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Phillies team doc 'cautiously optimistic' about Doc's return

Phils team physician Dr. Michael Ciccotti answers questions about Roy Halladay's surgery, recovery and rehab.

A day after Roy Halladay had successful arthroscopic surgery on his right shoulder, the Phillies made their team doctor, Michael Ciccotti, available to the media. Ciccotti briefed everyone on the procedure and the (long) road ahead in Halladay's recovery.

Ciccotti said once Dr. Neal ElAttrache went through the procedure in Los Angeles, the issues inside Halladay's shoulder were what the physicians had anticipated after last week's MRI.

"So it really was the best-case scenario in our minds," Ciccotti said of a procedure that involved having his labrum and rotator cuff repaired. "Roy is feeling good."

The team projects that Halladay could begin a throwing program in 6-to-8 weeks.

That might be possible, but is it probable? Is there a chance Halladay won't pitch at all for the remainder of 2013? And what's with all that turning back the clock stuff?

Here are highlights of Ciccotti's Q & A session with the media regarding all things Roy Halladay:

Q: Is three months a fair timetable for his return?

A: That's our progression. And given what was identified at the time of the arthroscopy and the procedures that were done, again because he didn't have any sutures placed, that is very possible. But there are a lot of ifs between now and then. Does he get his motion back? Does he feel strong again? How is he when he is throwing a ball? There are a lot of things between now and then that might prevent that from happening. But we remain cautiously optimistic about it.

Q: What's the worst case? Is it possible he doesn't pitch again this year?

A: That's very possible. The combination of a rotator cuff injury and a labral injury is a challenging injury for a professional pitcher to navigate through. But again, given when was identified at the time of the arthroscopy, that he had fraying of those structures, but not detachment, not tearing, and given the kind of athlete that Roy is and the kind of person he is, he's focused and dedicated and motivated and hard working, those are the things you put together that are most likely for success.

Q: There was a chance once you went inside his arm things could have been worse. So sense of relief that didn't happen?

A: Certainly there's a sense of relief that he didn't have an injury to the degree that would require suturing. Because again that's a real challenging for a professional pitcher to get back from when you have to repair both a labrum and a rotator cuff. So certainly there's a sense of relief, but again there are lots of ifs along the way between now and him being back on a mound in a game."

Q: What's the biggest obstacle Halladay faces in trying to return this year?

A: "There are actually a variety of obstacles. Number one, will he get his full range of motion back. Because for a professional pitcher to throw a ball with the velocities that make them successful, they need to have a certain arc of motion. So certainly him getting his full range of motion is important. Also being able to throw the ball at that velocity is dependent upon his strength. And he's had some weakness recently, probably the inflamed bursa was a part of it, so getting his strength back. And then all that happens from that point on, when he starts a tossing program, his ability to locate the ball confidently."

Q: With all of that, is it realistic to expect him to be back on a major league mound by September?

A: It's very possible. It is very possible. (Reporter interjects: But not overly optimistic?) Well, we remain cautiously optimistic about it. And given the person that he is, the motivation that he has, the dedication that he has, he has all the intangibles that are important in getting someone back, but we're realistic about it, too, that it is very possible that he is not pitching at the level that he wants or what Phillies fans and his teammates deserve him to be pitching at.

Q: But could be benefit in the long run with more time down, or in being shut down for remainder of season?

A: That is very possible. And as we bring him through this rehab program, we're going to be very careful with him. He's a big part of this. How he feels, how confident he feels. Roy wants to pitch at a certain level. We know him. We know the person he is. He really feels when he steps on that mound that he deserves to perform at a certain level. So that's going to be a big part of it. So we're not going to push him.

Q: Roy said last week Dr. ElAttrache told him he could turn back the clock for him. How does that work?

A: If he recovers from what was found and his rehab goes smoothly and he's confident, the hope was he would be able to feel the way he did before the most recent onset of pain. Rolling back the clock is something that is virtually impossible to do for any of us whether we were elite level athletes or not. The translation of that is making him feel comfortable enough so he can be effective."

Q: Why not just shut him down for the rest of the year?

A: We are going to be so careful with Roy Halladay and Roy wants to be a part of this team, but he needs to meet certain milestones along the way before he can progress to the next level. If he does that, if he achieves his range of motion and if he's strong … and if he progresses to a very specific throwing program … he has to pass each of those tests along the way. If he doesn't pass them in a way that we're comfortable and he's comfortable, then we're not going to allow him to go out on a mound and pitch the way he would not want to pitch.