By Abby Sims
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Mets starting pitcher Jon Niese is on the disabled list after getting an MRI on the shoulder that caused him to leave the game early in the fourth inning on Thursday.
Niese noted that he’d felt great after missing a start and having 12 days of rest in late May and early June due to what was reported to be tendinitis. Though he apparently also expressed that he was not overly concerned about the shoulder despite the reappearance of symptoms, it seems logical for Mets fans and management to worry.
I assume it is one of his rotator cuff tendons that is affecting Niese. Like most non-traumatic sports ailments, tendinitis is an overuse injury. Tissues are simply subjected to more demand than they can tolerate. The result? Breakdown.
Sometimes the cause entails weakness of specific muscles or strength imbalances. Insufficient muscular endurance to undertake a repetitive activity might be another issue. This is particularly true with overhead motions, such as those common in throwing and racquet sports, which involve complex dynamics. At the shoulder, variants in the shape of the acromion, a portion of bone overlying the joint can place additional stress on a tendon, making it more vulnerable. Another outcome of any of the above factors could be impingement on a tendon, which also plays into a cycle of inflammation.
Niese reportedly complained of weakness in the shoulder before being removed from the game. Though he’d rested for only 12 days before his prior start, the rest that alleviated his symptoms might have contributed to further weakening from disuse.
As I’ve written about in previous columns, rest and treatment of inflammation — with or without cortisone — may relieve pain, but don’t address the causes. That is why we see so much recurrence of injury amongst players who may feel well enough to return to the field but find that they can’t stay out there. Healing is often incomplete and underlying factors have not been sufficiently addressed — nor can they be — in the limited time allotted. In fact, if the healing is incomplete, the boundaries of function cannot be pushed in rehab to fully simulate the demands of competition. Then, of course, there are the many athletes who play through the pain, whether silently and without complaint or because they are encouraged to do so.
Niese’s numbers this season may be evidence that something is holding him back. His command is not as sharp as it had been, resulting in more walks and fewer strikeouts. Now, even before the midpoint of the season, he is out for the second time due to the left shoulder. The diagnosis may not turn out to pinpoint significant pathology, but that doesn’t mean it should be taken lightly.
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