"As I'm taking these steps forward, I have to tame the beast, because as much as in my mind, I know what I am going to be able to get to, I want to get there faster than I'm probably capable of getting there," Smoltz said.
The fact that Smoltz has been on the disabled list eleven times before, including missing the entire 2000 season after Tommy John surgery, has prepared him to take the long view. Right now, rehabbing is his job and he's working at it full time with the hope of returning to the mound perhaps as early as May. He's not punching a clock, but he's definitely following a schedule -- something that Kathy Shillue, a Physical Therapist at Beth Israel Deaconess Medical Center, advises all of her patients to do.
"Sometimes we have to tell patients who are rehabbing after an injury to slow things down," Shillue notes. "There are a few who have a hard time grasping the concept that pushing things to the limit can do more damage -- especially after surgery."
Shillue would like all of her patients to understand that rehabilitation is a process and that the process can range from relatively simple to quite complex depending upon the injury and the repair.
"Let's take a labral repair, as an example," she explains. "First, you have to let the tissues heal, which may require your arm to be immobilized for several weeks. Now you have to address the loss of muscle tone and rebuild the strength in a way that stabilizes the joint, but doesn't jeopardize the repair."
While pushing too hard can push back recovery, sitting back and doing nothing has consequences, too. Rehabbing is also about regaining full function and range of motion. That's a goal which can only be accomplished with an exercise and treatment plan based on a patient's specific condition. Supervised rehab is best but not always possible, admits Shillue.
"Professional teams have large training and rehab staffs that most of us will never have access to," she says. "There are insurance issues and co-pays that impact people's ability to access supervised rehab. Some people, especially in today's economy, cannot afford to take any time off. In those cases, we teach people to do as much as they can on their own and check in with us as the rehab progresses." She pauses, and adds, "then, there are the golfers."
"Well, not all golfers," chuckled Shillue, "But it does seem that they are among the worst offenders when it comes to pushing things. They won't stop playing even when I try to explain that taking time off will actually help their swing!"
Well John Smoltz (who is an excellent golfer, by the way) would be happy to accept that as an added benefit of his layoff. And if the same goes for his throwing arm, there'll be a lot of swinging and missing for Sox opponents.