Doctors at Odds on Schilling's Treatment

[February 09, 2008]  FORT MYERS, Fla. (AP) -- Curt Schilling's doctor insists the only way the 20-year veteran can pitch again is through surgery on a torn shoulder tendon that resembles strands of pasta.

Boston's team physician disagrees. He believes the tendon is damaged, not torn, and rehabilitation gives Schilling the best chance to play this year.

"The problem has probably been building up for two years, and he just went over the red line," Schilling's physician, Dr. Craig Morgan, said Friday. "Instead of being a single tendon, it's like three pieces of spaghetti or linguine, and when that happens it's end-stage disease in the tendon."

A third doctor, Mets medical director David Altchek, agreed that the tendon was torn but said surgery would probably sideline him for the season, Morgan said. Schilling, concerned that the Red Sox would invalidate his $8 million, one-year contract if he chose surgery, then agreed to rehab.

"On our conference call on Wednesday it was their strong recommendation that he go with the conservative approach," Morgan said in a telephone interview with The Associated Press on Friday.

"And, furthermore, it was their strong - how do I say this? - they would not approve him having surgery. Basically, according to the collective bargaining agreement, if they don't approve it, they don't have to pay him. His contract's null and void."

The team declined comment Friday.

Schilling spent seven weeks on the disabled list last year with tendinitis in the shoulder. But he passed the physical exam for the contract he agreed to on Nov. 6. Then, the shoulder deteriorated.

He couldn't shake hands or open a door without intense pain, Morgan said.

"I think his chance of coming back to pitching with rehab or a conservative approach is zero," Morgan said. "He might not come back after surgery, either. However, if the surgery is successful, he should be fully rehabbed by about All-Star break."

In his blog, 38pitches.com, Schilling praised Morgan in a posting Thursday night but said he never considered acting against the club's wishes.

Morgan said among those on the conference call were Red Sox general manager Theo Epstein, manager Terry Francona, team physician Dr. Thomas Gill, Schilling, the pitcher's lawyer and Altchek.

Under a side letter baseball's collective bargaining agreement, when there is disagreement between a team doctor and a second opinion obtained by a player, the sides are urged to settle on an acceptable third physician to resolve the disagreement.

Schilling "felt trapped" and agreed to rehabilitation since his contract could be voided if he had surgery, Morgan said. "He didn't have any alternative other than throw $8 million away."

Altchek did not return a call seeking comment.

The 41-year-old right-hander has struggled with his health and weight. He was sidelined for parts of two of the last three seasons and has said that 2008 will be his last season.

"The non-medical people in the Red Sox organization are relying on the advice of their medical people, and there's nothing wrong with that," Morgan said.

Schilling couldn't complete an MRI exam on Jan. 24 because the pain prevented him from keeping his right arm raised for 10 minutes as required, Morgan said.

"On a 1-to-10 scale of pain, where 1 is you feel great and 10 is you're being burned alive," Morgan said, "he's an 11."

Morgan said he's performed the surgery about 50 or 60 times but it's rarely been done with a "throwing athlete" and never with a major leaguer.

The two shoulder operations he performed on Schilling in 1995 and 1999 while the pitcher was with Philadelphia were different from the one Morgan is proposing now.

"I was told that both were experimental and he'd never come back," Morgan said.

After those surgeries, Schilling had his only three 20-win seasons and was selected co-MVP of the 2001 World Series with Arizona. In 2004 he helped Boston sweep St. Louis in the World Series after undergoing rare ankle surgery, which wasn't done by Morgan.

"He's been on the cutting edge of treating throwing shoulders for over a decade," Schilling said in his blog. "I trusted him with my career then, and always will."

Without Schilling, Boston's rotation shapes up as ace Josh Beckett, Daisuke Matsuzaka, Tim Wakefield, Jon Lester and Clay Buchholz. Julian Tavarez is a possibility.

"With Schilling going down, it hurts the team," Lester said. "If he's down for a while, we'll just have to adapt."

Lester was the only major leaguer at the Red Sox spring training facility Friday. The first workout for pitchers and catchers is next Saturday.

Schilling was 9-8 with a 3.87 ERA in 24 games last season. In the postseason, he went 3-0 with a 3.00 ERA to help the Red Sox win their second World Series title in four years. He is 216-146 with a 3.46 ERA in his career.

A career, Morgan said, that will end without surgery.

"Correct," he said. `I want to be very clear on that. Correct."

[Associated Press; By HOWARD ULMAN]

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