Osuna Set for Season-Ending Surgery?

It didn’t look good when Roberto Osuna threw a pitch, pointed to the dugout and gestured for the trainer to come to the mound during Saturday’s game against the Angels.

On Tuesday, Astros manager Dusty Baker said the same thing about Osuna’s MRI.

The Astros closer reportedly was recommended to have season-ending Tommy John surgery, a source told Mark Berman, the sports director at Fox 26 KRIV-TV in Houston. Per Berman, Osuna will seek a second opinion before making a decision.

Need for Speed: MLB’s Hardest Throwers Are Paying a High Price

First Luis Severino broke. Then Chris Sale. Now Noah Syndergaard. When it comes to pitching health, these are hard times for hard throwers.

All three were All-Star pitchers in 2018. All three were among the 20 hardest-throwing starting pitchers in the majors that year. Severino and Syndergaard ranked 1-2. Sale just made it inside the top 20, as did Michael Fulmer, Jameson Taillon, Chad Kuhl and Shohei Ohtani, if he had lasted long enough to qualify.

All of them had Tommy John surgery in the past 17 months to repair a torn elbow ligament. The breakdown rate is staggering: one-third of the 21 hardest-throwing starters blew out in less than a year and a half.

After the latest blowout, the one to Syndergaard, it’s time to ask some serious questions about the connection between velocity and health.

Is It Wrong for Baseball Players to Get Tommy John Surgery?

On March 13, a recommendation came from the American College of Surgeons: Minimize, postpone, or cancel all elective surgery amid the spread of coronavirus. This instruction was shared the next day by the U.S. Surgeon General, and in the two weeks that have followed, it’s been echoed in executive orders issued across the country.

In that same time frame, MLB teams announced pitchers who would undergo Tommy John surgery: Tyler Beede of the Giants, Chris Sale of the Red Sox, Noah Syndergaard of the Mets. But what does it mean to have the procedure in a pandemic? Especially when every medical resource is precious—and pro athletes are already under fire for receiving preferential testing and treatment.

Legally, teams and players are on solid ground. The national recommendations are just recommendations, and it’s still feasible to perform a surgery like Tommy John in many parts of the U.S. Among the states that have issued executive orders on the subject, there’s varied language on what exactly is prohibited, from “elective” procedures (New Jersey) to “non-essential” (Ohio) to “non-urgent” (Kentucky). In many states, doctors themselves can determine which of their own procedures fit that terminology, at least for now. So, barring additional local regulations, an individual practice can quite easily make a legal determination that its essential procedures may include Tommy John.

“I think it’s a really fuzzy line,” says Christopher Scott, the chair of medical ethics and health policy at Baylor College of Medicine, when it comes to defining what procedures are, legally speaking, essential or not.

Anyone here with the grounding in medicine, the law, or general ethics needed to fully assess this question?

Chris Sale undergoes Tommy John surgery in Los Angeles

And the slow-moving story reaches its inevitable conclusion:

Chris Sale’s road back officially started Monday.

The Red Sox announced that the pitcher underwent Tommy John surgery in Los Angeles with Dr. Neal ElAttrache performing the surgery at the Kerlan-Jobe Institute. Recovery. The Boston Globe was first to report the procedure had been executed.

News that Sale would need Tommy John surgery was surfaced March 19, with the team uncertain at the time regarding a timeline for the operation due to the complications regarding elective surgeries during the coronavirus crisis. Dr. James Andrews, for one, has suspended elective procedures according to the Globe.

Leading Tommy John surgeon defends procedures for MLB players during coronavirus crisis

Jumping ahead somewhat to the relevant content:

In an interview with the San Francisco Chronicle’s Henry Schulman, Dr. Neal ElAttrache — a Los Angeles-based surgeon who performs Tommy John surgery and other procedures for several teams — said that such surgeries are too important to players’ livelihoods to be considered elective.

From the Chronicle:

“People need to be a little more thoughtful how they judge Tyler Beede or the Giants for trying to take care of him,” Dr. Neal ElAttrache said by phone from Los Angeles, where he is based.

“I know that I’m going to get criticized for taking care of these kinds of guys, but it’s essential to their livelihoods,” ElAttrache said. “If you have somebody’s career at stake and they lose two seasons instead of one, I would say that is not a non-essential or unimportant elective procedure.”

As our British friends would put it, Mandy Rice-Davies applies.

Mets’ Noah Syndergaard to have Tommy John surgery for torn UCL

New York Mets right-hander Noah Syndergaard has a torn ulnar collateral ligament in his pitching elbow and will undergo Tommy John surgery this week, the team announced Tuesday.

Dr. David Altchek will perform the surgery Thursday at the Hospital for Special Surgery, according to the Mets.

“After experiencing discomfort in his elbow before spring training was suspended due to the pandemic, Noah and our health and performance department have been in constant contact,” Mets general manager Brodie Van Wagenen said in a statement. “Based on the persistence of his symptoms, Noah underwent a physical examination and MRI that revealed the ligament tear. A second opinion from Dr. Neal ElAttrache confirmed the diagnosis and the recommendation for surgery.

“Noah is an incredibly hard worker and a tremendous talent. While this is unfortunate, we have no doubt that Noah will be able to return to full strength and continue to be an integral part of our championship pursuits in the future.”

Padres reliever Munoz, prospect Lawson have elbow surgery

SAN DIEGO (AP) — Hard-throwing Padres reliever Andres Munoz and minor leaguer Reggie Lawson underwent Tommy John surgery Friday.

Both right-handers were injured shortly before spring training was suspended due to the coronavirus pandemic.

Munoz, 21, made his big league debut last year and appeared in 22 games. He went 1-1 with a 3.91 ERA and 30 strikeouts, against 11 walks. He would have been a key member of the Padres’ beefed-up bullpen this season, if and when it resumes.

The 22-year-old Lawson was 3-1 with a 5.20 ERA in six starts with Double-A Amarillo last season before being shut down with an elbow injury. He returned for the Arizona Fall League, going 1-0 with a 0.82 ERA in three appearances, including two starts.

Giants pitcher Tyler Beede to undergo Tommy John surgery Friday

There is no timetable for Major League Baseball to resume this season, but most around the game are expecting to miss at least a couple of months’ worth of games.

Tyler Beede will be out considerably longer.

The Giants right-hander will have Tommy John surgery Friday, president of baseball operations Farhan Zaidi announced.

Beede had an MRI on March 3 after feeling tightness in his right elbow, and immediately was shut down with an elbow sprain and flexor strain. He has spent part of the last couple of weeks getting additional opinions, and it was clear that surgery was the best option.

Royals’ Pérez catches for 1st time since Tommy John surgery.

SURPRISE, Ariz. (AP) — Salvador Pérez was back behind the plate for the first time since Tommy John surgery.

The six-time All-Star caught the first four innings of the Kansas City Royals’ 3-1 loss to a San Francisco split squad on Friday.

“I was super-excited to be back behind the home plate,” Pérez said. “I feel great. I feel good. I wasn’t nervous.”

A five-time Gold Glove winner, the 29-year-old had not caught in a game since Sept. 26, 2018.

Fulmer making progress in return from Tommy John surgery

LAKELAND, Fla. (AP) — At this time last year, Michael Fulmer was hoping for a healthier 2019. Instead, his injury woes went from bad to worse.

Fulmer needed Tommy John surgery and did not pitch at all last season, another setback for the right-hander who won AL Rookie of the Year honors for Detroit in 2016 but now faces an uncertain future for the Tigers. Still just 26 years old, Fulmer can give the team a lift if he comes back healthy, but that’s still a work in progress.

“I feel better than I thought I would at this point, playing catch out to 120 feet,” Fulmer said this week. “Next progression is getting on the mound. Very anxious for that moment, but we’ve got to wait until it gets here.”

Fulmer said he was hopeful he could throw on the mound around the end of March, perhaps before the team heads north.