Garcia shut down again with shoulder issues

Jaime Garcia will be shut down once again, the Cardinals announced today as they placed Garcia on the 15-day Disabled List and recalled Mitchell Boggs from Triple-A Memphis. I’m sure I’ll post about Mitchell Boggs later, but he isn’t fixed yet.

Many fans and bloggers have already tried to pin this on the Cardinals’ medical staff as a mistake. They’ll say that he should have had the surgery last year. That they called it that he needed it. Lets remember here that there is only one man who can elect to have surgery, that man is Jaime Garcia. The club and the doctors can want him to have surgery, but if Garcia wants to try rehab, then they try rehab. So to say that the doctors prescribed rest and rehab for it assumes facts not in evidence.

And it’s not that I want to let the Cardinals medical staff off scott free. I’ll say that they do make plenty of mistakes. What I am saying is that this wasn’t a mistake.

Something we need to remember in all of this is that Garcia is a 26-year-old man being forced to make a decision on a surgery that has a greater chance of ending his career than saving it.

Garcia has what has been described in multiple articles as a moderate tear in his labrum and rotator cuff. I read a few times that rest and rehab are very preferable to surgery in this situation. Which is very true because unlike Tommy John surgery, which has an 80-90% success rate, labrum surgery has about the opposite odds.

In an article for Baseball Prospectus written in 2004 called “Labrum, it nearly killed him,” author Will Carroll looked at 36 cases where a player underwent labrum surgery and found that just 1 player returned to his previous level of success. He recounted that doctors don’t know the best way to treat a labrum injury and because of that, “if pitchers with torn labrums were horses, they’d be destroyed.”

In an updated article last year, Jay Jaffe revisited the idea of labrum injuries and their effect. He compiled a list of 67 cases of players undergoing labrum surgery. Over a third of them either were unable to return to pitching or have been unable to return to the major leagues. Cardinals fans will recognize some of these names: Mark Mulder, Matt Clement, and Bud Smith.

Labrum surgery most recently ended the career of a former Cy Young winner, Brandon Webb who finally decided to end his four year battle to return to the mound.

After looking at the list, Jaffe found that about 58% of the players had little or no return and that doesn’t include the probably countless number of minor league players who have labrum surgery and don’t get a chance to return or choose not to. He also found that only about 16% of players who underwent labrum surgery returned to have some level of success in the major leagues.

Look at those numbers and say to yourself you’re willing to peg your career on that until you’ve exhausted all other options. Even if the doctors wanted to pursue surgery, I wouldn’t touch it until the other options were tried and failed. So while we all sit here from our armchairs and criticize the handling of the situation, I have to think that we’d all handle it exactly the same way.

And now there’s a 26-year-old pitcher who is likely to undergo a surgery that has very good odds of ending his career. That’s a lot to have to contemplate at 26 years old.