It’s no secret that Roy Halladay has not been ‘Doc’ over these past two seasons. With the pitcher turning 36 today, May 14, and his recent placement to the disabled list (DL) due to bone spurs, a partially torn rotator cuff, and frayed labrum in his throwing shoulder, his future does not look too bright. The pitcher’s throwing velocity has been steadily declining and his ERA has skyrocketed during the 2012 and 2013 seasons. The fans of Philadelphia are buzzing, wondering if they will ever see Doc be Doc again or if it’s a thing of the past, a memory that we Philadelphia Phillies fans will never see again. Halladay’s dominance and work ethic over the course of his career are unquestioned, but will his dominance continue if he returns? Have we seen the last of the brilliance that is Roy ‘Doc’ Halladay?
Why does Halladay have all of these injuries to his throwing shoulder? If you have read a recent post about shoulder impingement, you understand the intimate balance required of the shoulder musculature working together to hold the shoulder properly in place. If not, let me describe it for you. The rotator cuff muscles work to hold your humerus (arm) in place with the glenoid of the scapula (shoulder blade), the humerus and glenoid create the shoulder joint. The humerus is housed by bone from your shoulder blade and clavicle (collar bone) with some soft tissue structures in between these bones like the long head of biceps tendon, supraspinatus (one of 4 rotator cuff muscles) tendon, the sub acromial bursa, and shoulder joint capsule. This space housing these four structures is called the subacromial space. Shoulder impingement or compression of these structures causes shoulder pain and can lead to further injury just like in Halladay’s case. The rotator cuff muscles hold the humerus in place and prevent shoulder impingement allowing a person to reach overhead or even throw a baseball w/o compressing these structures. If the rotator cuff muscles are weak or overworked they cannot hold the shoulder joint in place and the humerus rubs on these soft tissues structures and even rubs the bones which house the humerus causing irritation and pain.
Halladay has bone spurs because his humerus was rubbing on the roof created by the shoulder blade and collarbone. This rubbing of bone was either due to weak and overworked rotator cuff muscles or due to Halladay’s throwing mechanics. Bone is strengthened and even created, in the case of bone spurs, as a response to the forces placed upon it. The body sees the bone rubbing against bone and ‘thinks’ that bone needs to be placed there to support the forces put on the bone, therefore bone spurs are created. With bone spurs in this subacromial space, which is already very tiny, about 10-12mm, there is going to be further rubbing and irritation of structures that will lead to injury. Halladay continued to pitch with these bone spurs that eventually rubbed on his labrum and rotator cuff causing partial tears in these structures as well.
Yes, Halladay needs surgery to remove these bone spurs and sew together the partial torn rotator cuff and labrum, but this will not solve the real problem. The real problem and the reason behind the injuries to Halladay’s shoulder are one, or both, of two things. Halladay either has weak and overworked rotator cuff muscles that need proper strengthening in rehab to maintain the stability of his shoulder or his throwing mechanics are such that this rubbing and irritation will continue when he returns, or both are happening. If Halladay does not address these two issues and returns in 2-3 months as projected, the shoulder pain will return, the velocity will fall, and Halladay will be once again on the DL. The reason you see some many older ‘submarine’ pitchers is because their previous throwing mechanics caused irritation of the subacromial space when they threw overhand. The pain in these pitchers is so severe that they needed to change their mechanics completely by not even throwing over hand, instead throwing submarine style. This is not to say that Halladay needs to become a submarine pitcher, but that he should not rush back. Halladay needs to take the proper time to allow his shoulder to heal from surgery and then strengthen his rotator cuff muscles in rehab. His throwing mechanics also need to be evaluated to see if they are contributing his shoulder pain.
If Halladay goes through the proper rehabilitation in physical therapy we could see Doc of the past once more possibly late this season, but more realistically next season. If Halladay does not address rotator cuff strength and his throwing mechanics, Doc Halladay will just be a memory of the past. Sure, time is not on Halladay’s side at 36 years old in a league of young superstars and countless pitching prospects in the minor leagues eager for their chance to shine under the bright lights. But, as Philadelphia Phillies fans, we saw Jamie Moyer pitch and win well into his forties. Let’s hope Halladay gets the proper rehab, continues with his iconic work ethic, and doesn’t rush back, then maybe we’ll see Doc deal again.
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