Shoulder injuries in Baseball Players & the Mets’ Michael Conforto
New York Mets outfielder Michael Conforto, the 21-year-old who was taken with the 10th pick in the 2014 draft from Oregon State, was a pleasant surprise for the New York Mets in 2017. He had an 0.939 OPS with 27 homeruns, 68 RBIs in 109 games – respectable numbers for only playing a two-thirds of the season. Unfortunately Conforto’s season came to a close early as he suffered a shoulder injury September during a swing.
Unlike some other sports (the NHL comes to mind), MLB teams often release a great deal of information about injuries, which makes my job much easier – I hate speculating. As you can see by the chart below, there are a wide range of injuries that can affect the shoulder.
In the middle column, near the bottom of the ‘intrinsic’ category you see ‘Posterior Labral Tear / Posterior Instability’ and this is what Conforto was diagnosed with, a torn posterior capsule in his left shoulder. The good news is that Conforto is not a pitcher, and the fact that the injury was to his non-throwing shoulder. As this injury could have been potentially detrimental to his young career if it were, as the shoulder plays an integral role in pitching (see the diagram below)
What is the treatment for a Posterior Capsule Tear of the Shoulder?
Depending on the severity of the tear, treatment options can range from intense rehabilitation to injections (like PRP) to surgery. Unfortunately for Conforto, the extent of the damage must have been significant, because he underwent surgery in Los Angeles in early September. The typical timeline for return to play with this type of shoulder surgery (in a non-pitcher) is 4 to 6 months, which will place him very close to being able to return to play starting 2018.
I think realistically Conforto should be aiming to return May 1, as opposed to trying to shoot for Opening Day. Conforto has the talent to become a staple in the Mets lineup for many years to come, so the Mets should not rush a serious shoulder injury that could derail his career. In order to help alleviate some of that pressure of returning too quickly, the Mets signed Jay Bruce to a 3-year deal in mid-January to hold down right field in the meanwhile.
How will this injury affect Conforto?
Conforto bats left-handed, and with the injury to his left shoulder this will potentially cause issues with his swing. He throws right-handed so this injury won’t have any effect on his throwing from the outfield. Although the injury may affect his ability and range of motion of his left hand while he is attempting to catch fly balls or underhand catches as he’s running to attempt to catch a line drive or fast sinking liner.
Posterior capsule of the shoulder injuries have become increasingly common in baseball players, especially pitchers over the years. One study showed that while batter’s shoulder is an uncommon form of posterior instability in hitters affecting their lead shoulder. 11 out of the 12 surgically treated patients returned to their previous level of batting, with an average return-to-play (RTP) of 5.9 months. Four of these patients played professionally, and all twelve of them had MRI-confirmed consistent with posterior labral tears involving the lead shoulder. Treatment for the majority of them (10 of 12) involved arthroscopic posterior labral repair, which is presumably what Conforto underwent.
The majority of the players returned to hitting off a tee at 3 months post-operatively, and faced live pitching at 6 months. Applying this timeline to Conforto, he should have already hit off a tee (sometime in December or early January), and should be in line to start facing live pitching in March. The good news is that all of the patients from the study regained full internal and external range of motion as compared to their preoperative data. In light of this, this is wonderful news for Conforto, because if he follows in suit, he should be able to return to his impressive level of play after what could have been a career-derailing shoulder injury.
Let’s look at Conforto from fantasy perspective. Everyone is justifiably worried about his shoulder and how it will affect his power. His 27% HR/FB from 2017 (12% HR/FB in 2016) is likely unsustainable, and his shoulder surgery may affect this ratio as well. Conforto has always managed to carry an above-average hard-hit rate, and has hit right-hand pitchers well. The question is how much will Conforto play versus southpaws when he is healthy? Only time will tell, but expect the 25-year old Conforto to return around May 1, and expect his power to gradually return, as his shoulder gets stronger. It is realistic for Conforto to reach 500 ABs this year; along with about mid-20s HRs, low 20s strikeout percentage and a walk rate just north of 11%.
1. Seroyer, Shane T et al. “Shoulder Pain in the Overhead Throwing Athlete.” Sports Health, 1 Mar. 2009, www.ncbi.nlm.nih.gov/pmc/articles/PMC3445067/.
2. Wanich, Tony et al. “ ‘Batter’s Shoulder’: Can Athletes Return to Play at the Same Level After Operative Treatment?” Clin Orthop Relat Res, Jun. 2012, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3348296/.
Information about the Author:
This was written by Dr. Jesse Morse, I am a Board-Certified Family Medicine physician, and I am currently completing a Sports Medicine Fellowship at the University of South Florida in Tampa. Dr. Morse is part of the medical staff that covers the Spring Training for the Philadelphia Phillies and the Toronto Blue Jays. This information should be used for entertainment only, and not for medical advice. If you have any questions or comments, you can contact me directly at @DrJesseMorse or visit my website at: www.DrJesseMorse.com.