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March 1, 2012 at 5:26 PM

Medical experts say Franklin Gutierrez still faces several weeks of additional work after initial injury layoff is up

Spoke to some experts who work with the type of pectoral muscle injury Franklin Gutierrez suffered. Neither have worked directly with Gutierrez, nor have they seen his test results, so they are speaking in general terms.
One was Dr. Jeffrey Spang, an orthopedic specialist from the University of North Carolina, while the other was Dr. Christopher Wahl, an associate professor at the University of Washington’s orthopedics and sports medicine department.
Both agreed that the amount of time Gutierrez will be off depends largely on how serious a tear he had and where in his pectoral muscle it’s located. If it’s in an area where the pectoral tendon tears away from muscle fibers, that’s not as severe and can be recovered from more quickly.
But if it’s a case of the pectoral tendon separating from the humerus — or “arm” bone — then that injury can take longer. Wahl said that’s usually a two, or three-month ordeal before a player can step back on a field.
The Mariners so far have yet to say which injury Gutierrez is dealing with.
They have said he’ll need four weeks before he can try resuming baseball-related activity. Once that happens, Spang said he’ll need several more weeks to get his arm back to major league throwing caliber.
“Obviously, they will move him through the process of rehab as quickly as they feel possible,” Spang said. “But it’s going to take a few weeks at a minimum to get back into playing-type condition.”
Spang added: “I would think that, for a throwing athlete, if they start him back on throwing activities in roughly four weeks, it’s going to take at least a couple of weeks to get back to game competition level where he’s really letting it fly.”
Both specialists agreed there is plenty the Mariners can do to keep Gutierrez’s conditioning level up even while his pectoral region is recovering. They said he’ll be able to get on a treadmill fairly quickly, with his injured right side and arm immobilized to a large degree.
Wahl said that, depending on the severity of the tear, he can even start to strengthen the muscles around the pectoral injury.
“You can do a lot of strengthening as things come along and are tolerated,” he said. “Again, if it’s a partial tear, there are going to be parts of the pec muscle that can be strengthened while the parts that are injured are healing.”
There are still limits.
While Gutierrez can do a good amount of running to keep his cardiovascular strength, it won’t be the same as the all-out, start and stop running his teammates have been doing outdoors. That’s because the team will want to avoid having him slip and fall on grass and risk re-injuring himself.

This is all part of what was mentioned in this morning’s blog post. Gutierrez will likely be able to keep himself in relatively good physical shape because of the elite training staff the Mariners employ and their ability to operate under even constraining circumstances.
But there’s a world of difference between that and getting a player into game-ready MLB shape.
There’s running on a treadmill with one arm strapped tight and then there’s real, unrestricted running outdoors on grass with explosive starts, stops and cuts.
There’s strengthening of muscle tissue and then there’s all-out bench pressing and other serious lifting.
“What you want to avoid are a lot of really heavy, or sudden loads to the pec,” Wahl said. “So, things where you’re bringing your arm across your body by throwing or trying to swing a bat.”
Another no-no will be so-called “eccentric loads” — like activity that suddenly pulls the arm away from the body to catch a ball way off to the side.
And then there’s getting the body conditioned for MLB-style throwing and hitting.
Wahl said that, generally, if a tear is minor enough, he’d allow a player to begin throwing once the injured pectoral muscle reaches about 80 percent of the strength of the healthy one. That could even happen during that four-week period while Gutierrez waits for the green light to resume baseball activity.
But again, there are controled throws and then there are MLB-style throws where the arm is uncorked completely and not restricted.
So, in reality, as Spang said, if all is clear for Gutierrez by, say, April 1, you’re still looking at about the third week in April before he’s throwing up to professional grade.
At that point, you maybe send him out on a mior league rehab assignment, which carries him well into May.
No quick fix for this.
The good news, which Wahl noted, was that there is about a 70 percent recovery rate from these types of injuries where the player comes back as strong or even stronger. In Gutierrez’s case, right now, he just has to stay patient and keep in as good a physical shape as possible so that his recovery is not delayed any longer.



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