Houston Astros pitcher Lance McCullers Jr. will spend the entire 2019 MLB season on the disabled list (DL) after having Tommy John surgery to reconstruct the ulnar collateral ligament. Symptoms of elbow discomfort began on August 4th, 2018 and was originally diagnosed as a right forearm strain that led to 6 weeks on the DL (See Pitcher’s Elbow for more details). His particular problem was described as“pitching through some stuff” (increased elbow discomfort) during his return. Diagnostic tests included an MRI and postseason physical. Treatment is described as gradual elbow/forearm strengthening and rest/ice/compression rehab to work towards a normal pitching routine. Since surgery on November 6th, 2018, McCullers is currently passing all medical clearance checkpoints (according to medical staff) and is expected to make a full recovery. The plan for return to play is spring training for the 2020 season.
Category Archives: Baseball
Goran Dragic Swollen Right Knee
The Miami Heat’s point guard Goran Dragic underwent arthroscopic knee surgery on Wednesday for what was described as a swollen right knee. The Heat announced the 45-minute surgery was to “clean up his knee.” The point guard had been dealing with a lingering problem throughout the season that caused swelling in his right knee.
Two weeks ago, Dragic underwent a small procedure to have the fluid drained from his knee, but the pain and swelling returned. It’s not clear what the problem is and the odds of surgery helping. If there are degenerative changes in the knee, arthroscopic surgery might not be better than simulated arthroscopic surgery.
As reported, the procedure should sideline Dragic for two months, but will provide a more thorough fix to the problem.
Kris Bryant’s Shoulder Injury
Chicago Cubs third baseman, Kris Bryant was placed on the disabled list on July 26, 2018 with what was described as “left shoulder inflammation”. This is a non-specific term and it’s not clear what the issue is. There was no specific injury that would be expected to cause damage. Pitchers have expected changes in their shoulder and some position players may get some changes as well. Such changes are usually well adapted but may occasionally cause enough symptoms for a player to be less effective than needed to play at the top level.
From MLB.com: “Bryant had an MRI and a cortisone shot when he went on the disabled list June 26, and he had another MRI and cortisone shot this week before being placed on the DL on Tuesday. The second MRI confirmed what the first one had shown — that there is no structural damage.”
The approach of always getting an MRI is unusual and not particularly helpful in general. MRIs can be misleading. They must be interpreted in the context of what is likely to be found. Professional athletes generally get more MRIs than is supported by evidence.
The repeated use of cortisone injections is likely a move of desperation. Cortisone injections are not notably better than simulated cortisone injections. And cortisone is catabolic–it weakens and breaks tissues down. Repeated injections are not good for mechanical structures. Clinicians often offer cortisone injections when they don’t know what else to do.
Other treatments may include shoulder muscle strengthening exercises, pain relievers such as acetaminophen or ibuprofen, and ice or heat. A structurally sound shoulder is cleared for all activity. Rest might help the shoulder feel better and help him be more effective.
This blog was written by Ramla Kiyar and David Ring.