Now that the smoke has cleared on the news that Greg Bird has a right labral tear requiring surgery, let's talk about this Boogeyman (known as a labral tear) and what this really means.
The labrum is a ring of soft fibrous tissue located in the shoulder socket. It's job is to help stabilize the shoulder joint. This collagen material cannot be strengthened and there are no reliable techniques to prevent labrum injuries. Oh, and did I mention they are tough to diagnose too!
A type I tear is when a portion of this tissue frays but remains intact. Usually PT can help regain motion, strength and function. In some circumstances arthroscopic surgery is recommended. Most procedures involve removing torn sections of this tissue.
A type II tear is when the labrum actually becomes detached from the bone. To correct this, the labrum is sutured back to the bone through anchors arthroscopically. As you can imagine this is a more involved rehab process than recovery from a type I tear.
These procedures are far more complicated and pose more of a threat to a throwing athlete's career than Tommy John surgery. In two separate studies it was reported that 3% and 14% of pitchers suffering from labrum tears were able to return to their previous level of success. This is far from the nearly 90% reported following Tommy John surgery.
Recovery really depends on a lot of factors such as the location and severity of the tear, how well the repair went, how well the patient heals, if they follow their physician's protocol and is compliant with physical therapy. Return to full essential function is usually between 6 and 8 months however the stress of throwing a baseball requires much more time. (12-14 months)
The good news is Greg Bird is not a pitcher and he plays a position in the field that requires the least arm strength. What makes Bird special is his bat not his arm. Expect him to be ready to compete at 2017 spring training. Ok... now everyone take a deep breath.
Can these be treated through PRP as well? I suppose depends on the grade of the tear.
ReplyDeleteA general question removed from sports, From a P.T.standpoint, is there different therapy involved post prp injection, or would it be similar to to the therapy for a tear? (figure shoulders, elbows knees)
Im a nursing student, and I work with a pain specialist. We are meeting with a few PRP reps this week about bringing in this equipment. So thus always interests me.
Good questions Darryl. As far as I know PRP can be used with a type I tear however I haven't had any come in to my clinic as of yet.
ReplyDeletePhysical therapy would be more conservative with regard to high impact activity to that joint during the early phase of rehab otherwise no real difference in treatment compared to non PRP.
Are their other first basemen or power hittters playing with repaired labral tears? Would be interesting to compare pre-op and post-op BA, power numbers and fielding stats.
ReplyDeleteGreat question Gerry. Brian McCann had his right labrum repaired in 2012. He has said it is much easier for a non pitcher to return with success than a pitcher. He believes the impact of the injury is greater with throwing than batting. Last year's results throwing and with power should be encouraging for Bird.
DeleteMore recently Michael Pineda has returned from the same injury and his velocity has been very good. My only concern is that he still hasn't come close to 200 innings in his career. I wonder if he ever will.