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How Ryan Zimmerman’s shoulder injury affected his throwing

John McDonnell / The Washington Post

Ryan Zimmerman heard the same question a lot this season, and he always had the same answer. How is the shoulder feeling? Fine. No pain. Nothing that will keep him out of the lineup or affect him on the field.

Now that Zimmerman is no longer in heat of a playoff race, equipped with hindsight and four weeks into a smooth recovery from arthroscopic surgery, his answer has changed.

He kept the pain in his aching shoulder at bay with a series of cortisone shots – a procedure that saved him at least of a month after he came perilously close to in-season surgery. The medication also masked a mangled shoulder that, Zimmerman can say now, changed the way he threw at third base.

“It was obviously affecting me, but I couldn’t really feel it,” Zimmerman said. “It was so jammed up in there, I couldn’t do things like I normally do.”

The damage in his shoulder, Zimmerman said, hindered his oft-scrutinized throwing mechanics at third base. His ailing shoulder led to inconsistency he had never previously endured. One day would feel normal. The next would feel off.

“Physically, I couldn’t tell because nothing hurt,” Zimmerman said. “Mentally, I knew something was happening. I felt like I was a lot more consistent of a player. I’d go through times where I was fine, and I’d go through times where I was absolutely horrible.”

When Zimmerman underwent surgery Oct. 25, the procedure cleaned up several parts of his shoulder. “It was all jammed up and gunked up in there,” Zimmerman said. He had no structural damage in his labrum or rotator cuff, but he had had minor fraying in both. Zimmerman had a bone spur on his collarbone that needed to be shaved down. The major damage was in his AC joint, which had nearly closed completely off, he said.

Zimmerman knew all season he would need surgery. In April, he dove into home plate and exacerbated pain he had been feeling in his shoulder. He rested on the disabled list for 14 games, but when he returned he was not himself, and the strength in his shoulder dissipated. His batting average dropped to .218, and his power dried up.

On June 24 in Baltimore, Zimmerman told Manager Davey Johnson and team medical personnel, “We have to do something or we have to fix it. I’m hitting third and I’m basically an out.”

The Nationals’ medical staff, led by head athletic trainer Lee Kuntz and team physician Wiemi Douoguih, decided on a final measure to keep Zimmerman on the field: a cortisone shot. That day, he swatted two hits. For the remainder of the season, he clobbered the ball as well as any National League hitter, posting a .321/.383/.584 line.

Zimmerman’s season almost never happened.

“If that shot in Baltimore didn’t work,” Zimmerman said, “I was going to have to get this [surgery] done during the season.”

Zimmerman understood the risk of a cortisone shot, which masks pain and, therefore, allows a player to damage joints and ligament as he plays through pain that otherwise would have been debilitating. But after playing through six losing seasons, he refused to watch as the Nationals contended for the first time and, ultimately, captured the best regular-season record in the majors.

“It would have been devastating for me not to be out there,” Zimmerman said.

Zimmerman credited the Nationals’ medical staff for finding the right balance and allowing him to play.

“It’s a slippery slope,” Zimmerman said. “You can only give so much medicine or so much drugs without worrying about the future. I have more than a year or two left. They had to obviously worry about the future as well.”

As Zimmerman thrived at the plate, he frequently struggled in the field. He overhauled his throwing mechanics to great effect in 2011. But in 2012, despite the stint on the DL, he made 12 throwing errors, second-most in the majors among third basemen. He never felt pain in his shoulder. But the myriad bone chips and fraying in his shoulder prevented his arm from working like he expected it to.

“When you guys were asking me if I felt fine, I was being honest,” Zimmerman said. “Mentally, that was the most frustrating part – waking up and not knowing if it was going to be a good day or a bad day.”

Zimmerman is four weeks into a rehab process that should take eight weeks. He has started exercising – core work, cardio and light lifting for now – and will be able to throw again in a couple weeks.

In the wake of his surgery, Zimmerman’s ability to find a consistent throwing motion could help define the shape of the Nationals roster in coming seasons. Zimmerman signed a six-year, $100 million contract extension before last year that starts in the 2014 season. His throwing struggles last season led some to wonder if he would have to move across the diamond to first base.

The Nationals’ top hitting prospect, Anthony Rendon, also plays third base, and his advanced offensive game could have him ready for the majors by the end of 2013. Already, the Nationals are shy about re-signing first baseman Adam LaRoche to a contract of more than two years, partly because they want to keep first base flexible.

Both the Nationals and Zimmerman hope that with a full year with a repaired shoulder, his throwing will match up with the rest of his defense, which remained excellent. Zimmerman will be fully healed and prepared by spring training, at which he can say his shoulder no longer affects him and really mean it.

As for what happens between now and then, Zimmerman feels confident about where the Nationals stand. He said he and his teammates share the same sentiment as most Nationals fans: He would like to see LaRoche re-signed.

“LaRoche is the guy that everyone is talking about,” Zimmerman said. “I think all of us would love to have him back. This is the part where it gets down to business decisions. And I know Rochie wants to get back here. I think Adam makes us a better team.

“Adam has put himself into a very good position with the year that he had. You only get so many years to cap in this game, and you have to do that. We all understand that. It’s still very early in the winter. He doesn’t have to make any crazy decisions yet. I think we would all like to have him back.”