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.