Study shows pitchers who get Tommy John surgery almost all pitch again

Bobby Parnell stands on the mound in the

Bobby Parnell stands on the mound in the ninth inning of a game against the Washington Nationals at Citi Field on March 31, 2014. (Credit: Newsday / Thomas A. Ferrara)

One game was all it took for the Mets to lose their closer for potentially the entire season with a torn right elbow ligament. Yet once the shock of the cruel timing of Bobby Parnell's injury passes, we should ask ourselves: Should we really be that surprised that another pitcher could be headed for Tommy John surgery?

This season's list of established major-leaguers with injuries that require Tommy John surgery already is an expansive one. It features Atlanta's Kris Medlen and Brandon Beachy, Oakland's Jarrod Parker, Kansas City's Luke Hochevar and Arizona's David Hernandez and Patrick Corbin.

This is nothing new.

Last year, for example, the Chicago White Sox saw eight of the pitchers in their organization undergo Tommy John surgery, an abnormally high figure for one club. It was that experience that led team doctor Charles Bush-Joseph to put together a team of researchers last fall to study the effectiveness of the surgery from a statistical standpoint.

His hope wasn't to figure out why pitchers' elbows are breaking down. Team doctors have been studying that for years, and those studies are what led to innings limits for young pitchers and pitch counts across the board.

Instead, this time Bush-Joseph figured that with Tommy John surgery essentially now an accepted cost-of-doing-business factor in baseball, it is about time for teams to get as crisp a picture as possible of what they should expect from these pitchers when they return.

"We know who's getting hurt," he said, "so we looked at it from the outside-world perspective. How are they actually doing after they have surgery performed? That was the impetus for where the study came from."

The study, published last month in The American Journal of Sports Medicine, looked at 216 major-league pitchers who have had Tommy John surgery from 1986 to 2012 and focused on their statistics by comparing their two years before the surgery and the two years immediately afterward.

It found that pitchers' ERAs and WHIPs actually improved in the two years after the surgery and that their total innings pitched dropped.

There's a logical explanation to both findings. Teams tend to be conservative with pitchers as they come back from such a significant surgery, and those pitchers often say they are focused more on their mechanics than they had been, potentially increasing their control and limiting walks.

The study also showed that 83 percent of the pitchers they looked at made it back to the majors after surgery and 97 percent were at least able to pitch in a minor-league game after the surgery.

That success rate may seem low, but you have to take into account that the study included pitchers who had Tommy John surgery in the late 1980s, when it still was a relatively new procedure. And the study also had no way of differentiating between the fringe major-leaguer and the star pitcher. The only requirement was that the pitcher had to have thrown at least an inning in the majors before the surgery.

Bush-Joseph said the findings essentially confirmed what they thought would be the case, but seeing it on paper -- that statistically, pitchers usually make it back to the mound and are just as effective as they were pre-surgery -- is a telltale sign of just how successful this surgery is when done on elite athletes.

Nowadays, about a quarter of the pitchers in the majors have had Tommy John surgery, in part because so many of them are forced to do so before they even get to the majors. That's just another sign that the surgery, though time- consuming, represents only a bump along a pitcher's path, and usually nothing more.

"If you pitch long enough and hard enough, you're probably going to hurt yourself," Bush-Joseph said. "I think what the study showed, the surgery is pretty successful."

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