Just spent 45 minutes perusing the medical literature - looks like trainer Lessard is right - the rehab route is not usually adequate when there's recurrence, a labral tear, and in an athletic person - rehab works better for more sedentary types, or where general shoulder muscle weakness is a culprit to begin with.
The more dislocations or subluxations (dislocation means it is OUT of joint and must be put back in; subluxation means it slips out and in on its own) the poorer the long term outcome even with surgery for full return to function with minimal risk of spontaneous reccurrences down the road. Plus the more times it goes in and out, apparently the higher the risk of serious premature arthritis in the joint.
Surgery has several different approaches, but mostly they open it up, and use little staples and anchors to close the tear and tighten up the stretched ligaments and capsule. This has a pretty high success rate: "The clinical outcome was excellent in 97 patients (77%), good in 16 (13%) and fair in 13 (10%). 2 patients had resubluxation, while no patient had a complete redislocation. The average loss of range of motion of external rotation, as compared to the contralateral shoulder side was 13 degrees. 67 of 72 patients returned to sports."
However, some studies show the reduced range of motion (10-25% over several studies) can be problematic for some throwing athletes - which may be why pitchers with torn labrums are often ruined despite treatment. Interestingly, although everyone here talks about 'being back to 100% in 6 months' the Docs don't usually look at follow-up for rating full recovery until 18-24 months post-surgery - wonder if Danny's poor 2003 season was based partly on unrealistic expectations for one year after surgery - esp since his damage was far more extensive. (Wonder if Gonzo trying to compensate for a not-quite-ready shoulder threw a kink in his elbow last year.)
Anyhow, I think Richie would be nuts to risk long-term damage. This team can't go anywhere with this pitching staff, with or without him.
Do we resign him for $10-$12-$15 M a year? The stuff I'm reading at least suggests we won't absolutely know how well he's recovered till maybe 2006. Lot of money. Could buy an actual pitcher.
