David Chao, MD: Shoulder Surgery For Fernando Tatis Jr. A Matter Of When, Not If.

On Monday, young Padres superstar Fernando Tatis Jr. exited the game against the Giants after a swinging strike. 

By video, he appears to have subluxed his shoulder again, and it seems surgery is in his future. 

He initially held his wrist/elbow to support his shoulder. The follow-through of the bat hitting his scapula did not cause the injury but indicates that when the shoulder shifted, the shortstop had no power to slow down the follow-through of the swing.

This is Tatis, Jr.'s second exit for a left shoulder issue in two weeks. The Padres called it shoulder discomfort when it first occurred, but by video it was a shoulder subluxation with labral tear back then as well. My video analysis thoughts have been confirmed by the main baseball beat reporter in San Diego. 

And the team has confirmed them as well.

The only good news is that this is not a new injury. The team knew about it and knew that it would come and go through the years. The Padres were confident enough in the shoulder to reward Tatis Jr. with a "lifetime" 14-year $340 million contract. The plan seemed to be to have him play through it, as he has in the past. That may change now.

The bad news is he has now had two episodes of shoulder instability in under two weeks. That they happened on routine plays and in different ways (fielding and swinging) makes it worse. The easier a shoulder comes out of socket, the more likely that it will again. It is inevitable that it will shift again. Typically, arthroscopic surgery to repair the labral tear is the only permanent solution, but rehab and a brace could help get him through some games.

Another MRI is likely coming. If the tear is the same size, the team and player could choose to rehab the shoulder and try to finish the season before fixing it. If the labral tear is bigger, he will likely have surgery so as not to risk his future.

Surgery would mean a six-month recovery timeline and his season would be over. 
Certainly, no one wants to jeopardize the future of this young player. The team and player are aligned here with a long-term, big money contract. The decision will be a joint one. Surgery is in this young man's future, the question is when.

I am pulling for Tatis. As a San Diego Padre, he is my kids' favorite player and we were there to watch him on Opening Day.