The career-ender: For baseball players, labrum tears still one of most debilitating

By Will Sandman | gargoyle@flagler.edu

Michael Gaither sat in the doctor’s office massaging his right shoulder. He lightly moved it in a circle stretching it, testing it. His shoulder had been causing him pain as he threw, and had had been getting worse every day for several weeks. Gaither said he first noticed discomfort his freshman season playing baseball at Triton Junior College in Illinois. It finally got to the point where he needed to get it checked. His fastball — once hitting 90 mph — was now only touching the low 80s, a huge difference for a college pitcher.

After his third MRI, doctors finally discovered he had a labral tear in his right shoulder after undergoing a semi-risky procedure that injected dye into his shoulder. The news was bad, but it was just an injury. Some surgery, a little rehab and he would be back as strong, if not stronger than he was before.

Except that’s not exactly how it worked out.

Gaither underwent the surgery with one of the best surgeons in the southeast, Dr. Erol Yoldas, and fully expected to come back throwing 90-mph fastballs again. Yet, after surgery and six months of rigorous rehab, his shoulder still hurt and throwing the ball just wasn’t right. Some of the scar tissue refused to go away and that fastball kept floating over the plate.

Slowly Gaither, a Flagler College Communication major who graduated this spring, started to understand the futility of his efforts.

“It’s hard,” he said. “You begin to realize that something you’ve been doing your whole life, something you’ve succeeded at your whole life, you just can’t do it anymore.”

Gaither felt empty. He had lost a big part of his life and had no way to get it back. Eventually he decided to move on and moved back home to Florida.

After being removed from baseball for over two years, Gaither says he still thinks about “what if?”

“Of course I think about it,” he said. “You just don’t forget about something like that. When you invest that much time into something you want to be the best. “You want to get drafted.”

Gaither’s story is a familiar one for baseball players who suffer labrum tears.

Dave Barnett, Flagler’s head baseball coach for the last 28 years said, “I have yet to have a player return from labrum surgery and throw with the same velocity as before.”

Barnett blames bad mechanics and a little bad luck as the cause of this injury. “The shoulder is so complex that sometimes bad luck, one throw, can result in a tear,” he said.

Flagler currently has two baseball players who are dealing with the aftermath of a labrum tear, and Barnett said neither is at 100 percent of their pre-injury form.

The Return

Michael Pineda toes the rubber, sending little clumps of dirt scurrying off the mound. He finds a comfortable spot and takes a deep breath. Then, just before he looks in to the catcher for the sign he touches his shoulder, gently, subtly, almost as if to reassure himself that he can trust it. Then he looks in, rears back, and unleashes a mid-90s fastball.

This is one of the rare cases. Pineda is lucky to ever have stepped back on a mound.

Pineda, 23 at the time and a burgeoning star for the New York Yankees, had just come off shoulder surgery to repair his labrum on his throwing shoulder. The labrum is a general term that applies to the fibrous cartilage that keeps the arm attached to the shoulder. Once torn it can cause pain, but more importantly in the case of baseball players, decreased velocity and effectiveness when throwing.

While most medical procedures in today’s day and age are fairly routine (even the once feared Tommy John Surgery is almost 90 percent effective now), labrum surgery is not. In 2004, Will Carroll authored an article for Slate in which he detailed the results of a study he did. Of the 39 pitchers that he had used for the sample, only one — mid-level reliever Rocky Biddle — returned to his former level of success.

According to Carroll’s survey, in 2004 pitchers had a 3 percent chance of coming back from an injury like this. You’re more likely as a college baseball player of getting drafted to the MLB — about 8.6 percent according to NCAA.com.

In 2012, Jay Jaffe wrote an article for baseballprospectus.com where he did his own survey to compare it to the results of Carroll’s eight years earlier. What Jaffe found was that out of 67 players he surveyed, only 9 returned to some level of success post surgery. That’s about a 14 percent chance of achieving success after tearing a labrum, not something anyone who is or is aspiring to make a career out of baseball wants to hear.

Tough to diagnose

Flagler College’s head athletic trainer Eva Beaulieu identified some of the difficulties of diagnosing this injury, the first step in a long process of healing. “A labrum tear can be difficult to diagnose because the structure is deep in the joint,” she said. “The difficulty with diagnosing a labrum tear is that there are several types of tears.”

These differing types of tears — a SLAP tear, a Kim lesion, a Bankart lesion, etc — make it very difficult for doctors to come up with a surgery that can fix them. Each different type of tear requires slightly different surgery and rehab. This specialized individuality makes recovery that much more difficult.

It also detracts from the likelihood of doctors coming up with a more effective surgery, according to Beaulieu. While she believes that there is always the potential for medical advancement, she doesn’t think that labrum surgery will ever be as effective as Tommy John.

“This surgery has been seen to happen if it is only necessary, and due to the complexity of the joint I can’t imagine doctors making surgery a routine first step in the labrum tear process,” she said.

She also mentioned that the rehab process is long and difficult because of the complexity of the injury. The ball and socket joint in the shoulder is much more difficult to fix because, unlike other joints in the body, “it doesn’t just flex and extend like a knee.”

Labrum tears are to be taken seriously, as unlike other injuries, they can be very destructive to an athlete’s career, as players like Gaither came to understand.