iinjury started in Seattle and got worse in ST
Say, I don’t recall Bowden posting on LoHud :eyeroll:
Just SMMFH and banging head against desk right now
Can’t wait to hear randy’s tirade on all this – I’ll go nuke the popcorn
“I wonder how Dr. Andrews did before CAT or MRI, or is he old enough to remember only X-rays?”
Back then pitchers just rubbed some backer juice on Labrum tears and went back on the mound though
It’s funny. Bowden is now mentioning all of this now. He loved the trade from the Yanks standpoint back in January. Hindsight 20/20 is so clear.
Blake-
That’s why I said the other day that I wondered if they were thorough enough in doing their DD, and why I said if they threw up any obstacles it would be a red flag IMO.
It’s unlikely they could gave gotten a needle through all of Pineda’s body fat to even do a dye injection in mid-January, so it’s kind of a moot point.
Thanks, LGY. Pat M and Patrick and I will settle these bets ourselves and Jerkface will continue to not get his steak dinner.
Shame I hated the trade at the time it was made. IMO the fact that Hughes fell apart in the second half of 2010 and then experienced arm trouble in 2011 should have been a warning for Cashman or whoever pushed the trade. So should Pineda’s performance in the second half of 2012.
Again, in my opinion, Montero was traded for the same reasons as Mike Napoli was traded. The manager with a defensive background didn’t like the the defence deficient Montero. Same thing happened with Napoli. Now we have a catcher (Martin) who will be lucky to hit over .200.
I do think the there should be a housecleaning of the Yankee’s front office or at the very least a clear list of responsibilities, with no overlap when it comes to making baseball decisions. If Cashman is the GM then no-one else should be pushing for someone like Soriano to be signed. Think of the money the Yankees would have, if not for ownership pressure to sign him. ARod was signed to his horriffic contract because of ownership interference.
Either give Cashman unquestioned authority or replace him with someone you trust and are willing to give full authority to.
Regards
C
Oh and good afternoon Shame, Erin and Tom and MtU.
Hey Nick, how is life treating you these days?
Hey Blake how is the little guy?
What changes would you make to steady the ship?
Buenos tardes Comet.
Hello comet. Life is pretty good with the usual ups and downs. Hope it’s treating you well.
blake,
And a little Absorbine Horse Linament.
One thing I’d really like to know is who formulates the rehab plan and schedule for Yankee players. Is it Ahmad?
If Cashman truly does believe Pineda tore his labrum in the Extended Spring Training outing this question should be important.
“It’s funny. Bowden is now mentioning all of this now. He loved the trade from the Yanks standpoint back in January. Hindsight 20/20 is so clear.”
I don’t think what he said about the MRI changes that….
shannondrayer
A lot of concern about Pineda in the clubhouse right now. Terrible news.
===
TheDA53
I’m in shock about Pineda, everyone please pull for him. Great kid with a huge heart! He worked hard to come back #keepworking
===
I’m on record here and elsewhere as hoping the trade would be a win-win as well as that I would be heartily cheering for Pineda, despite the pinstripes he would be donning….
So, I was very sad to hear the news about his ailing shoulder.
I’ll go on record now as hoping for the very best possible outcome.
Heal fast and well, Michael!
Comet,
He’s doing very well…..id sign Cole Hamels this winter if I could.
“Either give Cashman unquestioned authority or replace him with someone you trust and are willing to give full authority to.”
I don’t think now is the time to expand Cashman’ role, at least not with the Yankees.
Labral tears are difficult to diagnose and some sort of dye contrast study is often needed to see if the contrast leaks thru the tear. With regards to Dr Romeo’s technique of replanting the biceps tendon outside of the capsule, it might make sense.
The biceps tendon attaches to the front part of the labrum. The biceps is the large muscle on the front of your upper arm. Sports can cause injuries to the labrum when the biceps tendon pulls sharply against the front of the labrum. Baseball pitchers are prone to labral tears because the action of throwing causes the biceps tendon to pull strongly against the top part of the labrum. Weightlifters can have similar problems when pressing weights overhead. Golfers may tear their labrum if their club strikes the ground during the golf swing.
Blake-If you go to extremes with workups all athletes should probably have full cardiac work-ups including Echocardiograms to look for underlying cardiac disease.
http://www.totalprosports.com/.....d-tickers/
comet,
Proud to have made the acknowledgement list!
Rosy-
We want Montero back.
What happened to Pineda’s warranty ?
We’ve been robbed.
Seriously. It’s a damn shame. I hope he is one of the lucky ones and heals well.
That’s all that’s left for now.
munson15 April 26th, 2012 at 4:56 pm
Maine Yankee..Are you near Lake Umbegog ? ( probably spelled wrong ). Used to camp up there.
————————————————————————-
It’s about 50 miles from me. It would be about an hour trip.
Got to go and pick up dinner, but I’ll check back later on your comments.
Hopefully at surgery, the findings won’t be so grim.
Trader,
I don’t think a dye contrast MRI is overboard when you’re trading for a pitcher…especially when the regular one doesn’t always show everything.
“Sports can cause injuries to the labrum when the biceps tendon pulls sharply against the front of the labrum. Baseball pitchers are prone to labral tears because the action of throwing causes the biceps tendon to pull strongly against the top part of the labrum”
Does biceps tendinitis increase the chances of a labral tear?
has cashman been fired yet for this blunder?
Rich-
I don’t think so because Joba had biceps tendonitis in College and he’s never had a labral tear.
blake,
When you do your non-invasive images, do you always go for the dye? Does it not cause more side effects? I’ve had a couple of MRIs with dye, a couple without. Always felt punk after the dyed ones, plus a little radioactive.
Bowden never mentioned about saline-enhanced MRI or dye-injected MRI. If he was so smart and prescient he would have mentioned it back in January.
Tom,
I don’t think always….but I think the point was that in a trade of this magnitude perhaps they should have asked.
Nilson,
It wasn’t an issue then….he just said that was his practice as a GM.
MTU
I wouldn’t expect for it to occur every time. Just wondering if it increases the risk.
Again, what really defies logic is Cashman’s claim that the injury occurred during Pineda’s latest attempt at pitching, because it doesn’t explain why his velo was down so dramatically since he arrived at ST, and why, when it continued, they didn’t view it as a reason to get further testing, instead of just trotting him out there again and again.
The more pressing question for me is whether that list on the side is actually Chads favorite sites or did he pirate them from the former blogmaster and call them his own?
Inquiring minds want to know.
[Comment From BJBJ: ]
Should Betances and Hughes be moved to the pen? Are Manny B and Campos better off being traded?
Thursday April 26, 2012 1:10 BJ
1:12
Frankie Piliere:
No on Betances, yes on Hughes. I’m a firm believer on letting a guy start for as long as possible. Make him prove he can’t. Betances hasn’t come close to that point yet. Hughes is nearly at that point. I still believe he can be a capable big league starter and he’s done it before, but his style also translates very well to the pen. Attacks, his velo would play up, etc. As for Campos and Banuelos, I wouldn’t say better off.
Someone asked him if he would have asked for a saline enhanced MRI before doibg the trade…..and he said yes…..that he always did because Andrews told him that regular ones didn’t show everything…….he said the player coukd refuse.
[Comment From Yankees N MoreYankees N More: ]
How can Brian Cashman look people in the eye and say (according to reports) he STILL believes he traded for a healthy player when Pineda was clearly not right from the start?
Thursday April 26, 2012 1:00 Yankees N More
1:01
Frankie Piliere:
Good place to start. I’d be a hypocrite if I didn’t say that at the time I was torn on the deal and called it fair in my analysis. I’m sure Cashman probably believes that he was healthy but you’re right that you have to wonder if he actually was.
when you are busy cheating on your wife, its easy to miss on details like a players health, stats, bad 2nd half performance, etc
Isn’t Yankees N More the name of the weird guy who used to post here and wish Jeter ill?
Rich,
Yes. Weird is the word.
Rich,
Did you go to NYU Law?
No, undergrad.
Rich-
I suspect we will never know the full details of how or why this happened.
It may have simply been an act of God, or it may have been something else.
I’m not even convinced we’ll get the full story on the surgery.
My focus now is on hoping we get a useful Pitcher back at some point.
Keep your fingers crossed that AP is AP once again and stays healthy.
Absolutely astounding how our Pitching surplus just evaporated before our eyes.
Gotta make dinner. Later.
How about they declare mis-trade?
YankeesNmore still posts here…..almost every day.
blake, is that cashSUX
JAP-
I told Rosy we want Montero back.
That the warranty on Pineda was bogus.
Grounds for a reversal.
@Deadspin: Are you allowed to keep that foul ball? A helpful chart explains. http://t.co/SAnQKqRw
MTU,
Mitchell and Warren labor under the radar and are a phonecall away.
Did someone put a hex on our Pitchers ?
1st Roberston falls down a flight of stairs.
next Joba destroys his ankle playing with his Son.
And now Pineda’s shoulder blows up rehabbing.
I say it’s suspicious.
I suspect Bobby V.
He’s desperate.
JAP-
We can’t even get Phelps a shot at starting and he’s already here.
MTU,
I admit I have very little sense of humor about this whole thing. I am also putting some blame on the Yankees for pushing that kid to show the velo. The whole thing stinks.
MTU,
LOL.
At least the Vato feels some vindication
.
“I’ll show you a No. 2″!!
But that’s not right; Vato thinks of himself as a No. 1.
When Warren gets it figured out, then, he’ll be ready. A 6+ ERA and nearly as many walks as strikeouts in AAA isn’t figuring much out right now.
Rosy,
I am remiss.
Thank you for your good wishes for MP, whom you’re probably more attached to than anyone here, LOL. And thanks for generously supplying this site with news about The Son.
Out to dinner tonight at a good old Southern road house. Bret would die if he knew what we are going to eat tonight. I haven’t, yet.
It’s too bad the Yankees pitching staff at AAA is not exactly covering themselves in glory – so much for depth
Too early to wig out over ERA and BB/K rates
When Warren gets it figured out, then, he’ll be ready.
–
He pitched 150 3.6 ERA innings at AAA last year.
Betsy,
I didn’t realize you were attending AAA starts. Hope you brought you woolly mittens and ear muffs.
JAP-
Sometimes ya’ just have to laugh so ya’ don’t cry instead.
Yeah, I deserved that J. Alfred. Don’t take your anger out on me, please.
Tom-
Enjoy your dinner.
It sounds like a winner.
While this doesn’t sound like the more significant SLAP tear of the labrum, here’s a short article on it and the use and possible complications of dye injection.
Blake -I would think that the saline would need a radiacive trace to enable it to be viewed on the MRI.
http://orthospecialistsnj.com/.....oulder.php
Bowden is now an analyst, so I guess that he is going his job, but it seems pretty unfair for him to be playing Monday Morning QB on the Pineda deal.
Hughes is struggling, but everyone around here seems to forget that a few years ago he was every bit as dominant out of the pen as Robertson as now, so going back to a set up role is a good back up plan for him. I would like to see Hughes go back to AAA and work on locating his secondary pitches and figuring out how to throw borderline pitches with two strikes. With Martin behind the plate, every Yankee pitcher should be trained to throw a 0-2 and 1-2 breaking pitch in the dirt.
If I understand correctly, Roy Halladay went back to the minors after being in the bigs for a few years, and he ended up being pretty good.
Betsy April 26th, 2012 at 5:50 pm
Yeah, I deserved that J. Alfred. Don’t take your anger out on me, please.
///
Anger? You summarily dismissed the AAA pitching staff. I assumed you had some vantage point you were going to share with us.
Cashman has ruined Mike Pelfrey. A visit to James Andrews coming up. TJS
Dr Schilling weighs in. For once I hope he’s right.
@AndrewMarchand: Schilling: Pineda could be back in less than year http://t.co/FLFeNjsC
Wow, talk about an overreaction. They’re not having a good year – what’s so hard to understand about that? I didn’t trash them personally. Whatever – it’s not really that important to me to explain any further.
I doubt Hughes lands in AAA, which means landing at a bus station. There is no home field. Send him to Tampa. Good weather, good facilities, away from the pens.
Betsy, how many starts have they all had since ST? What’s the weather been like? They can’t be having any kind of “year” yet.
YT,
Every time I got a dye MRI, I had to sign a “radioactive” waiver.
MTU, As soon as I can get the wife moving, it’ll be (for me, at least) high fat, high calorie, no fiber but lots of gravy, satisfying supper, something you could march all day on. I need to add a few pounds, anyway!
how many frontline starters has cashman developed? ZERO
joba bust
phil bust
brackman? LOL
pineada bust
fire him
give freidman 10M a year to run this team
I didn’t say it was going to last all year……we’re just not going to get any help from them right now since they are struggling; that was my point.
A very long talk with Nardi Contreras
Yankees pitching coordinator Nardi Contreras spoke at length Thursday with myself and Mike Ashmore. Here’s what he had to say.
Q: Where have you been so far this season?
A: I started the season off with the Empire State Yankees, where it was a lot of cold and bad weather. The 30s, rain, some snow, wind. It wasn’t pretty.
Q: So you’re happy to be here, is what you’re saying?
A: Well, Erie (the Thunder’s second stop on their road trip) was pretty ugly too, pretty freezing. Yesterday here was pretty nice, last night got nippy.
Q: So how hard is it for guys to pitch in awful weather like that?
A: It’s really tough. Warren’s first game was in that cold. D.J., it was freezing the day he pitched. Manny wasn’t good. Dellin (was) for the first two or three innings and then he wasn’t (good), so it seemed like everybody was having problems with that weather, and the scores let you know it.
Q: Do you think the cold contributed to Manny’s injury?
A: I would think that. It was a lat muscle. It was hard to stay warm. I know that when we’re in the stands and he’s doing charts, he was freezing. He was just shivering all over the place, and that was just sitting in the stands. When you’re out on the mound, it just makes it tough.
Q: Is there a way to better prepare them for that stuff?
A: Spring training is in Florida, how can you prepare them? You’ve just got to hope for real warm weather (when the season starts).
Many years ago, when I started doing this for the Yankees, my first stop was Trenton. It was in the 30s, windy, and I said ‘I’m never going to do that again,’ so every year after that I would start at Tampa, Charleston, somewhere warm.
http://minormatterstrenton.blo.....reras.html
Now if you really want to be depressed before we actually know to what extent the labrum is torn, read this article a few hours ago from “It’s about the Money”
http://itsaboutthemoney.net/ar.....shoulders/
Cashman made this trade after consulting with the professionals about all Pineda’s tests. He shouldn’t be blamed.
“Bowden is now an analyst, so I guess that he is going his job, but it seems pretty unfair for him to be playing Monday Morning QB on the Pineda deal.”
If you heart the conversation that wasn’t what he was doing….someone just asked him a question and he answered it……didn’t come across like he was saying they shouldn’t have done the deal.
Trader,
When he said “saline enhanced” im sure that’s what he meant.
“”I came back after my surgery, throwing four-to-six miles harder than I did before,” he said. “That is where the magic is. It is all about rehab. Most doctors can make you 100 percent well physically. I would tell you that it is 25 percent about the surgery and 75 percent about the rehab.”"
Who’s in charge of the rehab? Maybe pessimism is warranted here…
We are covered for “right now” I would say. I’d want the kids to have their arm strength and good weather, any way, so if one was needed, he would hit the ground running.
Phelps is up already. No reason DJ couldn’t come up in a bit, if needed.
oops
I think when they get in there they always find more. I hope they don’t, but I think folks should be aware that the outcome will probably be worst then what they were able to gather from the MRI. At any rate if he comes back it’s going to be a long ways off.
We are only a few games into the season and were going to see some additional injuries to pitchers as they always happen also during the season. We are now already into chewing gum and bailing wire, don’t know what will happen. Got to believe the Yanks are talking to anyone still left out there, as they need another insurance arm from somewhere. My opinion Hughes and Joba have let this club down big time, such high expectations and such low results.
I don’t put any great stock in what Bowden said, but I also don’t see why he’s obliged to paint a rosy picture on this. I imagine the guy said what he thought…take it for what it’s worth.
A devastating turn of events for the Yankee’s franchise. There’s no question about it. it has an enormous material impact on the next 10 years of the franchise’s future at least.
I said this immediately after the trade. Yes it’s true that Pineda and Montero could be considered almost equivalent assets in terms of value. But there was never a doubt that the yankees were the party absorbing the overwhelming risk in the deal. That was clear from teh start.
I also said that there was a non-trivial chance that Pineda would get seriously injured this spring and that if he does you don’t get to go back and say wow what a surprise who could have predicted this? Doesn’t work that way. This isn’t any shocking surprise.
That’s not knowledge of anything in particular on my part. It’s just the general probability that’s at play with a pitcher at that age.
It’s always unfortunate but never truly surprising if a young pitcher get seriously injured. It literally is just math.
And right now I don’t particularly believe the Yankees “explanation” of this. Sure it’s possible that he could have torn his labrum worse during rehab (which makes them look completely incompetent in another dimension…)
But there is absolutely no way they can “definitely” say that’s when it happened.
This is why I was so infuriated that last spring training start Pineda threw. That’s when he said he shoulder really started to hurt.
It was just so blatantly obvious that something was broken with him. His mechanics were just awful. His front shoulder kept flying open and his back shoulder dragging as he tried to reach for velocity he clearly didn’t have.
And Girardi and Rothschild just sat in the dugout and literally did nothing as he threw one pitch after another after another.
This after Girardi made it clear that in order to make the team Pineda would need to show that he could throw 95. What a incredibly perverse thing to say. What else is the kid going to do other than try to throw the ball through the catcher’s glove in order to stay in the bigs even if he physically can’t handle.
The Yanks gave him huge incentive to throw max effort even if he physically couldn’t do it. You know what can happen with that combination? Shoulder injuries. Huge stress to throw gets transmitted to the shoulder.
And what makes all of this even worse it’s not as if the Yankees or the coaching staff had ever worked with Pineda or knew him. He’s a 22 yo kid going through his first spring training camp after a full major league load. He doesn’t know how his body will react. He’s never done this before. He’s not Pettitte or Mo. The Yankees don’t know him either so it’s not like they know what to look for if something goes wrong.
But rather than be cautious they just kept going along despite the fact that he had absolutely no life on the ball.
There is no way the Yankees can say definitely that he didn’t tear his labrum the night of his last spring training start. Or earlier in the spring. It could have been last year though with the MRI it makes it less likely.
But Pineda was broken from the beginning of spring training. And they just kept letting him throw and throw and throw while spitting out cliches.
This franchise is simply incompetent when it comes to young pitching. There’s is no two ways about it. Grossly negligent.
Someone needs to held accountable for this. It’s mind boggling.