Shoulder experts speak: Is Andrew Luck on schedule?

Zak Keefer | IndyStar

Show Caption Hide Caption Chuck Pagano: Andrew Luck is 'doing great' Indianapolis Colts head coach Chuck Pagano says Andrew Luck is rehabbing every single day and doing everything but taking snaps.

INDIANAPOLIS – He’s noticeably thinner than before, maybe 10 pounds slimmer, maybe more. He’s relegated to watching practice these days, to instructing, encouraging, even coaching. Inside, it’s gotta be killing him, right? Andrew Luck is a quarterback who craves every single snap, even in the dead of summer. In years past, his Indianapolis Colts backups have complained that months would pass without them ever sniffing a first-team repetition.

Now things are different. Now they’re getting all of them.

It’s been nearly six months since we’ve seen Luck throw a football, five since the state’s most valuable appendage – that right arm of his – went under the knife. In six weeks, the Colts will commence training camp for the 2017 season, with or without their $140 million quarterback on the field. In 12 weeks, they’ll play a game that matters.

Outside the cocoon of team doctors and physical therapists working with Luck on a daily basis, the status of his recovery from January surgery remains an enigma. True to form, Luck has leaned on the vague and the vanilla when probed for updates.

“Feeling great ... rehab is going well ... it’s a long and patient process,” was all he would say last week at the team’s town hall event. “When it’s time, he’ll start going,” adds his coach, Chuck Pagano.

So much for clearing things up.

MORE LUCK: Still not throwing after 5 months

MORE COLTS: Irsay wants multiple Super Bowls

What we do know: Luck underwent an outpatient procedure to fix a lingering issue in his throwing shoulder in mid-January. Colts owner Jim Irsay stressed last week it was a “simple labrum repair,” offering that Luck is “healing tremendously” and that “the surgery has been a positive thing, not a negative thing. ... This was, quite frankly, not that complicated of a surgery. There are a lot of other things that could’ve gone into that type of surgery that weren’t involved at all.”

What we don’t know: When Luck will be ready to hit the field again, and how his arm will respond when he does.

The Colts have wisely resisted placing a target date on Luck’s return simply because they don’t know when that’ll happen. Pagano noted last week that Luck has yet to begin throwing – and, in reality, he might not for several more weeks.

The team is taking the longer view. This is an injury, remember, that lingered for more than a year and a half. It required pain-killing shots before games in 2015. It required off-days every Thursday during the 2016 season. Eventually, it required surgery. The Colts want this shoulder healed, once and for all, and they’re willing to wait to ensure it does.

The franchise’s fate over the next decade could depend on it.

“No pressure on Andrew – none,” new General Manager Chris Ballard said this spring. “I want to do what’s right for Andrew and his career. We’re not going to force Andrew Luck and put a timetable on him and say, ‘You have to be back by this time.’ This is a team game, and it’s our job to put enough around him and find a way to get it done if he’s not in the mix. And if he’s not ready right away, we’ll move forward.”

But, five months into what is expected to be a six-to-nine month recovery, where should Luck be at this stage? What, exactly, is happening inside that oh-so-important-appendage? And what’s up with Luck’s noticeably thinner appearance?

Discussions with multiple shoulder specialists indicate one thing: There is no cause for concern. Yet.

“People are probably worried, he had a labrum repair and he’s not throwing five months later, but that is not alarming to me at all,” said Dr. Brian Schulz, a sports medicine surgeon at the Kerlan-Jobe Clinic in Los Angeles. (Schulz did not treat Luck but is familiar with the surgery and its recovery.) “There’s no point for the team to push him with the season still a few months away.”

Dr. Jamey Gordon, a physical therapist and certified athletic trainer for Indianapolis-based St. Vincent Sports Performance who also did not treat Luck but is familiar with the operation, explains it this way: The labrum is a ring of cartilage encircling the shoulder. Picture a clock. A healthy labrum shoots straight up – 12 o'clock. A partially-torn labrum, like Luck’s at the end of last season, is peeling back a tad.

“How far did it peel back? One o’clock? Two o’clock?” Gordon said. “That’s how you find out how severe the tear was and how long it will take to heal.”

By Irsay saying Luck’s surgery was a “simple labrum repair” and that “there are a lot of other things that could’ve gone into that type of surgery that weren’t involved at all,” Gordon is inclined to believe the bicep muscle wasn’t torn as well.

Also, consider: Luck started 19 regular-season games after originally suffering the injury and last fall seemed in no way limited on the field. The fact that he was cleared to play, missing only one game in 2016 due to an unrelated concussion, indicates to Schulz that the tear wasn’t that severe.

“A simple labrum tear would mean they only had to deal with the labrum; that’s what I would read into that,” Gordon added. “That means they didn’t have to deal with the humerus or biceps tendon or rotator cuff or anything like that.”

For comparison’s sake, Carolina QB Cam Newton underwent surgery on his throwing shoulder this offseason to repair a partially-torn rotator cuff. The Panthers have said they expect the former MVP to be ready for the start of training camp. New Orleans’ Drew Brees is the most visible quarterback to undergo labrum surgery in recent years: Famed surgeon Dr. James Andrews repaired Brees’ complete labrum tear in 2006. Brees has since said the operation saved his career.

But every shoulder heals differently. As for Luck, if the humerus, bicep or rotator cuff indeed weren’t involved, that means less recovery time, in theory at least. If the surgery was successful – Irsay has said it was – then Luck’s labrum is healed by now, Gordon believes. At this point, the objective is to gradually rebuild the range of motion and strength in his arm. It is a process that requires several months.

While Pagano revealed last week that Luck is still not throwing a football, Gordon points out that he could very well be throwing other objects as part of his rehabilitation.

“Or maybe he is throwing the football and they just don’t want it out there,” Gordon said. “They said he’s not throwing, but given the nature of them not wanting this out for public information, he still could be, just behind closed doors. What about tennis balls? Weighted balls? Underweight footballs? He could have started his throwing progression by now.”

Central to getting Luck on the field for the team’s Sept. 10 regular-season opener in Los Angeles: how his arm responds when he does hit the field in training camp, which begins the final week of July at the team’s West 56th Street facility. Both Schulz and Gordon agree Luck’s workload will begin modestly, with drills “that would be laughably easy for people who didn’t have surgery,” Schulz said. “He might throw one day, then take a day or two off. If his arm feels good, he’ll keep going. It’s all about how the shoulder responds. It may feel a little tighter than before, but the reason he had surgery is because it was probably a little loose.”

What Gordon would be looking for if he was monitoring Luck at that stage is his throwing motion. He said he expects the team to bring Luck along cautiously – 40-50 passes a day, tops – and routinely give the quarterback off days to rest his arm as it regains its previous strength.

“Is he throwing the same way he did before?” Gordon said. “If his motion is normal, that’s a very, very good sign. If he’s not throwing normally, then you have a problem.”

Critical here is how the shoulder responds to the increased workload. If it gets weaker, Schulz noted, that’s a red flag. If it bounces back and Luck is able to increase his practice regimen as the weeks pass, all signs point to a full recovery.

“At that point, you’re relying almost strictly on the thrower and how he says it feels,” Schulz said. "And no one will know him better than the team doctors."

And what about Luck’s seemingly thinner appearance? Gordon said it’s sometimes normal post-surgery and could even be on purpose.

“That’s probably more under his control,” Schulz added. “Maybe he’s on a different kind of diet.”

The Colts will hit the field this week for a mandatory three-day minicamp, then break for a six-week hiatus before training camp opens. Backup quarterback Scott Tolzien has taken the majority of the first-team snaps throughout the spring. Whether he does so when training camp opens remains to be seen.

For now, everything rests on that surgically-repaired $140 million right arm and how it responds in the coming weeks and months.

Call IndyStar reporter Zak Keefer at (317) 444-6134. Follow him on Twitter: @zkeefer.