Shoulder Labrum Surgery: A Look at Baseball's Toughest Injury, Part II

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Shoulder Labrum Surgery: A Look at Baseball's Toughest Injury, Part II
Kathy Willens

Michael Pineda took the mound for the first time as a Yankee last weekend. After missing all of 2013, Pineda came in and looked solid against the Blue Jays. While he ended up taking the loss, Pineda had good stuff and command in his six innings, walking none and striking out five. 

The question now is how long he'll be able to keep it up. Shoulder injuries like what Pineda had often show up not as a complete loss of stuff, but an inability to recover and retain that stuff. We'll only know with a few more starts. He takes the mound on Thursday night for the second time.

However, we can learn more about what Pineda has gone through to get here. Michael Schlact is a former top prospect in the Rangers organization that underwent very similar surgery to repair a damaged shoulder that derailed his career. In a previous article, Schlact explained what it was like to be injured and see his career slipping away. In this one, he'll explain how he came to undergo the surgery itself:

Courtesy Michael Schlact

As my wife and I pulled up to Beacon Orthopedics in Sharonville, Ohio, after a long drive up from Atlanta, we were blown away by what we saw. The building was large and three different wings were visible. As we walked into the main entrance, a wooden carving of a surgeon performing an arthroscopic shoulder surgery greeted us.

Each side of the main entrance had trophy cases full of signed memorabilia from every sport imaginable. “Thanks for saving my career, doc. I owe my career to you, Dr. Kremchek. Thank you for allowing me to play the game I love.” So many thankful, grateful messages adorned the seemingly thousands of helmets, jerseys, shoes, balls, bats and gloves.

Walking from the main entrance down the long hallway to the waiting room, we were met by hundreds more pictures and memorabilia from athletes, celebrities and VIPs who were fixed up by Dr. Kremchek. The collection at Beacon Orthopedics rivals any Hall of Fame collection in the world.

A friendly and welcoming staff of people met me and took me into one of the rooms where another doctor in Kremchek’s practice examined me. I was run through a number of tests on my right shoulder, all of which were painful and all of which caused the doctor to write down notes. After a thorough examination, he told me that an MRI was going to be ordered because my shoulder didn’t seem to be functioning like he expected it to.

I was cautiously optimistic as I lay motionless in the MRI tube, listening to the “90s and now” station on Sirius XM radio. Thoughts ran through my head like, “maybe it’s just sore, or maybe all I need is a little bit more rehabilitation.” Before I knew it, the MRI was over and the radiologist was looking over my slides.

Sitting on that cold, thin paper that draped the doctor’s table was a time for reflection and, to be honest, fear. I didn’t know what the results were going to be, but from what I had heard, Dr. Kremchek would have an answer. The past few doctors, physical therapists and baseball people had told me the odds of coming back from a second shoulder surgery.

I knew how painful the first process was. I remember the agonizing wait that came with the rehab. As far as I knew, if I needed another shoulder surgery, I could kiss my career goodbye. Then, there was a knock on the door.

Dr. Tim Kremchek entered and greeted my wife with a warm hello and a kind handshake. Then, turning his attention to me, he told me that he had looked over my MRI personally. Even though another doctor (Dr. Angel Velazquez, one of the physicians at Beacon) had already ran physical tests on me, he went through his own process, analyzing and measuring along the way. Again, all were painful, and again, all made me wonder what his facial expressions meant.

Finally, he sat down and told me bluntly, "You need another shoulder surgery." The feeling associated with those words was nothing short of a mixture of fear, heartbreak, questions, pain and numbness. Those were quickly erased when he told me, “I will tell you this: I believe with everything that I have that if you do this surgery, you’ll be back on the field again.”

To say that a roller coaster of emotions was present would be an understatement. Dr. Kremcheck, with his quiet confidence, incredible track record and amazing bedside manner, genuinely believed that I could come back. He treated me like a person and not just a number, and he convinced me that a second surgery would be the smartest choice for my future on the field and off.

I agreed with him, and the final decision came after a long talk over lunch with Will Carroll and my wife, Jillian. My shoulder capsule was too tight after my first surgery, resulting in a labrum tear upon rehab and throwing. This surgery was going to be a shoulder capsule release and to clean up and repair any necessary area of the labrum

I have played baseball since I was eight years old. I love the game, and I always told myself that a team would have to rip the uniform off my back to get me to stop. If my shoulder failing me was the cause of my career ending, I needed to know that I gave myself every available opportunity to fix it. I knew in my heart that Dr. Kremchek was going to be that opportunity. On June 7, 2013, I underwent surgery to fix my shoulder.

Beacon Orthopedics has a “stadium surgery” setup. My wife and family watched Dr. Kremchek perform the surgery from about 15 feet away through a window looking into the operating room. He and his staff were in constant communication with my family throughout the procedure and what he saw through the arthroscopic camera, they saw too. At one point, he performed the capsular release and turned to my wife to show her my newfound range of motion!

Courtesy Scott Lucas

I spoke with Dr. Kremchek regarding Schlact's surgery. He remembered the surgery clearly after almost a year. "The problem with shoulders is that it's like what [Dr. Neal] ElAttrache says—it's like putting a puzzle together without the photograph. I call it the 'TJ Maxx' issue, how to do the max for the minimum. What I want to do is as little as possible while getting the function back.

"With Michael, we did a posterior capsular release and then shaved down—debrided—the labrum. Sometimes the shoulder is too loose or too tight. Doing the surgery on the labrum isn't that difficult, the cuff, the capsule, they're all just techniques. It's figuring out which one or ones is necessary to get the player back. You do too much and they'll never make it."

Dr. Kremchek did the procedure in about 45 minutes using mostly an arthroscopic approach. From the time Schlact came in the door at Beacon to the time he left was about 10 hours. 

AL BEHRMAN

From what I heard, the efficiency and confidence in which he performed the operation were almost artistic. The confidence and pride in which he performs his work were evident from start to finish. As I woke up in the recovery area, Dr. Kremchek was there with me to let me know how the surgery went (which was better than anticipated) and that he again expected me to make a full recovery. Numerous times throughout the day he spoke words of encouragement and positivity to me, and it made me feel very good to know that I not only had a surgeon who cared, but I had one that was a friend!

Leaving Beacon Orthopedics that day, I had no idea what the long-term future held. I did know, however, that I put myself in the care of one of the best surgeons around. A long road of rehabilitation stood in my way of pitching on a mound again some day.

The bright lights of stadiums were going to be replaced by training room tables for the foreseeable future. For a second time in less than four years, I had undergone surgery on my throwing shoulder, but this time the feeling was different. I had a renewed sense of hope, faith that I could overcome, and confidence knowing that I had been in this spot before.

Schlact has had his surgery, but the long journey back to the pitching mound is just starting. While Michael Pineda needed more than a year to come back for the Yankees, Schlact has about that ahead of him after surgery and will be starting soon with the Wichita Wingnuts in the American Association. Until then, you can follow him on Twitter. We'll be back with Part III, where Schlact details the long hard road of rehab from shoulder surgery. Full disclosure: I was involved from the beginning with this surgery and was in the exam room when Schlact initially met with Dr. Kremchek.

 

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