Shohei Ohtani’s labrum surgery could delay return to pitching

SAN ANTONIO —  If you’re buying tickets to the Dodgers’ season-opening games in Tokyo next March, don’t count on seeing Shohei Ohtani pitch.

Though the Dodgers slugger is expected to be in the lineup for the start of the season — which will begin with two games in Japan against the Chicago Cubs at the Tokyo Dome — the two-way star is not expected to take the mound. It already was an uncertainty after the right-hander underwent a revision to his Tommy John surgery last year that prevented him from pitching in his first season with the Dodgers. Then came this week’s news that he needed surgery on the labrum in his left shoulder after he partially dislocated it in the World Series.

Ohtani’s shoulder procedure is not on his throwing arm and isn’t expected to have any “big-picture” impact on his ability to pitch next year, according to general manager Brandon Gomes. But it will add another complication to the 30-year-old’s offseason throwing program — and probably will push back his timeline to join the starting rotation.

“We’ll see how he gets through this phase and then take it each step by step, because it’s complicated with somebody who’s also hitting,” Gomes said Wednesday at Major League Baseball’s general managers meetings. “So we’re just gonna make sure we’re checking every box to make sure he’s in the best possible position health-wise. And then whatever falls out of that smart, methodical process will be what it is.”

Ohtani’s chances of being ready to pitch on opening day rotation were narrowed during the playoffs when he and the team decided to delay the completion of his rehab until after the season. Entering October, Ohtani was nearly ready to face hitters for the first time since his September 2023 elbow surgery. He’d progressed enough to be throwing bullpen sessions regularly. But wary of overtaxing Ohtani during his first postseason, the team elected to wait until the winter to have him face hitters again. And now his surgery recovery has thrown another wrinkle into those plans.

“We’re going to take it piece by piece and get through this … and not say, ‘Hey, we need to be ready by this day,’” said Gomes, who stopped short of ruling Ohtani out of pitching by opening day but did not cast an optimistic picture of that possibility.

The specifics of Ohtani’s recovery process aren’t clear. But in an interview with The Times on Wednesday, orthopedic surgeon Paul Rothenberg, director of sports medicine and shoulder surgery at Optum Orthopedic Institute, offered insight into the standard rehab for most labrum surgeries.

First, patients go through a period of “immobilization” of roughly four weeks, Rothenberg said, during which time the shoulder should be subjected to only “very controlled movement” and often is kept cradled in a sling.

“Early recovery is just kind of maintaining the range of motion, dealing with the inflammation, dealing with the pain, and doing it in a controlled, very specific fashion,” Rothenberg said, noting he advises his patients against even running during that stage of recovery. “So that you’re not putting undue stress on the surgery that you just performed.”

After that, the rehab focuses on allowing the athlete to regain full range of motion in the shoulder. At the 10-to-12-week mark, they can begin strengthening that part of the body again.

Rothenberg described Ohtani’s case specifically as a “decent situation” since the injury wasn’t to his throwing arm. Had he hurt his right shoulder, he might not have been able to throw again for four to six months.

“[That] would have been really bad,” Rothenberg said, “considering he’s already had elbow surgery.”

Given the need to protect the shoulder early in the recovery process, the team’s pitching plan for Ohtani “will look a little bit different now,” Gomes acknowledged. “But the positive thing is that, as far as big picture, no real concern on that end.”

A delayed start to Ohtani’s 2025 season as a pitcher might not be a big issue either. Coming off his elbow surgery, Ohtani probably was going to be on a restricted workload anyway. Though Gomes didn’t specify any innings limit, he noted that the main focus is on having Ohtani “at his peak come the biggest games of the year,” ostensibly in October.

The Dodgers’ hope is that Ohtani won’t be compromised at the plate, since the injury, which he suffered after jamming his arm into the ground on a slide into second base, occurred to the back shoulder in his swing.

“It’s just far less of a concern of how violent any of that would be as opposed to if it were the other [shoulder],” Gomes said.

Rothenberg agreed.

“For him, [it’s good] it’s the top hand, and not the one where in the follow-through of the swing you can sometimes fling the bat over your shoulder, because that would be the one motion where it would potentially irritate a torn anterior labrum, just that motion,” Rothenberg said. “For me, the fact that he’s a lefty batter, and it’s his left arm, the range of motion required to perform that motion, he should have it. And he should have it without any significant due stress on what was done. So in my opinion, I think he should be OK.”

The Dodgers are familiar with the opposite example.

In the 2020 postseason, outfielder Cody Bellinger suffered a similar shoulder dislocation and labrum tear to his right shoulder and underwent surgery in the offseason. Bellinger was in the opening-day lineup the next spring but struggled mightily through the 2021 and 2022 seasons, a period during which his agent, Scott Boras, said the former National League most valuable player was playing with “a 35% strength deficiency” because of the injury to his lead shoulder.

“These guys are Ferraris,” Rothenberg said. “If you’re a little bit off, it makes a difference.”

The Dodgers are hopeful Ohtani won’t endure any such regression and that the impact of his surgery will be minimal.

“He had his surgery, and his prognosis is really good,” Gomes said. “We expect him to be ready for spring training.”

As a hitter, at least.