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Might be a nerve issue...joy
Sources say Carpenter will seek second opinion from Andrews
By Joe Strauss
ST. LOUIS POST-DISPATCH
Saturday, Jun. 14 2008
Cardinals ace Chris Carpenter will seek a second opinion from Birmingham, Ala.,
orthopedist Dr. James Andrews on Monday regarding his problematic right elbow,
club and industry sources confirmed Saturday.
The club has not confirmed the findings of a Friday examination performed by
team medical supervisor Dr. George Paletta, but a source familiar with
Carpenter’s situation said Paletta focused on a potential nerve condition that
could result in additional surgery to move, or transpose, a nerve located near
Carpenter’s surgically repaired elbow.
General manager John Mozeliak spoke Saturday to Carpenter’s agent, Bob LaMonte,
to determine the pitcher’s choice of doctors. Carpenter opted for Andrews, one
of several orthopedists who examined the 2005 NL Cy Young Award winner before
he submitted to ligament transplant surgery last July 25.
The club apparently suggested that Carpenter seek an outside opinion after
Friday’s examination, which ruled out structural damage to the elbow or to the
transplanted ligament.
Four doctors, including a neurosurgeon, examined Carpenter in St. Louis on
Friday. Results were "inconclusive" enough, according to general manager John
Mozeliak, to warrant an additional consultation.
Lingering uncertainty about Carpenter’s condition and treatment has caused the
club to modify earlier projections that Carpenter could return to the rotation
around the All-Star break.
"That’s a tough break for him, a tough break for us," manager Tony La Russa
said. "I’ve been saying based on the progress he’d been making that he would
pitch before the first half was over. But the guy that’s going to take it the
hardest is Chris. Whatever it takes to get him 100 percent, he’s got plenty of
a great career left. I’m plenty disappointed for him and a little bit for us."
Yet the prospect of additional surgery is not enough for the club to scrub the
righthander’s potential return later this season.
"If this is something they determine does not need to be moved, then he likely
can pitch through this," Mozeliak said. "If it does have to be moved, we
estimate it as a two to four week setback for when he might be able to return."
If Andrews recommends a procedure, it will not be performed immediately.
Carpenter and LaMonte are expected to meet with Mozeliak and the team’s medical
consultants before finalizing his decision and a time for potential surgery.
The suspected condition is common among pitchers who have required ligament
transplant surgery. Transfer of the ulnar nerve is performed in a significant
percentage of so-called Tommy John surgeries, but not in Carpenter’s case.
The condition derailed what team medical and training staff considered a
seamless progression. Carpenter threw with impressive velocity with only
moderate effort during spring training and had continued to progress until
experiencing what one club source called "a hiccup" last month at the team’s
Jupiter, Fla., spring training headquarters. Carpenter resumed after a brief
shutdown, only to endure forearm discomfort within the last two weeks. After
another brief hiatus, Carpenter experienced more discomfort following Wednesday’
s throw and returned to St. Louis to be seen by the medical team.
Cardinal relievers Russ Springer and Kyle McClellan had required nerve
transfers following elbow ligament replacement.
Springer threw within two weeks. McClellan’s more elaborate procedure followed
a 2005 ligament replacement. He made only three starts for Rookie League
Johnson City in 2006 before returning last season to work 40 games, all but one
in relief.
Carpenter has made only one start since signing a five-year, $63.5 million
contract extension in December 2006.
Fellow starting pitcher Mark Mulder and Matt Clement appeared in opposite ends
of a Saturday doubleheader for Double-A Springfield, and Mozeliak confirmed
that Clement is in the mix to start this week should Todd Wellemeyer be bumped
with elbow discomfort. Mulder also helped his case with a strong showing in the
first game.
By Joe Strauss
ST. LOUIS POST-DISPATCH
Saturday, Jun. 14 2008
Cardinals ace Chris Carpenter will seek a second opinion from Birmingham, Ala.,
orthopedist Dr. James Andrews on Monday regarding his problematic right elbow,
club and industry sources confirmed Saturday.
The club has not confirmed the findings of a Friday examination performed by
team medical supervisor Dr. George Paletta, but a source familiar with
Carpenter’s situation said Paletta focused on a potential nerve condition that
could result in additional surgery to move, or transpose, a nerve located near
Carpenter’s surgically repaired elbow.
General manager John Mozeliak spoke Saturday to Carpenter’s agent, Bob LaMonte,
to determine the pitcher’s choice of doctors. Carpenter opted for Andrews, one
of several orthopedists who examined the 2005 NL Cy Young Award winner before
he submitted to ligament transplant surgery last July 25.
The club apparently suggested that Carpenter seek an outside opinion after
Friday’s examination, which ruled out structural damage to the elbow or to the
transplanted ligament.
Four doctors, including a neurosurgeon, examined Carpenter in St. Louis on
Friday. Results were "inconclusive" enough, according to general manager John
Mozeliak, to warrant an additional consultation.
Lingering uncertainty about Carpenter’s condition and treatment has caused the
club to modify earlier projections that Carpenter could return to the rotation
around the All-Star break.
"That’s a tough break for him, a tough break for us," manager Tony La Russa
said. "I’ve been saying based on the progress he’d been making that he would
pitch before the first half was over. But the guy that’s going to take it the
hardest is Chris. Whatever it takes to get him 100 percent, he’s got plenty of
a great career left. I’m plenty disappointed for him and a little bit for us."
Yet the prospect of additional surgery is not enough for the club to scrub the
righthander’s potential return later this season.
"If this is something they determine does not need to be moved, then he likely
can pitch through this," Mozeliak said. "If it does have to be moved, we
estimate it as a two to four week setback for when he might be able to return."
If Andrews recommends a procedure, it will not be performed immediately.
Carpenter and LaMonte are expected to meet with Mozeliak and the team’s medical
consultants before finalizing his decision and a time for potential surgery.
The suspected condition is common among pitchers who have required ligament
transplant surgery. Transfer of the ulnar nerve is performed in a significant
percentage of so-called Tommy John surgeries, but not in Carpenter’s case.
The condition derailed what team medical and training staff considered a
seamless progression. Carpenter threw with impressive velocity with only
moderate effort during spring training and had continued to progress until
experiencing what one club source called "a hiccup" last month at the team’s
Jupiter, Fla., spring training headquarters. Carpenter resumed after a brief
shutdown, only to endure forearm discomfort within the last two weeks. After
another brief hiatus, Carpenter experienced more discomfort following Wednesday’
s throw and returned to St. Louis to be seen by the medical team.
Cardinal relievers Russ Springer and Kyle McClellan had required nerve
transfers following elbow ligament replacement.
Springer threw within two weeks. McClellan’s more elaborate procedure followed
a 2005 ligament replacement. He made only three starts for Rookie League
Johnson City in 2006 before returning last season to work 40 games, all but one
in relief.
Carpenter has made only one start since signing a five-year, $63.5 million
contract extension in December 2006.
Fellow starting pitcher Mark Mulder and Matt Clement appeared in opposite ends
of a Saturday doubleheader for Double-A Springfield, and Mozeliak confirmed
that Clement is in the mix to start this week should Todd Wellemeyer be bumped
with elbow discomfort. Mulder also helped his case with a strong showing in the
first game.
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