Tweet
By Joe Strauss
ST. LOUIS POST-DISPATCH
Tuesday, Sep. 23 2008
Disabled Cardinals ace Chris Carpenter is suffering from career-threatening
compression and scarring of a series of nerves feeding his right shoulder,
according to sources familiar with his situation.
Less than a week after undergoing three days of exams administered by a team of
local neurologists, Carpenter on Tuesday visited a St. Louis neurosurgeon as
another step in formulating treatment. Surgery to alleviate the condition is
"very much on the table," said a source.
Carpenter’s current condition is viewed as more than an isolated instance.
Rather, it is believed symptomatic of a problem that has contributed to various
nerve complications dating to 2004, when a nerve running to Carpenter’s right
biceps shut down, making him unavailable in the postseason.
The latest complication did play a part in the muscle strain that forced
Carpenter from a Sept. 10 start against the Chicago Cubs. Carpenter was
diagnosed with a strain of the teres major, a flattened muscle beneath and
behind his right shoulder. Doctors believe the strain occurred because of undue
stress placed on the muscle as it compensated for several other muscles’
inability to "fire."
"This is a big deal," according to source close to Carpenter. "If the nerve
doesn’t recover, it’s a serious problem. It could prevent him from pitching."
Carpenter’s condition is believed unique among active major-league players.
The Cardinals have withheld official comment about Carpenter’s situation,
pending a decision on a course of action. Team officials, however, are
increasingly unsure about Carpenter’s availability for next season.
As recently as Monday general manager John Mozeliak and manager Tony La Russa
abstained from comment about the situation. The club has stayed largely silent
about the matter despite receiving authorization from Carpenter to clarify the
issue. Carpenter was at Busch Stadium Monday but did not make himself available
to media.
Carpenter last pitched in a one-inning relief appearance against the Arizona
Diamondbacks Sept. 2 but subsequently cited ongoing "weakness" in the area and
was shut down.
A magnetic resonance imaging performed after Carpenter’s abortive August start
found no structural damage in either Carpenter’s surgically repaired shoulder
or elbow. Persistent weakness led team medical supervisor Dr. George Paletta
last week to order an additional MRI of Carpenter’ neck. The imaging found
damage to at least five nerves, according to a source familiar with the
findings.
Carpenter has experienced tingling in the pinkie and ring finger on his right
hand while also experiencing symptoms typically associated with carpal tunnel
syndrome, according to a source.
At times, the 2005 NL Cy Young Award winner has been unable to fully extend all
the fingers on his pitching hand.
Neurologists have concentrated their focus on the brachial plexus, a bundle or
"superhighway" of nerves running from the spine to the neck and beneath the
collarbone. The brachial plexus is responsible for firing most of the muscles
in the upper arm.
A nerve conduction study performed last week found that Carpenter’s condition
has existed for years rather than weeks or months, according to the source.
Surgery is not described as radical but would be performed only if
neurosurgeons are convinced a significant chance exists for improvement. A
recovery of 2-3 months would be typical before Carpenter could resume a
throwing program.
The musculocutaneous was the nerve affected in 2004. It eventually recovered
after rest, as Carpenter won 21 games and compiled a 2.83 ERA in 241 2/3
innings during the ’05 season.
The current problem again revealed itself on a cool night at Wrigley Field.
During the fifth inning of his third start since returning from elbow surgery,
Carpenter felt a pull behind his right shoulder. He felt the same sensation on
the next pitch and summoned head athletic trainer Barry Weinberg and La Russa
to the mound.
The problem is not thought connected to Carpenter’s aggressive rehab from the
ligament replacement.
The club theorizes that Carpenter’s ongoing condition may represent a
complication from 2003 surgery to repair his right rotator cuff and labrum
while he still played for the Toronto Blue Jays.
ST. LOUIS POST-DISPATCH
Tuesday, Sep. 23 2008
Disabled Cardinals ace Chris Carpenter is suffering from career-threatening
compression and scarring of a series of nerves feeding his right shoulder,
according to sources familiar with his situation.
Less than a week after undergoing three days of exams administered by a team of
local neurologists, Carpenter on Tuesday visited a St. Louis neurosurgeon as
another step in formulating treatment. Surgery to alleviate the condition is
"very much on the table," said a source.
Carpenter’s current condition is viewed as more than an isolated instance.
Rather, it is believed symptomatic of a problem that has contributed to various
nerve complications dating to 2004, when a nerve running to Carpenter’s right
biceps shut down, making him unavailable in the postseason.
The latest complication did play a part in the muscle strain that forced
Carpenter from a Sept. 10 start against the Chicago Cubs. Carpenter was
diagnosed with a strain of the teres major, a flattened muscle beneath and
behind his right shoulder. Doctors believe the strain occurred because of undue
stress placed on the muscle as it compensated for several other muscles’
inability to "fire."
"This is a big deal," according to source close to Carpenter. "If the nerve
doesn’t recover, it’s a serious problem. It could prevent him from pitching."
Carpenter’s condition is believed unique among active major-league players.
The Cardinals have withheld official comment about Carpenter’s situation,
pending a decision on a course of action. Team officials, however, are
increasingly unsure about Carpenter’s availability for next season.
As recently as Monday general manager John Mozeliak and manager Tony La Russa
abstained from comment about the situation. The club has stayed largely silent
about the matter despite receiving authorization from Carpenter to clarify the
issue. Carpenter was at Busch Stadium Monday but did not make himself available
to media.
Carpenter last pitched in a one-inning relief appearance against the Arizona
Diamondbacks Sept. 2 but subsequently cited ongoing "weakness" in the area and
was shut down.
A magnetic resonance imaging performed after Carpenter’s abortive August start
found no structural damage in either Carpenter’s surgically repaired shoulder
or elbow. Persistent weakness led team medical supervisor Dr. George Paletta
last week to order an additional MRI of Carpenter’ neck. The imaging found
damage to at least five nerves, according to a source familiar with the
findings.
Carpenter has experienced tingling in the pinkie and ring finger on his right
hand while also experiencing symptoms typically associated with carpal tunnel
syndrome, according to a source.
At times, the 2005 NL Cy Young Award winner has been unable to fully extend all
the fingers on his pitching hand.
Neurologists have concentrated their focus on the brachial plexus, a bundle or
"superhighway" of nerves running from the spine to the neck and beneath the
collarbone. The brachial plexus is responsible for firing most of the muscles
in the upper arm.
A nerve conduction study performed last week found that Carpenter’s condition
has existed for years rather than weeks or months, according to the source.
Surgery is not described as radical but would be performed only if
neurosurgeons are convinced a significant chance exists for improvement. A
recovery of 2-3 months would be typical before Carpenter could resume a
throwing program.
The musculocutaneous was the nerve affected in 2004. It eventually recovered
after rest, as Carpenter won 21 games and compiled a 2.83 ERA in 241 2/3
innings during the ’05 season.
The current problem again revealed itself on a cool night at Wrigley Field.
During the fifth inning of his third start since returning from elbow surgery,
Carpenter felt a pull behind his right shoulder. He felt the same sensation on
the next pitch and summoned head athletic trainer Barry Weinberg and La Russa
to the mound.
The problem is not thought connected to Carpenter’s aggressive rehab from the
ligament replacement.
The club theorizes that Carpenter’s ongoing condition may represent a
complication from 2003 surgery to repair his right rotator cuff and labrum
while he still played for the Toronto Blue Jays.
Comment