BALTIMORE — Carson Smith’s Red Sox career may well be over after a combined 31 appearances for Boston in parts of three seasons, including one postseason. As the righty reliever prepares for shoulder surgery on Wednesday in New York, the more pertinent question is how difficult will it be for him to return to the major leagues at all?
Smith, 28, saw his season end on May 14 when he slammed his glove in frustration on the Red Sox bench and suffered a right shoulder subluxation. Nearly a month later, Smith is set to undergo surgery to fix anterior instability in the shoulder. The extent of the surgery and projected length of the recovery won't be known until the operation is underway and completed, but some labrum damage is known to be present.
- MORE DRELLICH - Cora and Nunez turn a tight one into a laugher
"The capsule is one of those things that may be in question," Red Sox head athletic trainer Brad Pearson said Tuesday. "But any time you go in there, you're going to evaluate the rotator cuff, too. That's something the surgeon will do."
This is the second major arm operation for Smith, who underwent Tommy John surgery in 2016, his first year with the Red Sox. Sox president of baseball operations Dave Dombrowski traded for Smith ahead of that season, sending pitchers Wade Miley and Jonathan Aro to the Mariners in a deal that also brought Roenis Elias to the Sox.
“Any shoulder injury isn't a good injury,” Smith said when he spoke to the media the day after he was hurt. “Elbow's one thing. Shoulder’s something you don't want to mess with. I'm concerned.”
Dr. David Altchek is to operate on Smith at Hospital for Special Surgery in New York on Wednesday, manager Alex Cora said.
“Always difficult with the labrum as well, because there's chronic labral tears and there's acute labral tears,” Pearson said Tuesday. “Differentiating what was new and what was old is something the surgeon will evaluate. But he does have some labral tearing and it's really up to the surgeon to decide what to fix to add stability to the shoulder, but what to fix to allow his shoulder to still move functionally in a way that a baseball player needs it, which is a really important piece to the puzzle. If you don't have the right range of motion you can stiffen anybody's shoulder up with surgery, but the real art to it is being able to achieve all the great range of motion that they typically have.”
- MORE SOX - Top pick chooses Red Sox over U. of Miami
The Sox can non-tender Smith after the season, making him a free agent.
Boston Red Sox
Pearson highlighted that he believed the injury to be a freak happening. Smith said he took full responsibility for the injury when he spoke to the media in May, but he also said he thought his shoulder was generally tired from pitching, which implied that usage contributed to his injury.
“He had done a really good job with all his [elbow] rehab up to that point, including making his shoulder strong,” Pearson said. “I think it's a freak thing. It's unfortunate that it happened. Who knows where his arm was in space when he was throwing. Sometimes most of the injuries happen on the awkward plays. I would classify this as an awkward motion, and just bad luck.”
Smith had at least three different doctors give an opinion on how to best proceed.
“We wanted to do our due diligence and make sure we had a pretty clear understanding of what damage had been done to his shoulder,” Pearson said. “Taking a pitcher out of the season and doing a shoulder surgery is not something anybody wants to do lightly. I think everybody pretty much had consensus that there were suspicions of anterior instability, and any time you're looking at a situation like that, the rehab outcomes are not quite as tolerated as you would hope for. So after a lot of deliberations and discussions and most importantly talking to Carson and what his desires were, I think surgery seemed like the right option. That was the consensus of all the doctors.”
- MORE SOX - Was Swihart-for-Hanley an error?
If Smith's time with the Sox is over, he finishes with a 2.66 regular-season ERA for the team in 23 2/3 innings.
NBC SPORTS BOSTON SCHEDULE