July 3, 2025 • 10 mins
Dr. Brandon Kohrs from OrthoCincy joined us to talk about Jake Fraley's labrum tear and his decision to delay surgery while he plays with the injury.
Learn more about OrthoCincy by going here.
Listen to the show live weekday afternoons 3:00 - 6:00 on ESPN1530.
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Learn more about OrthoCincy by going here.
Listen to the show live weekday afternoons 3:00 - 6:00 on ESPN1530.
Listen Live: ESPN1530.com/listen
Get more: https://linktr.ee/MoEgger
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
And today is a Wednesday.
Speaker 2 (00:01):
We talk injuries with one of the experts from Orthos
since the Orthopedics and sports Medicine. The great thing about Orthos,
since he is they have specialists and locations and services
all over the Tri State. This includes walkin orthopedic urgent
care at five locations with extended evening and weekend hours
in Edgewood and Anderson. Learn more, go to Orthosincy dot com.
(00:22):
That's ortho ci ncy dot com. Doctor Brandon Coors is
with us from Orthosincy. I want to talk extensively about
Jake Freeley, who is going to need shoulder surgery on
his torn laborm at the end of the season. The
plan though, and it's worth mentioning it's his non throwing shoulder.
The plan now though, is taking a cortisone shot and
(00:44):
when he can come off the injury list, he's going
to give it a go and try to get through
the season. We'll see if this works. Let's let's begin
with this walk me through the differences between a torn
labram that would require immediate surgery and one where the
procedure can can wait a bit.
Speaker 3 (01:01):
Number one thing on that would be where the exact
tear location is if it's a more anterior inferior tear
so front bottom commonly seen with a shoulder dislocation shoulder
instability event, that tends to you know, require more surgery.
You tend to be more aggressive with those. But you know,
(01:23):
even like you saw sho Heotani last year, I think
he had a dislocation event with that and he took
you know, a little bit of time off and then
got back into playing in the World Series as well.
So even those you can rehab and the good thing
on him, So a few things. If you look at
the mechanism when you watch the play, it almost looks
like his elbow kind of slams into the turf resulting
(01:44):
in his shoulder almost being forced backwards. So you wonder
if in him, if it's more of a posterior label tear,
which is a tear in the back of the shoulder,
those you actually tend to start out with more nonoperative
management where you treat a lot of those noncertically, where
you rehab them. And a text So switching sports again,
Logan wilson Y, I think he had a posterior label
(02:04):
tear in his shoulder, and you know, what did he do.
He took a few weeks off and then got back
to playing, played in the super Bowl, and then I
believe he've got surgery after the season. So those and
then and then you alsay have superior. So what's called
a slap terry might hear people talk about superior labor
an tier to post here slap That's what that stands for.
And those are also injuries that you can treat nonoperatively,
(02:28):
especially initially. Now I would say too, in overhead throwing athletes,
there is a very high percentage of label tears, especially
in especially pitchers, but anybody who's an overhead thrower. I
mean you look at asymptomatic label tears and that specific population,
it's pushing forty fifty percent in some of these individuals,
so very high just baseline. So let's talk about Jake.
(02:50):
So it's a non throwing shoulder, which is good based
on the mechanism. You know, probably I'm guessing more posterior
superior type labeling injury. And so you know, hopefully cortizone
injection calms that down, you get him on some mansi
inflammatory medications, get him back to you know, baseline pretty
quick and hopefully he doesn't lose a lot of time
(03:10):
throwing shoulder maybe a little different, but non throwing shoulder.
You know, you anticipate a full recovery with this as well.
Speaker 1 (03:16):
All Right, so the good news is non throwing shoulder.
Speaker 2 (03:19):
But is he still incurring the risk of damaging this
even further and then complicating the surgical process and his
comeback from that.
Speaker 3 (03:27):
It depends on the tear severity, and without seeing the
MRI or the advanced imaging that was obtained, kind of
hard to tell the exact type of tear that he has, Right,
There's always a risk that you can injure something more.
I think with a post Heier label tear, you know,
superior label tear, even anterior label tear, as long as
that shoulder is not coming out of socket, and a
(03:49):
lot of times that takes a pretty good amount of
force to do that. It's typically pretty well tolerated. And
you know, I don't think there's a huge risk of
you know, major significant injury without any other significant trauma.
Speaker 1 (04:02):
He's having a cortisone shot. What does that do?
Speaker 3 (04:05):
I tell people, a cortizone is like a super anti
inflammatory medication. So you have your insids non steroidal anti
inflammatory medications. Well, a cortizone injection is a steroidal anti
inflammatory medication. So if you draw, you know, you have
all these little pathways or even you think about it
like a like a you know, like a tree, like
(04:26):
a genetic tree where you have, you know, your brothers.
Speaker 1 (04:30):
It's up at the top, you have.
Speaker 3 (04:32):
The cortizone which is blocking the inflammatory pathway downstream, and
then below that you have all these different inflammatory pathways.
So it's basically a more potent non steroidal you could
think of it as that. So it's basically going to
decrease all the inflammation in that shoulder.
Speaker 2 (04:48):
Is it the sort of thing where you have one
and then you're good for a while. Is this the
sort of thing he's going to have to have on
a frequent basis as he tries to play throughout the
course of the next three months.
Speaker 1 (05:00):
Now, and you don't want that.
Speaker 3 (05:01):
And typically you only do corteris in injections three to
four times a year, so that's usually once every three
to four months. You know, long term, if you do
a bunch of shots over time, there can be some
detrimental effects to the joint. I think one or two
is typically pretty well tolerated. But hopefully this is a
one time thing where you have that it calms down
the inflammation unless you do something to flare that back up.
(05:23):
You should be good from an inflammation pain standpoint until
you do something else to irritate it.
Speaker 2 (05:29):
Let's assume for a second that this works out and
he gets through the rest of the season and then
has surgery once the offseason begins.
Speaker 1 (05:36):
Number one, what does that timeline look like?
Speaker 2 (05:38):
And I guess with that number two, are we talking
about something that could jeopardize the beginning of his season
next year.
Speaker 3 (05:43):
I think he's probably good as far as next year
and return to play as far as the specific timeline
on surgery. So what we would typically do here at
arthurs since he is you know, you do the surgery,
you have a nerve blocks of your arms. Numb helps
it with immediate pain relief. You just typically start therapy
about three to five days after surgery, so pretty much
right away we're starting on gently stretching that shoulder back
(06:06):
out and working on some passive motion, which means that
you know somebody else is moving your arm. You're typically
in a sling for four to six weeks. And you're
doing formal physical therapy for probably three to four months
to some degree with you know, for something like this,
probably a sixth month, I would say, six months to
a year until you're as good as you're gonna get.
(06:26):
You're probably looking at, you know, six to nine months recovery,
until you're you know, really solid, really stable, and ready
to get get.
Speaker 1 (06:34):
Back out that playing again. All right.
Speaker 3 (06:36):
One, I don't think I think if you sorry, I
was gonna say, I think if you have all season
surgery right after the year, you know, you should be
good to go by the beginning of the year.
Speaker 1 (06:45):
All right.
Speaker 2 (06:46):
One other Reds injury situation to talk about. Ian Jabou
is the third Reds pitcher this season to have to
miss time because of a shoulder impingement. Uh and and
he's had this multiple times. I feel like we've heard
about impingements more this season than at any point that
I can recall. So let's talk about what the injury
is and what the symptoms are.
Speaker 3 (07:04):
With shoulder impingement, there's two types of impingement. There's what's
called internal impingement and external impingement. So external impingement is
typically what we're going to see in our general population,
where you sleep wrong on it, you move something wrong
and create some inflammation. You basically get pinching between your
humorous bone and your chromium bone and the roofbone of
(07:26):
the shoulders. You kind of pinch the rotator cuff causes
some rotator cuff tendonitis. Potentially, that's what he has going on.
But the other thing you can see, especially in overhead throwers,
is what's called internal impingement, and this is very common
and high level baseball players. It's based on the mechanism
of throwing, which is a very unnatural position to be in.
So when you go to externally rotate your arms, so
(07:49):
when they're really pulling their arm back to get ready
to throw, you can end up pinching basically the rotator
cuff between the humorous bone and the back part of
the socket to actually end up irritating the undersurface of
that rotator cuff. So you can get some biseep irritation,
some undersurface rotator cuff issues, some posterior superior label issues
(08:10):
as well, And I would anticipate that's probably more than
likely an internal impingement type situation, which is just based
on the mechanism of throwing a baseball really hard. Over time,
you can get that. Now, things you can do to
mitigate that is proper stretching and actually improving your internal rotation.
So you get what's called gird, not like you get
(08:32):
for reflux, but glenny humoral internal rotation deficit where you
can't where you lose the ability to internally rotate your arm.
And if you actually look from side to side and
a lot of these pictures, you'll see they have more
loss of internal rotation on their throwing side than they
do on their non throwing side. And the goal is
to stretch that out. That then improves the mechanics of
(08:52):
the shoulder and allows the shoulder to move in a
more natural position. So when all those capsules and ligaments
in the shoulder are tight, shoulder moves in a more
unnatural position. But with that being said, you know when
you lose internal rotation, a lot of times you gain
an external rotation of the arms, your ability to rotate
the shoulder back, which gives you more torque and allows
(09:13):
you to throw the ball faster. So it's kind of
a compensatory response to like to throw a baseball harder.
But you just got to make sure you're working on that,
and neither are stretches that these guys are doing that
the training staff is working with them on. I just
think it's the mechanism of, you know, throwing the ball
really really hard over and over again over an extended
period of time that predisposes you to these types of injuries.
Speaker 2 (09:34):
Yeah, and unfortunately for Ian, he has dealt with it
often this season. Doctor Brandon core Is from Ortho sincey
tremendous stuff is always.
Speaker 1 (09:41):
I appreciate the expertise. We'll do it again soon. Thanks Mel.
Speaker 2 (09:45):
That's our guy, Doctor Brandon core Is. Awesome stuff as
always from him Orthosinc. Dot com. We do it every
single week. I say this every single week because it
is absolutely true that the awesome thing about Ortho since
he is, you never need an appointment right walk in.
Appointments are available. You don't have to call ahead, you
(10:06):
don't have to look ahead. Just go to Orthosinc. Dot
com and you can learn more. They've got extended evening
and weekend hours and Edgewood and Anderson evenings nine to
nine and on Saturdays nine eight to one. Pay one
p in both Edgewood and Anderson. It's more convenient than
an er, and it's definitely cheaper. Whenever you have an
(10:27):
urgent orthopedic issue, check out Orthosinc.
Speaker 1 (10:31):
Dot com. That's Ortho c I n c Y dot com.
And today is a Wednesday.
Speaker 2 (00:01):
We talk injuries with one of the experts from Orthos
since the Orthopedics and sports Medicine. The great thing about Orthos,
since he is they have specialists and locations and services
all over the Tri State. This includes walkin orthopedic urgent
care at five locations with extended evening and weekend hours
in Edgewood and Anderson. Learn more, go to Orthosincy dot com.
(00:22):
That's ortho ci ncy dot com. Doctor Brandon Coors is
with us from Orthosincy. I want to talk extensively about
Jake Freeley, who is going to need shoulder surgery on
his torn laborm at the end of the season. The
plan though, and it's worth mentioning it's his non throwing shoulder.
The plan now though, is taking a cortisone shot and
(00:44):
when he can come off the injury list, he's going
to give it a go and try to get through
the season. We'll see if this works. Let's let's begin
with this walk me through the differences between a torn
labram that would require immediate surgery and one where the
procedure can can wait a bit.
Speaker 3 (01:01):
Number one thing on that would be where the exact
tear location is if it's a more anterior inferior tear
so front bottom commonly seen with a shoulder dislocation shoulder
instability event, that tends to you know, require more surgery.
You tend to be more aggressive with those. But you know,
(01:23):
even like you saw sho Heotani last year, I think
he had a dislocation event with that and he took
you know, a little bit of time off and then
got back into playing in the World Series as well.
So even those you can rehab and the good thing
on him, So a few things. If you look at
the mechanism when you watch the play, it almost looks
like his elbow kind of slams into the turf resulting
(01:44):
in his shoulder almost being forced backwards. So you wonder
if in him, if it's more of a posterior label tear,
which is a tear in the back of the shoulder,
those you actually tend to start out with more nonoperative
management where you treat a lot of those noncertically, where
you rehab them. And a text So switching sports again,
Logan wilson Y, I think he had a posterior label
(02:04):
tear in his shoulder, and you know, what did he do.
He took a few weeks off and then got back
to playing, played in the super Bowl, and then I
believe he've got surgery after the season. So those and
then and then you alsay have superior. So what's called
a slap terry might hear people talk about superior labor
an tier to post here slap That's what that stands for.
And those are also injuries that you can treat nonoperatively,
(02:28):
especially initially. Now I would say too, in overhead throwing athletes,
there is a very high percentage of label tears, especially
in especially pitchers, but anybody who's an overhead thrower. I
mean you look at asymptomatic label tears and that specific population,
it's pushing forty fifty percent in some of these individuals,
so very high just baseline. So let's talk about Jake.
(02:50):
So it's a non throwing shoulder, which is good based
on the mechanism. You know, probably I'm guessing more posterior
superior type labeling injury. And so you know, hopefully cortizone
injection calms that down, you get him on some mansi
inflammatory medications, get him back to you know, baseline pretty
quick and hopefully he doesn't lose a lot of time
(03:10):
throwing shoulder maybe a little different, but non throwing shoulder.
You know, you anticipate a full recovery with this as well.
Speaker 1 (03:16):
All Right, so the good news is non throwing shoulder.
Speaker 2 (03:19):
But is he still incurring the risk of damaging this
even further and then complicating the surgical process and his
comeback from that.
Speaker 3 (03:27):
It depends on the tear severity, and without seeing the
MRI or the advanced imaging that was obtained, kind of
hard to tell the exact type of tear that he has, Right,
There's always a risk that you can injure something more.
I think with a post Heier label tear, you know,
superior label tear, even anterior label tear, as long as
that shoulder is not coming out of socket, and a
(03:49):
lot of times that takes a pretty good amount of
force to do that. It's typically pretty well tolerated. And
you know, I don't think there's a huge risk of
you know, major significant injury without any other significant trauma.
Speaker 1 (04:02):
He's having a cortisone shot. What does that do?
Speaker 3 (04:05):
I tell people, a cortizone is like a super anti
inflammatory medication. So you have your insids non steroidal anti
inflammatory medications. Well, a cortizone injection is a steroidal anti
inflammatory medication. So if you draw, you know, you have
all these little pathways or even you think about it
like a like a you know, like a tree, like
(04:26):
a genetic tree where you have, you know, your brothers.
Speaker 1 (04:30):
It's up at the top, you have.
Speaker 3 (04:32):
The cortizone which is blocking the inflammatory pathway downstream, and
then below that you have all these different inflammatory pathways.
So it's basically a more potent non steroidal you could
think of it as that. So it's basically going to
decrease all the inflammation in that shoulder.
Speaker 2 (04:48):
Is it the sort of thing where you have one
and then you're good for a while. Is this the
sort of thing he's going to have to have on
a frequent basis as he tries to play throughout the
course of the next three months.
Speaker 1 (05:00):
Now, and you don't want that.
Speaker 3 (05:01):
And typically you only do corteris in injections three to
four times a year, so that's usually once every three
to four months. You know, long term, if you do
a bunch of shots over time, there can be some
detrimental effects to the joint. I think one or two
is typically pretty well tolerated. But hopefully this is a
one time thing where you have that it calms down
the inflammation unless you do something to flare that back up.
(05:23):
You should be good from an inflammation pain standpoint until
you do something else to irritate it.
Speaker 2 (05:29):
Let's assume for a second that this works out and
he gets through the rest of the season and then
has surgery once the offseason begins.
Speaker 1 (05:36):
Number one, what does that timeline look like?
Speaker 2 (05:38):
And I guess with that number two, are we talking
about something that could jeopardize the beginning of his season
next year.
Speaker 3 (05:43):
I think he's probably good as far as next year
and return to play as far as the specific timeline
on surgery. So what we would typically do here at
arthurs since he is you know, you do the surgery,
you have a nerve blocks of your arms. Numb helps
it with immediate pain relief. You just typically start therapy
about three to five days after surgery, so pretty much
right away we're starting on gently stretching that shoulder back
(06:06):
out and working on some passive motion, which means that
you know somebody else is moving your arm. You're typically
in a sling for four to six weeks. And you're
doing formal physical therapy for probably three to four months
to some degree with you know, for something like this,
probably a sixth month, I would say, six months to
a year until you're as good as you're gonna get.
(06:26):
You're probably looking at, you know, six to nine months recovery,
until you're you know, really solid, really stable, and ready
to get get.
Speaker 1 (06:34):
Back out that playing again. All right.
Speaker 3 (06:36):
One, I don't think I think if you sorry, I
was gonna say, I think if you have all season
surgery right after the year, you know, you should be
good to go by the beginning of the year.
Speaker 1 (06:45):
All right.
Speaker 2 (06:46):
One other Reds injury situation to talk about. Ian Jabou
is the third Reds pitcher this season to have to
miss time because of a shoulder impingement. Uh and and
he's had this multiple times. I feel like we've heard
about impingements more this season than at any point that
I can recall. So let's talk about what the injury
is and what the symptoms are.
Speaker 3 (07:04):
With shoulder impingement, there's two types of impingement. There's what's
called internal impingement and external impingement. So external impingement is
typically what we're going to see in our general population,
where you sleep wrong on it, you move something wrong
and create some inflammation. You basically get pinching between your
humorous bone and your chromium bone and the roofbone of
(07:26):
the shoulders. You kind of pinch the rotator cuff causes
some rotator cuff tendonitis. Potentially, that's what he has going on.
But the other thing you can see, especially in overhead throwers,
is what's called internal impingement, and this is very common
and high level baseball players. It's based on the mechanism
of throwing, which is a very unnatural position to be in.
So when you go to externally rotate your arms, so
(07:49):
when they're really pulling their arm back to get ready
to throw, you can end up pinching basically the rotator
cuff between the humorous bone and the back part of
the socket to actually end up irritating the undersurface of
that rotator cuff. So you can get some biseep irritation,
some undersurface rotator cuff issues, some posterior superior label issues
(08:10):
as well, And I would anticipate that's probably more than
likely an internal impingement type situation, which is just based
on the mechanism of throwing a baseball really hard. Over time,
you can get that. Now, things you can do to
mitigate that is proper stretching and actually improving your internal rotation.
So you get what's called gird, not like you get
(08:32):
for reflux, but glenny humoral internal rotation deficit where you
can't where you lose the ability to internally rotate your arm.
And if you actually look from side to side and
a lot of these pictures, you'll see they have more
loss of internal rotation on their throwing side than they
do on their non throwing side. And the goal is
to stretch that out. That then improves the mechanics of
(08:52):
the shoulder and allows the shoulder to move in a
more natural position. So when all those capsules and ligaments
in the shoulder are tight, shoulder moves in a more
unnatural position. But with that being said, you know when
you lose internal rotation, a lot of times you gain
an external rotation of the arms, your ability to rotate
the shoulder back, which gives you more torque and allows
(09:13):
you to throw the ball faster. So it's kind of
a compensatory response to like to throw a baseball harder.
But you just got to make sure you're working on that,
and neither are stretches that these guys are doing that
the training staff is working with them on. I just
think it's the mechanism of, you know, throwing the ball
really really hard over and over again over an extended
period of time that predisposes you to these types of injuries.
Speaker 2 (09:34):
Yeah, and unfortunately for Ian, he has dealt with it
often this season. Doctor Brandon core Is from Ortho sincey
tremendous stuff is always.
Speaker 1 (09:41):
I appreciate the expertise. We'll do it again soon. Thanks Mel.
Speaker 2 (09:45):
That's our guy, Doctor Brandon core Is. Awesome stuff as
always from him Orthosinc. Dot com. We do it every
single week. I say this every single week because it
is absolutely true that the awesome thing about Ortho since
he is, you never need an appointment right walk in.
Appointments are available. You don't have to call ahead, you
(10:06):
don't have to look ahead. Just go to Orthosinc. Dot
com and you can learn more. They've got extended evening
and weekend hours and Edgewood and Anderson evenings nine to
nine and on Saturdays nine eight to one. Pay one
p in both Edgewood and Anderson. It's more convenient than
an er, and it's definitely cheaper. Whenever you have an
(10:27):
urgent orthopedic issue, check out Orthosinc.
Speaker 1 (10:31):
Dot com. That's Ortho c I n c Y dot com.
Mo Egger News
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