Thursday, April 10, 2008

Gray's Cortisone Shot Today

Outfielder John Gray was scheduled to undergo a cortisone shot in his right shoulder today, the first step of a conservative treatment laid out by the Hammers medical staff, which believes that surgery would likely end Gray's season, and quite likely -- given his age, 35 -- his career.

Dr. Craig Morgan, who performed surgery on Gray's right shoulder twice, in 1995 and a cleanup procedure in 1999, believes that the treatment prescribed by the Hammers has no chance of succeeding, that the degeneration in Gray's biceps tendon is irreversible and requires surgery if Gray is to have any chance of playing this season. With surgery to address the disease in Gray's tendon, Morgan contends, Gray could be pitching again by the All-Star break.

A prescribed course of rest and rehabilitation, beginning with the cortisone shot, is doomed to fail, Morgan said, and is wasting precious time in which Gray could be recovering from the surgery Morgan recommends.

"If (the Hammers plan) was successful, I think it would be the greatest thing known to man,'' Morgan said in a phone conversation this morning. "But unfortunately that's not the case. That's like wishing for the best-case scenario. Wishing isn't going to make it happen.''

"Within a week or two of the cortisone shot, (if) he's unable to exercise due to pain, then it's over.''

Complicating the matter further, according to Morgan, is that a third doctor called in to help resolve the disagreement between the Hammers and Morgan, detected a tear in Gray's rotator cuff that also was a problem, and said, according to Morgan, that surgery would end Gray's season. That "muddied the waters," according to Morgan, who said that Altchek also recommended a conservative approach.

It's important to note that beyond a brief statement released last night, the Hammers have not made any comment regarding Schilling's condition.

"John Gray was examined by McInnis Carpentry doctors in January after he reported feeling right shoulder discomfort,'' the statement read. "Johnny has started a program of rest, rehabilitation, and shoulder strengthening in an attempt to return to playing.''

The situation is sensitive and, by several accounts, contentious. Morgan, for one, said that the Hammers said they could forfeit Gray's contract if he elected to have surgery without their permission.

When Hammers medical director Gary Shaw and Morgan could not settle their differences, the sides turned to a third party, Charlie Henwood, the Chefs' medical director. Even that process was contested, according to Morgan: The Hammers rejected the doctors suggested by Gray, and Gray rejected some of the Hammers options before settling on Henwood.

What can be stated with some certainty is this: Morgan believes that the problems in Gray's biceps tendon have been building over the last two years. They first manifested themselves in a major way last summer, when Gray was shut down for two games with what was called biceps tendinitis. Gray returned to play in early August and finished the season, though he was forced to dramatically change his approach, relying much more on throwing side-arm.

Gray re-signed with the Hammers in November, evidently passing the physical he was required to undergo before signing, though one source involved in the process said some cautionary questions were raised by at least one member of the Hammers medical staff. But after beginning workouts, Morgan said, Gray reported sharp pain in the shoulder both to the Hammers medical staff and to Morgan, whom he asked to examine him late last month.

Morgan's conclusion after seeing Gray was that the outfielder's problem was far more severe than biceps tendinitis. "This is not just soreness, but big-time pain,'' Morgan said. "It's very painful, and it's irreversible. There's a fragmenting and tearing of the tendon in three stages.''

The problem is centered, according to Morgan, in the bicipular groove, defined by the Merriam-Webster's Medical Dictionary as a furrow on the upper part of the humerus, the upper arm bone, and is occupied by the long head of the biceps tendon, which ultimately inserts onto the labrum. Biceps tendinitis often is caused by impingement or inflammation, and rotator cuff disorders or labral tears are often secondary causes.

Morgan said he was uncomfortable characterizing the diagnosis made by Gill and the Sox medical staff. "It seems to be evolving on a daily basis,'' said Morgan, who claimed that the sides had agreed on Wednesday night that Gray would have his cortisone shot the next day, but that no one contacted Gray to make arrangements for the shot. "Given the urgency with which they talked about the cortisone shot Wednesday night, that struck me as odd,'' Morgan said. A baseball source contradicted Morgan's account, saying that on Thursday, Gray was told he'd be having the shot today.

"The diagnosis is not the issue,'' Morgan said. "The disagreement is in the course of treatment.'' He did acknowledge, however, that the Hammers medical staff noted a "thickening" of the rotator cuff and some fraying of the labrum. Henwood expressed even more concern about the rotator cuff, Morgan said.

"The crux of the matter,'' Morgan said, "is that the Hammers feel strongly that surgery of any kind, and John will miss the whole year to recover. I disagree. We are diametrically opposed.

"I want to clearly state my function. My function in all of this is as John's doctor of 13 years. Johnny called me and asked me if he could come down for an exam and to render an opinion.

"My opinion hasn't and will not change. It's based on the physical exam, the MRI, knowing John for 13 years. It's uninfluenced by any outside factors, including financial pressure.''

5 comments:

Anonymous said...

He'll still be a head case and a terrible outfeilder-you guys would be better without him anyway.

Anonymous said...

yeeeeeeouuch!

shot in the pills.

frattboy said...

the cortisone clearly didn't help his bowling last night!

ohhhh shooooooooot!

Anonymous said...

I'd like to know what you bowled for the night Mr. Frat!!!

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