AGM Chats: An Orthopaedist's Take on the Yankees' Injury Woes

Hopefully we don't have to see Mo like this for too long.

The Yankees have certainly had their fair share of pitching injuries during the first few months of the season. Mariano Rivera, Michael Pineda, and Joba Chamberlain all have to face significant time away from the team as they recover from their respective injuries. Rivera will soon undergo surgery to repair his torn ACL and meniscus, Pineda had arthroscopic surgery on May 1st to fix his anterior labral tear, and Chamberlain, who had Tommy John surgery last June, had ankle surgery on March 23rd after dislocating it in a trampoline accident with his son.

It’s a laundry list of maladies that’s hard to properly examine without a medical background, but I was fortunate enough to have the opportunity to speak for a few minutes on the phone with Dr. James Gladstone, the co-chief of sports medicine and associate professor in the Department of Orthopaedic Surgery at Mount Sinai Hospital. Dr. Gladstone was able to shed some light on the situation, and help us further understand these injuries.

Mariano Rivera tore his ACL and meniscus. He is 42 years old. Will his age make rehab tougher than it would be on a twenty-something?

I don't think so. Generally speaking, I've seen people in their forties recover like they were in their twenties. There are other factors in terms of recovery. There's not much of a difference in age, it's a matter of getting the muscles going again. It's a question of how the ligament behaves, which is hard to predict. That's biology and how nature runs its course.

How long do you expect it will be before he is able to walk without pain again?

It varies from person to person. He'll be putting weight on his feet by the end of the first week. There are a lot of different protocols out there, and none are "right" or better than the other. He'll likely have some pain for the first month or six weeks. The first five to seven days are always the worst.

How long do you think it will be before Rivera is able to pitch at all, not necessarily even from the mound?

It will likely be at least six months, maybe a little more. For him to throw off the rubber, there's a whole series of things that need to happen with his knee for him to be where he wants to be. He needs to recover muscle strength and get his muscle coordination back, which is very important. It's a very progressive and gradual rehab protocol.

Do you expect that his pitching motion, which so heavily involves his legs, will be permanently affected by the injury? Will he be able to generate the same amount of force from his legs?

I think eventually, he should be able to make a full recovery. Again, how long that is, it's very difficult to say because a lot of people get back to the competitive level while they're still improving. It might be six to nine months before they achieve the ultimate level after the surgery.

Some pitchers have actually said they were able throw harder after shoulder surgery. Curt Schilling said the other day that he had the same surgery in 1995 and threw harder afterwards. Can we expect that from Michael Pineda?

Quite possibly. It really depends on what's wrong and what's being done. A lot of players will play for a long time while their shoulder's hurting. They don't want to admit to it hurting. That will affect velocity.

Are they throwing harder after surgery or does velocity normally come back to pre-injury levels? Was Schilling's case an anomaly?

I think throwing harder is probably an anomaly unless when you're rehabbing, a lot of focus is put on mechanics. If you improve mechanics, you could throw harder.

What will be Pineda's toughest challenge in rehabbing? Control, velocity, mechanics? What's a realistic ETA for him?

With shoulders, you just don't know. If you look across the board at the guys who have been operated on, you might hear the same diagnosis, but one guy takes six months, and another will take eighteen. Once the surgeons see exactly what's wrong, there are different things that need to be fixed in different ways. No matter the length of the tear, it depends on how the shoulder reacts to surgery, not the labrum.

Joba Chamberlain suffered an "open dislocation of his right ankle" in March. How will that affect him in rehabbing from Tommy John surgery that he had last June?

It'll obviously slow his rehab down. It's not going to affect the surgery on his elbow. It will probably affect the pace for when he gets back to throwing. He'll have to protect his ankle until that's fully healed. It will probably take three to four months for the ankle to recover. There will be a period of time when he's really recovering from ankle when he can recover his arm, but he won't be able to work on throwing as much.

***

Pinstripe Alley is very thankful that Dr. Gladstone was able to take some time out of his day to talk to us about these injuries. Hopefully these players can recover soon and get back to helping the Yankees without any further problems.

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