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Doctor weighs in on Mets ace Kodai Senga's shoulder injury: 'I think the key is going to be doing less than more'

Abbey Mastracco, New York Daily News on

Published in Baseball

PORT ST. LUCIE, Fla. — Much like Justin Verlander last season, Kodai Senga could be looking at an early May return to action.

The Mets didn’t give a timeline for Kodai Senga’s injury, with president of baseball operations David Stearns saying the Mets would shut him down until the symptoms subside. Stearns said timelines vary on a “case-by-case basis.”

According to Dr. Abigail Campbell MD, the director of the Center for Women’s Sports Medicine at NYU Langone Orthopedics, a mild sprain of the posterior shoulder capsule would prevent him from throwing for 4-6 weeks. Senga would then have to go through his typical spring training progression to ramp up for competitive action.

Dr. Campbell, a sports orthopedic surgeon, has not treated Senga and has not seen his imaging results, but she specializes in knee and shoulder injuries, performs shoulder surgeries and manages non-surgical sports injuries of the elbow, hip, ankle and foot.

“If it’s truly just a little strain and he needs some rest, it could be a four- to six-week recovery, if he needs rest and there’s a little inflammation in there,” Dr. Campbell told the New York Daily News in a phone interview. “If there’s a true tear that needs to heal, then that could take several months, and I would hope, not surgery for him. But I imagine if it was that significant that it would have already been stated.”

A tear of the capsule would show up in an MRI. Senga underwent imaging and received the results Thursday morning.

“The fact that they’re calling it a strain, mild or moderate, makes me think that it’s, obviously, not a full capsular tear, that it’s basically an irritation,” Dr. Campbell said. “Just thinking of common shoulder stuff, it could be like a true posterior capsular injury, which comes from, essentially, overuse during the deceleration and follow-through part of the pitch.”

The capsule itself is important for keeping the shoulder joint stabilized. Each joint has a capsule, so when it swells, it’s because the capsule has inflated. However, shoulder joints don’t often swell because they’re buried underneath so many layers of muscle, so shoulder injuries can present as discomfort, which is what Senga reported.

 

Senga complained of arm fatigue after a side session earlier in the week, which Dr. Campbell said is likely “dead arm” and consistent with a capsular injury. His velocity was still mid- to high-90s, but he couldn’t locate the ball. Again, this is consistent with this type of injury.

When the capsule becomes stretched, pitchers lose the ability to put the ball where they want it to go.

“Velocity is generated more from the back part of the swing, it’s the accuracy that will probably be more affected by a capsular injury,” Dr. Campbell said. “You can’t control that ball release as much. So either way, it’s not great, but I think as far as speculation goes true, capsular injuries, if mild, could potentially tighten up and heal.”

Resting the joint is all Senga can do right now, though an injection is sometimes recommended. A steroid injection, like cortisone, could help with inflammation. A platelet-rich plasma injection would be beneficial for a tear but would take longer for recovery.

Progression following the recovery of the injury has to go slow, which is why early May could be targeted for a return.

“They’ve got top-of-the-line physical therapists and they’ll do everything they can do to help rehab it,” Dr. Campbell said. “But I think the key is going to be doing less than more.”


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