Saturday, April 25, 2015

Can Halladay return at full strength?

Wednesday's press conference confirmed some of our worst fears when Roy Halladay announced he would undergo arthroscopic surgery to address a partially torn rotator cuff and a fraying labrum in his right shoulder.

Can Halladay return at full strength?

Roy Halladay should have learned from last year that any kind of discomfort should be disclosed. (Michael Perez/AP)
Roy Halladay should have learned from last year that any kind of discomfort should be disclosed. (Michael Perez/AP)

Wednesday’s press conference confirmed some of our worst fears when Roy Halladay announced he would undergo arthroscopic surgery to address a partially torn rotator cuff and a fraying labrum in his right shoulder.

Uncertainty was the theme of the press conference, as Halladay shared that doctors are optimistic he can return to pitching later this season. Later, however, he admitted that doctors could find more extensive damage once they are able to see the shoulder during surgery.

Sports Doc went in search of some hints as to the most likely outcome for Halladay in 2013—and beyond. The key may be the bone spur in Halladay’s shoulder that is causing the fraying of the labrum.

“It’s not the surgery that will allow him to get better—if he gets better,” says Justin Shaginaw, MPT, ATC, lead therapist and coordinator for Sports Medicine at Aria 3B Orthopaedic Institute. “He would improve because the 3-4 months he spends on the disabled list would allow him time to rehabilitate correctly.”

Shaginaw cautions, however, that Halladay’s specific injuries are more than likely the result of long-term wear and tear due to kinetic chain issues over several years.

“If he has a bone spur, then this has been going on for a long time,” he adds. “And if the results of the MRI have progressed from last year, that’s obviously not a good thing.”

The fraying of the labrum means it’s slowly wearing out, as opposed to a tear which would indicate an acute injury. “Again, this has apparently been going on for a while. It just finally reached the tipping point.”

Halladay’s sparkling career record and history overshadow the fact that is at least his 4th career trip to the disabled list due to shoulder issues—and the second such occurrence in the past 12 months. From this point forward, it will be safe to say he has a history of shoulder problems. Even with proper rehab, what are the odds that a 36-year old pitcher will be able to fix those underlying issues and put these problems behind him?

“He’s got three problems—the rotator cuff, the labrum and the bone spur. Those are all long-term issues, which means that the issues along the kinetic chain are pretty well engrained by now.”

The return-to-play rates of MLB pitchers following rotator cuff surgery are inconclusive—for every success story like Jimmy Key, there’s a sad, career-ending tale of a Mike Scott. It’s safe to say, however, that the Phillies’ ace faces an uphill climb to become the Roy Halladay of old.

“That’s the hardest thing about this,” admits Shaginaw. “I’ve seen people with terrible knees who get scoped, and you think they’re not going to get any better. But sure enough, they’re back out there playing at the same level they did before the injury. You just never know.”  

So in the end, even the medical community can’t conclusively answer whether data and evidence will outweigh the will of a Hall of Fame-caliber pitcher. The likeliest outcome, as always, lies somewhere in that grey area.

“I think [Halladay] can return to baseball,” Shaginaw concludes. “But I don’t expect we’ll see the same Doc Halladay we all recognize.”

Read more Sports Doc for Sports Medicine and Fitness.

Event coverage, Sports Doc contributor
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J. Ryan Bair, PT, DPT, SCS Founder and Owner of FLASH Sports Physical Therapy, Board Certified in Sports Physical Therapy
Brian Cammarota, MEd, ATC, CSCS, CES Partner at Symetrix Sports Performance
Ellen Casey, MD Physician with Drexel University Sports Medicine
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Head Team Physician for Phillies & St. Joe's; Rothman Institute
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Justin D'Ancona Philly.com
Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
Joel H. Fish, Ph.D. Director of The Center For Sport Psychology; Sports Psychology Consultant for 76ers & Flyers
R. Robert Franks, D.O. Team Physician for USA Wrestling, Consultant for Phillies; Rothman Institute
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer, The Sporting Club at The Bellevue
Brian Maher, BS, CSCS Owner, Philly Personal Training
Julia Mayberry, M.D. Attending Hand & Upper Extremity Surgeon, Main Line Hand Surgery P.C.
Jim McCrossin, ATC Strength and Conditioning Coach, Flyers and Phantoms
Gavin McKay, NASM-CPT Founder/Franchisor, Unite Fitness
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales and Hatfield, PA
Kelly O'Shea Senior Producer, Philly.com
Tracey Romero Sports Medicine Editor, Philly.com
David Rubenstein, M.D. Sports Medicine Surgeon, Rothman Institute
Robert Senior Event coverage, Sports Doc contributor
Justin Shaginaw, MPT, ATC Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
Thomas Trojian MD, CAQSM, FACSM Associate Chief of the Division of Sports Medicine at Drexel University
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