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July 22, 2008

Under The Knife

Deep Cut with Jorge Posada

by Will Carroll

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It's not often that news breaks during a chat. I'd ignored a couple calls, but apparently my readers didn't, asking about Jorge Posada almost as soon as the news started to trickle out. The Yankees' catcher was headed to the DL with more shoulder problems, and worse still, the season could be over for the irreplaceable backstop if he elects for surgery to correct the damage. But what is the real story on Posada and his throwing shoulder? Let's take a deeper look at Posada, what's going on with his shoulder, and the short- and long-term outlook for him.

Posada is not your 'normal' catcher. Even at 36, his body hasn't taken the wear and tear most catchers have. He was initially a second baseman, only beginning to shift to catcher in his second season in the minors. He was introduced to the challenges of the position, suffering a serious ankle injury in a collision at the plate while at Triple-A. The late switch saved some erosion on his legs and back, a fact some have pointed to in explaining his longevity. Posada has really only been catching full time since 1993, and didn't establish himself as a major league catcher until he was 26. Scouts talk about his continued athleticism being another factor in his relative health and production.

The main problem for Posada is a torn rotator cuff. While the tear is not complete and does not involve all four muscles of the cuff, it's best to understand the anatomy, so I turn to my mentor, Dr. William Carroll. (Yes, he's my father.)

"The rotator cuff is the name for the tendons of four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis-often referred to as the SITS muscles) that surround the shoulder joint. The rotator cuff is important in allowing the shoulder to function through a wide range of motions. In part due to the rotator cuff, the shoulder joint can move and turn through a wider range than any other joint in the body. This motion of the shoulder joint allows us to perform an amazing variety of tasks with our arms. Unfortunately, a rotator-cuff tear is not an uncommon problem, and these injuries make even routine activities difficult and painful. The rotator cuff is part of this mechanism that, when healthy, functions very well, but when injured can be a difficult and frustrating problem."

Posada also has a torn labrum, but this is more effect than cause. While the surgery to repair both can be done arthroscopically, I wouldn't exactly call it minor. Granted, it's better than an open repair, which is what would be necessary for a full-thickness cuff tear. This type of injury is more common in pitchers, but several catchers have had this problem due to the awkward throwing mechanics many of them employ. Posada has often been criticized for his footwork and has made several intimations that while he could throw effectively in certain positions, he was unable to make "awkward throws." This is again similar to what a pitcher goes through, adjusting the release point in order to find a combination of comfort and effectiveness.

This isn't Posada's first go-round with shoulder problems. He ended his 2001 season in Birmingham having off-season surgery to correct a SLAP lesion (a type of labrum tear), but Posada not only had no trouble coming back, he's had no trouble until this season. In April, he seemed worried that he'd torn the labrum again, saying that it was the same type of pain with the same symptoms. Usually, a player isn't a good judge of their own injury, but score one for Jorge on this self-diagnosis. Of course, saying "it could have been worse" is always true. Looking back at the results of that surgery, there was a negligible loss of power the following season, and no real change in his ability to throw out runners, which was admittedly never a strength.

Many are asking if this had been "seen coming." The Yankees re-signed Posada to a four-year, big-dollar deal this offseason, but until camp, there were no real indicators. According to sources, there were "no problems at all, no red flags," and Posada himself points to an off-balance throw made on April 1. His health record matches up with this. Along with the general warnings for any catcher in his age-36 through age-39 seasons (should he get to them), there has been discussion of Posada shifting to first base as early as next season. He earned a Yellow light in this year's Team Health Report, so given the extra information that the Yankees have, as well as their comfort level with Posada, it's doubtful that this is anything beyond what we're actually seeing. Then again, it's also clear that this looked serious early.

Posada does not have a full-thickness tear (or rupture,) but according to sources there was significant damage in at least two of the four muscles, though there will be another set of images taken on Tuesday to gauge whether playing for the past few weeks has aggravated the issue. Most of the damage was focused in the subscapularis and was described as "moderate," a diagnosis that was agreed on by Andrews, David Altchek, and Yankees team physician Stuart Hershon. Posada is scheduled to see Dr. Altchek again after this imaging to make a determination about surgery. All indications are that that's what will be necessary, but there's still some question about whether he'll have it now and be ready for next season, or wait until after the season and put part of 2009 in jeopardy.

There continues to be some question about how Posada's situation has been managed. He appears to have tried to play through it, with Joe Girardi-the former Yankees backstop who started ahead of Posada earlier in his career-not 'allowing' Posada to play through pain. Yet Posada told the press that "it hurts to throw, and I can't catch like this" on Monday. He can hit, but if his or the team's insistence on catching has caused an exacerbation, it's clear that this was mismanaged. For a team willing to sign Richie Sexson, playing Posada at first base or designated hitter should have been an option. If Posada elects to have surgery, he should be able to return, though the impact on his throwing will be seen well into 2009, raising these same questions again.

Overall, Posada is truly the irreplaceable Yankee. While Derek Jeter is more beloved and Alex Rodriguez is more productive, both have credible backups and replacements from within the system for each. The Yankees committed to Posada long-term in large part because there was nothing else available inside or outside the system that matched his production, even when adjusted for risk and age. That remains true, even as Posada heads for surgery and leaves the Yankees hoping that his shoulder comes back in 2009 the way it did in 2002.

Related Content:  Shoulder,  Jorge Posada

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