Major League Baseball

What to expect from San Diego Padres star Fernando Tatis Jr. in return from injury

Updated Jul. 21, 2021 3:23 p.m. ET

By Dr. Matt Provencher
FOX Sports Injury & Performance Analyst

Fernando Tatis Jr. has taken baseball by storm since he reached the major leagues as a 20-year-old in 2019.

The electric shortstop played so well both offensively and defensively that the San Diego Padres rewarded him with a 14-year, $340 million contract in February.

As such, it’s understandable that baseball fans gasped when Tatis crumpled to the dirt in pain after a swing April 5 against the San Francisco Giants.

It was frightening to watch, but it isn't the end of the world. In fact, Tatis is expected to be activated from the 10-day injured list for Friday’s game against the Los Angeles Dodgers, the first day he’s eligible to return.

What happened?

Looking at the video of the injury, what I see is a right-handed hitter taking a vicious, solid swing. He misses the ball, and as his right hand lets go of the bat, his left arm moves into an externally abducted position, with the left shoulder rotating beyond its normal range of motion.

Tatis immediately goes down in a lot of pain. There's clearly something wrong with his left arm, and as he walks off with the trainers, he holds it in a way that suggests he is trying to protect his shoulder joint.

Tatis’ motion on this swing would put a lot of strain on the front of his labrum, which is the thick piece of tissue that holds the ball of the shoulder joint in place. The Padres said Tatis suffered a "slight" labral tear on what they called a partial shoulder dislocation, and there might have been damage to other parts of the joint as well.

Why does it matter?

The left shoulder is crucial for a power hitter and shortstop such as Tatis.

At the plate, he needs shoulder joint control to give him lead-through power when he hits the ball. As a right-handed defender at shortstop, he’s going to need that glove hand — and the accompanying left shoulder — to reach and stab for the ball, either above his head or out to the side. He will also find instances in which he will be reaching and diving, and his arm will go into a forced abducted external position.

Tatis has dealt with shoulder issues as far back as 2016 in the minor leagues, and team officials have acknowledged that Tatis has had "three instability issues" in the past month. This could mean labrum issues, this could mean a partial strain of the rotator cuff, and this could even mean a strain of the subscapularis muscle at the front of the joint. Regardless of the specifics, his shoulder joint has been implicated before.

His vicious swing April 5 might have significantly aggravated something that was preexisting, possibly with a Bankart tear, which is a specific injury that can occur to a labrum when a shoulder pops out of joint.

How does rehab work?

The injury presented the Padres with a dilemma. They could have Tatis undergo surgery to repair his shoulder, which would put him out of action for an extended amount of time, or they could have him undergo rehab and hope he can make it through the season.

It’s obvious why the Padres opted for rehab, as surgery would have forced Tatis to miss four-to-six months – the majority of the season, if not all of it. Even then, it would have been a lot to ask for him to be in prime playing shape for the playoffs or even the World Series.

Rehabbing the shoulder, on the other hand, can work. It typically takes one-to-three weeks to return from a labrum strain, so Tatis’ 10 days off fit into that window. As long as he meets strength requirements and range of motion requirements and is able to execute provocative maneuvers, he should be able to play.

The Padres are probably putting him through a number of other tests – apprehension testing, surprise testing, relocation testing – that are important. As long as his responses are reasonable, he can return to the lineup.

I would say to watch closely to see how his arm behaves in space when he's catching, to see how he moves it, to see how his swing looks and how his follow-through looks. That'll give you a good indication of the magnitude of the injury and how his recovery is going.

Could this happen again?

With or without surgery, once you disrupt your native anatomy, there's always a predisposition to it happening again.

With a lead batting arm and a lead fielding arm, the shoulder will be put in provocative positions quite a bit. What I mean by this is that the joint will often be put in a position of abduction external rotation that puts stress at the front of the rotation.

We often like to stabilize an injury such as this immediately through surgery, but the Padres want their star on the field. They can do their best to strengthen the muscles around the joint to keep everything in place and as stable as possible and, hopefully, keep Tatis in the lineup. It also might help that the team is trying to have Tatis keep both hands on the bat on the follow-through of his swing.

But rehab will not repair the labrum. Only surgery will do that. It's one thing when someone who is just a weekend warrior has this injury. It’ll be harder for someone who swings with that kind of power and has to do other activities such as diving for a ball to get through this without needing a procedure.

Without surgery, there is a 50-70 percent chance that Tatis will hurt his shoulder again this season, so he could be back on the injured list at some point this summer. If Tatis opts for surgery in the offseason, the likelihood of his reinjuring the shoulder diminishes significantly to 5-10 percent. That’s a big difference.

Offseason surgery might be a good idea, and though the months Tatis would need to recover might keep him from being ready for the start of next season, an offseason of working really hard and being totally focused on rehab should make it close.

What is the long-term prognosis?

We know from 25 years of data that you can return to a very high level of athletics in the NFL, Major League Baseball and the NBA after a shoulder stabilization procedure and perform at basically the same level.

There could be some impact on Tatis' performance in the first year after surgery. His fielding arm might lack flexibility and range of motion, and his hitting power might be a little bit diminished.

But with good rehab and a successful offseason program, he's going to be fine, and production should return to normal by the second year back. Flexibility, strength and other therapies will be key from the team’s athletic trainers.

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