After all the hand-wringing about ‘s velocity this spring, and his subsequent sidelining with shoulder pain/weakness, we finally have a resolution. Unfortunately, the resolution was not a positive one, as a dye-contrast MRI found that Pineda had a torn right anterior labrum (a ligament that goes around the socket of the shoulder). This injury (as I learned in researching this piece) is also known as a Bankart Tear. This injury would require arthroscopic surgery, sidelining Pineda for the entire 2012 season, and possibly jeopardizing his future. Shoulder injuries tend to be considered more difficult to recover from than elbow injuries, so it appears likely that Pineda will have a long road to recovery ahead of him.
Hospital for Special Surgery, illustration by Robert O'Connor
This injury certainly provides ample opportunity for criticism and second-guessing. Despite the Yankees’ (and Mariners’) assertion that Pineda wasn’t injured at the time of the trade (since he passed his physical), this injury does raise the possibility that the Yankees may have acquired damaged goods in Pineda. Even if the Mariners had no knowledge of the injury, perhaps Pineda’s second-half struggles in 2011 could be linked to some health problems. There will also likely be criticism for trading a top hitting prospect in Jesus Montero for a young power pitcher like Pineda, because the injury risk for pitchers is so much higher than for hitters. There will be plenty to discuss on this front, but for the moment, I’m going to leave that topic behind.
Instead, I want to take a look at what the potential likelihood was for Pineda to make a full recovery, by looking for comparable historical cases. The existing perception regarding labrum tears is that a torn labrum is one of the worst injuries that a pitcher could suffer, and recovery is unlikely. In a 2004 article in Slate, Baseball Prospectus’ Will Carroll referred to a labrum tear as “baseball’s most fearsome injury.” He mentioned that of 36 pitchers who suffered a torn labrum between 1999 and 2004, only 1, former Expos closer Rocky Biddle, was able to get back to his previous level of performance. ”If pitchers with torn labrums were horses they’d be destroyed” Carroll wrote ominously.
While Carroll’s take on the chances of recovering from a torn labrum was exceptionally pessimistic, a 2010 article by Larry Stone of the Seattle Times had a more of an optimistic outlook. Stone was examining the possibility of recovery for then-Seattle lefty , and looked at 5 cases to see the range of possibilities. Of the 5, 3 (Chris Carpenter, and ) recovered and were able to go on to further major league success while was never the same. The 5th pitcher, was too recent of a case for Stone to assess, but has come back to be a serviceable (1.7 bWAR) pitcher in a relief role in 2011.
Since Stone’s article, we can add a few more data points that may provide additional information. Diamondbacks ace had surgery for a torn labrum in August 2009, this after a strong 2008 season in which he finished as a runner-up for the Cy Young Award. Webb’s recovery process was slow, as he demonstrated diminished velocity. After exercising Webb’s 2010 option, a year in which Webb did not make a major league appearance, the Diamondbacks did not attempt to resign Webb, who was now a free agent. Webb wound up signing a 1-year deal with the Rangers, as he attempted to work himself back into form (he was reportedly throwing in the mid-80′s). Webb pitched 12 mediocre innings for Texas’ AA club before undergoing another shoulder surgery (this time to fix a torn rotator cuff) in August of 2011. Webb has been rehabbing and will attempt to latch on with another team when he is ready, but after his second surgery, his chances of regaining his Cy Young form (or anything near that) look remote.
is a similar situation to Webb. Escobar went under the knife in 2008 to repair a torn labrum, and looked to work his way back in 2010 with the Mets. However, Escobar tore a capsule in his right shoulder while he was working his way back, and did not pitch a game for the Mets. He is still working his way back and hopes to return to the majors, but as with Webb, the chances are slim.
Erik Bedard had labrum surgery in 2009, but unlike Webb and Escobar, he was able to make it back to the major leagues. After missing the entire 2010 season, Bedard re-signed with the Mariners and was traded to the Red Sox in 2011. Bedard missed time in 2011 due to a knee injury, limiting him to 129 innings on the season, but it was a major step for a guy who didn’t pitch in 2010. Bedard actually pitched pretty well in 2011, striking out nearly a batter per inning and posting a 3.64 ERA, good for 1.8 bWAR. He is off to a good start to as the Pirates’ nominal ace, and this will be a big test to see if he can hold up over a full season.
In addition to Bedard (so far), Rauch, Hoffman, and Carpenter, is at least one additional success story. apparently had a torn labrum repaired way back in 1995, but went on to toss 183 innings with a 3.19 ERA in 1996 (and to have a phenomenal career afterward). I am assuming this was a very minor tear compared to some of the others based on the quick recovery and apparent lack of long-term problems, though it is possible that Schilling is just a freak (or maybe it was just ketchup on his shoulder).
What does all this mean for Pineda? It still seems that the odds are stacked against him fulfilling his potential as a future ace for the Yankees, but it is not completely out of the question. Carpenter and Schilling were both able to recover from their surgeries and win Cy Young Awards, while others such as Escobar and Webb saw successful careers sidetracked. Making predictions is difficult because there is very little information available on the type and severity of tear suffered by the other players, so it is difficult to know who would be the best comparable for Pineda.
Pineda’s injury, if it is in fact a Bankart Tear seems to typically be the result of a shoulder dislocation (though throwing and other overhead motions have also been associated with these injuries). Typically, the purpose of repairing the torn labrum would be to prevent further dislocations, and the success rate for this procedure is believed to be over 90%. However, preventing a shoulder from dislocating and getting a pitcher’s shoulder strong enough to throw 95 mph heat are entirely different, and presumably the latter would be much harder to achieve.
Despite all the doom and gloom, there may be room for optimism. That Pineda is undergoing arthroscopic surgery, rather than the more invasive open surgery, is a good sign, as the recovery time tends to be shorter. Mark Feinsand got a good quote from the Yankees’ team physician, Dr. Christopher Ahmad, who observed that Pineda’s prognosis was better than it could have been because there was no tear in his rotator cuff. With rotator cuff damage on top of the labrum injury, long-term velocity would be at greater risk.
Dr. Stephen Fealy of the Hospital for Special Surgery in New York wrote on the hospital website regarding labrum tears: “If fixed properly, most athletes should be able to return to at least 80 percent of their pre-injury level of play.” Eighty percent of Michael Pineda could still be a pretty good pitcher, but certainly not what the Yankees hoped to get when they dealt Jesus Montero. Pineda does have youth on his side, which could increase his chances of making a full recovery (just speculation on my part here). He certainly won’t be back any time in 2012, and could very well miss some time in 2013 depending on his progress. It will be a long and arduous road back to the majors for Pineda and Yankee fans, but I’ll be hoping that he can follow in the legendary footsteps of “Big Carp” and become an impact pitcher again.
Addendum: A few other names of pitchers who have come back successfully after having some kind of labrum surgery: Anibal Sanchez, Roger Clemens, Kerry Wood, Ted Lilly, and Jeff Francis.
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“Ketchup on his shoulder,” thanks for that.
I hope he takes his recovery from surgery more seriously than his off-season conditioning.
I do what I can, trying to lighten the mood in these troubled times.
I definitely agree that Pineda will need to be serious about his rehab if he wants to come back healthy, giving the low success rate for the surgery. Considering he hasn’t made much money yet in his career (relative to other baseball players), hopefully the financial motive would be a sufficient driving force.
I wish getting on a mound for the New York Yankees with the goal of performing at a high level would be enough motivation. Apparently it wasn’t this off-season.
In his defense, only for about a month of his off-season was he a Yankee.
Hopefully there’s been some improvement over the past couple years in treating this injury (sports medicine seems to improve quite a bit every year). That and not using the knife are pretty good signs. A lot of people thought that Rich Seubert couldn’t possibly play again, but he was just as good when he came back. Different injury, but the point is that predicting what sports medicine can and can’t do is a fool’s errand.
Oh, and go Campos! (And Hughes, get yer head outta yer keester.)
Very true, modern sports medicine is pretty amazing. I’m not sure how much labrum surgery has advanced in recent years, but I imagine at very least it has become less invasive (using arthroscopic rather than open surgery).
80% of a power pitcher does not make me fell very confident. I wish him all the luck in the world, but I don’t think the Yankees should keep him in there plans for the future until he proves he can make it back. Does anyone know if his arm angle changed last year as the season progressed.
Have to figure anything the Yankees get out of him going forward as a bonus. For all intents and purposes I consider his career as an impact pitcher as most likely over. It seems far more likely he comes back a diminished product and/or develops other injuries and is a chronic DL guy. Its very sad and I hope the best for him, but realistically we cant expect anything out of him.
Agreed. I’m not going to get my hopes too high, but I do hope to be pleasantly surprised.
I’m a Junior at Montclair State University, a local school in New Jersey just over the bridge. I read sports articles all day long. Naturally I read more about the Yankees and Eagles, my two favorite sports teams (I know it’s an odd combination but I’m from Jersey so cut me a break). Anyway, I just wanted to say that this was a true pleasure to read. Great article.
On the baseball side of things, I’ve got some quiet confidence in his recovery. Michael Kay said that Al Leiter had the same injury, and Al said he threw 97 when he came back. However, Al did say that it’s all in the rehab and how hard you work at it. Hopefully either the lack of money he’s made, the veteran presence of CC and Andy will rub off, or maybe just because he loves to play baseball that he gets it together and trains hard to recover.
One final note, does this possibly open the door for Joba the starter? There’s really no need for Joba to rush back this year. If he trains to return as a starter, I see no need for him to be regulated to the bullpen for the rest of his career. If anything positive came from his gruesome injuries, it’s the fact that Joba essentially got a restart on his role. He has a clean slate now. What do you think?
Hey Zak,
Thanks for reading and commenting. A lot of work went into this article, so I’m glad to hear you enjoyed it. I’ll let the fact that you are an Eagles fan slide for the moment.
Leiter is definitely another interesting name to add to the list. I really wish there was more information out there on injuries so I could find comparable cases to Pineda, but unfortunately that seems to be lacking.
As for the Joba situation, I thought the Tommy John Surgery provided a good opportunity to bring him back as a starter (and wrote about that when the news came out). Pineda possibly being out for over a year certainly makes that an even better idea in my opinion. However, it will likely never happen, because Joba seems to have been pigeonholed (fairly or unfairly, I can’t be certain) as a reliever going forward.
Here’s the article on bringing back Joba as a starter:
https://yankeeanalysts.com/2011/06/jobas-injury-as-an-opportunity-a-pipe-dream-30753
If Joba comes back throwing 98 MPH, the Yanks would have to at least talk about reconsidering his role. But not before. He was put in the bullpen after 09 because his stuff was down all year, and they figured it would play up in the pen, which it did. If the elite stuff is back, then that equation changes.
Personally, I think the media bears some of the blame for this injury. If Pineda indeed had a clean bill of health at the start of Spring Training, it is not difficult to imagine him overthrowing and straining his shoulder after the headlines about his diminished velocity began surfacing. Granted, if he had been in shape when he came to camp, perhaps his velocity would not have diminished so much, but the 24 hour cycle sports media has gotten out of hand, particularly in New York.
Eh, Cashman’s to blame. He stocked the media fires. The Yankees should have known that Pineda was told to completely shut it down by the M’s. That Pineda planned to report to camp in January and work himself into shape. How the Yankees didnt get with Pineda to find out what his schedule, routine and plans were is beyond me, and is unforgivable.
Don’t shoot the messenger. The media was simply running with the info they were getting from sources on the team. And the team was unhappy with the shape he showed up in, knowing that out of shape pitchers pitch badly and/or get hurt. Yes, the Yanks and media put some pressure on Pineda, but the reasons were of his own doing. He has to deal with pressure if he’s going to succeed here.
No matter how much one tries to spin it, it’s Carl Pavano all over again, a Yankee GM/ownership tradition of boneheaded pitching moves (Irabu, Igawa, Vazquez, Brown, Burnett, …).