Ortiz Has a Heavy Burden to Shoulder

Ramon Ortiz says his shoulder feels fine.

Lewis Yocum, the Angels’ team physician, says Ortiz’s shoulder should be fine.

But are the Angels gambling with their prize right-hander by having him pitch with a partially torn labrum in his shoulder tonight at Edison Field against Toronto?

Some people think so.

Matt Perisho knows the sickening feeling of tearing a labrum--the gristle-like cartilage surrounding the shoulder socket--and he doesn’t wish it on anybody.

“It felt like somebody stabbed me in the back of my shoulder,” Perisho said.

Perisho, the third-round pick of the Angels in 1993, also knows what it feels like to go from bright prospect to 25-year-old journeyman with a rebuilt arm. So when he heard that the 24-year-old Ortiz was going to pitch with a partially torn labrum in his shoulder, he winced.

“It seems to be fine now, but how long is it going to last?” said Perisho, who was traded to Texas in 1997. “If I’m young, I want to get it fixed. I don’t want it to come back in four or five years. Do you want to be facing Derek Jeter with a doubt in your mind, that if you throw this pitch, this hard, it could be your last pitch?”

Yocum declined comment for this story. His office referred inquiries to the Angels, who obviously don’t think Ortiz’s last pitch is in the near future. That’s why he’s starting tonight against the Blue Jays, less than a month after Yocum made his diagnosis.

Ortiz’s injury was discovered after he complained of shoulder stiffness before a spring training start on March 11. After resting and rehabilitating his shoulder for 10 days, Ortiz has pitched 15 innings in minor league games without discomfort. Last Thursday in Lake Elsinore, he was throwing freely with a live fastball in the sixth inning.

“I’m fine,” he said. “My arm feels good. No pain. My fastball was good.”

Angel Manager Mike Scioscia and pitching coach Bud Black saw Ortiz’s tuneup at Lake Elsinore. They were satisfied with what they saw.

“Some pitchers pitch a whole career with this,” General Manager Bill Stoneman said. “We’ve been told the pitcher isn’t going to do themselves irreparable harm by continuing to pitch.”

Relief pitcher Jeff Brantley’s career would seem to support Stoneman’s claim. Brantley believes he suffered a partially torn labrum in 1990, his second season in San Francisco. Six years later, he had the best season of his career with Cincinnati--recording 44 saves in 71 appearances. But the next year Brantley’s velocity decreased and the pain in his right arm became unbearable.

James Andrews of Birmingham, Ala., a shoulder specialist, performed Brantley’s surgery in 1997. But Brantley’s velocity never returned and the pain never left. In 1999, Brantley had more surgery. This time, it was performed by Craig D. Morgan, who resurrected Curt Schilling’s arm and career.

“Curt Schilling is the poster boy for this type of surgery,” said Morgan, from his office in Wilmington, Del. “He was the first post-operative pitcher to have back-to-back 300 strikeout seasons [in 1997 and 1998].

The second time around, Brantley was satisfied.

Throwing pain free for the first time in almost five years, Brantley, 36, is on rehabilitation assignment in Clearwater, Fla, the Phillies’ Class-A team. He is throwing only in the mid-80s, but is hopeful of resurrecting his career.

After hearing of Ortiz’s situation, he had some advice for the rookie right-hander.

“In my opinion, you throw until you can’t throw anymore,” Brantley said. “If you have surgery, it doesn’t necessarily mean it’s going to be better.”

Morgan, who has repaired 124 torn labra over the last six years, said Ortiz should continue to pitch if he is not having pain.

“If you can catch these injuries at an early phase, they’ll respond to a stretching program,” Morgan said. “I usually decide whether they need surgery based on the magnitude of their symptoms and whether they hear the clicking sound.”

If they hear the clicking sound, Morgan said, the labrum is usually torn.

“Once the labrum tears away from the bone, it has zero healing potential,” Morgan said.

What if there is no clicking sound? How can someone be sure he has a torn labrum?

“It’s really hard to tell,” Morgan said. “An MRI is only between 60% and 80% accurate and you have to have the right doctor looking at it. Otherwise, the only real way to tell is by doing arthroscopic surgery.”

Brantley believes his labrum took nearly seven years to tear away from the bone because of the way he was used.

“My injury had gotten so scarred over because I didn’t have to extend myself,” he said. “I think if I would have been a starter, there would have been a lot more pain involved.”

Perisho was diagnosed with a partially torn labrum in June of 1998. After four weeks of rehabilitation, he was back on the mound. With one pitch--in the second inning of his comeback--he tore his labrum, a biceps tendon and his rotator cuff. After six months of rehabilitation at a physical therapy clinic in Tempe, Ariz., Perisho pitched the 1999 season for triple-A Oklahoma City. This year, he is back with the Rangers as a spot starter and long reliever.

“I’m throwing as hard now as I did in high school,” Perisho said. “I don’t even think about my shoulder anymore.”

But Perisho wishes he had thought twice about pitching with an injured shoulder in 1998.

“I want to feel healthy every day,” he said. “I don’t want to think, ‘Is it going to hurt two days from now?’ I lost a year, but I think I gained a lot more by having the surgery.”

The Angels are betting that Ortiz won’t lose any time.

“He’s important to us,” Stoneman said. “We’re not going to rush him back. I actually think we’ve kind of overdone it [by keeping him out]. But I think that’s smart. We just want to make sure there continues to be an openness between us and Ramon. So if there is a sign of danger, he’ll tell us.”