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.