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.
#1 Re: Picking at a Scab
It was however the beginning of the beginning of the “Mark Prior is a/an (effeminate term)” or “Mark Prior strained his (random female body part)” posts that never really seemed to get old.
__________________________Rooting for Laundry since 1987
#2 Since you bring it up
It's been five years so here's what the collision looked like
http://i.xanga.com/Starlix/Prior%20collision.jpg
Clearly, Prior is about to land directly on his shoulder.
Which is what we all saw at the time. Why only fans thought
this was troublesome is beyond my ken.
At the time there was much more general concern for Marcus Giles who was knocked out (ironically replaced by Mark DeRosa) and taken to the hospital. Reports said he appeared to take Prior's knee directly to the face.
A sane manager, but we're talking Dusty Baker here, would have immediately replaced Prior as well but Baker left him in the game until his shoulder stiffened in the fifth.
Oh yeah,
Prior was out for interference on the play. It was all so unnecessary.
#5 Re: Since you bring it up
#43 Re: Since you bring it up
Great pic, indeed. Love Furcal's expression.
#8 Re: Since you bring it up
"Why only fans thought
this was troublesome is beyond my ken."
Was the unlicensed trainer the Cubs trainer that year?
Dusty's cronie.
__________________________I hate to advocate drugs, alcohol, violence, or insanity to anyone, but they've always worked for me- hst
#3 Re: Picking at a Scab
At the risk of bringing up a sore subject again, could this be evidence of some performance - enhancing drug use earlier in his career? If not, and the chief reason appears to be the collision on the base paths, then that truly does suck. No reason he should have still been in that game, I remember screaming at the manager (whom I will not name here) to yank him the hell outta there.
#4 Re: Picking at a Scab
At the risk of bringing up a sore subject again, could this be evidence of some performance - enhancing drug use earlier in his career?
Risk? You just brought it up. Sigh...
__________________________The Mexican homeboy.
#6 Prior really should get more of a pass IMHO
For all the flack he has taken about not "manning up". Prior obviously had a serious injury that needed to be taken care of. Who's fault is it that it took 3-5 years to discover the injury?
__________________________Rooting for Laundry since 1987
#7 Re: Prior really should get more of a pass IMHO
#9 Could the damage that was done by to his shoulder
be caused by colliding with a 5'7'' second baseman who one Cub's Blogger had a serious man crush on? It would just be typical Cubs if the Giles play did that and the idiotic unlicensed trainer Dusty brought over did not detect an issue.
#10 Re: Picking at a Scab
Congrats to Griffey..... just like Maddux, in this era, it's hard to root against the guy.
__________________________All right, all right, all right....
#15 Re: Picking at a Scab
Congrats to a dude who I will be proud to say I saw play "once upon a time." I hope he can hang around the AL a few more years and take a serious run at 3K hits.
__________________________The Todd Zeile of Internet handles.
#11 Re: Picking at a Scab
is will carroll still trying to be the "guy you call when you need a medical/stats baseball prediction dude on your radio/tv show" guy, btw?
mmm professional branding.
#13 Re: Picking at a Scab
I was going to say something to that effect, but you beat me to it.
I've probably done more than enough to establish my feelings on Mr. Carroll around here. I find it wierd that everybody calls HIM about injuries to pitchers despite not being a doctor or a pitcher.
#14 Re: Picking at a Scab
I know he's on XM radio every Monday morning...probably throws darts at a picture of Stephania Bell though, who took his ESPN gig.
http://insider.espn.go.com/espn/blog/index?name=be...
#16 Re: Picking at a Scab
he deserves to work...its just the whole pitcher-expert/medical-buff thing he's went into with his career that i found odd.
#12 Re: Picking at a Scab
Now, how they didn't discover this with his first surgery, you got me...
---------------------
I'm not so sure this was an issue at the first surgery. It's unlikely that this would have been missed the first time around and I do believe it's a new finding. Sorry if I subsequently use too many anatomic/medical terms but I can translate later if anyone has questions.
Remember the first surgery was a capsular tightening apparently to treat a chronic Bankart lesion (a detachment of the labrum and main stabilizing ligaments of the anterior shoulder particularly the middle/inferior glenohumeral ligaments) . This procedure took redundant capsule tissue and reattached it to the front of the glenoid (socket). So tearing the anterior capsule off the humerus is pretty far from where the capsular work that was done in the first surgery (almost the other end of the shoulder capsule joint attachment but still in the front or anterior capsule). It tearing in this location might be related to the capsule now being tight and when stretched during his current rehab, just happened to be the weakest place where something could give. Still it's a pretty unusual site to tear. I would have thought it would re-tear in the area adjacent to the repair, near the glenoid.
__________________________Pitchers and Catchers report in 6 weeks. Woo!
#17 Re: Picking at a Scab
what the hell does 'translate' mean?
btw, i imagine a lotta people, including myself, would want to know at least if this is something that would generally show up on a MRI/xray if applicable.
#18 Re: Picking at a Scab
translate means... if you don't understand chinese, someone who does will tell you what it means.
Confucius
__________________________Pitchers and Catchers report in 6 weeks. Woo!
#19 Wainright to the DL
according to Rotoworld with a sprained middle finger. One of the posters over at NSBB is saying the rumor in STL is that the tendon is ruptured to in a simlair fashion to Zumaya (who missed 4 months).
#20 Re: Picking at a Scab
It wouldn't show up on an xray. It might show up on a MRI. The results of the most recent MRI apparently were read as an anterior capsular tear but they didn't indicate more precisely where in the anterior capsule.
Sometimes MRI's are done with dye injected into the joint to enhance the imaging (MRI/Arthrogram). Not sure if that was done, but it doesn't sound like it. It took an MRI arthrogram to diagnose Kerry Wood's rotator cuff tear. Of course he didn't get surgery for it (his surgery was for a labrum tear and no cuff tear was seen at the time of his arthroscopy).
__________________________Pitchers and Catchers report in 6 weeks. Woo!
#22 Re: Picking at a Scab
thanks.
#21 Re: Picking at a Scab
Cincy's JHJ with a fractured thumb. Voodoo doll, no?
Who's next in line for their shortstop job?
__________________________Pitchers and Catchers report in 6 weeks. Woo!
#30 Paul Janish for a week to 10 days
until Keppinger comes back from the DL.
#23 Re: Picking at a Scab
If the Giles run in really is the cause for the shortened, if not completely ended, of what could have been great career for a young man that really is a shame.
We all knew he wasn't going to throw for the cubs ever again, i just hope he can get his shoulder in order and make a living once again...
erm, should i say EARN a living once again...
__________________________President of the "Jeff Samardzija for President" Club
#24 Because we miss rumor mongering
http://msn.foxsports.com/mlb/story/8225468/Fresh-r...
some sort of Roberts for Weeks talk and this:
One thing is certain: The Orioles no longer can get the same deal for Roberts that the Cubs offered during the off-season. One reported package included right-hander Sean Gallagher, shortstop Ronny Cedeno, Class AA left-hander Donald Veal and Class A righty Jose Ceda; another proposal substituted outfielder Matt Murton for Veal, according to a source.
Cedeno since has emerged as a valued utility man who can play three infield positions and help spell shortstop Ryan Theriot, who batted .202 last September. Gallagher, meanwhile, is showing progress in the Cubs' rotation and drawing raves from new teammate Jim Edmonds.
"He's the first guy I've seen in a while with Carpenter stuff," Edmonds says, referring to his former Cardinals teammate, Chris Carpenter.
I guess Gammons mentioned something about Burnett, Meche or Wolf being possible Cubs targets on the broadcast Sunday night.
#25 Re: Because we miss rumor mongering
"One reported package included..."
yeah, one of 10,000 reported packages...they kinda went for a sensational group of "could have beens" in that article.
veal, gallagher, AND ceda...oh wait...AND cedeno, too.
reminds me of some of the j.santana rumor offers before he went to the mets.
either way, though...it would have probably involved at least a couple of those guys. not like he was gonna go cheap.
#55 Re: Because we miss rumor mongering
And to think that I took heat for comparing Gallagher to Peavy and Carpenter last year...
__________________________The Mexican homeboy.
#57 Re: Because we miss rumor mongering
This is TCR, Carlos. People will make you take the heat for anything, anything!!
__________________________That's Manila with an "L"
#26 Re: Picking at a Scab
I would take one more starting pitcher and I would be happy with this team in the playoffs.
No not Traschel!!
__________________________I hate to advocate drugs, alcohol, violence, or insanity to anyone, but they've always worked for me- hst
#31 Re: Picking at a Scab
During the trip to SD, I thought Maddux would be great :) A short-term loan? :) I love watching him pitch whatever team he is on. I think he looks best as a Cub tho.
#27 Re: Picking at a Scab
I still think we could use another bat to upgrade at either SS or CF. It would be nice to have a Crawford or H. Ramirez type player around for when the offense sputters, as it has been doing so lately. Yes, neither of those players are available, and it would be difficult to get anyone similar to them, but if we're talking about wishes, that's one of mine. I would agree that starting pitching is more of a concern however.
#41 Re: Picking at a Scab
It would be nice to have a Crawford or H. Ramirez type player around
Heh... you think that would be nice? I am sure that there are a lot of Crawford or Ramirez types lying around.
__________________________wasting way too much time on TCR since 2003.
#45 Re: Picking at a Scab
Right, which is why I wrote the rest of my post.
#28 Re: Picking at a Scab
My wish: C.C.
__________________________All right, all right, all right....
#32 I'd rather have Lowe than CC
because Sabathia has yet to show this season he is worth the haul the Tribe will want for him. With the Phillies as are main challenge in the NL right now, I would like to have his groundball machine right arm on the hill in Game 3 of the NLCS at the Citizen's Bank Park. Also with the Dodgers lacking solid back of the rotation options for next season I think we can make a deal work. Lowe for Sean Marshall and a B grade prospect seems fair.
#44 Re: I'd rather have Lowe than CC
I don't think Lowe will be available. Why would the Dodgers give up arguably their best pitcher when they still have a likely chance of winning their division? That's a fantasy trade scenario.
#48 Re: I'd rather have Lowe than CC
Despite the D-backs playing bad baseball for awhile now, the Dodgers are 3.5 games back. I would give it 1 in 3 odds that the Dodgers will be sellers at the deadline. BTW, the Dodgers best pitcher far and away has been Billingsley.
#51 Re: I'd rather have Lowe than CC
I agree; Lowe could be the odd pitcher out in the rotation next year, especially if Schmidt ever comes back. They will want to keep Penny because he's only 30, so that would mean:
Penny
__________________________Billingsley
Kuroda
Kershaw
Schmidt/Kuo/Lowe?
Losing sucks
#29 Re: Picking at a Scab
Wow, good catch, Dr.
And, who wants to bet it isn't "genetic looseness", but an old injury. Who wants to bet he'll eventually get back to pitching and only be mediocre? Of course, I hope for the best for him, but still...
__________________________"Gasp... You used Ghostbusters for evil!" ~ Liz Lemon
#33 Re: Picking at a Scab
chifan
i would agree the phillies are our top competition and if dodgers drop off
lowe could be a good pickup definately playoff experienced.
#34 Re: Picking at a Scab
noticed the iowa cubs played i think the cardinals team
both teams had a hoffpauir in the lineup
arethey related?
#35 Re: Hoffpauirs
If you're talking about Jarrett Hoffpauir, they're brothers.
#37 Re: Hoffpauirs
josh/jarrett are brothers. micah's on his own in baseball.
#38 Re: Hoffpauirs
I assume you meant by brothers, not at all.
http://mvn.com/mlb-cubs/?comments_popup=3155#comme...
Jarret Hoffpauir had a brother Josh, that doesn't seem to be in organized ball anymore (born in Natchez, Mississippi)
Micah Hoffpauir had a brother named Bradley that briefly played with the Cubs (Fort Worth, Texas)
Bradley
http://www.thebaseballcube.com/players/H/Bradley-H...
Micah
http://www.thebaseballcube.com/players/H/Micah-Hof...
Jarrett
http://www.thebaseballcube.com/players/H/Jarrett-H...
Josh
http://www.thebaseballcube.com/players/H/Josh-Hoff...
Micah and Bradley played for their Dad (and another brother Adam), at University of Louisiana-Monroe. Micah transferred to Lamar University for his last 2 seasons.
http://www.jacksonvilleprogress.com/sports/local_s...
#36 Re: Picking at a Scab
thank you navigator i thought that was a definate possibility
micah definately got the size lefthandedness and power
in that family.
heres hoping he is in toronto on friday
#47 errata
that should have read, jarrett and josh
sorry rokfish
#39 Re: Picking at a Scab
Rickie Weeks lands on the DL with a knee injury (it's being called a sprained left knee).
http://www.jsonline.com/story/index.aspx?id=760138
__________________________Pitchers and Catchers report in 6 weeks. Woo!
#40 Kerry!
Very late with this -- but, when I heard the Cubs were making Wood the closer, my "best case scenario" vision looked exactly like the 9th inning Sunday. Dominant, efficient and pounding the strike zone. 95+ mph fastball, nasty slider, batters helpless. Miller and Morgan were falling all over themselves gushing over his stuff. Hopefully, he is building confidence and comfort in the role.
Edmonds is growing on me -- not only his bat, but to go out of his way to compare Gallager to Carpenter has got to give Sean a big boost of confidence. He was also apparently the first guy to grab an Iowa "Gallagher" jersey to wear under his Cubs uniform, and others joined in. Good stuff.
#42 Gil Meche does not want to be a Cub
http://www.kansascity.com/sports/royals/story/6568...
He has a NTC and does not like big cities.
#46 Re: Picking at a Scab
A GOLDEN OLDIE FROM THE TCR VAULTS...
Arizona Phil — February 19, 2008 @ 8:27 pm response to:
Rob G. — February 19, 2008 @ 7:32 pm Is Jarrett Hoffpauir related to Micah?
==================
ROB G: No. Jarrett’s older brother is Josh Hoffpauir, a 2B who played in the A’s organization a few years ago. Josh is now an assistant baseball coach at Southern Missisippi.
Jarrett and Josh are from Vidalia,LA, where their dad is head baseball coach at Vidalia HS. Jarrett was an All-American 2B at Southern Miss (where Josh also played college ball), and resembles Mike Fontenot.
Conversely, Micah is from Jacksonville, TX, and is a 6′3″ strapping 1st baseman. If Will Ohman is a total jerk (which he is), then Micah Hoffpauir is a total nice guy, just a good ol’ boy from Texas.
Hoff-POWER!
#49 AZ PHIL - a ?
AZ PHIL: How would yoyu compare Olka. State's former standout, and Cubs prospect, to EPat?
I have read Cubs scouting reports that Thomas is super speedy, nice glove, and terrific arm. But, as you know, EPat is a lefty, and already at AAA - also, the team has, like 35 2B players already...
What say ye PHIL?
CUBSTER - check your email.
ROB G. - Glad you had a fun and a big W.
__________________________Disappointed by "Cubbery" since 1966
#50 AZ PHIL ?
It pays to edit.
I was meaning Tony Thomas, if you could not guess this from the above.
Sorry!
__________________________Disappointed by "Cubbery" since 1966
#52 State of Illinois won't be buying Wrigley
http://chicago.cubs.mlb.com/news/article.jsp?ymd=2...
#53 4th Rounder Cerda
already moving to catcher...
http://cubs.scout.com/2/760842.html
#54 Even Sun-Times writers hate Mariotti
http://deadspin.com/5014966/colleagues-dislike-jay...
#56 Re: Picking at a Scab
I thought that Prior was shot after he struck out The Whammer.
__________________________Equal Opportunity Offender