Price throwing, but he's not out of the woods yet
DUNEDIN, Fla. — David Price came back from Indianapolis triumphant. Two accomplished orthopedic surgeons had told him not only that he wouldn’t need Tommy John surgery but that he had a “unique” elbow, built to withstand what he needed it to withstand. He since has expressed nothing but optimism that his elbow, given a bit of rest and rehabilitation, once again would have him back on the mound for the Red Sox.
But Price acknowledged Monday that he wasn’t listening all that closely to the specific diagnosis from Dr. James Andrews and Dr. Neal ElAttrache, two of the sport’s most well-regarded orthopedic surgeons.
“As soon as I heard what I wanted to hear, I shut it off,” he told reporters in Fort Myers. “I went to my own little happy place.”
And to the chief of sports medicine at Brown University Medical School, what Andrews and ElAttrache told Price is in line what any orthopedic surgeon would tell any patient who without an acute tear of a ligament. Elbow damage is elbow damage, and the only variability is the extent.
“Sometimes we use phrases or say things to finesse a patient through an injury,” said Dr. Paul Fadale, who cautioned that anything he could say about Price specifically would be speculative. “What we do as orthopedic surgeons and team physicians is as much art as it is science. I just don’t think he has such a ridiculously different anatomy than any other pitcher has, per se. He has perhaps a different laxity than other pitchers, but it’s hard to say that he’s got some crazy anatomy no one else has.”
Price felt pain in his left elbow after a March 1 simulated game in Fort Myers, prompting the Red Sox to send him for a second opinion with Andrews and ElAttrache — both of whom were working at the NFL combine in Indianapolis.
The Red Sox still have not disclosed the specific diagnosis of the injury Price suffered. Price himself has been cagey with whatever details he knows.
That he didn’t immediately go under the knife, however, doesn’t mean Price is completely healthy.
“They throw hard for year after year after year, and the ligaments will stretch a little bit,” Fadale said. “As they stretch, the elbow will wobble or clang. That sets up congenitive changes. That sets up pain in the elbow, stiffness after games, swelling after games. It’s a slow and insidious onset. That’s in contrast to the pitcher who lets it rip one day and acutely tears the ligament. That’s a whole different injury. David Price didn’t do that. He is probably just having some element of a little bit of laxity or wiggle in the joint.”
Further evidence of wiggle in the joint comes from the uncharacteristic lack of command Price displayed at times last season. Price was far from erratic. His walk rate was about the same as it had been the year before. Still, however, he lamented his inability to spot the ball to the edges of the plate the way he had in years past.
The subtle nature of his diminished command is characteristic of a pitcher with subtle but present damage in his elbow.
“They don’t have that strength or stability in the joint,” Fadale said. “There’s a tiny bit of wobble or weakness in that joint. Their control starts to fade on them. For the elbow, when David comes over the top or throws, sometimes the stability is not there and the pitch is off. He starts to lose control.”
To the Red Sox, the lack of command Price showed last year came from a fundamental change in his stride direction, something they’d worked to alleviate this spring.
“He was across his body a little bit more than normal, than he’s been in the past,” Boston manager John Farrell said. “He’s done some physical work with his lower half this winter to help allow that alignment to be more on line. That’s the way he was throwing the baseball this spring. His delivery was as clean as it has been in a number of years this camp.”
Whatever the symptoms, it’s clear that Price has at least some wear and tear on his elbow ligament. The question remains what to do about it.
The lefty has gone through three sessions of throwing a baseball into a net under the supervision of trainers. The next step might be to play catch on flat ground from 50-60 feet. How quickly he progresses will depend on how his elbow responds.
A setback might force Price to undergo Tommy John surgery at some point, but Fadale endorsed the caution of Andrews and ElAttrache in not sending Price straight to the operating table. The success rate of elbow surgeries in the modern era is remarkable — but it’s far from 100 percent. Far too many pitchers have not come back from Tommy John surgery for Price and the Red Sox to take that step before it might be necessary.
“You always hear about the guy who came back from his (surgery),” Fadale said. “You never hear about the guy who never came back. He just kind of slips from your memory. If surgery worked on everyone at all times, holy cannoli, we would do it like crazy. I know the fans are like, ‘Cut the crap. Just get it done.’ But the recovery for that is a long time. I don’t know of a surgeon who’s going to pull the trigger just yet on a $20-something million arm.”