Kyle Trimble is a licensed physical therapist here to provide MLB injury analysis on Trevor Rosenthal’s thoracic outlet syndrome.
Oakland Athletics closer Trevor Rosenthal has been placed on the IL for 60 days following surgery for severe neurovascular compression, also known as thoracic outlet syndrome. This issue is affecting his right throwing side and could potentially keep him out longer than the stated timeline.
Trevor Rosenthal’s Thoracic Outlet Syndrome
Thoracic outlet syndrome is a condition in where either the subclavian artery, vein or brachial plexus becomes compressed between the first rib and clavicle either due to anatomical defects or slowly over time due to repeated activity.
Compression of the blood vessels or nerves can cause a variety of symptoms including numbness, tingling, coldness, pain and swelling in the involved arm. This can lead to grip, control and fatigue issues. In Rosenthal’s case, it appears his brachial plexus is involved. This injury is not always immediately diagnosed as it can be subtle in its presentation and also present very similar to other, more common injuries.
Anatomy of the structures involved with TOS. (Credit: Physiopedia)
One possibility is cervical radiculopathy which occurs as a result of a herniated disc or compression of the nerve in the neck, causing pain and weakness down the arm. TOS can also be misinterpreted as a rotator cuff issue, which is what Rosenthal was sent to the IL initially with right shoulder inflammation.
Rosenthal had surgery on April 6 to remove the first rib along with releasing the scalene muscles and pectoralis minor to allow for greater space for the nerves during arm movement. According to research, 77 percent of pitchers return to play with the average return to play is 10-to-11 months. Fortunately, once pitchers do return, their performance is unchanged. Another study stated that on average pitchers returned on average in 297 days with ranges anywhere from 105 days-to-638 days, also confirming no change in performance. MLB.com also even gives a best-case scenario of 12 weeks to return.
MLB Betting & Fantasy Baseball Outlook
Despite initial reports of 3 months, it’s unlikely that Rosenthal returns this season based on the research above. Unless he is an incredibly fast healer, his timetable to return still puts him after the All-Star break. The A’s were unfortunately burned on this signing and will need to find another closer if they want to challenge for the AL West crown this year, currently at +250 even after a 2-7 start. For fantasy, sell Rosenthal if you can, even if he does come back quickly, I don’t believe that he will be effective until at least 2022.
Kyle Trimble is a licensed physical therapist who also works as an injury spotter for Dr. David Chao. Kyle has extensive experience in outpatient orthopedics, skilled nursing, acute care hospital, and home care. He’s also a member of Bills Mafia and runs the website Banged Up Bills.
Disclaimer from Kyle: My opinions are my own. Any thoughts I have on the injuries are based on media reports, my knowledge of the injury, and speculation based on the information currently available including video and print media. This information is subject to change based on the information released by the team.
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