Baseball Nation - Michael Pineda Having Surgery For Torn Labrum

Cashman: Michael Pineda A 'Massive Decision Gone Wrong'

2012-04-28T00:47:51Z

Brian Cashman is one hell of an honest, candid general manager, and he's at it once again in the wake of this week's disastrous Michael Pineda news. Via Wallace Matthews at ESPN New York:

"This is a massive decision gone wrong right now," Cashman told ESPNNewYork.com on Friday. "So all scrutiny is fair."

There's really not any other way to put it. Trading Jesus Montero (and a guy) for Michael Pineda (and a guy) was a massive decision. For Michael Pineda to develop a tear in his shoulder labrum is for something to go wrong. Ergo, this is a massive decision gone wrong. But not every general manager would put it that way.

Later in the article, Cashman offers further rejections of the suggestion that the Mariners knew they were trading a damaged pitcher. Cashman has repeatedly insisted that the Yankees gave Pineda a thorough work-up at the time of the trade, and could find nothing wrong. If Pineda had a damaged labrum, they would've found it. They didn't find it. But people will continue to believe what they want to believe, despite all the evidence, because people are irrational and frequently horrible when they're upset. Certain Yankees fans have to believe in sabotage because certain Yankees fans have to believe this wasn't just bad luck.

Tucked in at the bottom of the article is some very interesting information, at least in my mind:

According to Dr. Chris Ahmad, the Yankees' team doctor who will assist in the surgery, and other sources who spoke to ESPNNewYork.com, the fact that Pineda's tear is in the anterior, or front, of the labrum increases his chances for a full recovery. A posterior labral tear often involves the rotator cuff, which Dr. Ahmad said was not affected in Pineda's case.

One source put Pineda's chances for a full recovery at 85 percent after a long period of rehabilitation, expected to be 12 months from the date of the surgery.

So, something encouraging. And something maybe discouraging, depending on how much you believe that one source, and what you think of approximate 85-percent odds. Michael Pineda coming back and looking strong is more likely than Michael Pineda not coming back, or Michael Pineda coming back and not looking so strong, but for now, nobody knows much more than that.

Baseball Prospectus: Not Many Comps For Pineda's Injury

2012-04-27T17:23:53Z

In the wake of the disheartening news about Michael Pineda, there's been a lot of loose talk about the history of labrum injuries and Pineda's prognosis. For instance, Curt Schilling weighed in with his personal experience, and essentially suggested that if Pineda works hard enough he'll come back better than ever. And sooner than everyone says.

Unfortunately, a lot of the analysis implicitly assumes that all labrum injuries are the same. They're not. The reports suggest that Schilling's injury was not the same as Pineda's.

Fortunately, Baseball Prospectus's Jay Jaffe has done the grunt work, identifying 67 pitchers with labrum injuries, then distilling all the details until he found those with injuries that seem truly similar to Pineda's.

The grand total is three.

Jaffe found three pitchers whose shoulder injuries were similar enough to Pineda's that they seem like useful comparisons: Wade Miller, Jose Valverde, and Anibal Sanchez.

The bad news is that Miller never really made it back, and that Sanchez needed roughly three years to get back on track. The good news is that Sanchez is back on track, and that Valverde became a fine closer (though as Jaffe notes, Valverde's injury might have been less severe than the others').

The takeaway is that we really just don't know what's next for Pineda. Except many months of grueling rehabilitation. That's a given. But there is a wide range of possible outcomes here. If you're a fan of fulfilled potential, all you can do is hope for the best.

Schilling: Michael Pineda Could Return Ahead Of Schedule

2012-04-27T12:30:17Z

Michael Pineda's torn labrum is a pretty important baseball story, and here's how you know it's a pretty important baseball story: Curt Schilling has weighed in on it. Schilling, you see, had surgery on his labrum nearly two decades ago, recovered quickly, and went on to have an outstanding career. What does he think about Pineda's situation? Let's ask him, because he's only too willing to tell.

"He can be back better than he has ever been in 10 months," said Schilling, now an ESPN baseball analyst. "Maybe less, because he is younger. It is going to be 100 percent on him."

"I came back after my surgery, throwing four to six miles harder than I did before," he said. "That is where the magic is. It is all about rehab. Most doctors can make you 100 percent well physically. I would tell you that it is 25 percent about the surgery and 75 percent about the rehab."

Michael Pineda was given an approximate 12-month timetable, and Schilling thinks he can be back much sooner than that. In fact, Schilling seems to think he should be back much sooner than that, provided he's disciplined in his rehab. Schilling believes Pineda can recover quickly because Schilling recovered quickly.

Curt Schilling knows more about recovering from a torn labrum than I do, because Curt Schilling has recovered from a torn labrum. But Curt Schilling is just providing anecdotal evidence, which is worthless. What happened with Schilling doesn't mean anything for Pineda. What means something for Pineda is what happened with the entire pool of pitchers with torn labrums. And that's where we see mixed results.

Hell, this same article concludes by talking about Mark Mulder, who went under the knife and never came all the way back. What Schilling might say is that Mulder didn't rehab well enough. It isn't that simple.

This stuff is tricky. Schilling hasn't seen Pineda's medical file. Dr. Craig Morgan, who's quoted in the article, hasn't seen Pineda's medical file. They don't know what his situation is, they don't know how well the operation's going to go, and they don't know how well Pineda's body is going to heal. There's so much they don't know. It's definitely possible that Pineda could return ahead of schedule. No doubt. It's also possible that he could return behind schedule, or even never return at all. The timetables that players get are essentially averages. Averages come with error bars. Every average.

There have been a lot of advances. Most likely, a torn labrum becomes decreasingly serious for a pitcher with every passing day. Procedures get better, recoveries get faster. We don't know what's going to happen with Michael Pineda. Neither does Curt Schilling. He might think that he does, but Curt Schilling thinks a lot of things.

Will Yankees Miss Michael Pineda?

2012-04-26T12:30:11Z

Upon the news that Michael Pineda's going to miss this entire season because of a serious shoulder injury, one couldn't help feeling a bit sorry for oneself; after all, not so terribly long ago, Pineda ranked among baseball's greatest prospects. One major-league season followed, in which Pineda struck out a batter per inning and might reasonably have been the American League's Rookie of the Year.

One's next reaction, perhaps -- judging by the Twitter, anyway -- was to pronounce judgment on the off-season trade that sent Pineda (and Jose Campos) from the Seattle Mariners to the New York Yankees, for Jesús Montero (and Héctor Noesí).

Pineda's out, and 19-year-old Campos is pitching in Class A (and pitching exceptionally well, for what that's worth). Montero's playing regularly for the Mariners, and Noesi's in the Mariners' pitching rotation.

Which seems like a big win for the Mariners, even with both Montero and Noesi off to slow starts.

In the short term, though, does any of this matter to the New York Yankees? Last year the Yankees won 97 games, with Pineda pitching 3,000 miles away in Seattle. This year they're 10-8, again without him.

Are the Yankees going to miss Pineda?

Maybe more than you think.

After the Yankees signed Andy Pettitte and before Pineda went down for the count, the Yankees seemed to have seven worthy starting pitchers: those two, plus CC Sabathia, Hiroki Kuroda, Phil Hughes, Ivan Nova, and Freddy Garcia.

Sabathia and Kuroda are veterans, reliably.

Hughes spent much of last season on the Disabled List; this season he's given up 18 runs in 16 innings.

Garcia's given up 14 runs in 12 innings.

Nova's been good, except for giving up four home runs in 19 innings.

Everyone's probably going to be fine. They've all got good (or better) strikeout-to-walk ratios; where the earned-run averages are inflated, it's largely because of home runs, and home-run rates this early in the season just don't tell us much about how well anyone's actually pitched.

Well, two of them will probably be fine; the other probably will flame out, and spend at least a few weeks on the DL (or in Hughes' case, perhaps back in the minors). Should that happen, the Yankees will still be one starter short of a reliable quintet. But of course there's still wily old Andy Pettitte. Even if -- after pitching five somewhat shaky innings against double-A hitters Wednesday night -- he's at least two or three weeks away from rejoining the Yankees.

And the Yankees also have prospects; entering this season, their two best prospects were starting pitchers Manny Banuelos and Dellin Betances. The good news is that both are pitching for the triple-A Empire State Yankees. The bad news is that both have pitched dreadfully this spring.

The best news is that the Yankees don't need five good starting pitchers to thrive; remember, last season Phil Hughes and A.J. Burnett combined for 46 starts and the Yankees still won 97 games.

But just a month or two ago, the Yankees seemed awash in good starting pitchers. Today, it looks like Brian Cashman might actually have to do some work this summer.

Stone: Michael Pineda, And Five Labrum Tear Case Studies

2012-04-25T23:24:56Z

This article from Larry Stone was actually written more than two years ago, and was written because of Erik Bedard's labrum tear, and not Michael Pineda's labrum tear. At the time, Michael Pineda didn't have a labrum tear. At the time, Michael Pineda was barely a thing. I mean, he was a pitcher, and a very big pitcher, but he wasn't yet a can't-miss pitcher, and, er, you know what I mean. Bedard, Pineda, it doesn't matter. Stone's information is still valid.

Stone looks at five pitchers who underwent labrum surgery and tracks their recoveries. This is some ground that Grant already covered in the update below, but also some new ground. An (extended) excerpt:

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.

And, hey, Erik Bedard. Bedard had surgery on his labrum in 2009. He wound up missing the entire 2010 season after experiencing a setback during a rehab assignment, but in 2011, he was mostly outstanding, striking out a batter an inning over 24 starts. There is hope for Michael Pineda and the Yankees yet. There's just a long, long way to go before the Yankees have an idea of what Pineda's going to be on the other side.

Michael Pineda Injury: The Horrors (And Success Stories) Of The Torn Labrum

2012-04-25T21:35:20Z

There are injuries that take time to heal. There are injuries that take a lot of time to heal. And then there are torn labrums, which take a lot of time and even more luck.

Luck might not be the right word. But there's an uncertainty about labrum tears and shoulder injuries in general that makes them especially ominous when they happen to pitchers. Michael Pineda's career might not be over, but it's hard to imagine worse injury news. In 2004, Will Carroll described labrum injuries thusly:

But if pitchers with torn labrums were horses, they'd be destroyed. Of the 36 major-league hurlers diagnosed with labrum tears in the last five years, only midlevel reliever Rocky Biddle has returned to his previous level. Think about that when your favorite pitcher comes down with labrum trouble: He has a 3 percent chance of becoming Rocky Biddle.

Even more ominous: Biddle's career ended a few months after that article was published. The article goes into great detail about the perils of shoulder injuries for pitchers.

But it is 2012, not 2004, so it's safe to assume that some progress has been made over the last decade. Bartolo Colon is a major-league pitcher again -- and a good one -- because he was injected with stem cells. Alex Rodriguez is playing with the help of his own centrifuge-spun blood. So it follows that medical science has advanced with regards to labrums as well.

Chris Carpenter is a famous success story, coming back after labrum surgery to star with the Cardinals and become something of a workhorse. Perhaps the best recovery from a labrum injury in baseball history was Curt Schilling, who had a labral tear repaired in 1995, before he was a star pitcher. If you are not squeamish -- I mean if you're really not squeamish -- you can look at pictures of Schilling's second labrum surgery and read his accompanying writeup:

This first picture is my labrum. This actually looks rather innocent until you realize this. That white wispy cotton looking material is my labrum and that solid bone thing to the right is my bone at the joint. The white wispy thing is supposed to be adhered to the bone and NOT all frayed and floating. Basically I had a torn labrum from about 10 o’clock to 3 o’clock.

If you're the squeamish type and you still click on that link after reading that, you have only yourself to blame.

Pineda will not be back for a long time, that much is a given. And there is no shortage of scary names associated with labrum surgery -- Robb Nen, Ben Sheets, Brandon Webb -- but there are also success stories like Carpenter, Schilling (the first time), and Ted Lilly. It's about a year or two too early to know a whole lot more.

But Pineda has one of the few injuries in baseball that doesn't have a great history of recovery, nor does it have an exact timetable to follow. The shoulder is still a pitcher's worst nightmare

Michael Pineda Injury Might Have Occurred During Rehab Outing

2012-04-25T21:22:26Z

Michael Pineda has a torn labrum. That's a thing in his shoulder, and that's a lousy thing for a pitcher to tear. If there's any silver lining for the New York Yankees, it's that the tear is small and should be able to be repaired arthroscopically. But it's still a torn labrum, and a torn labrum is still one of the worst things that can happen to a pitcher's body.

So when did this happen? Has this been the problem the whole time, or is this a new thing? Brian Cashman has his suspicions:

Cashman: "We believe this took place on the last pitch of his rehab outing."
— Mark Feinsand (@BloggingBombers) April 25, 2012

Pineda supposedly felt a sharp pain in his last game. That would seem to correlate to the injury. The question, then, is if the labrum injury is new, why was Pineda's velocity down all spring? Were the two unrelated? It's curious. It's also not what's important at the moment.

Here's the present outlook:

Dr. Ahmad said if rehab goes well, Pineda could be ready to pitch in major league games in 12 months. Best-case he's looking at late-April.
— Mark Feinsand (@BloggingBombers) April 25, 2012

"If rehab goes well." You can never know with these things. I like how Dr. Ahmad skipped right over saying "if surgery goes well, too". There's a guy who's confident. The best the Yankees can hope for is that come next May, Michael Pineda is the Michael Pineda they thought they were getting. I don't know how probable that is, but this isn't the time for pessimism. The time for pessimism was when Michael Pineda was throwing with reduced velocity, and now look where we are. It's time for optimism. Michael Pineda will be fine! Baseball would be better if Michael Pineda turns out fine.

Michael Pineda Injury Severe; Surgery Required For Torn Labrum

2012-04-25T21:05:52Z

I'm going to go ahead and rip the band-aid right off. You've seen the headline. Michael Pineda has been on the disabled list for the Yankees, and he recently had an MRI on his right shoulder, which has led to the following:

pineda has a torn labrum. surgery tuesday
— Jon Heyman (@JonHeymanCBS) April 25, 2012

When people noticed Michael Pineda's reduced velocity in spring training, this is what they were afraid of.

When people noticed Michael Pineda's continued reduced velocity in spring training, this is what they were afraid of.

When people heard Michael Pineda experienced a setback during a minor-league rehab assignment, this is what they were afraid of.

At any point, it could've been nothing. It's all very much something. Pineda doesn't have inflammation, and he doesn't need Tommy John surgery, and he doesn't need to get his rotator cuff repaired - he needs to get his shoulder labrum repaired, and this is about as bad as it gets for a pitcher. There are degrees of labrum tearing, of course, and smaller tears are better than bigger tears, but a tear is a tear, and this is one procedure from which full recovery is not guaranteed. This isn't Tommy John surgery. The Yankees can't simply count on having Pineda back and available and good next May or June.

There are success stories. Chris Carpenter had labrum surgery a long time ago and he turned into Chris Carpenter. One figures the outlook is getting better all the time, but the only way this news could've been worse for Pineda and the Yankees is if Pineda had injuries to his labrum and something else. Or a damaged brain stem, but I don't think that was ever a possibility.

Michael Pineda underwent a full examination when he was traded to the Yankees from the Mariners, which he passed. Either that examination missed something, or in the time since, he's developed a torn labrum. He's going to be out for a long time. One simply hopes that someday he can get back to being Michael Pineda.