Will Bradish pitch for the Orioles this season?

[orioles119]

Just get the surgery and prepare for 2025.  Don't delay the inevitable.

[Birdland in NC]

This quote from Elias is why I voted no.  It sounds like a hedge. 

"I think we have it in a really good spot right now, and our plans are to get him pitching in 2024"

 

[Moose Milligan]

4 hours ago, Tony-OH said:

Where's the option, of yes, he'll show up for a start or two in June, get shut back down, try to rehab, but eventually get surgery in September so he misses all of 2025 too? That's where my optimism is after today's kick in the nuts news.

Accurate. 

[24fps]

4 hours ago, Moshagge3 said:

The one shred of hope I'm clinging to is that if Elias really thought that surgery was >90% likely he wouldn't let Bradish wait this long before getting it. By waiting they're jeopardizing a good chunk of 2025.

The decision to have surgery is 100% Bradish’s call. Elias could advise and make the O’s resources available, and I’m sure he has, but he’s not in a position to force anyone to have surgery.  Hopefully Bradish is a sensible guy with good representation who will take the best course. 

[doccat]

4 hours ago, Tony-OH said:

Where's the option, of yes, he'll show up for a start or two in June, get shut back down, try to rehab, but eventually get surgery in September so he misses all of 2025 too? That's where my optimism is after today's kick in the nuts news.

This

[tntoriole]

5 hours ago, Jim'sKid26 said:

The most significant element in this discussion is not available to anyone but Bradish, his physician and the folks in the O's front office who have access to his medical information. What is the degree of injury to his UCL and surrounding tissue? The fact that they are starting a throwing program early after a PRP injections implies a strain that is either grade I or II. PRP is not effective and therefore not used on Grade IV strain/tears. Most Grade III tear/strains require extensive rest and usually end up with operative treatment. 

If he has a grade I or II strain, PRP and a rehab program can deliver good results without surgery. I know there is a lot of doom and gloom on the board today but it may be a bit premature. Here's a quote from a recent journal article:

"Ultrasound-guided UCL PRP injection, a minimally invasive technique, has gained traction due to its potential to facilitate tissue healing and repair. PRP has demonstrated success in returning pitchers to throwing quickly and successfully 73-96% of the time following medium-grade UCL tears or UCL insufficiency. In prior studies, use of PRP to treat partial tears resulted in an 88% success rate in returning athletes to play after an average of 12 weeks."

Ref:

1) Mills FB 4th, Misra AK, Goyeneche N, Hackel JG, Andrews JR, Joyner PW: Return to play after platelet-rich plasma injection for elbow UCL injury: outcomes based on injury severity. Orthop J Sports Med. 2021, 9:2325967121991135. 10.1177/2325967121991135

Case study: 

https://www.cureus.com/articles/213637-from-dugout-to-the-mound-a-tale-of-platelet-rich-performance#!/

This is a single case study of a nonMLB high school pitcher.. the case also had no long term results mentioned.. did he ultimately fail conservative management?. 
 

I think the stress on an arm in the big leagues is vastly more intense.  Which is why I believe PRP injections and conservative management usually don’t work. 
 

[interloper]

18 hours ago, Jim'sKid26 said:

The most significant element in this discussion is not available to anyone but Bradish, his physician and the folks in the O's front office who have access to his medical information. What is the degree of injury to his UCL and surrounding tissue? The fact that they are starting a throwing program early after a PRP injections implies a strain that is either grade I or II. PRP is not effective and therefore not used on Grade IV strain/tears. Most Grade III tear/strains require extensive rest and usually end up with operative treatment. 

If he has a grade I or II strain, PRP and a rehab program can deliver good results without surgery. I know there is a lot of doom and gloom on the board today but it may be a bit premature. Here's a quote from a recent journal article:

"Ultrasound-guided UCL PRP injection, a minimally invasive technique, has gained traction due to its potential to facilitate tissue healing and repair. PRP has demonstrated success in returning pitchers to throwing quickly and successfully 73-96% of the time following medium-grade UCL tears or UCL insufficiency. In prior studies, use of PRP to treat partial tears resulted in an 88% success rate in returning athletes to play after an average of 12 weeks."

Ref:

1) Mills FB 4th, Misra AK, Goyeneche N, Hackel JG, Andrews JR, Joyner PW: Return to play after platelet-rich plasma injection for elbow UCL injury: outcomes based on injury severity. Orthop J Sports Med. 2021, 9:2325967121991135. 10.1177/2325967121991135

Case study: 

https://www.cureus.com/articles/213637-from-dugout-to-the-mound-a-tale-of-platelet-rich-performance#!/

The part that jumped out to me was "average of 12 weeks". Woof.

Edited February 16 by interloper

[Ripken]

6 minutes ago, interloper said:

The part that jumped out to me was "average of 12 weeks". Woof.

I'm not feeling good about this at all but 12 weeks from the middle of January is the middle of April.  He's soft tossing now.  In other words, while I expect TJ surgery, killing his '24 season and a big chunk of next, my concern isn't the PRP recovery timeline itself; it's just whether it works or not.

[interloper]

2 minutes ago, Ripken said:

I'm not feeling good about this at all but 12 weeks from the middle of January is the middle of April.  He's soft tossing now.  In other words, while I expect TJ surgery, killing his '24 season and a big chunk of next, my concern isn't the PRP recovery timeline itself; it's just whether it works or not.

Derp. Good point lol

[Jim'sKid26]

14 hours ago, tntoriole said:

This is a single case study of a nonMLB high school pitcher.. the case also had no long term results mentioned.. did he ultimately fail conservative management?. 
 

I think the stress on an arm in the big leagues is vastly more intense.  Which is why I believe PRP injections and conservative management usually don’t work. 
 

So you are basing your opinion on a single case study? The journal article provided is about professional pitchers, mostly MLB, and there is a considerable literature available if you wish to search for it. Its up to you.

Edited February 16 by Jim'sKid26

[Can_of_corn]

14 hours ago, tntoriole said:

I think the stress on an arm in the big leagues is vastly more intense.  Which is why I believe PRP injections and conservative management usually don’t work. 
 

I agree that they usually don't work.

But that doesn't mean you shouldn't try a less invasive means of fixing the issue first.

 

[yark14]

20 hours ago, Sports Guy said:

They will save a lot of money since he’s a super 2 guy. That’s probably the only positive.

Our new ownership group is worth billions upon billions of dollars.  I don't think we need to worry about a few million arbitration dollars anymore.

[dystopia]

5 minutes ago, Jim'sKid26 said:

So you are basing your opinion on a single case study? The journal article provided is about professional pitchers, mostly MLB, and there is a considerable literature available if you wish to search for it. Its up to you.

In fairness, I’m sure the Orioles medical staff is no match for the world class doctors on Orioles Hangout. 

[Can_of_corn]

1 minute ago, yark14 said:

Our new ownership group is worth billions upon billions of dollars.  I don't think we need to worry about a few million arbitration dollars anymore.

John Fisher is worth 2.9B.

[Sports Guy]

21 minutes ago, yark14 said:

Our new ownership group is worth billions upon billions of dollars.  I don't think we need to worry about a few million arbitration dollars anymore.

It’s a lot more than a few million.