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April 25, 2007, 02:53 PM ET
Prior Damage

by Will Carroll

I interrupt my viewing of Chelsea v Liverpool to bring you today’s big injury news: The Cubs have announced that Mark Prior’s surgery involved a debridement of the rotator cuff as well as repairs of the shoulder capsule and labrum. Sources indicate the surgery was done completely with the scope and involved a Bankart repair and capsular shift.

So what does this mean? First, it means that Prior had been pitching with significant damage for the past two years. Do NOT take this to mean that he was misdiagnosed. MRIs are imperfect instruments but it does show that this surgery was necessary. The cuff debridement is the most significant injury, but indicates that the tears in the muscles of the cuff were not significant enough to make them structurally unstable. Instead, Andrews would have scraped away scar, loose fragments of tendons, and bursae, as well as any other associated debris from the area.

Second, the capsule repair probably involved a capsular shift. In this the surgeon will make a small incision in the front of the shoulder, then folds an overlap to shrink the capsules circumference. It’s like folding over one of those funny pictures on the back of Mad Magazine.

Finally, the Bankart repair involves stapling, sewing or anchoring the capsular ligaments and glenoid labrum into anchors drilled into the scapula. Despite all this, it can be done completely arthroscopically. It’s as significant as it sounds, but since 2000, there’s been some success with this type of procedure, with several pitchers including Chris Carpenter able to come back to varying levels of success.

All in all, this is a very negative result for Prior, but gives him the knowledge that he was pitching with significant damage. His mechanics protected him from more significant damage, such as the complete tears or larger labral tears that we’ve seen in Kerry Wood, but no pitcher is immune. Did we overstate the case for Prior’s being immune? Absolutely, but as with most things, it’s a point from which we’ve learned. Prior, at 26 years old, now has the rest of 2006 to rehab and still could have a career ahead of him. Without pain, one would assume that he could return to those same mechanics that allowed him to become the pitcher he once was. There’s a small silver lining here in a dark black cloud over Wrigley.

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