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Hot Stone League

Larry Stone gives his take on a wide array of baseball issues and weighs in about the Mariners, too.

February 9, 2010 at 1:16 PM

The dreaded labrum: Five case studies

carpenter.jpg

With all the speculation over Erik Bedard’s timetable for his return from shoulder surgery on Aug. 14, I thought it would be instructive to look at some real-life pitchers who had labrum repairs, and see how long it actually took them to get back on the mound.

For Bedard, the estimations for his return have ranged from the eight to nine months that Bedard agent Mark Pieper said they were told by Dr. Lewis Yocum, who performed the surgery, to the 10- to 12-months that were mentioned by Mariner trainer Rick Griffin a couple of weeks ago.

That’s quite a wide range. Taking the most optimistic estimate, eight months, that would mean a return in mid-April. Most pessimistically, 12 months, it would be mid-August. And that’s assuming, frankly, Bedard comes back at all — Matt Clement, to take one example, had shoulder surgery Sept. 26, 2006, and never returned to the major leagues. He’s been limited to 32 innings in the minors in the ensuing years, hampered by numerous setbacks, and now is all but out of baseball at age 35. That sad story has been repeated numerous times, from Mark Prior to Scott Elarton. The Mariners have expressed confidence that Bedard will return this season, but the truth is, no one really knows for sure.

Here are five case studies, three of them successful comebacks (Chris Carpenter, Trevor Hoffman and Jon Rauch), one of them unsuccessful (Jason Schmidt), and one of them still in progress (Casey Janssen). All were reported as having surgeries to repair a torn labrum, but keep in mind that I don’t really know how similar the operations were to Bedard’s. And some of those pitchers had other shoulder issues as well that might have made their comebacks more difficult than Bedard’s. But I still think it’s instructive to look at the road some other pitchers traveled en route to coming back from shoulder surgery. I used team media guides, Nexis-Lexis, and Baseball Reference.com to help piece this together.

Chris Carpenter, Cardinals

Sept. 4, 2002: Underwent what Cardinals’ media guide terms arthroscopic surgery to repair slap lesion (labrum tear) in his right shoulder (while a member of the Toronto Blue Jays)

June 16, 2003: Now in the Cardinal organization, Carpenter makes first rehab appearance for Class A Palm Beach. Carpenter makes four outings for the Florida State League team, pitching seven innings, plus three rehab appearances for Memphis (AAA) totaling 8.1 innings pitched. His final game appearance occurred on July 14.

July 29, 2003: Undergoes arthroscopic surgery to remove scar tissue, ending his season.

2004 season: Carpenter comes back strong, making 28 starts and going 15-5 with a 3.46 ERA. He’s named Sporting News Comeback Player of the Year. Misses final two weeks of the season and the entire postseason with a right biceps strain, but comes back in 2005 to win the National League Cy Young Award.

Timetable: From initial surgery to first rehab appearance, nine months and 12 days; from surgery to first major-league appearance (April 9, 2004), 19 months and five days.

Trevor Hoffman, Padres

Oct. 16, 2002: Undergoes arthroscopic surgery to repair what’s termed slight tearing of the labrum and rotator cuff.

Feb. 28, 2003: Hoffman undergoes another operation, this one to shave about a half-inch from the end of his right clavicle.

Aug. 12, 2003: Hoffman throws live batting practice to hitters for first time.

Aug. 23, 2003: Hoffman makes first rehab appearance for Class A Lake Elsinore.

Sept. 2, 2003: Pitches scoreless inning against Arizona Diamondbacks in major-league return. Goes on to appear in nine games, with 2.00 ERA, 11 strikeouts in nine innings.

2004 season: Appears in 55 games and saves 41 games, first of four consecutive 40-save seasons.

Time table: From initial surgery to first rehab appearance, 10 months and one week; from surgery to first major-league appearance, 10 months and 16 days.

Casey Janssen, Blue Jays

March 18, 2008: Undergoes surgery to repair torn labrum in right shoulder, misses entire 2008 season.

May 23, 2009: After throwing 23 2/3 innings of rehab assignments in the minors, with a 0.76 ERA, Janssen makes first major-league appearance, giving up three runs in a six-inning start against Atlanta.

June 16, 2009: Janssen placed on disabled list with inflammation in his right shoulder. He had a 2-3 record and 6.23 ERA in five starts.

Aug. 15, 2009: Janssen returns to majors, working a scoreless inning of relief against Tampa Bay. He appeared in 16 games the rest of the season, all in relief, with a 5.14 ERA.

Timetable: From initial surgery to first major-league appearance, 14 months and five days.

Jason Schmidt, Dodgers

June 20, 2007: Undergoes surgery to repair a torn labrum, remove scar tissue from the bursa sac, and repair a frayed biceps tendon.

May 31, 2008: Schmidt returns to the mound with a rehab start, suffering a bruised calf in the game. He worked 3 2/3 innings for Class A Inland Empire, giving up two runs and four hits. The L.A. Times reported that Schmidt consistently threw his fastball in the low 90s. In four starts at Inland Empire, Schmidt had a 3.84 ERA. In five starts with Triple-A Las Vegas, he had a 7.30 ERA.

Aug. 29, 2008: Schmidt made his last appearance of the season, pitching a scoreless inning for Las Vegas.

Sept. 10, 2008: Schmidt undergoes season-ending arthroscopic surgery to clean up scar tissue. The surgery revealed that Schmidt’s torn labrum was completely healed, according to the Dodgers’ media guide.

July 20, 2009: Schmidt returns to the major-league mound for the first time since June 16, 2007. He earned the win in a five-inning start against the Reds, giving up three runs. In four starts, Schmidt went 2-2 with a 5.60 ERA before returning to the disabled list on Aug. 7 with shoulder problems. Schmidt didn’t pitch again and his career is believed to be over.

Timetable: From initial surgery to first rehab appearance, 11 months and 11 days; from initial surgery to first major-league appearance, two years and one month.

Jon Rauch, Washington Nationals

May 31, 2005: Underwent arthroscopic surgery to repair what was initially thought to be a torn labrum. However, doctors discovered no tear, but rather, degeneration around the area where he had similar surgery in 2001.

Mid-August 2005: Rauch has a seven-game rehab stint in Class AAA New Orleans, compiling a 2.53 ERA.

Sept. 8, 2005: Returns to major-league action with an inning of relief against Florida Marlins. He appeared in seven games the remainder of the season with a 3.00 ERA.

2006 season: Rauch appeared in 85 games for Nationals, tied for second-most appearances in the major leagues, and has 3.35 ERA. He appeared in 88 games in 2007, 74 games in 2008, and 75 games in 2009.

Timetable: From surgery to first rehab appearance, approximately 2 1/2 months; from surgery to first major-league appearance, three months and one week.

Note: Rauch also underwent labrum surgery on May 24, 2001, while a Chicago White Sox minor-leaguer, to repair a tear. He made the Opening Day roster of the White Sox in 2002 and pitched 138 innings that season between Chicago and Triple-A Charlotte.

(Photo by Associated Press)

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