by 
Last week’s devastating news that infielder Matt McLain had undergone shoulder surgery cut through Reds fans like a guillotine. McLain had injured himself a week earlier diving for a catch during a team workout. The announcement followed the club’s earlier statement that its second baseman would get a second opinion on his shoulder from world-renowned sports surgeon Dr. Neal Attrache in Los Angeles. The executioner’s blade had dangled over our hopes for a few days.
Last year, Elly De La Cruz and his photogenic dreads received most of the adoration from press and fans alike. But it was McLain’s May 15 call-up and play that jumpstarted the Reds 2023 turnaround. David Bell’s team was 48-41 in games McLain played. That clip would produce a postseason-worthy 87 wins over a 162-game season. After an oblique strain season ended McLain’s season on August 27, the Reds sputtered to a 14-16 finish.
Over McLain’s 89 games, he batted .290/.357/.507 for a wRC+ of 128. That’s run production 28% better than league average. Adding defense, he posted a 3+ WAR season (3.2 FanGraphs, 3.7 Baseball Reference). In a 162-game season at that pace, McLain would have blasted 29 homers and 42 doubles (2nd most in MLB), stolen 25 bases while scoring 118 runs (6th most in MLB).
The surgery “addressed cartilage damage and repaired his labrum” of McLain’s non-throwing left shoulder. Reds fans have experience with this injury. A headlong crash into an unforgiving outfield wall tore Nick Senzel’s labrum and ended his promising rookie season. Opening Day starter Frankie Montas had labrum surgery in February 2023. Catcher Devin Mesoraco underwent season-ending labrum surgery on his non-throwing arm in May 2016. Earlier this year, shortstop Edwin Arroyo tore his labrum diving back to first base on a pick-off play. The Reds announced Arroyo would miss the entire season.
Labrum Surgery 101
For decades, labrum tears ended baseball careers. Improvements in surgical techniques and rehab have boosted the odds of recovery and returning to playing at the previous level, especially for position players.
Our shoulders are loose ball-in-socket joints. That sounds straightforward, but is anything but. A patchwork of muscles and tendons maintains an equilibrium that keeps the four major shoulder bones aligned and working together. That structure is put under tremendous stress by the act of throwing a ball and swinging a bat.
The labrum is a cup-shaped gasket of cartilage that surrounds the socket. It cushions the top of the arm bone (humerus) against the socket. A healthy labrum’s tight fit creates a suction that maintains the positional relationship between the ball and socket. A tear in the labrum disrupts the suction, cushion and stability.
Take your right hand and form a “c” and put your left fist inside that “c.” Your fist is the top of your arm bone at your shoulder, your right hand is the labrum. Squeeze your right hand around your fist. That’s the labrum stabilizing the socket. Imagine an injury to your right hand that prevented a tight grab of your fist. That’s how your shoulder ball-and-socket becomes unstable with this kind of injury.
Pitchers are the most common victims of labrum tears because of the repeated stress on the joint. To throw a baseball, a player uses his entire kinetic chain to launch his shoulder forward. Then, with equal power, he has to decelerate that same mass. The violent and unnatural force required to throw a baseball can wear out the labrum.
In contrast to elbow surgery, fixing a shoulder is loaded with ambiguity. Labrum surgery has been compared to assembling a jigsaw puzzle without the box top. That said, new techniques continue to raise surgical success rates.
As for McLain’s surgeon, to give you an idea of how well regarded Dr. ElAttrache is, the Reds second baseman joins this partial list of ElAttrache’s patients: Kobe Bryant, Tom Brady, Shohei Ohtani, Joe Burrow and Ringo Starr (hey, you try playing the drums for 60 years and see how your shoulder feels).
How Long Will McLain Be Out?
Ah, the big question.
The Reds statement announcing McLain’s surgery said this: “An exact timeline is still TBD as it has a wide range of possibilities. We hope to have Matt back this season.”
There are many variables. Johns Hopkins Medicine spelled out the uncertainties: “Recovery depends upon many factors, such as where the tear was located, how severe it was and how good the surgical repair was. It is believed that it takes at least four to six weeks for the labrum to reattach itself to the rim of the bone, and probably another four to six weeks to get strong. It is important not to re-injure it while it is healing. Because of the variability in the injury and the type of repair done, it is difficult to predict how soon someone can to return to sports and activities after the repair.”
Other teams have been less opaque. When Fernando Tatis Jr. had labrum surgery on his non-throwing shoulder (another Dr. ElAttrache patient), the Padres announced his recovery would take 4-6 months. Tatis was ready to play seven months later in April 2023. Dodgers infielder Cody Bellinger underwent labrum surgery (more ElAttrache) on November 17, 2020 and returned 5.5 months later for an April 1 Opening Day.
Three similar recent cases
A search for recent cases that are comparable to McLain’s situation using these criteria — (1) position player, not pitcher; (2) injury to non-throwing arm; (3) shoulder labrum surgery; (4) injury/surgery in first couple months of the season; (5) young player — revealed these three examples.
Brendan Rodgers (2B) Rockies second baseman Brendan Rodgers, like McLain, is a position player. His labrum injury was on his non-throwing arm and occurred in March. Rodgers hurt his shoulder diving for a ground ball. The 26-year-old Rodgers had surgery on March 7, 2023 and returned to the field about five months later on July 31. He had no setbacks during recovery and rehab. A similar schedule for Matt McLain would put his return on August 20.
Logan O’Happe (C) Another similar case is Angels catcher Logan O’Happe. The 23-year-old rookie had labrum surgery on his non-throwing arm on April 25, 2023. O’Happe returned four months later on August 18. That timeframe would put a possible McLain comeback in mid-July.
Garrett Mitchell (OF) Garrett Mitchell is a promising young outfielder for the Brewers. He injured his shoulder sliding into third last April and underwent labrum surgery on May 3. Mitchell returned five months later on September 28, as the Brewers were gearing up for a postseason run. The same schedule for McLain would put the Reds infielder’s return around August 20.
Conclusion
The Reds selected Matt McLain in the first round of the 2021 draft, the 17th player overall. He flew through the club’s minor league system, putting up gigantic numbers at Louisville early last year. McLain’s performance kicked open the Reds clubhouse door. He forced his way onto the Reds roster well before most expected. After just a couple weeks in the big leagues, his more-than-solid defense at short, aggressive and fast base running, and hard hits rattling all over the field announced a much-needed, daring new era in Reds baseball.
Now, it looks like Matt McLain will be out four to six months.
McLain’s surgery took place March 25. Four months out is July 25. Six months is September 25. That’s with no setbacks.
According to Johns Hopkins, the vast majority of labrum surgery patients achieve full functioning of their shoulder. Most can return to their previous level of sports with few or no restrictions.
Now, the cautionary part of the tale:
Cody Bellinger suffered through a horrible season in 2021. Fernando Tatis Jr. dropped 40 points of wRC+ the year following his surgery. Brendan Rodgers’ offensive production fell 15-20% for the rest of 2023. Logan O’Hoppe was a rookie, so not much to go by, but his production for the plate appearances after he returned last year was a lot lower compared to before and compared to what he’s projected for this year.
If you want a clear-eyed view of Matt McLain’s injury and recovery timeline, think end of July to the end of the season. Maybe he’ll make it back right in the middle of that range. Regardless of when he next takes the field, look to Opening Day 2025 for when McLain will be all the way back to being that hustling, essential piece of the Reds.
Matt McLain was the Reds’ best player for large parts of last season. He was expected to be filling a key role at second base right now. Even as a rookie, McLain’s impact on the Reds was significant. His loss for the bulk of 2024 is a serious blow to the club. For now, we fans have to hope McLain’s surgery proves successful and his recovery speedy and full.
Mr. Mancuso:
Your article was outstanding. If possible, please continue your work on this site and other sites you are involved with. You are one of, if not my favorite writer.
If you would please, I would appreciate if you would address each of my questions/opinions in as much detail as you can. I value your commentary on them.
I read your intro bio. I attended game 6 of the 1972 World Series. Sometimes growing up my dad would take me to spring training. That is the place to meet players, get autographs, and see things in a totally different close up vantage point. I have seen things in spring training that would only be seen in spring training.
Your article led me to delve into other areas, and resulted in a longer than average response. I hope this is OK.
Many of us are interested and curious regarding these details of a given injury. I believe due to your article I now know a good percentage of the basics regarding a labrum tear. Your discussion of ‘timeline of return’ clearly lets us know that it is unlikely to see Matt McLain back playing for the Reds before 4 months. Without your info some of us fans have the ‘false hope’ that McLain may somehow be back much sooner. Also, good point regarding the likelihood that we will likely not see the 100% capable McLain until opening day 2025. However, I hold out hope that McLain can be back to nearly his full form this year due to the non-throwing shoulder injury, his age, obvious determination, and an excellent dedicated recovery.
This is another related topic discussed some on a recent comment board. Few know exactly what the drill/practice/etc
that McLain was involved with when the injury occurred. I do NOT. I can only speculate. With speculation, to injure your should in such a manner would not generally be a ‘freak accident’ that has been suggested. Generally, the shoulder would need significant impact to cause that damage, or significant impacts on the shoulder due to the same drill, etc. That type of impact would most likely come from some sort of dive.
I am not a major league manager, staff, or part of the medical team. Regardless, it is my belief that the average major league fine tuned physical body is far from being even nearly fully ready for the start of the season while in spring training. Diving, etc. should be reserved for the season only. Also, in my opinion, it is more risky to ‘practice’ diving, because you are not executing what is natural. When you see dives, etc during the regular season, the dives are desperation and the body generally executes it naturally – the player is mostly thinking about catching the ball or arriving before the ball, etc., not about getting inured. In spring training, if practicing diving, etc the player has plenty of time, at least sub-consciously, to think about avoiding injury. Trying to avoid injury increases the likelihood of an injury. Practicing diving, etc in spring training increases the likelihood of an injury compared to the regular season. It is NOT common for players to significantly injure themselves diving, etc during the regular season, compared to the hundreds of dives, etc executed. It does happen on occasion, but as in spring training, these regular season injuries could be cumulative damage to the given body area. I would bet that some/many teams are told to dial back aggressiveness in spring training.
If I were to wager, I would bet that after Friedl and McLain were both injured due to diving, etc. that the entire Reds team was told by ‘someone’ or by multiple people, to stop risky dives, etc. I do not recall any non-pitcher injury after McLain’s injury. If this is the case, this policy should.have been implemented on ‘day 1’ of spring training. The Reds need to be pro-active, NOT reactive. When being reactive, it is too late. Bell’s desire to play aggressively must be very toned down in spring training, and be much more situationally executed during the regular season. Be aggressive running – I assume the Reds know how to safely execute a diving slide, but I admit, this is still diving. However, it is diving in a planned manner done hundreds of times previously. It is second nature and largely automatic and non-thinking. Being a small market team, in an unfair MLB environment, the Reds are hurt much more by injuries than are larger market teams.
If I were a major league manager, with the present Reds team, I would stress very much the running game, which Bell does very well. However, if important others in the organization agreed with me, I would coach players NOT to dive, etc for balls unless the game situation is in an extremely perilous situation. I disagree with those that say that the response is automatic.. These are professional athletes – they absolutely can control this to a large extent. Do you think that Friedl and McLain will have a different mindset regarding diving, etc. after spending months/year injured due to a 100% unnecessary foolish spring training dive? If the answer is yes, these professional athletes can be coached to back it way down in spring training and even in most situations in the regular season. Even then, isn’t it much better to lose a game (worst case) than whatever probability that a player (in this case two of your very most important players for Reds success) will be injured and out for months or the entire season? Players do not have to suffer the injuries in order to change risky behavior.
Elly is very likely to incur a medium to major injury soon. It may not be this year. His youth, etc. protect him some. In my opinion, he is diving way too much and too often in totally unnecessary situations. As we saw with his errors in the April 2 game, he needs to be coached (told) to stop the flair and play fundamental baseball. I like Elly and do not mean to unfairly critique him. He has potential to be a super-star.
Again, I stress that I am not a professional manager, staff, or part of a medical team. I respect what they do, and there may be a whole lot more involved than what I see. I doubt it. The. Reds could be a leader regarding the support, training, diet, exercise, injury prevention, coaching, therapy, etc. that they supply to the team. We cannot afford many expensive free agents, but the cost of only ONE low level free agent could allow the setup of a world class training staff. The Reds must be proactive and not be held back due to past team results and being a small market team. Why wait for LA, etc. to be the first to do this (perhaps some other team(s) have already done this – most likely large market teams)?
I must digress here, The unfairness of how MLB is skewed in favor of the large markets is just unfair – this must be corrected as it has been with most/all other major sports. The owners of the large market teams want to win, and winning in an unfair environment is OK with most of them, as long as they win. Look at the Big Red Machine before free agency destroyed the team. Cincinnati fans, the Cincinnati front office, managers and staff in general love Cincinnati baseball, but we are competing in a very unfair biased environment that favors the large markets DUE TO THE LACK OF A SALARY CAP AND OTHER THINGS. Someone/some people must step up and do the right thing ASAP. Cincinnati fans and other small market fans must unite to stop the unfairness. Most small market fans love the game and their team so much, that they do not think in terms of the unfairness, but rather, are led to believe that things will be better the next year, etc.
Again, if you would please, I would appreciate if you would address each of my questions in as much detail as you can.
Thanks