Rest is best for Halladay, doctor says

The advice Roy Halladay received from the Phillies, the single-best thing he can do to return his strained shoulder to baseball shape, runs counter to the hard-driving ethic that has made the all-star righthander one of the game's best and most diligent pitchers.

Rest.

"Really, in the end, it's going to be time," Bradford Parsons, an assistant professor of orthopedic surgery at New York's Mount Sinai Hospital, said Wednesday when asked what the now-disabled Halladay might do to hasten his return.

"You've got to let it [the inflamed latissimus dorsi muscle] cool off a little before you try to push it too much. You've just got to rest."

Rest won't come easily or naturally to a pitcher who has thrown 200-plus innings in eight of the last 10 seasons, who pushes his body to its limits in and out of season, who relaxes by challenging the Amazon River and anaconda snakes.

That restlessness, in fact, could be why Halladay sought a second opinion from the Mets' team physician Wednesday in New York.

But, as Parsons pointed out on the day after the Phillies put their ace on the shelf for what team doctors predicted would be six to eight weeks, there aren't a lot of options when it comes to the damaged muscle that is essential in the throwing motion.

"They might do some things in therapy to try to get rid of the inflammation quicker," the orthopedic surgeon said. "There are some modalities therapists will do to try to break up muscle inflammation or scarring. There's probably some gentle stretching they might do. But really, it's time.

"You want to let the muscle where the strain is cool off, give the body a chance to resolve the inflammation, repair the area where the muscle is injured or strained."

As that occurs, Halladay then might begin some mild arm exercises. If it's too soon, the discomfort the 35-year-old pitcher admitted to experiencing recently would return, in all likelihood.

Cortisone injections, which often speed healing in the rotator-cuff area of the shoulder or in the elbow, aren't indicated for a strained latissimus dorsi muscle, physicians said. In fact, there's no miracle drug that would get Halladay back on the mound sooner than anticipated.

"Sometimes anti-inflammatories can help decrease the inflammation and help alleviate some of the pain," Parsons said. "But there's not a lot of data that suggest that's going to get him back quicker, though it can alleviate some of the symptoms."

During spring training, in the last week of March, Texas lefthander Neal Cotts and St. Louis righthander Scott Linebrink were shut down with shoulder problems that involved the latissimus dorsi. Two months later in the 2012 season, neither reliever has yet pitched a big-league inning.

Parsons, who has no personal knowledge of the pitcher's injury or diagnosis, said that even if Halladay were to return too soon, it's unlikely his injury would develop into something more serious, as in what happened to Jake Peavy.

In July 2010, early in a game against the Angels, the Chicago White Sox pitcher tore the latissimus dorsi tendon right off the bone. He was operated on, missed the rest of that season, and was limited to 19 appearances in 2011.

"That's a rare injury," Parsons said. "If [Halladay] doesn't allow proper time to recover, he might have pain there again. But this is not likely a problem that's going to progress to other parts of the shoulder.

"I'm sure the people involved want to get Roy Halladay back as quick as possible," Parsons said, "so they're going to use all the tricks they have up their sleeves."