Why You Should Be Worried About Jon Niese’s Shoulder Tendinits

Jonathon Niese missed his Saturday start due to shoulder tendinitis. Is this a minor setback, or something to be genuinely concerned about?

According to NJ.com:

The left-hander said his shoulder has bothered him over his last four starts, affecting his recovery and inhibiting him from throwing strong bullpen sessions. Manager Terry Collins said he was first approached by Niese two days ago. Niese said that it became so bad he was unable to throw a bullpen Wednesday.

The tendinitis left Niese sore and he attributed the inflammation in his shoulder to it as well. He had an MRI yesterday that revealed there was no structural damage.

While Niese said he “could probably” pitch Saturday, he decided to eschew the risk and shut it down. The move was made for precautionary reasons. The feeling is that taking time off — Niese will rest completely for 3-4 days — will allow the tendinitis to dissipate. Continuing to pitch may force the injury to linger.

“I just didn’t want it to get progressively worse,” Niese said.

Personally, I thought his elbow would give out first, since he’s been throwing at a low arm angle during all of this season and most of 2012 (low arm angle and being “under” the ball tends to put extra stress on the elbow).

With news of the shoulder tendinitis, a light bulb went off in my head. “A-ha! Maybe THAT’S why he’s been throwing at a low arm angle — because he’s suffering from shoulder discomfort when he throws at a higher / more overhand angle.”

If that’s the case, then, yes, there should be significant concern for Niese’s health — because it means that Niese’s shoulder has been injured for over a year.

Just as concerning is that in addition to the shoulder issue, that low arm angle has to have been causing abnormal wear and tear on the elbow. So, he could be facing two arm injury issues.

What really turned that light bulb on for me was this information from Adam Rubin:

Jonathon Niese believed he got into bad habits early in the season, with discomfort unconsciously prompting him to lower his arm angle.

He aimed to correct that with 70-plus bullpen session Monday — about 20 pitches more than normal.

Niese felt he accomplished that mission. After allowing 15 runs in 8 1/3 innings over his previous two starts, Niese limited the St. Louis Cardinals to two runs on six hits and two walks in 7 1/3 innings Thursday as the Mets won, 5-2. Niese (3-4) earned his first victory since April 12.

“I tried to keep my arm in that good arm slot and it worked out today,” Niese said about throwing from a higher arm angle. “… I’m just glad [pitching coach] Dan [Warthen] and I were able to get that good work in the bullpen and figure out what was going wrong mechanically. Fortunately, I was able to fix it.”

Said Terry Collins: “He threw some 93 mph fastballs today. He hasn’t done that all year. His cutter was very good. That’s why he got the groundballs. His two-seamer was good today. So whatever they did in the bullpen worked.

“I wasn’t worried about Jon,” the manager continued. “I do believe the cold weather took a lot out of him. I really do. It caused some stiffness in him and he didn’t pitch very good. I knew he was going to get it going. If there’s no arm issues, which there wasn’t, he’s going to pitch well. I think right now, as the weather starts to get warm, you’re going to see the Jon Niese we’re all accustomed to seeing.”

First off, cold weather by itself doesn’t cause arm injuries any more than it causes the common cold. Improper preparation, poor mechanics, and overuse cause injuries. Certainly, Niese may have felt uncomfortable due to the cold weather, but that by itself is not what caused shoulder discomfort. Pitchers — and quarterbacks — throw in cold weather all the time and miraculously escape without injury.

My theory is that the shoulder discomfort emerged a long time before April 2013. I do agree, though, that Niese unconsciously dropped his arm angle as a result — we’ve been discussing this fact for over a year right here at MetsToday.

I also don’t think it’s a coincidence that the shoulder pain became unbearable immediately after Niese worked on raising his arm angle and throwing more overhand in his last start. There’s something wrong in the shoulder, his arm angle dropped to avoid the pain, and by “forcing” his arm higher, the root of the pain was exposed and aggravated.

Something else to consider: the fact that an MRI “revealed no structural damage” is moot. While MRI is a remarkable modern technology, it’s not perfect — and in fact, it’s not reliable specifically in regard to identifying instability in the shoulder and/or labrum tears. It IS fairly good at finding rotator cuff tears and rotator cuff inflammation – which is what it seemed to find based on Niese’s injury being defined as “shoulder tendinitis.” However, the “no structural damage” means primarily that the MRI didn’t pick up evidence of a rotator cuff tear. Could there be a labrum tear or other issue causing shoulder instability? Possibly.

The hope is that a week off from throwing will cause the inflammation to subside. It might. If it doesn’t, the next step, I imagine is a cortisone shot and another week off — possibly a stint in the 15-day DL. Knowing Niese, he’ll likely bulldog through it with a shot every five days — similar to what Mike Pelfrey did in 2010.

Oh my … remember that? Pelfrey pitched all year with a shoulder issue, and a year later, underwent Tommy John surgery for his elbow.


Remarkably, no. It’s simple science. Some day, MLB will wake up and acknowledge it.

Joe Janish began MetsToday in 2005 to provide the unique perspective of a high-level player and coach -- he earned NCAA D-1 All-American honors as a catcher and coached several players who went on to play pro ball. As a result his posts often include mechanical evaluations, scout-like analysis, and opinions that go beyond the numbers. Follow Joe's baseball tips on Twitter at @onbaseball and at the On Baseball Google Plus page.
  1. Izzy June 3, 2013 at 7:47 am
    John Maine part 2?. Find it funny they come up with a million phony stories to “protect” Wheeler, but they will rush their only long term signed pitcher back into the rotation based merely on one bullpen that he will probably lie about. The reason. They don’ want to pay Wheeler so don’t use but but they are paying Niese no matter what so over use him ! This org is a bigger joke than Miami and Houston combined.
  2. friend June 3, 2013 at 9:36 am
    “a light bulb went off in my head”

    Just like a refrigerator, when your mind opens, the light goes on.

  3. Jon C June 3, 2013 at 10:04 am
    Joe, WHY don’t teams have someone on staff who is knowledgeable in these things? Do they look at biomechanics and think its voodoo?

    Or do they believe it, but are scared of the truth? For example, what could Jon Niese have done? Do you think he could have adjusted his mechanics to prevent this type of injury, WHILE still allowing him to be a great pitcher? I wonder if teams are more concerned that those adjustments will correlate with decreased performance, so they knowingly just shoot these guys up on pain meds and ignore all the warning signs their body is giving them.

    My mother is chiropractor so I’ve always heard that doctors don’t “believe” in one thing or another, and it boggles my mind. I wonder if this is viewed upon in a similar way.

    Also, I have to say I’m already scared for Mr. Wheeler…Joe can you talk about Wheeler’s recent “tendinitis” in his shoulder, and how hopefully this is not the same type of injury?

    • Joe Janish June 3, 2013 at 1:34 pm
      “Do they look at biomechanics and think its voodoo?”

      “Do you think he could have adjusted his mechanics to prevent this type of injury, WHILE still allowing him to be a great pitcher?”
      ABSOLUTELY. Usually, improving mechanics results in improved performance.

      ” I wonder if teams are more concerned that those adjustments will correlate with decreased performance, so they knowingly just shoot these guys up on pain meds and ignore all the warning signs their body is giving them.”

      It basically comes down to lack of knowledge. Pitching coaches aren’t kinetic scientists, nor should they be. But because they don’t understand body movement, they’re afraid that making a change will result in decreased performance.

      In 99% of cases, the adjustment is minor. We’re not talking about a complete overhaul, such as what the Mets did with Aaron Heilman immediately after drafting him (BTW, no qualitative scientists were consulted during that debacle). The adjustment to keep Niese safe likely would have been unnoticeable by most people — and probably would have resulted in higher velocity and more movement on his pitches.

  4. Ms Met June 3, 2013 at 11:00 am
    Very informative. Does it surprise me. Of course not. After all this is the mets. There are enough red flags to see tommy john in Niese’s future. Incompetence runs up and down in this organization
  5. Ms Met June 3, 2013 at 11:04 am
    Speaking of pitching it was brought to my attention on mets broadcast that the mets selected Brandon Nimmo right in front of Jose Fernandez. The marlin kid that has baffled the mets. Looks like another bad choice as Nimmo dies not exactly the next Bryce Harper or anything resembling it. It was already on the DL this season
    • Joe Janish June 3, 2013 at 1:41 pm
      Looking at where Fernandez and Nimmo are today, it’s easy for me to agree with you.

      However, I’m going to remain objective and suggest that we until at least a year from now and see how Nimmo is doing. I’m not sure Fernandez would be a the MLB level right now if he were in any other organization. He’s certainly holding his own, but most likely he’d still be toiling in high-A or AA right now.

      Yes, Nimmo has had some injury issues, but he’s off to a red-hot start in Savannah. Let’s give him time before writing him off completely.

      BTW, Nimmo was also chosen ahead of C.J. Cron and Jackie Bradley Jr., among others.

      • argonbunnies June 4, 2013 at 8:10 am
        I hope Nimmo has a bright future, but his stock has already slipped far below “top 15 in the draft”, while Fernandez has an MLB ERA under 3.00 for a bad team at age 20. I don’t really see any comparison there. Nimmo was drafted to be an impact athlete who could hit in the middle of the order and play CF, and at age 20 he’s already being viewed as corner guy (and has 3 career steals). Some guys lose their speed as they fill out, and it appears he’s one of them.

        I liked that the Mets were angling for upside with the pick, but at least one other team with the same strategy chose a better player. Yeah, the draft is a maze of uncertainty, but this organization absolutely needs to navigate that maze better than the competition if it’s going to make up ground.

      • Izzy June 4, 2013 at 1:40 pm
        You might be right that Fernandez wouldn’t be in the bigs in a different org, but he certainly wouldn’t be in Low A ball either. And do you remember him from his first start against the Mets to last weekend. The guy has improved markedly. To say he’s holding his own is quite an under statement. Nimmo is in low A ball still. He should be hitting over 400 for the position he was drafted and how much better he should be than low A ball pitchers, virtually all of whom were drafted after him..
  6. Mic June 4, 2013 at 11:30 am
  7. Jimmy Prinzler June 4, 2013 at 3:45 pm
    Janish and my fellow Met fans,

    Off the point, WHEN will Mets call up Eric Campbell??His stats at Vegas .315/5/25 in 41 games along OBP .415. Clearly he has a better eyes than Davis. Mets got nothing to lose and give Campbell a shot. Any thoughts guys??

  8. Dan B June 4, 2013 at 6:17 pm
    His stats at Vegas are misleading since it is a hitter’s park. He would project to a .295/3/20 in another park, I am guessing. By the way, anyone read the WSJ article on how the Mets mishandled their way into Las Vegas? Spoiler alert — AAA affiliates have less respect for Jeff Wilpon then Met fans.
  9. TexasGusCC June 4, 2013 at 6:43 pm
    Mic, thanks for ruining my dinner. Just kidding, interesting article, but you have to give to get. We all wanted Santana and wouldn’t give up Martinez for the world. So, we gave Gomez. Even the Twins later gave up on him. Wish he didn’t resign with the Brewers this past winter, but it’s done.
  10. Mic June 5, 2013 at 6:02 am
    Texas and Joe,
    I am presently suffering with a severe infection I got from Izzy…..I I am so down on the Mets I think about them and get very ill.

    In my read of the great article on Gomez I extracted two points; The Mets coaches are a big part of our problem.
    Niese, Ike, Jordy, Bob P. CPT Kirk are all under-developed…not progressing. And Wally Backman is perfectly poised to enter the mix…and kick some collective A’s.

  11. david June 20, 2013 at 9:29 pm
    You called this over 2 weeks ago Joe. Can you explain why the Mets trainers would not have picked up on this same issue?
    • Joe Janish June 20, 2013 at 11:00 pm
      Maybe they did, and Niese chose to “pitch through it.” Maybe they’ve been applying painkillers, as they did for Pelfrey a few years back.

      In truth, the Mets trainers are not qualified to make a judgment; to my knowledge, none are trained kinesiologists / kinetic scientists. That’s not necessarily the Mets fault — there may be only two or three teams in MLB who are ahead of the curve and have scientists on their staff.