Jorge Posada Injury Update

Jorge Posada has just made many a grown man cry as he said he’s likely to return to the DL according to Rotoworld and The New York Post with his recurring shoulder problem. This isn’t surprising to me if he was catching every day but it is surprising because he has been DHing so much. Previously he’s been noted to have a labrum tear, rotator cuff tendinitis, and a subscapularis tear.

To me this is quite concerning as I expect them to find more damage now than before. In terms of the type of surgery it depends on the type of tear they find in there once they go in. One type of common tear is known as a SLAP tear of the labrum which means that there is a tear in the top part of the labrum running from the back of the shoulder to the front. It can also involve the biceps at times. (see images below courtesy of ptclinic.com and eorthopod.com) The repair for this is fairly lengthy because they need to allow the biceps anchor to heal as well as the actual labrum to heal before beginning any exercises. If only the labrum is frayed then it will be a much shorter recovery but it would still come close to ending his season at this point.

Also what needs to be considered is what type of rotator cuff tear there is presently. The subscapularis tear may have progressed to involve other rotator cuff muscles or was worsened by playing. Rotator cuff repairs are much lengthier often approaching a year to 16 months before they are fully healed. Complicating matters further is there is often damage to the rotator cuff, labrum, and biceps tendon all at once. The more that’s going on, you can imagine there will be a longer rehab.

I want to take the time to explain one thing. A common myth is that an MRI diagnoses an injury but it really doesn’t. Posada has been said to have his MRI diagnose the subscapularis tear or even that he was diagnosed with a subscapularis tear after his MRI. MRIs are not foolproof especially in the complexities of the throwing shoulder. There are many times especially in throwers where rotator cuff tears look like labrum tears or vice versa. I have seen this twice already in my career. The only way to be 100% definitively correct is to go inside the shoulder and actually take a look at it.

Pretty much any surgery will end Posada’s season and depending on the severity could easily push him back into 2009. Like I said, it really depends on the severity of the labrum/rotator cuff issues. I’ll keep everyone up-to-date.