To each and every respondent to my post, thank you. We have decided to go ahead with surgery, with the original doctor, who has performed this surgery on pro ballplayers. The good news is that my son's extensive physical therapy should make his recovery quicker. Let's hope.

Now we are contemplating his repeating his sophomore year at another school. Not sure if that's nuts, or if it is smart and increases his chances of playing college ball. Any thoughts?

My son had surgery on March 28, 2006. It was performed by Dr. Joseph Chase at St. Elizabeth's Hospital in Boston. Dr. Chase has performed the surgery hundreds of times, and believes that many times the injury is not properly diagnosed, in that a rotator cuff injury may be secondary to the primary injury of a torn labrum.

COACHDAD and TXMom are correct: A tear is not always visible on an MRI. Sure enough, when the doctor operated, he found a tear in the supraspinatus, which he stated would not have healed on its own. (Just like COACHDAD.)

Since that time, my son has been extremely diligent with his physical therapy. He treats with a former Red Sox trainer recommended by the surgeon (who also used to work with the Sox).

He also worked out all summer under the supervision of a trainer (in a group, and skipping anything that could harm his shoulder). Last week, he threw a baseball for the first time, lobbing it thirty feet about forty times on three days under the supervision of the PT. He will continue to throw with the PT two times per week, and will also work out with a trainer at the same facility two times per week, with an emphasis on baseball specific drills.

When he is able, and after consulting with the doctor and the therapist, he will work with a pitching coach I found through this forum, Brad Miller, to further correct his arm slot and other mechanics, so as to avoid further injury.

The truth is, we've heard more stories of failure than success, and we are very happy to hear of COACHDAD's son's successful return.

Another truth is, my son has not yet had the level of success that many of your boys likely have. He is 16, 6'1", 180lbs., throws and bats lefty, and is a very hard worker who works very hard and is quite coachable. He was making considerable progress before his injury, but had only gotten as far as his 9th grade team and 15 year old AAU. If heart and work were all that mattered, he'd go very far.

Having missed his sophomore and summer seasons, we want him to be in the best possible position next spring, and for junior year summer showcases. It will be one year since his surgery, and he should be at full strength.
If he is not, he'd like to repeat his junior year at another school.

What are your thoughts? Advice? Please know that the advice we have received so far has been excellent, and appreciated.

i'm glad things worked out for your son.my son is rehabing from tj surgery very hard not to throw a ball.heart and hard work do matter,people see those things and they can't be taught. good luck to you

My son underwent surgery for a labrum tear 6/28/05. Did all the work, including rehab all summer,fall, winter. When he was finally able to throw a ball (not off a mound) we took him to his regular pitching coach who worked mechanics (arm slot, balance, etc.) Has not yet gotten back to his former self but that was partly due to a h.s. coach who had no confidence in his "post surgery" shoulder. Pitched sporadically over summer but still has a long way before getting back his control. He is now at a D-3 school and we're hoping he makes the team and gets some decent training that he wasn't able to get in the year since his surgery. I think once your son gets the green light to throw off of a mound is PRACTICE. Re-learning to throw with control - not necessarily velocity - upon his return to the mound will be key. Velocity will come.

Good luck to him!! I know that road is a tough one - sometimes I think harder for us to watch than it is for them to go through.

We had a player who had labrum surgery, and keep in mind all operations are not the same,. He missed his junior year on the mound and came back 10 months later to pitch in the fall of his senior year

He had a great senior year and summer season and is not at Northeastern as a freshman pitcher.

BUT he worked hard and did all the right things pertaining to PT

13 weeks today out of surgery to fix my torn labrum. It has definitely been a battle so far and i am only a part of the way through. Everything has gone very well with my therapy according to schedule. My surgery was performed by Dr. Girhidar Burra in Naperville, Illinois..he is a product of Dr. Andrews and has been great. I agree, the next thing after getting a good doctor would be getting the right PT. I had a great one back home until I came to school and now with things being new it is going to take a while for the trust factor to kick in. It does make me a little nervous that I don't know him but I suppose we'll see how things go. I have been dying to throw or hit again but not for another couple months. Should be good for the season as long as everything goes to plan..I can't wait..

It's been over thirteen months since my son had surgery for his torn labrum. He has worked exceptionally hard at his rehabilitation, at improving his core strength, and at improving his mechanics. The pitching coach that he has been going to (Thanks for the referral, TRhit) is impressed and mildly surprised at his progress, and believes that he now needs innings. Son is a high school junior, 6'1", 190 lbs and still growing, throws and bats left, and made his high school varsity team as an outfielder. (Seems there's always a big, slow guy who can croke the ball playing first, and son wasn't ready to pitch during tryouts.) Since the team only uses two starting pitchers and one reliever, and one of the starters will be a top draft pick in June and the other is going D1 next year, son asked coach if he could pitch a few innings of JV game. He pitched for the first time in two years two weeks ago, throwing 38 pitches over three innings, no hits, no runs, one walk, seven Ks, two errors, and two runners picked off first base. Varsity coach indicated this week that the JV coach doesn't have any more innings for son to pitch, and it seems unlikely son will get varsity pitching opportunity before next year. The team plays only fifteen seven inning games.

Son throws two and four seam fastballs well, change-up is decent and improving, and is just developing a pretty good curve. His speed has gone from about 68 mph eleven months after surgery, to between 76 and 78 at thirteen months. Pitching coach doesn't want him to focus on speed yet, but expects velocity to continue to improve.

So while his pitching is improving and he throws without any pain or problem, and in fact will be a better pitcher as a result of the injury and resultant dedicated focus on rehabilitation, strength training and conditioning, and improved mechanics, the fact remains that he is entering the summer between his junior and senior years having pitched a total of three JV innings, and no varsity. He was unable to play last summer due to his surgery, and the summer before that couldn't pitch due to his shoulder pain.

We're still considering whether he should repeat his junior year at a different school, which would allow him two more school years to improve his grades (SAT score was 1990, grades B minus to C at very challenging school), give him two summers and two varsity seasons to pitch competitively and gain experience(no rules against), and two summers to attend showcases. Otherwise he will have to have a great showcase in August, when he should be peaking, to get noticed.

Any thoughts, suggestions or experiences to share?

Keep in mind that messing up a shoulder in football is not the same as a baseall injury

Be careful what you do---make sure you are doing the right thing

I hope he has a speedy recovery

I certainly don't agree that a labral tear means the end of a pitching career. What we've found is that it requires dedication to improved mechanics (since mechanical flaws likely contributed to the tear), a very serious commitment to physical therapy and conditioning, a strong desire to pitch, and more time than anticipated, for successful recovery from SLAP surgery.

It's been a very long and often discouraging road for my son. As the name I've chosen makes clear, I'm very proud of my son, whose tenacity in spite of adversity will serve him well in life.

He believed that he was ready to pitch in May, over thirteen months after surgery. But he failed to make his Legion team as a pitcher, and did not look great in tryouts. His velocity was only in the low 70's, and his control mediocre. He landed with another Legion team, and got some limited innings.

He kept working to get bigger and stronger, and to improve his pitching. He attended a couple of showcases that struck us as simply moneymakers for the organizers, and was getting discouraged. In August, he pitched two scoreless innings against pretty good talent at a showcase, and was clocked at 79 mph. Like that good golf shot that gets you back on the course, he and I had a little boost of encouragement.

He also began to long toss regularly. By December, he could throw 80 or 81 mph. He has developed four good pitches, and at least in the gym, has good control.

He is hoping for a great senior season. He's applied to quite a few D3 colleges, where we think he could have both academic and athletic success. He's 6'2" and 195 lbs., a good student, and a great kid. We've not done much to market him to prospective college coaches, but will be sending out emails to the coaches at schools where he's applied.

I'm very hopeful that all of his hard work will pay off in successful senior and summer baseball seasons. I believe that he will be a real find for some college baseball program, and that he will be a much stronger and better pitcher due to all that he has been through, including the labral tear.

In any case, he is a better person for what he has gone through as a result of that tear.

I would not do any shoulder or elbow with anyone other than Andrews. There isn't anything he hasn't seen. A very keen eye for shoulder injuries including any number of tears, partial tears, wearing, stress reactions (foolers), and a host and plethera and any other adjectives to describe the sheer numbers of injuries he has seen. Do yourself a favor and schedule him and no one else! You CAN get into his clinic for evaluation. He makes a point to see EVERYONE, no matter what his load is. He is just simply amazing and worth the trip & money (although the money is comparable to anywhere else because he does not rip people off).

I'm sorry if this post runs long, but we have learned a lot by going through this process twice, and, it would be terrific if our experience could somehow benefit another parent's child.

We have two sons (Pitcher and Catcher) who have had surgery with Dr. Andrews in Alabama. Pitcher is a first year college pitcher - had his surgery last June. Catcher is a high school sophomore - had surgery in October. We consulted great doctors here, in the DC metro area, before seeing Dr. Andrews and saw Dr. Andrews at the request of Pitcher's pitching coach (an ex pro player).

Both sons had MRI W/Wout contrast (arthorogram?) Results were not specific.

-With Pitcher - Dr. Andrews gave him the option of physical therapy to see if it would relieve the pain. He opted for the surgery (anxious to be rehabbed in time for College spring season) Surgery showed Labrum peeled away - needed an anchor. Pitcher is now pain free throwing at 80% It was a very emotional experience (found out he need surgery the week of graduation and was really looking forward to playing in college).

Proudpapa is right, it is not cancer or any other life threatening disease, but it still hurt to see our son's dreams potentially go up in smoke. The first thing that we told ourselves, and him, was that this was a challenge that he could either try to come back from (potentially stronger) or could allow it to take his dreams away without a fight. He chose to fight. We also reminded ourselves and him that, although it felt life shattering, it was NOT life threatening and it helped to put baseball in perspective (we have a friend whose son was diagnosed three days before his high school graduation with a usually fatal bone cancer).

Pitcher worked, worked , worked at physical therapy, followed the protocol to a "T", without pushing (although he was antsy and would liked to have cheated it, at least a little bit). He thinks that he should be able to play this season and will sit down with the coach to discuss whether he should play or red shirt. Pitcher feels stronger than he did before the surgery. He had lost some velocity when he was in pain and had lost a little bit of control (pain can be the cause of change in mechanics, muscle strength, not to mention the psychological effects on the head of a pitcher (or any player, for that matter).

Catcher has had shoulder problems since he was 10 (overuse issues). The doctors here, after YEARS of physical therapy, at different times (which he was religious about doing), upon the last exam, said there was extensive damage, needed to do surgery, did not even want an MRI. We insisted on the MRI. When the report came back, the Dr. called and said that the damage was not as extensive as he thought and that it would only take minor surgery.

When Catcher saw Dr. Andrews, Dr. Andrews said that he doesn't like to do surgery on players that young (15). Based on the non specific MRI findings, and one exam, not knowing what the arm looked like through the whole process, if Catcher were Dr. Andrews son, he would have him do another course of physical therapy and come back in several months. Dr. Andrews left the room to let us discuss it.

Catcher said that the arm really felt different this time, that he had been doing physical therapy as directed, shut down when directed, for as long as directed, and that if there really was something wrong with his shoulder, he would rather have it fixed earlier, rather than later so he could possibly play his HS season and be ready to start showcases the summer before his junior year. These were CATCHER"S thoughts, not mine. I was very conflicted. I knew that he was in genuine pain, had been following drs orders, but I trusted Dr. Andrews and did not want to see my son go under the knife, if not necessary.

When Dr Andrews came back into the room, CATCHER asked Dr. Andrews if he could start the surgery, but, if he went in and found nothing wrong, could he close him back up? (Yes) Would the exploratory surgery cause damage if there was no pre-existing cause for surgery? (Some, but not much) Would the physical therapy that he would have to do after exploratory surgery be any longer or different than the physical therapy Dr. Andrews would recommend with no surgery? (Same)

CATCHER told Dr. Andrews that he thought that there was really something wrong and different about his shoulder and that he would like to do the exploratory surgery. Dr. Andrews said that Catcher knew his body better than Dr. Andrews did and scheduled the surgery.

When Dr. Andrew went in, he found the labrum was frayed, the rotator cuff was frayed, and the fraying was starting to impinge the movement of the joint. He cleaned it up (shaved off the frayed part). Catcher has been doing physical therapy. While his recovery has not been as critical as Pitcher's (with an anchor or sutures, they want to make sure that they have had a chance to attach properly before they return to any kind of activity), we are not sure if he will be able to play ball this spring.

Catcher has been in chronic pain since he was 10. He is a little bit afraid that the surgery won't make a difference. He is not sure that he wants to play any more. We have encouraged him to complete his rehab and see how he feels then. Don't know whether this is just an indication that he is tired of baseball, or just tired of being in pain.

Some of the things that we have learned:

-MRI's often do not give a clear and accurate reading of the condition. Often, it is not until the surgeon gets in to the shoulder, that he knows what is going on. (I would be wary of a surgeon who spoke in terms of absolutes - either positives or negatives.)

-Different EXCELLENT Drs can disagree on how to proceed.

-Your son knows his own body better than any one else - even you.

-Go to a surgeon who works on baseball shoulders (or at least athlete's shoulders). The Dr. here wanted to tighten up Pitcher's capsul (I think). I was told by the pitching coach and by Dr. Andrews that they would do as little as possible to the shoulder to get him back to playing health. He was probably born with some laxity in the capsul and shoulder and that was probably what helped him to have a "live" arm. Although tightening things up on the average person would probably be the right thing to do, doing more than necessary on an athlete can limit range of motion and cause more scar tissue than necessary.

-If you don't do the surgery, the arm will not fall off. Pitcher and catcher were both told that they could continue to play. Granted, neither if them were very effective as they were, and both were worried about causing more damage. You probably wouldn't do more harm by doing further rehab, you just won't advance the ball if there is a labral tear that is affecting the motion.

-I think Dr. Andrew walks on water. He really understands the athlete's mindset. He is honest and frank, but very positive. He in no way ever pushed for surgery with either son. His staff and the hospital have the procedures down to a science. Sons were treated on same day a major league players (Pujoles, Sanchez, and others) and NFL players and WWF star (Cena), and treated with same attention and respect that they received. His office scheduled an appointment faster than I could get from a local doctor!

-Follow up rehab with a good physical therapist is critical, as is following the protocol for return to activity. You can have the best surgeon in the world, but if the work isn't put into proper rehab, you probably shouldn't bother going through the surgery.

-There is no "one size fits all" solution. Don't rush into anything and take time to figure out what feels right for your situation.

Proudpapa - congrats to you and your son. It sounds as if he is going through this with a great deal of tenacity and character. Good luck to him. Our Pitcher is at a great academic DIII with great baseball. The coaches have not only been great, they have been protective. He probably was never meant to play DI, but he did have some DI interest. I can't help but think that if he had gone DI, there was a good chance that he would have felt pressure (even if only self imposed) to produce as a first year.

Best wishes to all the players out there suffering from injury. Work hard, try not to be discouraged, and try to keep things in perspective.

P&CMOM

Great move on your sons part to ask those questions

We talk alot about the "miracle" surgeries but what works for one does not work for another all the time

I recall mine and it was not a sports caused injury--I was walking my Lab on a snowny night and slipped and fell on my left shoulder---OUCH-- went to the hospital for exrays etal---to my orthopedic guy the next day and he tells me he thinks it is just the rotator cuff but xrays were still cloudy from the blood--MRI was not even clear-- we schedule surgery, artho-- but three hours later I come off the table ---he had to open me up because of all the damage they found initially---he had prepared me for the worst so I was fine with it

The key is to ask questions-- and trust your surgeon---they can scope and always cut if they have to after seeing the damage--pictures do not always tell the entire story

I also a few years later had a impingement in my right shoulder---my arm could not raise above the shoulder level--he scoped and shaved ---9 months later not better---one massive shot of cortisone made it heal and it is fine now---every persons body reacts differently


Always get a number of opinions and have a doctor that will listen to you---you know your body better than anyone

quote:

Originally posted by TRhit:
one massive shot of cortisone made it heal and it is fine now

A massive shot of cortisone. How many milliliters did they shoot in there? The cortisone does not have healing powers. It simply helps with the imflamation in the area. Sometimes they work, sometimes they don't. Sometimes the relief can be temporary. Sometimes they can last a lifetime. However, they possess no healing qualities whatsoever.

Ennis,
With an inflammed joint that prevents playing or movement, a shot of cortisone can relieve the inflammation and allow movement/playing. Would that not be a healing of the joint inflammation?

As a veteran of many cortisone shots, I have had them take me from unable to game ready in days...very impressive results for me, but as you say, doesn't work everytime and results can vary.

My son is a senior in high school this year. In February of 2007 he felt a pain in his right throwing shoulder while doing a light bullpen session. He stopped throwing and we went to see an orthopedic doctor the next day. The doctor said that he should have an MRI with dye injected, which he did. The MRI was interpreted as showing a posterior labrum tear. The doctor recommended trying physical therapy first before surgery. A second opinion yielded the same result. My son did not throw at all for six weeks but still played as a DH and had no pain batting. He could not throw a ball even ten feet. He began throwing left handed and did therapy five days a week. After the six weeks was up he began light throwing for about two weeks and then announced to us that all was well and pitched as a closer for the last part of the season. His velocity was greater then before the injury (maybe due to the throwing specific therapy). He closed five games and pitched a total of 10 innings. His control was good as he struck out 19 batters and walked 4. He sits around 86-88 and maxs at 90-92. You would think that I would be pleased with the way things worked out. My problem is that I am worried that the labrum tear has not healed. From what I read the labrum has a poor blood supply and a tear will not heal without surgery.If this is true if he continues to throw harder it may cause a more serious tear that could end his baseball life. He has signed a letter of intent with a D-1 school. How do you know if the shoulder is truly healthy again? Is no pain the indicator? Is it possibly that a lot of pitchers have torn labruns but have no pain and don't have pain as a symptom until they really injure it seriously. Any thoughts?

quote:

Originally posted by CPLZ:
Ennis,
With an inflammed joint that prevents playing or movement, a shot of cortisone can relieve the inflammation and allow movement/playing. Would that not be a healing of the joint inflammation?

As a veteran of many cortisone shots, I have had them take me from unable to game ready in days...very impressive results for me, but as you say, doesn't work everytime and results can vary.

Ripped this off a website as their explainatin says it better than I do. I just look at cortisone as an anti-inflammatory (not to be taken in the buttocks). It's makes you feel better, that much is for sure.

What is cortisone?

Cortisone is a type of steroid that is produced naturally by a gland in your body called the adrenal gland. Cortisone is released from the adrenal gland when your body is under stress. Natural cortisone is released into the blood stream and is relatively short-acting.
Injectable cortisone is synthetically produced and has many different trade names (e.g. Celestone, Kenalog, etc.), but is a close derivative of your body's own product. The most significant differences are that synthetic cortisone is not injected into the blood stream, but into a particular area of inflammation. Also, the synthetic cortisone is designed to act more potently and for a longer period of time (days instead of minutes).

How does the cortisone injection help?

Cortisone is a powerful anti-inflammatory medication. Cortisone is not a pain relieving medication, it only treats the inflammation. When pain is decreased from cortisone it is because the inflammation is diminished. By injecting the cortisone into a particular area of inflammation, very high concentrations of the medication can be given while keeping potential side-effects to a minimum. Cortisone injections usually work within a few days, and the effects can last up to several weeks.

This outstanding thread has been re-opened for business. The troublemaker has been dealt with and the associated posts removed.

To get back on topic, P&CMom's post was outstanding. She is one of the very best writers we have here on the hsbbweb imho and it was nice she took the time to document her family's experience. All the posts in this thread have contributed nicely to a very serious topic - thanks.

We received word two days ago that the kid who was supposed to be the starting catcher has a torn labrum and will require surgery. Season starts on Feb 10th; he is out for the season. The injury happened during football, not sure if he saw a doctor or not, but I do know he has been going to PT for a couple of months with no results. I do know he never sat out a football game and I didn’t even know he was hurt. His parents brought him in for an MRI last week and it showed a tear. I cannot imagine the disappointment this kid feels as this was to be his first season as a starter. Hopefully the surgery will be a success and he can come back for his senior year next year. If anyone has any suggestions on a surgeon in Louisiana, I would be happy to pass the info on to the parents.

The parents should do everything they can possibly do to have the surgery performed by Dr Andrews in Birmingham.
Labrum repairs are not only difficult to diagnose, they are equally difficult to repair. When you combine those issues, and some others, with the need for a repair that will provide a player the best chance to resume playing baseball, you need the very best. I would strongly recommend Dr Andrews to maximize that young man's chances.