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Schilling's doctor disagrees with Sox
02/08/2008 11:45 AM ET
By Ian Browne / MLB.com
BOSTON -- The man who has performed two surgeries on Curt Schilling's right shoulder -- the first in 1995 and another one four years later -- feels that the Red Sox are taking the wrong approach by advising his patient not to have surgery at this point in time.
After telling the Red Sox about the pain he was experiencing in his shoulder, Schilling was examined by Red Sox medical director Dr. Thomas Gill in January. He then went to see his personal physician, Dr. Craig Morgan of Wilmington, Del.
Morgan's diagnosis is that the problem in Schilling's shoulder is in the bicipital groove, which is the part of the bicep tendon that runs outside the shoulder. Morgan feels the area has become diseased as a natural cause and effect from all the innings Schilling has pitched over his career.
A couple of weeks ago, Morgan advised surgery, which he felt the 41-year-old Schilling might recover from in time to pitch by the All-Star break.
The Red Sox have reportedly disagreed, feeling that Schilling's rotator cuff is not strong enough to withstand such a procedure, and that surgery would likely leave him out for the season.
It is Morgan's belief that avoiding surgery will end any hope Schilling has of pitching in 2008. The Red Sox and Schilling agreed Thursday to begin a course of treatment that includes rest, rehabilitation and strengthening instead of surgery.
"I think his chances of that being successful to the point where he can rehab, get stronger and become pain-free to be able to pitch effectively are near zero," Morgan said on Friday morning on Boston radio station WEEI-850 AM.
Schilling and the Red Sox disagreed over the course of action for a couple of weeks before following terms of the Collective Bargaining Agreement and seeking a third and independent medical opinion, which was agreed on by the two parties.
According to the Boston Herald, the third opinion was given by Mets medical director David Altchek, who sided with the Red Sox and advised against surgery.
Schilling revealed on his blog on Thursday night that he will take the club's advice.
"At this time I have agreed to abide with the club's wishes in hopes that will provide the results they believe it will," Schilling wrote on 38pitches.com.
Morgan realizes that Schilling is in a tough position, in that it's hard for him to go against the wishes of the organization that is paying his contract. By seeking the third opinion, the Red Sox and Schilling were going by the book, as it is laid out in the CBA.
As much as Morgan would love to see Schilling make a strong comeback in 2008, he doesn't see it happening without surgery.
When will Schilling pitch this season without surgery, best-case scenario? That is what Morgan was asked during his radio interview.
"Never -- and there again, that's my opinion," Morgan told hosts John Dennis and Gerry Callahan.
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On Thursday night, the the Red Sox issued a brief statement: "Curt Schilling was examined by Red Sox doctors in January after he reported feeling right shoulder discomfort. Curt has started a program of rest, rehabilitation and shoulder strengthening in an attempt to return to pitching."
Other than the statement, the Red Sox, as of late Friday morning, had not commented on Schilling's injury.
Morgan also disagrees with the Red Sox in their apparent belief that Schilling's rotator cuff couldn't withstand such a procedure.
"His rotator cuff, from my examination in January, there was really no interval change from an exam in September of '07 or exams in '06, '05, '04, '03, '02," Morgan said during his 11-minute radio interview. "In addition to that, this guy has had MRIs every year when he was in Arizona and several other MRIs, and I have all of his MRIs in my office and I have reviewed them with the current controversial MRIs. His rotator cuff images on his MRI, as well as his physical examination, in my opinion, have not changed in a decade."
In addition, Morgan was asked when Schilling would be able to pitch again if he underwent the surgery on his bicipital tendon.
"Ten days ago, when I was asked this question, the answer would have been, around the All-Star break," said Morgan. "You have to understand, this is an educated guess. I don't really have an accurate crystal ball, but we're already two weeks beyond that by inaction, one way or the other."
Still, Morgan also admitted that his prescribed course of action also provided no guarantee Schilling would be able to pitch effectively again, if at all.
"You have to understand, he may be done pitching no matter what. That's looming out there as well," Morgan said.
The Boston Globe cited several sources in saying that Schilling is not expected back until at least the All-Star break with the current rehab program he will partake in, under the watch of the team.
The Red Sox felt that what Morgan found in regard to Schilling's bicipital tendon were "artifacts of the MRI."
"They did say that," Morgan said. "That is their opinion."
What does that mean?
"Something that's not there, that it appears that it is there," Morgan said. "I had that reviewed by several people, and a third opinion agrees with me that ... the radiologist that I had look at it agrees that it is absolutely torn, not an artifact."
You can be sure Dr. Morgan will be following Schilling's attempted rehab with great interest.
"I don't think this guy will even be able to exercise, to be able to find out whether that approach will be successful in any way, shape or form," said Morgan. "The real issue here is, if you blow six or eight weeks trying that to see, and it's unsuccessful, then if you try to pull the trigger on surgery and you've blown six to eight weeks, then the season may be gone."
Morgan acknowledged that Schilling's shoulder worsened significantly over the course of the winter.
"I did a routine exam on him right after the World Series," said Morgan. "What happened was, the progression of the disease that I mentioned five minutes ago went over the red line. He started to have pain well before early January, when he started throwing. This got dramatically worse. He had pain with his normal exercise program. That was sort of a red flag that something was going on. But he didn't really communicate that to me, the progression of it getting worse, until he started his offseason throwing program and had a dramatic increase in pain.
"This guy's got pain opening a door -- he was not able to complete all of the positions that were requested for his MRI on the 24th of January because he couldn't put his arm above his head and hold it there without excruciating pain. That's what we're talking about here."
While Schilling is taking the advice of the Red Sox and the third opinion, he made it clear on his blog how much respect he has for Dr. Morgan.
"Dr Craig Morgan is inarguably one of the most highly respected shoulder experts in the world," Schilling wrote. "I'm here because 13 years ago he was the only person on the planet to actually get what was wrong with me and correctly diagnose, and then treat me. He's been on the cutting edge of treating throwing shoulders for over a decade. Much of the stuff that's now seen as cutting edge treatment and therapy he was doing 10 years ago. I trusted him with my career then, and always will."
Schilling re-signed with the Red Sox in November, at which time he passed a thorough physical provided by the club. But his shoulder has deteriorated since then to the point that there's no telling when or if he will pitch again.
Prior to this most recent injury, Schilling had stated numerous times that 2008 would be his last Major League season.
This story was not subject to the approval of Major League Baseball or its clubs.
