First of all, let me preface this by saying that I am not a doctor, nor do I play one on Bleacher Report.
Now that the disclaimers are out of the way...
It was announced on Tuesday that St. Louis Cardinals starting pitcher Chris Carpenter, sidelined since March with a nerve-related issue in his right shoulder, will undergo surgery later this month to relieve the numbness caused by nerve compression, according to MLB.com.
Carpenter has been diagnosed with Thoracic Outlet Syndrome, a rare condition that involves pain in the neck and shoulder, numbness and tingling of the fingers and a weak grip. Carpenter was actually diagnosed with the condition back in 2008 when he experienced numbness in his shoulder during rehab of his elbow.
Carpenter also experienced numbness during spring training in 2010, but he was able to work through it.
I guess the third time was the charm.
That leads to my question—if this condition has been known for a number of years and has now reared its ugly head for a third time, why was surgery not performed months ago?
The answer isn't always crystal clear.
According to the American Academy of Orthopaedic Surgeons, physical therapy is the first course of action, designed to strengthen the shoulder muscles and improve range of motion.
It certainly appears that both Carpenter and the Cardinals exhausted all options before making the decision to have surgery.
When Carpenter first experienced the symptoms in 2008, he elected not to have surgery at that time because of the inherent risks—additional damage to nerves can occur in some cases. Carpenter chose rest and rehabilitation.
Carpenter again worked through numbness and nerve issues in March 2010, and again, therapy was successful in alleviating the numbness.
Can Carpenter return and be an effective pitcher in 2013?
Enter March of this year, when the numbness returned. The Cardinals and Carpenter again opted for physical therapy. However, this time the therapy didn't work.
"We feel like we've exhausted everything internally," Cardinals GM John Mozeliak said in an stltoday.com article. "All the different things that were working back in '08 to get him back on the mound weren't working anymore. When you have no other options, the last thing you have to do is consider surgery."
The bottom line is that everything was done by both Carpenter and the Cardinals to get him back onto the mound without having to endure a surgery that involves a fair amount of risk. Now, the surgery is the last resort, and one that Carpenter hopes will get him back pitching next spring.
"I want to pitch again, and this is the way for me to pitch again," Carpenter said. "We tried since spring training to get this going, and every time I tried to come back, unfortunately, it just doesn't allow me to do that."
Dr. Gregory Pearl will perform the surgery in Dallas on July 19.
As for Carpenter, he's optimistic that Pearl can help him continue pitching well into the future.
"I asked [Dr. Pearl] one simple question," said Carpenter. "I said, 'I'm 36 years old. I've had a nice career. Is this worth getting this done?' And his comment to me was that he has seen me pitch. He saw me pitch last year. He knows that I can still pitch. There's no question that he believes that I can come back and be as strong as ever and continue to be successful."
Surgery is not always the first and best choice. Any surgical procedure is invasive and carries its own risk.
It's clear that the Cardinals and Carpenter exhausted every possible option with the hopes of getting him back on the playing field sometime this season. Now, they have clarity knowing that they did everything possible before deciding on the surgical route.
In this case, the Cardinals clearly showed that they value their employees and that they really do have their best interests in mind. Carpenter has been a valued employee since 2004, and the Cardinals went to every length possible to protect his best interests.
Doug Mead is a featured columnist with Bleacher Report. His work has been featured on the Seattle Post-Intelligencer, SF Gate, CBS Sports, the Los Angeles Times and the Houston Chronicle.