TAMPA, Fla. — Luis Gil was relayed the bad news Monday when the Yankees got the results from his weekend MRI.
The shoulder tightness that ended his bullpen last Friday after four or five pitches is a serious injury, a high grade lat strain.
A Grade 1 or 2 might have only cost the 2024 American League Rookie of the Year the first month or so of the season, which begins March 27.
His diagnosis was the worst, a Grade 3. His down time will be longer … probably months longer.
How long?
The Yankees only are saying that Gil will be in a no-throw for at least six weeks.
What is Gil facing?
What’s a best-case timetable for a return?
What’s most likely?
Could this lead to surgery?
We went to our medical expert on Yankees injuries for the answers.
Here is what Gil is facing, according to Dr. Spencer Stein, a sports orthopedic surgeon at NYU Langone Health.
What is a lat strain?
Dr. Stein: The lat is a back muscle that attaches from essentially the back to the upper arm. It’s a crucial muscle and tendon in the throwing motion, because what it does is it internally rotates and extends the arm. It also brings the arm closer to the body. It’s all part of the throwing motion. During the throwing motion, you can imagine this muscle can get overused or something can happen where it just pulls off the bone and gets injured. So that’s what the lab muscle is and a strain varies from a muscle-like injury or bruise all the way to a full tear of the tendon.
Clarke Schmidt had a similar injury last year and was on the injured list for more than three months. Does that timetable sound about right? Is surgery and a longer layoff unlikely?
Dr. Stein: The stat is 75 percent of athletes with lat strains do not require surgery, but those are those mild to moderate strains. But even a moderate to more severe lat strain where it is just a muscular strain, it could up to five or six months before a full return to play. And that’s without surgery. If it’s a high-grade tear that includes the tendon, which is the muscular attachment to bone, that’s when people start thinking about surgery. If it’s pure muscle, usually those heal. But when it becomes tendon involvement – like a tendon pulled off the bone - then we’re thinking more about surgery. When you’re looking at Grade 3, a high grade, sometimes that does require surgery. That can be a long return. It could be over a year.
Gil had Tommy John surgery in May 2022. He pitched only 25 innings that season before he was injured and then only four innings in 2023 after finishing up his rehab. Last year he was over 160 counting playoffs and a rehab start. Do you think that huge jump in workload contributed to a lat strain the following spring?
Dr. Stein: It’s hard to really say. There’s so many factors, but certainly going from the Tommy John and then throwing a lot of innings, it’s typically a chronic overuse injury. But sometimes weird things can happen and a tendon can snap, especially coming back from the offseason and now getting more into throwing.
What’s your best guess for a return timeline if he starts throwing in six weeks and has no setbacks?
Dr. Stein: It’s probably another six weeks minimum before he sees batters. It’ll take some time after that.
Counting postseason, Schmidt had more bad starts than good ones after he returned. Do you think it’s tough for a pitcher to be at his best right away after a months-long shutdown from a high grade lat strain?
Dr. Stein: Typically that first season back, pitchers will come back at a little bit slower performance metrics. Seventy-five of those patients do come and play, but it’s not always at the same level, especially initially. If a pitcher has surgery … after surgery he typically would come back and meet the performance metrics. But it’s always a slow process.
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Randy Miller may be reached at rmiller@njadvancemedia.com.