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Picking at a Scab
As I'm sure you've all heard by now, ex-Cubs wonder boy Mark Prior went under the knife yet again last week for his troublesome shoulder. But you might have missed this little detail (emphasis added):
The Padres' right-hander stood in the clubhouse with his right shoulder bandaged and his right arm in a sling following Wednesday's surgery to repair a torn anterior capsule. If that weren't enough to put an end to his bid to pitch this season, doctors also found a second injury -- one that isn't normally associated with baseball.
Prior's anterior capsule was torn away from the humerus, the bone in the upper arm. Team physicians Heinz Hoenecke and Jan Fronek performed the surgery and said the second injury is normally associated with traumatic events like a fall.
Hmm, that's an interesting little tidbit, now isn't it? I recall a time and place where our resident orthopedic surgeon, Dr. Hecht/aka Cubster, speculated that not everything added up with Prior's first surgery.
If MP(Mark Prior) really did have a Bankart lesion. That usually takes a trauma of some sort (of course he could have fallen on the pavement walking his dog). This type of injury is typically treated with rehab in the beginning (see my comments on Toby Hall), with decent recovery until the symptoms become more chronic. MP’s pitching was fantastic after he recovered from that the collison in 2003, so it took time for the looseness/instability the tear created to lead to what occurred in 2006 and 2007.
That answer was in response to a question of mine regarding if any of the rumors about Prior never fully recovering from that faithful collision with Marcus Giles in 2003 could be true. And now Hanz and Franz are saying that there indeed was a traumatic event that created at least one injury in Prior's shoulder.
Of course, for those who remember that conversation and article from last year, Will Carroll of Baseball Prospectus didn't take to kindly to Dr. Hecht's analysis:
Your take on my wrap up is emotionally based and wrong. This doesn’t happen to just the Cubs and suggesting that this was a misdiagnosis is … well, I hesitate to state anything in an absolute, but I think even Dr. Hecht would defer to the opinions of Dr. Andrews, Dr. Yocum, and Dr. ElAttrache.
And since we have nothing better to talk about on this off-day, let's play out the entire conversation:
(Dr. Hecht): A true bankart lesion is traumatic, it’s not just from stretch. Something has to detach the capsule from the glenoid rim. It’s just hard to sort out in a chronic situation. Plus your conclusion said he was dealing with this for two years, hence clearly chronic. I just put together the implications of what was the most traumatic event to MP’s shoulder.
Be careful of throwing terms out without explaining them. Mumford procedures are for AC joint stabilization after type 3 injuries. That would have been a significant surprise if such a procedure was needed.
I might be emotional and might be wrong, but I didn’t imply misdiagnosis, just delay in diagnosis. Certainly if MP listened to advice to treat his problems with rehab, it’s not the Cubs fault. It always boils down to the patient’s decision when it comes to elective surgery.
And last, but not least from Mr. Carroll:
And my “wrong” statement was stronger than I liked. I just want to make it clear that there wasn’t a “misdiagnosis” here. Believe me, I understand the frustration of this thing dragging on and on. I had to write about this thing every day it seems!
Oh and one last thing — the links I did on my Unfiltered post didn’t match up well. I thought the big filetted shoulders looked cool though and would reinforce just how serious this type of thing is. (Dr Hecht, feel free to email me directly anytime.)
When in doubt, trust the diploma! As our very own Dr. Hecht did say, Prior could have fallen walking his dog, but it's far more likely that the collision between him and Marcus Giles was the beginning of the end...at least for his Cubs career.
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