Thursday, August 16, 2012

Dallas Braden needs another shoulder surgery CBS Sports

CBS Sports reports that Dallas Braden needs another shoulder surgery. The A's pitcher who threw a perfect game in May of 2010 had a 'repair of a torn capsule in his left shoulder' one year later. Now, a little over a year after surgery, it appears that the shoulder has not responded as hoped for.

SFGate provides a bit of additional opinion from one of their staff writers:

"It’s bad news, unfortunately, for Dallas Braden, who had hoped to make a few starts in September for the A’s but whose left shoulder has not responded as hoped after surgery in May 2011 to repair the capsule. He will have more surgery; Melvin termed it “exploratory.”

As I have written before, shoulder-capsule repair is not a procedure that has been perfected, unlike elbow ligament replacement. It generally takes quite a lot of time to come back from (see: Johan Santana) and there is no guarantee of a full return. Here’s the main issue: Surgeons must basically guess on how tight to make the shoulder. There is no way to calibrate it. So some shoulders are too tight, some aren’t tight enough. The hope, of course, with any capsule repair is to get the tightness on the money the first time around. I don’t know if that’s what’s going on with Braden, but I have been told by medical experts that generally speaking, the tightness issue is the big question mark when it comes to shoulder capsules. "

Shoulder stability is very complex as explained in the text and videos explained here by my late partner Doug Harryman (while the video is a bit dated, the information is as solid now as it was when he produced it). This is especially the case for throwers who use their arm at the extremes of the range of motion.

Attempts to repair an unstable shoulder in a high performing athlete can be challenging and good followup is necessary to determine if the procedure has been successful, as pointed out in a previous post.


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