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Under The Knife

It's not too late for Prior to salvage his career

Posted: Thursday April 26, 2007 2:46PM; Updated: Thursday April 26, 2007 2:48PM
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By Will Carroll, BaseballProspectus.com

I spent most of Wednesday waiting and wondering, like most baseball fans. It was the day we'd all finally have some closure on Mark Prior. Was he pitching through a damaged shoulder? Was the damage related to mechanics (a SLAP lesion or torn cuff) or was it more related to overuse? Did Dr. James Andrews put his scope in and see more pitches left in the once-magic shoulder of Prior? I spent a lot of time on the phone and pouring through medical books and journals to make sure I had a grasp on all the possibilities. I find this outcome unsatisfying and can only imagine how Prior feels about now. By the time you read this, Prior will alread have begun his rehab, a long road that's aimed at taking the mound again, hopefully without the pain that's plagued him since 2003. (Yes, you read that sentence correctly.) Prior is an object lesson in the shoulder's fragility, in the fact that the sure thing isn't, not unless we do more.

I wondered aloud to one source yesterday about how much money was spent on Prior's lost time and medical bills, money that could have been invested in research into the prevention of pitching injuries. For an industry that lost over $212 million dollars to pitchers on the DL last season, the paltry few million they've earmarked for research is simply not enough. It's not just Prior that would benefit, but maybe the next Mark Prior. He's the one out on a Little League field, hearing parents and coaches complain about the new pitch count regulations. I actually had someone say to me yesterday that the regulations were ruining baseball. In contrast, I think the ruination of countless young arms on neighborhood diamonds is plenty of reason to, if necessary, nuke the game at that level. It's one thing to risk injury to a professional player in the heat of a pennant race, and quite another to do so in quest of a 12-year-old's trophy. We've got a long way to go and a lot left to learn.

Powered by Chelsea's 1-0 victory over Liverpool, on to the injuries:

• Prior's surgery went about as was expected. Dr. Andrews got his scope inside, looked around, and saw a lot of damage. My initial impressions were pretty much dead on with what sources have told me. It's telling that he'll start his rehab in Birmingham, as it appears that he's headed out of Chicago. Will a change of scenery and a new medical staff help Prior? That is as unclear as everything else in Prior's universe. At 27, he remains relatively young, and if he comes out of this surgery pain-free, he has a chance to do what Chris Carpenter did at age 28 after a similar surgical repair. That Prior had significant damage inside the shoulder tells us that the last couple seasons could have been different, years that were essentially lost to Prior and to the Cubs. Going forward, putting Prior with a pitching coach like Dave Duncan or Jim Hickey would make for an interesting mix.

• Most of the damage indicates a slow wearing rather than any significant trauma, which puts the blame more on Dusty Baker than anyone else, especially Marcus Giles. I've seen some blindly suggesting that the Bankart lesion was the result of that 2003 collision but if that had been the case, the amount of damage occurring to the ligaments would be sufficiently significant to cause instability that would prevent return to activity for an extended period of time -- extended here meaning far more than the three starts he missed. The reported outcome after the collision was a Grade II acromioclavicular sprain. Since the AC sprain involved the acromioclavicular ligament (which basically ties the clavicle and scapula together), there would be very little likelihood that this injury could have involved his labrum. With Prior, there does not appear to be any history of significant injury to the glenohumeral joint itself, therefore making this a wear and tear injury that could have been exacerbated by the fact that the may have been genetically bilaterally lax as compared to the "norm." We also have to remember that the shoulder laxity found during 2006 was said to be muscular, not structural. The once-vaunted mechanics fell apart when pain pulled down on his arm slot, leaving him "throwing pies" as one pitching coach described it.

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