Finn Balor was in the match of his life, wrestling in last year's SummerSlam for the WWE's inaugural Universal championship, when something went terribly wrong.
Shortly into the match, Balor was launched by opponent Seth Rollins into an external barrier. His elbow was positioned behind him with his arm elevated, just as the back of his shoulder made contact with the barrier -- a position that rendered the front of his shoulder vulnerable to popping out of the socket.
And pop out it did, a dislocation so violent that Balor immediately recognized what had happened. Reacting on instinct, he pulled down on his right arm with his left hand, creating a traction force that allowed the arm bone to at least approximate its natural resting position in the joint. The immediate pain signaled the injury had caused damage to his shoulder, but there was no way for Balor to immediately know the extent.
Balor had a decision to make.
"I kind of looked around and I thought, 'Well, there's two things that can happen here. You can tell the referee that you think you seriously hurt your shoulder and to stop the match, or you can get back in the ring and assess it in 30 seconds.'"
As the work it took to get to this match flashed through Balor's mind, the decision suddenly became easy. There's no point in quitting now.
"I came 16 years to this point," he said. "I'm not going to throw in the towel a moment earlier than I think I have to."
The Journey
Growing up in the small seaside town of Bray, County Wicklow,in Ireland, Balor (real name Fergal Devitt) played Gaelic football and soccer as a young kid, but it was wrestling that captured his imagination.
"I used to watch it as a kid on TV nonstop. Books, magazines, I'd even send away for rare [VHS] tapes from Mexico and Japan. This was before there was YouTube and everything was easily accessible. I was trying to get a collection of different leagues of wrestling, essentially just trying to absorb as much as I could and see as many different performers as I could."
His earliest matches were of the backyard variety, with one of his three brothers serving as his opponent. As a teenager he began to realize that if he was going to hone his skills in wrestling, he needed more formal training.
While reading one of his prized industry magazines, he found a school in the south of England: Hammerlock Wrestling. Balor told his parents that he was going to go train at Hammerlock for two weeks to see what this wrestling thing was all about. Two weeks completed and he returned to Ireland. Briefly.
Then came another two week session. And another. And another until it became clear that wrestling was his true passion.
"It morphed from training to, 'Hey, I want to have one match,' to 'Hey, I want to have two matches' and then it became three years of wrestling in the UK."
Balor's coach felt it would be beneficial to train and develop other talent in his hometown of Bray, but after several years along this path, Balor felt he had hit a plateau. He packed up and headed across the Atlantic to stay with an aunt in Boston as he sought to expand his wrestling horizons. He started training in Boston and was soon picked up by a scout to go train at the Inoki Dojo in Santa Monica, California. It was there five months later that Balor caught the eye of a visitor who would significantly alter his career trajectory.
"The president of New Japan Pro Wrestling -- which is the second-biggest wrestling company in the world -- came to visit the training center," recalled Balor. "He said, 'Oh, I see something in this guy. I want to take him to Tokyo and I want him to train in the New Japan Dojo.'
"It's renowned as the toughest wrestling dojo in the world. It's about mental toughness and stamina and trying to break people mentally on top of physically ... and it just had a reputation [in] turning out the best talent."
Balor could barely believe his good fortune. He was being given a rare opportunity to train with the elite of the elite in his chosen sport. But this was hardly a glamorous gig.
In exchange for the chance to train, Balor functioned as an intern. That meant answering phones, preparing food, cleaning the senior wrestlers' gear, even scrubbing toilets. From his perspective, this was a sign that he was moving up in the world. Not only was he keeping company with elite wrestling talent, he had graduated from a sleeping bag in a gym in Los Angeles to a bunk bed in one of the most renowned dojos in the world.
More importantly, he was gaining acceptance as a wrestler. As the lone "gaijin," or foreigner, wrestling at that time in New Japan in Tokyo, Balor rose through the ranks over the subsequent eight years, earning respect from his peers, and garnering the attention of the WWE. Initially Balor was apprehensive about leaving Japan where, despite multiple years on the circuit, he still felt there was much to accomplish in terms of fighters he wanted to face and titles he wanted to win.
Eventually, the allure of the WWE was undeniable.
A more mature Balor realized the opportunity to join the largest professional wrestling company in the world would not exist forever. Balor signed with WWE in 2014 and moved to Orlando to join NXT. It was during his training at the WWE Performance Center in Orlando that Balor began to learn how to meld his wrestling talent with performance artistry.
It was all coming together, in this moment ... the moment where he's performing in New York City in a championship match for a title that had never been awarded. The moment where Balor found himself thinking, "Yes, yes I have come too far to give in to an injury."
So he continued. But, as the match progressed, Balor quickly suspected the injury was worse than he initially thought.
"It wasn't until it started popping out on really minor things, like pushing him in the back, that I realized, 'oh, no. this is going to be a big problem tomorrow.'"
The next day, yes, it would be a very big problem, but in that moment Balor was determined to stay the course. Incredibly, despite repeatedly dislocating and relocating his shoulder, Balor held on to complete the match ... and win. Crowned Universal champion despite having only one good arm, Balor celebrated his victory in the ring, then immediately upon exiting went to be evaluated by team physicians.
The diagnosis
Initially the diagnosis appeared fairly straightforward. Doctors knew Balor had dislocated the shoulder during the match and suspected a labrum tear as the likely collateral damage. An MRI the following morning appeared to confirm the diagnosis. After discussing whether to give conservative treatment a trial or to go straight to surgery, Balor opted for the latter and was ready to move forward.
With a projected absence of at least four months, he had no choice but to relinquish his title. Less than 24 hours after earning his belt, Balor, his right arm in a sling, stopped by Monday Night Raw to formally turn it back in. He then exited the building and boarded a flight to Birmingham, Alabama, where he would have surgery the next day.
As Balor was prepped for surgery that Tuesday morning, he chatted about the plan with his surgeon, Dr. Jeffrey Dugas. Dugas, a partner at Andrews Sports Medicine and an orthopedic consultant for the WWE, told Balor he expected to repair the labrum. He did caution, however, that MRIs do not always reveal the whole picture and there was a possibility he could find more that would need fixing once he could see inside the shoulder.
As he began to explore the margins of the injury, even Dugas was surprised to find how much more inside Balor's shoulder needed fixing. In addition to tearing the labrum, the sheer force of the injury coupled with the awkward position of Balor's arm at the time of impact resulted in a tear of the pec tendon, a tear of the biceps tendon and damage to the cartilage covering the shoulder. In fact, the spectrum of damage was so unique that despite 60-plus years of experience and thousands of patients between them, neither Dugas nor his partners Dr. Lyle Cain and Dr. James Andrews had ever seen that exact pattern of injury.
Piece by piece Dugas repaired Balor's damaged tissue, satisfied as he closed the incision that the repairs were solid.
The X factor was the 6 square centimeters of cartilage damage to the humerus (arm bone) that required a microfracture procedure to help create a protective covering on the bone. It meant the rehab had to be guarded in the early phases in order to allow proper healing. The challenge then was for Balor to regain normal range of motion and strength while still protecting the vulnerable area of the shoulder joint -- not an easy task.
Fortunately, Balor had one of the most experienced physical therapists in the sports world in Kevin Wilk. Wilk, associate clinical director at Champion Sports Medicine in Birmingham, Alabama, has put numerous wrestlers, as well as baseball and football players with complex shoulder injuries, through their physical therapy paces, including Saints quarterback Drew Brees and wrestler John Cena. As for managing Balor's particular injury, Wilk said the most challenging aspect was keeping him "under wraps."
"He's used to pushing himself," Wilk said, noting the hardest part about navigating the rehab was the extent of the damage and the time needed for tissue healing, particularly to accommodate the cartilage injury. "[Balor] had a lot of pain early on and it was tough to get some of the muscles to fire."
Ultimately Balor's work ethic, honed while earning his keep as he trained overseas, paid off. His pain began to gradually decrease as his function improved. Wilk oversaw his progression from gentle manual therapy and modalities to more aggressive resistive exercises and movement sequences that would approximate working in the ring. Given the unique demands of a wrestler, Wilk incorporated a tremendous amount of functional movement training and testing, simulating specific patterns that would require Balor to push or pull with the arm, as well as anticipatory moves to avoid having the arm trapped.
"He's super hard-working; never skipped a day of rehab, never even skipped a rep," Wilk said. He went on to highlight the degree of Balor's dedication which expanded beyond his specific therapy regimen to include maintenance of his overall fitness level, nutrition and rest. "He's driven to make it back to the top. As driven as any athlete I've ever seen."
Dugas echoed Wilk's sentiment saying Balor is one of the best patients he's ever had.
"He worked hard within the confines of what we told him was OK," Dugas said. "He's done everything right and he hasn't done too much too soon, which was critical to his recovery."
After an injury of this magnitude, how do we know when Finn Balor is truly ready to unleash the Demon King? How does he know when he's ready? As Dugas notes, all the boxes have been checked for Balor to suggest that he is indeed ready: no pain, no instability, no weakness and no catching in the shoulder. The time frame for the tissue to heal has been met. The only element left is in-ring action.
With high level athletes there is no way to fully simulate the intensity or the emotion of competition.
"We don't know he's ready until he gets in the ring and tests it," said Wilk. "But his confidence has definitely been coming back recently which is always a good sign."
Balor is in lockstep with his surgeon and physical therapist.
"I don't think you ever know," said Balor when asked if he knew when his body was ready for him to return. "It's one of those things that I won't know when I'm ready until I'm actually in the ring and doing it in front of people live. You can kind of run drills and practice, rehab behind closed doors as much as you can, but there's nothing that simulates being in front of a live audience with live TV cameras."
The return
After more than seven months of patiently waiting and working diligently on things ranging from the tedious to the technically challenging, Balor stepped back into the ring on April 3 for Monday Night Raw. For anyone who thought he might appear apprehensive in his first action in over half a year, those concerns were quickly put to rest as he darted about the ring, engaging in big spots without hesitation. Victorious in his endeavor, Balor simply struck a tone of quiet reflection when asked what this return meant to him.
"The injury was very fitting on my career ... like it was meant to be. It gave me something to overcome again," Balor said on Tuesday morning. "There was always an obstacle in the way, this was just another one. The challenge has been as much mental as it was physical. I feel now like I've come back not only physically stronger, but mentally as well."
While it may be just one brief match, it is one giant step toward Balor's return to his pre-injury form. He's ready to become one of the biggest stars in sports entertainment once again and he's ready to do anything he can to get back to that moment in Brooklyn with the title in his hand.