Hope Springs Eternal, Even (Especially?) for Pitchers Starting Season on DL from Tommy John Surgery
Patrick Corbin threw a greater percentage of strikes than any other pitcher in Major League Baseball last season en route to a 14-8 record with a 3.41 earned-run average. But he won't be on the mound today during the Arizona Diamondbacks' home opener against the Giants. Last week, Tommy John surgery ended the Diamonback lefty’s 2014 campaign before it started. But according to a new academic paper, the promising pitcher should look upon the surgery as more career rejuvenation than regression.
A study in the new issue of the American Journal of Sports Medicine found that major-league pitchers who underwent Tommy John surgery, which inserts a tendon—often from the forearm—into the damaged area near the elbow, emerged from the operation better pitchers than they were immediately before it. Nine doctors affiliated with Chicago’s Rush University Medical Center concluded, “Reconstruction of the UCL allows for a predictable and successful return to professional baseball.” Ulnar collateral ligament (UCL) reconstruction is Jargonese for Tommy John surgery.
The jocks can thank the nerds that this is not the injury it used to be.
The AJSM study looked at 179 Major League Baseball pitchers who underwent the procedure. “After UCL reconstruction, pitchers played in fewer innings per season and had both fewer wins and losses per season versus before surgery,” the article “Rate of Return to Pitching and Performance after Tommy John Surgery in Major League Baseball Pitchers” concedes. “However, these pitchers also had a lower ERA and WHIP per season. In comparison with controls, pitchers who underwent UCL reconstruction had a lower ERA and WHIP, had a lower losing percentage, and gave up fewer hits per inning. The fewer wins and losses after UCL reconstruction could be explained by the fewer innings pitched because it is an MLB requirement to pitch a minimum of 5 complete innings before a pitcher earns a decision.”
The doctors report that returning to play after the surgery appears close to a fait accompli. “A total of 179 pitchers with UCL tears who underwent reconstruction met the inclusion criteria and were analyzed. Of these, 148 pitchers (83%) were able to RTP [return to play] in the MLB, and 174 pitchers were able to RTP in the MLB and minor league combined (97.2%), while only 5 pitchers (2.8%) were never able to RTP in either the MLB or minor league.” Hope springs eternal on opening day even when you open the season, as Patrick Corbin does, on the disabled list after Tommy John surgery. The 24-year-olds prospects for a comeback appear as close to automatic as it gets in Major League Baseball.
The 97 percent return-to-play mark stands in sharp contrast to injured pitcher prospects prior to the development of the operation. Hall of Famer Sandy Koufax and fifties phenom Herb Score rank among the pitchers whose careers could have been extended and enhanced through Tommy John surgery but ended for the lack of it. When Dodgers team physician Frank Jobe pioneered the surgery on pitcher Tommy John in 1974, he gauged his patient’s prospects for full recovery at one percent. Tommy John returned in 1976 campaign to go 10-10 and play in thirteen additional post-surgery seasons, giving him a share of the longevity mark for MLB players up to that point.
Dr. Jobe passed away earlier this month at 88. More than 1,000 MLB players have endured the surgery he invented. The American Journal of Medicine study estimates that ten percent of current MLB pitchers have benefited from the procedure. When Diamondback Corbin returns sometime next season, he will join a growing contingent of major leaguers sporting Frankenstein elbows that throw better than the ones with which they came into the world.
Baseball fans unwilling to trudge through the opaque doctortalk in the academic article nevertheless find affirmation of its findings in Stephen Strasburg’s right arm, the one that throws 95, and Joba Chamberlain’s right elbow, the one that, through the magic of modern medicine and crude tattoo artistry, now sports a smiley face.
Photo Credit: Julian Gonzalez