What Do We Know About Wade Miley's Lat Strain?

Wade Miley’s departure on Tuesday evening was another sad injury moment for a Milwaukee Brewers team that is currently plagued with a misfiring, depleted rotation. Given the early losses of Brandon Woodruff and Aaron Ashby to underwhelming performances from Corbin Burnes and Eric Lauer, Miley was one of the few positive points for the Brewers so far this season, but he was always going to be an injury concern, at his age and with his track record.

Going off against a revived Cardinals outfit after just five outs was crushing, although the bullpen did a magnificent job of pulling them through it. It was later reported as a lat strain, so without further ado, let’s get down to it.

What is a lat strain?

The latissimus dorsi (or “lats”) are the muscles providing width in the middle of your back, connecting to the rotator cuff (specifically the subscapularis) in the shoulders. They’re used extensively in any motion where the hands and arms are extending away from the body. As such, a throwing motion heavily relies on this muscle group, and one of the best things about Tuesday night was that Miley didn’t try to pitch through the injury. Had he done so, the strain would have gotten significantly worse, very quickly. As you can see below, it is a very large muscle, and this is a more worrying injury than a pectoral strain–because of its contraction through the throwing range of motion, and because due to its size, it can be grossly overused as a stabilizer through the motion of both cocking and accelerating the arm.

Image: Wikipedia

Differential Diagnoses           

Grade One/Two Strain

A grade one strain is categorized as mild, and this would involve feeling no loss of strength in the muscle, but a nipping pain that can make it difficult to throw. Grade two is a moderate injury, with some loss in the strength of the muscle, but both are partial tears, and neither would require surgical intervention.

A grade one tear will commonly take two to three weeks to repair, which would be the best-case scenario. A grade two gets slightly longer, taking at least six weeks and probably closer to eight weeks for caution’s sake before beginning to ramp up the throwing schedule again

Grade Three strain

This is a full tear of the lat off of the tendon, and requires surgical intervention, which takes a significantly longer period of time. The hope is that Miley has avoided this by his responsible approach in alerting the medical staff. However, if he has done serious damage (usually more noticeable due to a palpable mass around the tendons), then the recovery time would be in the region of four to six months.

Comparable Injuries

Luis Severino 2019

Severino suffered a grade two lat strain on March 26, 2019. He started throwing again after six weeks, but promptly injured his shoulder due to the extra strain it had to bear. In hindsight, the lat wasn’t fully healed, and Aaron Boone confessed they should have taken another MRI before starting up his throwing program again.
He has re-injured his lat to start this season, and still hasn’t pitched (although he claims he’s ready to go).

Freddy Peralta 2022

Peralta suffered a grade two or three lat strain on July 31, 2022. He did return after six weeks, but his velocity deteriorated quickly, and the Brewers sat him down for the rest of the season after several worrying and short starts.

Grayson Rodriguez 2022

Rodriguez suffered a grade two strain on June 1, 2022, a big disappointment given he was pushing to get a call-up to the major leagues at the time. It shut him down until September that year, taking him out for three months in total.

The long and short of this injury is that it’s far better to take your time with it than to rush it if it’s a grade-two tear. The question then becomes how the Brewers will deal with his absence, and can you see an impending trade for a back-end starter that can hold down the fort?