On Thursday afternoon, Orioles interim manager Tony Mansolino was solemn as he sat before the media and spoke about the news that closer Félix Bautista had undergone shoulder surgery to repair a torn rotator cuff and a torn labrum.

It’s a procedure and recovery that Mansolino knows well — he had labrum surgery when he was a minor league player. But he wasn’t a pitcher, a position that requires more strain on the shoulder than any of the others, and he knew by that point that his future probably wasn’t as a player.

Bautista isn’t in the same situation. One of the best closers in the game two years ago, he is staring at a recovery period of 12 months or more, and that’s only if everything goes as planned, a major variable with shoulder surgery.

“He’s handling it as good as he can,” Mansolino said. “It’s just tough circumstances. We feel for him.”

The odds that Bautista will even make it back and be the same pitcher that he was before surgery are low but not zero.

He’s already completed one grueling comeback. In August 2023, Bautista was coming off his first All-Star appearance and had a 1.48 ERA with 33 saves when he tore his ulnar collateral ligament. He underwent Tommy John reconstructive elbow surgery and missed the 2024 season.

Bautista returned this season, regaining his closer role and inching closer with each outing to being the powerhouse he was before the surgery. But in July shoulder pain crept up and further evaluations necessitated the surgery.

Bautista now faces another daunting recovery — one that has taken out many elite pitchers. Ben McDonald is one of those. He played nine major leauge seasons, including seven with the Orioles, before labrum and rotator cuff surgery ended his career.

“The reality is, we may never see him again,” said McDonald, who is a color commentator for Mid-Atlantic Sports Network.

Although the timelines for Tommy John and shoulder surgery are both estimated to be about 12 months, the success rate for the elbow procedure is high.

Dr. Mohit Gilotra, an orthopedic surgeon at the University of Maryland Medical Center who specializes in shoulder and elbow repairs, has not evaluated Bautista or seen his imaging, but he has treated other pitchers. He spoke broadly about the recoveries from the procedures.

He estimates he’s had 80 to 90 pitchers return to baseball after an elbow surgery.

But for shoulder surgery? That number is fewer than five, and those were minimalistic approaches such as a cleanout, not the repair of a tear like Bautista had.

“Elbow success rate is way higher,” Gilotra said. “The return to play is over 90% and for shoulder is much lower. Us as doctors, we’re more hesitant to do the surgery, knowing that the success rate is much lower. It’s not the same as the elbow. It’s much worse.”

That’s because of the range of motion required to be a pitcher. A normal shoulder reaches about 90 degrees of external rotation, about the position someone would lift their arm to give someone a high five. A pitcher can bend his arm back further — it’s part of what makes the players so special — but it can cause the rotator cuff and labrum to smack against each other and peel each other back, causing tears. It’s almost like peeling off a Band-Aid, Gilotra said.

In a repair, the shoulder has to be tightened to prevent retearing, so a pitcher may never regain that abnormal range of motion that makes him special, Gilotra said. And, without that, Bautista, who could top 100 mph both before and after Tommy John, may not be able to throw as hard as he did prior to the surgery. That could greatly impact his results.

“Flexibility creates velocity in the shoulder,” McDonald said. “Typically, the more flexible you are, the more velo you can create. I never got the range of motion back in my shoulder. Most guys, and this is tough to say, but most guys are not the same after those types of surgeries.”

In a best-case scenario, Bautista will spend the first six months of his recovery regaining range of motion and strength. Then, Gioltra speculated, he’ll pick up a baseball and begin a throwing progression.

And there are success stories to look at, such as Chris Carpenter, who had two surgeries to repair his labrum and went on to pitch nine more seasons for the St. Louis Cardinals, winning a Cy Young Award in 2005. And Dodgers pitcher Blake Treinen, who had surgery in 2022 to repair his labrum and rotator cuff, returned to a major league mound in 2024.

Now it’s Bautista’s turn to see if he can beat the odds.