Shoulder injury. Discuss.

 

http://www.espn.com/mlb/story/_/id/19721838/julio-urias-los-angeles-dodgers-needs-shoulder-surgery-expected-12-14-months

Edited June 24, 20179 yr by Hosken Bombo Disco

It's a bummer. I wish him the best in his recovery.

 

If this kills his career, he won't be the first or last to get thrown into the career ending injury abyss, even at his age.

Hopefully he has good people around to keep his spirits up. This is a tough injury to return to old form.

 

It gives new meaning to the phrase "at that age" -- he's only 20.

 

Shoulder injury. Discuss.

http://www.espn.com/mlb/story/_/id/19721838/julio-urias-los-angeles-dodgers-needs-shoulder-surgery-expected-12-14-months

 

Saw him pitch this year in LA, no command, everything was off. He got beat up. Not the same kid I saw at the futures game in Minny. Hope he comes back from this. 

Pitching is so necessary but trading for it scares me. Major arm injuries now seem inevitable for most young arms.

Stinks... I don't care... great players are great to watch. I would have preferred the Twins play against Trout than him be hurt. But, hopefully he can come back strong.

This does suck. Hope the kid is ok longterm.

Hope he comes back. I realize he was never a serious target for Dozier but man we really dodged a bullet with the Dodgers organization arms.

And after everything they did to baby his arm...

From the article I gather the injury is repairable and the prognosis is good. Why the doomy headline? It sounds like the young man will be back with a full recovery in about a year. 

 

 

From the article I gather the injury is repairable and the prognosis is good. Why the doomy headline? It sounds like the young man will be back with a full recovery in about a year. 

This is a fairly unusual injury. While it is essentially necessary, for everyone's sake, to publicly state the positive prognosis, I would be leery of his shoulder going forward. Some shoulders (and elbows) are built to pitch at the MLB level for a decade or more. Some, simply, are not. An injury such as this at a young age and with a fairly low overall level of use is concerning to me. I wouldn't be so bold as to see he can't make it back. But I know where I would put my money.

 

From the article I gather the injury is repairable and the prognosis is good. Why the doomy headline? It sounds like the young man will be back with a full recovery in about a year. 

 

This is the same injury Johan Santana had. And he made multiple comeback attempts and couldn't do it. 

 

Mark Prior also had surgery on his shoulder and everyone knows how that went.

John Smoltz also underwent shoulder surgery his first full year with the Braves organization before getting to the majors. He went on to an okay career. I'm sure there are plenty of other positive examples as well.

 

It is intriguing to me that many believe elbow recovery is nearly guaranteed, but shoulder recovery is a near-zero proposition, and not just here. Elbow surgery still sits in the 40-60% return to effectiveness rate. Numbers look higher due to more in the 2/3 to 4/5 of clients making it back to baseball in some capacity, but many are drastically changed in their career.

 

Shoulder injuries, while rough, are still in the 30-40% return to effectiveness number, but the return to baseball is about the same rate, which is why I think the numbers seem so much more heavily positive with elbow injuries. Those who do make it back from a shoulder injury, tend to find an equivalent level of success as before the injury at a fairly good rate, but fewer make it back to even a base level of performance with shoulder issues.

 

John Smoltz also underwent shoulder surgery his first full year with the Braves organization before getting to the majors. He went on to an okay career. I'm sure there are plenty of other positive examples as well.

 

It is intriguing to me that many believe elbow recovery is nearly guaranteed, but shoulder recovery is a near-zero proposition, and not just here. Elbow surgery still sits in the 40-60% return to effectiveness rate. Numbers look higher due to more in the 2/3 to 4/5 of clients making it back to baseball in some capacity, but many are drastically changed in their career.

 

Shoulder injuries, while rough, are still in the 30-40% return to effectiveness number, but the return to baseball is about the same rate, which is why I think the numbers seem so much more heavily positive with elbow injuries. Those who do make it back from a shoulder injury, tend to find an equivalent level of success as before the injury at a fairly good rate, but fewer make it back to even a base level of performance with shoulder issues.

While true, Smoltz is probably not a good comp here. I have seen his shoulder MRI (Dr. Andrews keeps it around for teaching purposes). He had a cuff injury, which is different from the capsular issue Urias is dealing with. In addition, Smoltz was an incredible outlier in terms of what he was able to tolerate and still pitch at a high level. His MRI shows a ton of problems, and he was somehow able to overcome (and excel) at the MLB level. This is exceedingly uncommon and remarkable. 

 Most of the shoulder surgery data we have is with respect to cuff injuries and/or SLAP tears- neither of which are what Urias is having issues with. I would agree with the numbers you quote as an overall statement, though for this problem specifically I am making an educated guess that the numbers are even lower than that. I am not aware of any large case series of this specific injury in the literature (though it's certainly possible it exists and I haven't seen it). Feel bad for the kid and wish him the best, but unfortunately the odds are probably stacked against him.

 

While true, Smoltz is probably not a good comp here. I have seen his shoulder MRI (Dr. Andrews keeps it around for teaching purposes). He had a cuff injury, which is different from the capsular issue Urias is dealing with. In addition, Smoltz was an incredible outlier in terms of what he was able to tolerate and still pitch at a high level. His MRI shows a ton of problems, and he was somehow able to overcome (and excel) at the MLB level. This is exceedingly uncommon and remarkable. 

 Most of the shoulder surgery data we have is with respect to cuff injuries and/or SLAP tears- neither of which are what Urias is having issues with. I would agree with the numbers you quote as an overall statement, though for this problem specifically I am making an educated guess that the numbers are even lower than that. I am not aware of any large case series of this specific injury in the literature (though it's certainly possible it exists and I haven't seen it). Feel bad for the kid and wish him the best, but unfortunately the odds are probably stacked against him.

 

He throws a baseball. The odds are already stacked against him...

I guess what is all comes down to is this:  there's no "one size fits all"  when talking about people/pitchers throwing 90+ mph from an abnormal arm movement.  

 

I'd be really interested in seeing follow-up reports on those who the surgery failed and those that were successful.  

 

This is a fairly unusual injury. While it is essentially necessary, for everyone's sake, to publicly state the positive prognosis, I would be leery of his shoulder going forward. Some shoulders (and elbows) are built to pitch at the MLB level for a decade or more. Some, simply, are not. An injury such as this at a young age and with a fairly low overall level of use is concerning to me. I wouldn't be so bold as to see he can't make it back. But I know where I would put my money.

 

Thank you for clearing up the situation! I love reading your thoughts on injuries on this site. 

 

We're all cheering for Urias to make his return one day... From what you're saying it's a long road to recovery. It wouldn't be the first time baseball lost a young, exciting arm to injury. It certainly won't be the last time either. 

The Ringer's baseball podcast had a great interview specifically about Urias's shoulder. Very good discussion with one of the better surgeons you could ask to hear from...

The Ringer's baseball podcast had a great interview specifically about Urias's shoulder. Very good discussion with one of the better surgeons you could ask to hear from...

Thanks for the note. Good discussion.