KC Royals reliever Luke Hochevar was diagnosed with thoracic outlet syndrome on Friday. Hochever will seek a second opinion, but is expected to miss the rest of the season.
According to the Cleveland Clinic website, thoracic outlet syndrome is actually a group of disorders that can involve nerves or blood vessels getting compressed between the collarbone and the rib cage. While the exact cause is unknown, it’s a common injury for people who play sports that involve repetitive arm movement—which perfectly describes a baseball player.
KC Royals pitcher Chris Young suffered from this problem for years before finally getting diagnosed in 2013. Young became the Comeback Player Of The Year for the Seattle Mariners in 2014, and went 11-6 with a 3.06 ERA for the Royals in 2015 before crashing this season.
Oddly enough, only 10 to 20 percent of patients require surgery to recover. Most can overcome the problem through a course of physical therapy. However, most patients with thoracic outlet syndrome involving blood vessels (veins or arteries) will require surgical repair. This is likely the reason why Hochevar is seeking a second opinion. He probably would like to avoid surgery.
Surgical repair is risky. Medscape.com states:
"Success rates for surgery vary dramatically in the literature. One review of 47 patients with thoracic outlet syndrome revealed 75% lower plexus and 50% upper plexus compressions remained asymptomatic at 4.6 years. Morbidity in this study involved 17% of patients and was most frequently the result of incisional pain. However, not all studies have been so impressive. One retrospective analysis of patients with nonspecific neurogenic thoracic outlet syndrome demonstrated work disability at 1 year after surgery in 60% of patients. At 4.8 years of follow-up, 72.5% patients were limited in activities"
Luke Hochevar is the second player in the Kansas City Royals organization to come down with thoracic outlet syndrome this season. Perennially injured prospect Kyle Zimmer was diagnosed with thoracic outlet syndrome earlier this month and elected to undergo surgery.
Whatever the results of Hochevar’s second opinion, his shoulder injury kills any interest that deadline buyers might have had in making a deal for him before August 1.