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Mets' approach to Noah Syndergaard's rehab from Tommy John surgery: Patience is key

Mets pitcher Noah Syndergaard during a spring training

Mets pitcher Noah Syndergaard during a spring training workout Saturday, Feb. 27, 2021, in Port St. Lucie, Florida. Credit: Newsday/Alejandra Villa Loarca

PORT ST. LUCIE, Fla. — Jeremy Hefner’s approach to coaching pitchers returning from Tommy John surgery includes an extra element: empathy.

A two-time recipient of the elbow ligament reconstruction operation, Hefner learned the hard way that the rehabilitation process takes a certain kind of patience, diligence and self-control. He had the surgery in August 2013 and October 2014, and he never made it back to the majors.

For Noah Syndergaard, who is 11 months removed from Tommy John surgery and at least three months away from returning to a major-league mound, Hefner’s experience is a reminder not to rush anything.

"We’ve had conversations about controlling intensities and pushing it, while also walking that line of not overdoing it," Hefner, the Mets’ second-year pitching coach, said Sunday. "Noah has been outstanding in terms of controlling his intent and his energy, and he’s doing exactly what he’s supposed to be doing."


Manager Luis Rojas added: "He looks strong out there. It’s almost like you gotta hold him back a little bit, that’s how good he feels. So I think Hef is a great influence for that."

Hefner said he tries to be "a listening ear who has lived this before."

"He knows that I’ve lived with this, so just being there for him and with every Tommy John [patient], not just Noah specifically," Hefner said. "There’s ups and downs, hills and valleys of maybe soreness or you’re working through things, you’re trying to get your mechanics back to where they were after doing rehab for a certain amount of time."

Syndergaard hasn’t spoken to reporters in nearly a year, declining multiple interview requests in recent days. But every indication is that his rehab has been largely unremarkable, which is the goal.

Rojas said he threw sliders on Saturday for the first time since surgery, one in a long series of checkpoints. The Mets have not said when he will face batters, another big step.

As is always the case with Syndergaard, staying in top shape has been a priority. On Sunday morning, he popped out of the Mets’ weight room wearing a blood-flow restriction contraption on his arms. "BFR" training allows an athlete to "make greater strength training gains while lifting lighter loads, thereby reducing the overall stress placed on the limb," according to the American Physical Therapy Association.

The Mets have been impressed with Syndergaard’s mental approach.

"He’s been locked in the whole time, listening, adjusting," Hefner said. "I’m proud of him for sticking to that, because it can be tough. Sometimes when you feel good, you want to do too much, and when you don’t feel good, you want to do less. But trying to be as consistent and constant as possible will get a better outcome at the end of this thing."

The end of this thing isn’t a near-term proposition. The Mets already have put Syndergaard on the 60-day injured list, the clock for which doesn’t start until the regular season. That puts him on track for June, in a best-case scenario, which has been the Mets’ publicly stated expectation since December.

Scheduled to be a free agent after the 2021 season, Syndergaard would have a bit more than half of a season to show teams he is healthy and effective. He has a career 3.31 ERA in five injury-filled seasons. That is inflated by his rough 2019, when he had a 4.28 ERA.

A total rehab timeline of 14-plus months has become standard for Tommy John surgeries.

"That’s the beautiful thing about the way Tommy Johns are done now," Hefner said. "They’re not as quick. They’re much more drawn out, and I think rightfully so. It’s good for the player, for their long-term success, to draw things out a little bit, making sure that you’re really locked in before the lights turn on and intensity goes up and everything like that."

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