Nick Senzel’s Shoulder and the Wait of the Baseball World

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The ball rocketed off Harrison Bader’s bat. The Reds center fielder turned and raced full speed toward the wall. Bader had launched a 396-foot line drive to the deepest part of Busch Stadium. Statcast calculated it had a 94% hit probability. With two runners on in the 7th inning, an extra-base hit would put the Reds 2-0 lead over the Cardinals in mortal jeopardy.

Nick Senzel took a peek over his right shoulder to find out where he was. To learn how far away he was from a collision. In that instant, Senzel had no idea he was taking the final healthy strides of his 2019 season.

Yet, the Reds center fielder made the improbable catch

crashed awkwardly into the padding

and fell grimacing in a heap to the ground.

In obvious pain, Senzel collected himself and from one knee threw the ball back to the infield.

The Reds lost the game 3-2 on a blown save by Raisel Iglesais as the Cardinals swept a double-header. But the toll paid by the Reds was far greater than putting a single regular season game in the Loss column.

Shoulder Labrum Tears 101

The human shoulder is a loose ball-in-socket joint. It sounds uncomplicated, but the physiology is anything but. A tangled patchwork of muscles and tendons maintains an equilibrium that keeps the four major bones aligned and working together.

The shoulder’s labrum is a gasket of cartilage that spans the circumference of the socket. It cushions the top of the arm bone (humerus) against the socket. When healthy, the labrum’s tight fit also creates a suction that maintains the positional relationship between the ball and socket. A tear in the labrum disrupts the cushion and stability.

Usually, shoulder labrum tears are caused by repeated use. The violent and unnatural motion of throwing a ball overhead places extreme stress on the shoulder. Players use their entire kinetic chain to generate a high level of energy that launches the shoulder forward with tremendous force. Then with equal power, the shoulder’s soft-tissues, including the labrum, must decelerate that same force.

A different human joint, the elbow, is built in a straightforward manner. Fixing an elbow ligament (Tommy John surgery) is relatively simple. In contrast, shoulder health is fraught with ambiguity. “With your elbow, you go through the program, get the range of motion back, the pain goes away, everything feels good and off you go,” said Chris Carpenter, a Cy Young winning pitcher who had both elbow and shoulder surgery. “When you get into the shoulder, it’s a flip of the coin. You never have the same shoulder.”

A prominent orthopedic surgeon once compared the complex process of surgically fixing a shoulder to assembling a jigsaw puzzle without the box top.

There’s a good chance that Nick Senzel’s labrum tear resulted from a single trauma, that run-into with the Busch Stadium wall. Similar examples? Outfielder Michael Brantley suffered a season-ending injury diving for a ball in the outfield. You might remember Ryan Ludwick separating his right shoulder hustling head first into third base on Opening Day in 2013.

For years, shoulder labrum tears — once dubbed a pitcher’s most fearsome injury — ended careers. But improvements in surgical technique and rehab have improved the odds of recovery and return to playing baseball at the same level, especially position players.

The End of Nick Senzel’s Debut Season

We remember vividly how the season began for the Reds #1 prospect. A new position in spring training. Competition with a red-hot Scott Schebler. Service time controversy. Assignment to Louisville. Ankle injury. Finally, a May 3 debut.

But by the end of August, we had other things on our mind. The late-season hullabaloo over Marty Brennaman’s retirement, terrific pitching, Eugenio Suarez’s pursuit of league-leading home runs and the supernova of Aristides Aquino monopolized our attention.

It was easy to lose track of how Nick Senzel’s first season with the Reds ended.

The day after his collision with the wall, he hit a home run. A couple days after that, manager David Bell reduced Senzel’s role to pinch runner. On September 7, Nick Senzel played in the final game of his debut major league season.

Surgery wasn’t a foregone conclusion. Not every labrum tear requires it. People walk around every day with a partially torn shoulder labrum. A cortisone shot and treatment works for athletes in some cases. Another plus factor for a nonsurgical course was the way Senzel was injured. Labrum tears caused by single events, such as crashing into a wall, or diving for a catch, have a better chance of healing within 3-6 weeks. But if your career depends on repeated overhead throwing, surgery is recommended.

The Reds tried the alternatives. Senzel’s shoulder showed no sign of improvement.

On September 12, Dick Williams announced that an MRI had revealed a partial tear in the labrum of Senzel’s right shoulder. The tear had gotten worse since an earlier baseline MRI. A few days later, Senzel flew to California for a second opinion from Dr. Neal ElAttrache, a world renowned orthopedic surgeon. ElAttrache confirmed the diagnosis and joined in the recommendation for surgery.

Reds orthopedic surgeon Dr. Tim Kremchek performed surgery on Nick Senzel’s right shoulder labrum on September 24.

The recovery protocol involves a protective sling, then range-of-motion exercises, then a strengthening program. Before players resume baseball activities, they have to check the boxes of being pain free and having a full range of motion.

The standard timeline: After four months, players can start swinging a bat. If the injured shoulder was on the throwing arm, then throwing can begin after 4-6 months. Players can take part in games in the 5-6 month range.

Five months out for Nick Senzel would be the start of spring training.

Surgical Outcomes

Outcomes are variable for hitters who undergo shoulder surgery. Ryan Ludwick returned 4.5 months after his surgery and was never the same. His isolated power plunged from .256 (2012) before to .085 (2013) to .132 (2014) after. It’s worth noting that Ludwick was 35 years old, not 24.

Michael Brantley’s shoulder offers another cautionary tale, but one with a happy ending. Brantley sat out five months after surgery then played through discomfort in 11 big league games before having a setback that required a second operation in August 2016. Brantley’s 2017 return was hampered by a serious ankle sprain that cost him August and September. But fully healthy in 2018 (3.5 WAR) and 2019 (4.5 WAR), he put up spectacular seasons.

Beyond individual anecdotes, a recent study (2019) shows a high rate of return to previous level of play among professional position players after labrum repair surgery. If you’re a young, elite athlete, the odds of returning to your previous level of performance are good.

Nick Senzel has already been in the weight room. Dr. Kremchek reports that Senzel has a full range of motion and his shoulder strength is coming back. In the next week or so, we’ll read the excellent news that the Reds outfielder has resumed hitting and throwing. A full recovery is expected.

Relearning swing mechanics is the hardest part for position players, especially when they miss significant parts of the season. Many hitters struggle early, even for months. Senzel’s mechanics were going to be a point of interest this spring even prior to his injury. After a failed experiment with a new swing in August, Senzel has vowed to return to the way he’d always swung.

The timing of his injury was fortunate, as these things go. Senzel missed just the last month of the season, not several months or virtually an entire year like Brantley. He won’t be trying to come back in the middle of a season like Ludwick. Senzel’s surgery took place quickly enough after his injury that his January return to baseball activities will coincide with his normal offseason schedule.

Senzel seems destined to return to the Reds outfield. The club’s signing of free agent infielder Mike Moustakas squelched speculation that Senzel’s shoulder injury would precipitate his return to the infield, where he had played throughout his career prior to 2019.

Nick Senzel’s Trade Value

From start to finish last year, 24-year-old Nick Senzel played baseball with reckless abandon and flashed the hair-raising talent that had propelled him to the top of draft boards and prospect lineups. That same quality now has him on a new list.

National baseball writers have mentioned Nick Senzel as part of a trade package the Reds might use to acquire a premium shortstop such as Cleveland’s Francisco Lindor or the Dodgers’ Corey Seager.

Senzel will enter his age-25 season having earned 150 days of major league service time. That means he has six full seasons of team control remaining. Given his early 2019 debut, Senzel will qualify for Super Two arbitration status. He’ll play the next two seasons at league minimum salary and then have four years with the right to arbitration.

Prospects, even ones as talented and promising as Nick Senzel, don’t have infinite value. Craig Edwards of FanGraphs studied Top-100 players, sorted into categories based on FanGraphs “future value” scores. He calculated average WAR production, bust-rates and the rate of becoming a star player for each category. Edwards found that players in Senzel’s category (60) will produce an average of 6.1 WAR over a career. That includes a 32% bust-rate and a 27% chance of becoming a star. Researchers at Driveline did their own analysis, with slightly higher estimates of WAR value and found basically the same results as Edwards.

That figure of 6.1 WAR is for an average player in the 60-point category, not Nick Senzel in particular. You could make arguments that Senzel is better than the average player in that category. On the other hand, Senzel’s history missing games creates added uncertainty about his value.

The shoulder injury will lower projections for Senzel’s production, at least until he proves he’s healthy and back to form. It will also increase uncertainty over the longer term. But projections aren’t destiny and players can dispel uncertainty.

The effect on trade conjecture isn’t simple or one-directional. Lowering expectations for Senzel might let the Reds front office consider trading him. But they might also want to avoid selling low. Trade partners will be skeptical about Senzel’s recovery, again at least for the moment. Yet one might see this as a buy-low opportunity to take a gamble on a player who might prove to be a star.

Bottom line: Nick Senzel’s right shoulder should make all parties pause. A month from now, which would still be several days before pitchers and catchers report to spring training, Senzel should be immersed in baseball activities and the arc of his progress better known.

Oh, that return to baseball activity? It’ll take place in Goodyear, Arizona. At the spring training facility shared by Cincinnati and Cleveland — a proximity quite convenient for both sides to wait on Nick Senzel’s shoulder.

[Featured image: https://twitter.com/Reds/status/1138566641569210369/photo/1]