Johan Santana is done. He has another capsule tear, the same shoulder injury that sidelined him for all of 2011. He'll make the final decision this weekend whether to undergo surgery, the same surgery he had in Sept. of 2010, but this isn't the sort of thing that gets better with rest. He'll go under the knife, and won't play another game in a Mets uniform, and maybe not anywhere else either. Humans weren't meant to be pitchers, especially not ones as great for as long as Santana was.
GM Sandy Alderson confirmed the MRI diagnosis last night, as the Mets were preparing to break camp. Santana has re-torn the anterior capsule in his left shoulder, his throwing shoulder. "I think in all likelihood Johan will be lost to the Mets for the season,” Alderson said.
Santana signed a six-year, $137 million deal after being traded to the Mets before the 2008 season. He would only play parts of four seasons in New York, and for much of those he was great. Not as great as in Minnesota, where he was the best pitcher in the world for three years or so mid-decade and seemed destined for the Hall of Fame, but still dominant, with an out pitch—the circle change—that's supposed to put less stress on a player's arm.
After missing all of 2011, Santana seemed to return to form last year. He looked like the Santana of old for the first half of the season, culminating in the first no-hitter in Mets franchise history. He stayed in that one for 134 pitches, a career high, and was never the same again. The Mets say they have no idea how Santana re-injured his shoulder, but there's going to be debate about leaving him in that magical night in June, a decision manager Terry Collins agonized over and Santana endorsed unconditionally.
Here's a shocking fact: medical science is nearly helpless when it comes to Santana's specific injury. It seems odd, in a sporting landscape where a frayed ligament can be replaced by a tendon from the leg or from a dead person and we expect that player to come back stronger, but the shoulder capsule is a strange beast.
The capsule is a mass of tissue that nearly completely surrounds the ball-and-socket joint of the shoulder. Rather than containing defined ligaments, there are thickenings of the tissue that serve the same purpose. When these tear, the ball can slip out of the socket on each pitch, causing pain and weakness. The human body was truly not designed to throw a baseball overhand.
We don't know how to fix these tears permanently, at least not with anything close to confidence. The first capsule tear repair was performed just 17 years ago on Bret Saberhagen, and of the very few pitchers who have undergone the procedure, it's exceedingly rare to come back as anything close to 100 percent.
The sparse list of pitchers now also includes Chris Young, Mark Prior, Chien-Ming Wang, Rich Harden and Dallas Braden.
Because anterior capsule surgery has been performed so infrequently on pitchers, how Santana's recovery unfolds will contribute to determining the procedure's effectiveness in extending careers, Altchek had added.
Santana is 34 now, a perfectly respectable age for a player to decline a painful and arduous yearlong rehab from an unproven procedure. (It's also the same age at which Roy Halladay, another "best of his generation"-type, started to go downhill last year.) He couldn't be blamed for not attempting a comeback, especially when available evidence says he'll won't be meaningfully effective again. His value now, though, is as a guinea pig. Maybe lessons learned in this second surgery will become common medical practice in coming decades. Maybe Santana's rehab will teach doctors something that one day saves a young phenom's arm. Maybe, years from now, one of the best pitchers the Twins and Mets have ever known will be more remembered for lending his name to the career-saving Johan Santana surgery.