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Thursday, February 16, 2017

Cardinals’ Alex Reyes has difficult road ahead |

But there are two things to consider about the realities of Tommy John surgery.

One is that just about every terrific pitcher of the last decade did not go through Tommy John surgery. It’s striking: There are very, very few exceptions. The past 10 Cy Young Awards winners are Max Scherzer, Rick Porcello, Jake Arrieta, Dallas Keuchel, Clayton Kershaw, Corey Kluber, R.A. Dickey, David Price, Justin Verlander, Roy Halladay and Felix Hernandez. Not one of them had Tommy John surgery. Then you throw in other pitchers who have had dominant seasons—Madison Bumgarner, Zack Greinke, Cliff Lee, Chris Sale, Cole Hamels and so on. None of them had Tommy John surgery, either.

This probably shouldn’t be a surprise … but it is. There is this sense you get sometimes from people that Tommy John surgery is no big deal in the grand scheme of things, that it is just a year-long delay on the road to greatness. But almost without exception, the very best pitchers in the game manage to avoid serious injury when they are young.

The second thing to think about is when a pitcher has Tommy John surgery. There are those who have had it mid-career—think John Smoltz, David Wells, Tim Hudson, John Lackey, Chris Carpenter and others—who do come back and pitch well. That was true of Tommy John himself. And while that’s encouraging, it is not of much use when talking about a breathtaking young pitcher like Reyes, who was just beginning his big league career.

Jim Furtado Posted: February 16, 2017 at 01:48 PM | 9 comment(s) Login to Bookmark
  Tags: alex reyes, cardinals, tommy john surgery

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   1. RMc's Unenviable Situation Posted: February 16, 2017 at 05:16 PM (#5403312)
I always wonder if (at least part of) the reason it's called "Tommy John surgery" is the fact it rolls off the tongue so well. John's top comp in 1975 was Burt Hooton, a more-or-less contemporary. What if it was Hooton who had the procedure done? "Burt Hooton surgery" doesn't quite sound right, does it?

What about pitchers with similar records to John from 1970-74? Mel Stottlemyre surgery? Rick Wise surgery? Bill Lee surgery? Stan Bahnsen surgery?
   2. Never Give an Inge (Dave) Posted: February 16, 2017 at 05:30 PM (#5403322)

It's kind of cheating to include R.A. Dickey on that list -- he had no UCL to begin with! (He's also an irrelevant comp for other reasons, but I just found his inclusion with no asterisk kind of funny.)
   3. 3Com Park Posted: February 16, 2017 at 07:46 PM (#5403418)
This article cries for data. Yep. Pretty much all anecdotal -- some come back and some don't. How long does it take? Velocity differences? Other factors?
   4. Cargo Cultist Posted: February 16, 2017 at 10:39 PM (#5403485)
Very poor article. Apparently the author has never met data analysis.
   5. Walt Davis Posted: February 16, 2017 at 10:49 PM (#5403487)
Unfortunately (and not understandably), it's hard to find data and analysis on pitcher/baseball injuries. I will simply never understand why b-r doesn't track at least DL days -- the old baseball encycolpedia used to do that, b-r manages to track other transactions, b-r even manages to give us uniform numbers, agent names and twitter handles. Heck, when you look at the in-season 40-man roster, it will list players on the 15-day and 60-day DLs ... but apparently doesn't do anything to accumulate this info over time.

That said, there are a few studies out there, can't vouch for the accuracy of any of them:

Study 1

an article with some links

I'm sure there was a pretty thorough study linked here a couple of years back where the guy had done a pretty good job of tracking down TJS and other injuries among pitchers, didn't seem to come up quickly in google though.

The question's not easy to answer. You've got to try to control for talent/performance pre-surgery. You've got to take into account that a young pitcher is missing at least one and realistically 1.5-2 years of development. Even if the talent level returns to where it was, do we expect the same from a 24-year-old with current talent level X as from a 22-year-old with current talent level X? And of course whatever caused (or contributed to) the first injury may well still be around to contribute to a second.

Age at first CYA, recent winners:

Scherzer 28
Porcello 27
Arrieta 29
Keuchel 27
Kershaw 23
Kluber 28
Dickey 37
Price 26
Verlander 28
Halladay 26
Felix 24

Halladay won his 2nd at 33 and Scherzer his 2nd at 30 (and Kershaw at 25 and 26) but generally winning the CYA has become a young man's game. In that light, it's not surprising that a guy not missing, say, all of his age 23 and probably part of 24 or at least still recovering for half of age 24 helps his CYA chances.

I recall a surprising bit of research (from MGL I think) concluding that pitchers are in "decline" in stuff/peripheral terms almost from day one. Meanwhile, some of them are learning how to pitch more effectively (and to have better control I'd think). The "typical" CYA season may be at an individual pitcher's intersection where the stuff hasn't fallen off too bad and they've finally learned how to pitch. For the TJS pitcher, their stuff presumably takes an extra step down and they miss out on the inning where they learn how to pitch. By the time they've learned how to pitch, the stuff has fallen off too far to have much chance at a CYA.
   6. The Duke Posted: February 16, 2017 at 11:31 PM (#5403501)
I think elite arms probably suffer more because they are on the far side of the bell curve and while they recover from TJ, my guess is that it pushes them down Into great mass of other pitchers in the middle of the bell curve. Plus, losing 2 years early is irreplaceable. I'll be amazed if Reyes ever is a top of the rotation talent now. On their own team they can see how much injuries retarded the performance of Jaime Garcia, who is still very good but had the chance to be special. Wacha is the same. Different injury but same result. He's still good but no longer a number 1 candidate. Before Reyes' injury, it wasn't clear he was even in the rotation.
   7. cardsfanboy Posted: February 17, 2017 at 12:16 AM (#5403510)
Do you say stuff, just to say stuff?

Reyes was clearly in the rotation, and was going to be the number 3 guy, but with a moderate pitch count where they were hoping to make him the defacto 6th starter in innings pitched by giving him time over semi frequently. The only reason he might have missed the roster was a Cubs like saving him from arbitration eligibility scam, not because he was not ready.
   8. The Duke Posted: February 17, 2017 at 07:27 AM (#5403532)
I meant Wacha - my mistake
   9. Tom T Posted: February 17, 2017 at 01:07 PM (#5403847)
The "typical" CYA season may be at an individual pitcher's intersection where the stuff hasn't fallen off too bad and they've finally learned how to pitch. For the TJS pitcher, their stuff presumably takes an extra step down and they miss out on the inning where they learn how to pitch.

Intuitively this makes sense. From discussion with the (baseball) athletic trainer for the local U, the supposition (perhaps evidence??) is out there that about 85% of all pitchers have tears in their labrum, but only a fraction experience symptoms associated with said injury. If there truly is a widespread incidence of injury, it would be most likely to manifest itself in the continued/longitudinal decline of velocity/control/durability. Frankly would love to get in touch with MLB's medical director...perhaps we could model a study on Youth/Travel/HS pitchers to evaluate when/how low-level tears/injury are developing in the shoulder and elbow and then do a longitudinal component in which we track later injuries/surgeries and performance. I know MLB was working with the NCAA to try to do a multi-year study of valgus stress on the elbow (will be challenging to implement/interpret...sensors are embedded in a sleeve, so data will be "noisy" from day-to-day of usage), but odds are good that --- as in football --- the injuries are probably developing well before the players get to college.

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