Friday, February 12, 2016

What does the future hold for the Phillies' Ryan Howard?

On Monday the Phillies learned that first baseman Ryan Howard will miss the next 6-8 weeks with a torn meniscus.

What does the future hold for the Phillies' Ryan Howard?

Phillies first baseman Ryan Howard. (Lenny Ignelzi/AP)
Phillies first baseman Ryan Howard. (Lenny Ignelzi/AP)

On Monday the Phillies learned that first baseman Ryan Howard will miss the next 6-8 weeks with a torn meniscus. While numerous concerns arise as a result of this injury—the Phillies owe the increasingly injury-prone slugger $75 million through 2016, after all—one overlooked question centers on the cortisone shots Howard has received in the past.

Just last week, Howard received a shot in the injured left knee and was placed on the DL six days later. Some fan may remember the “Big Piece” receiving a similar shot in his ankle a couple seasons ago just weeks before going down with the Achilles injury we all remember in the divisional series against the St. Louis Cardinals. But those occurrences are unrelated—right?

“Cortisone won’t mask pain,” says Arthur Bartolozzi, MD, Director of Sports Medicine at Aria 3B Orthopaedics. “It’s used to decrease fluid and inflammation near a joint.”

In other words, cortisone shots won’t help torn cartilage, which is what Howard has. As far as the Achilles injury two years ago, the cortisone shot was in the inflamed bursa sac near his left ankle—a very small area. At the time, there was some discussion and debate over whether the injection could contribute to an eventual rupture of the Achilles tendon. This injury seems more cut and dry.

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Howard received his first cortisone shot back in mid-May, at which time the Phillies confirmed they’d seen “a change” in the left meniscus. “All I know is it hurts,” Howard commented at the time.

He received a second shot last Sunday, but landed on the disabled list Saturday. Monday’s tests confirmed the torn meniscus, so it’s unlikely that either cortisone shot was particularly effective. Most likely, Howard’s been playing through considerable pain since at least May.

The good news is that the torn cartilage in his knee can be repaired in such a manner to allow for a quick return to play.

“I’ve seen athletes return in as little as 10 days,” says Dr. Bartolozzi, who quickly added that the case in question was the exception rather than the rule.  “With about 11 weeks remaining in the season, I absolutely believe he can come back healthy—this year—and contribute.”

Of course, this second significant injury to Howard’s left leg will only serve to increase the murmurs around Citizens Bank Park that the slugger’s best days are behind him. Time will tell whether the former MVP will get a chance to silence his critics during what remains of this 2013 season—and beyond.

Read more Sports Doc for Sports Medicine and Fitness.

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J. Ryan Bair, PT, DPT, SCS Founder and Owner of FLASH Sports Physical Therapy, Board Certified in Sports Physical Therapy
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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
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Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
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Gavin McKay, NASM-CPT Founder/Franchisor, Unite Fitness
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales and Hatfield, PA
Justin Shaginaw, MPT, ATC Athletic Trainer for US Soccer Federation; Aria 3B Orthopaedic Institute
Thomas Trojian MD, CAQSM, FACSM Chief of the Division of Sports Medicine at Drexel University
Robyn Weisman, ACE-CPT B.S., Exercise Science & Physiology, Certified Personal Trainer, Fitness and Lifestyle Coach
Sarah M. Whitman, MD Sports Psychiatrist; Clinical Assistant Professor, Drexel University College of Medicine
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