A 2nd Tommy John surgery could be tougher for Shohei Ohtani to return from. But it’s not a given

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Shohei Ohtani’s potential need for a second Tommy John surgery raises questions about the intricacies of his recovery process. While the prospect of undergoing another surgery might suggest a tougher road to recovery, it is not an absolute certainty.

Reflecting on his own experiences, Chicago Cubs pitcher Jameson Tallion shared insights into the challenges of recovering from Tommy John surgery. He revealed that after his initial surgery, the rehabilitation was arduous, and he never fully regained a sense of well-being. The prospect of advising others about the surgery was rather grim, as he humorously noted that they could expect to never feel truly good again. However, the narrative shifted with his second surgery, likening it to the rejuvenation of a new arm.

Shohei Ohtani encountered a similar dilemma when he tore the ulnar collateral ligament in his right elbow while pitching against Cincinnati on August 26. Although he continues to contribute as a designated hitter, pitching is currently off the table as he deliberates his medical options.

Having undergone his first Tommy John surgery on October 1, 2018, Ohtani’s journey was not without setbacks. Following his return as a batter in May 2019 and as a pitcher in July 2020, he faced struggles with injuries, including a strained forearm that sidelined him until 2021. However, his subsequent performances have been remarkable, boasting a 34-16 record with a 2.84 ERA in 74 starts. Coupled with his offensive prowess, characterized by a .278 batting average, 124 home runs, 290 RBIs, and 56 stolen bases over three seasons, Ohtani’s potential in the league is substantial.

Before his recent injury, expectations for Ohtani’s future were grand, with the possibility of commanding a record-breaking contract exceeding $500 million as a free agent. However, if he were to undergo a second Tommy John surgery, his return to pitching wouldn’t be expected until 2025 at the earliest. While pitchers usually require 12 to 18 months for recovery, position players have occasionally made speedier comebacks, such as Bryce Harper’s return as a designated hitter just 160 days after the operation.

The mechanics of Tommy John surgery involve the ulnar collateral ligament (UCL), which connects the humerus bone to the ulna bone in the elbow. Surgeons commonly use an almaris longus tendon from the forearm to replace the torn ligament, but if unavailable, a gracilis tendon from the knee becomes the secondary choice. A second surgery tends to be more complex, as it contends with scar tissues and bone spurs, affecting the recovery timeline. Dr. David Altchek, New York Mets medical director, noted that after a second surgery, the delay in resuming throwing activities could extend to weeks 21 or even 41.

The challenges in predicting outcomes are further complicated by factors such as training methods and the use of weighted balls. While weighted balls enhance velocity, they also exert additional pressure on the ligament, raising concerns about their impact on recovery. The decision-making process for Ohtani’s case involves consultation with medical experts, as details about the extent of the tear remain undisclosed. Dr. Matthew Best, an orthopedic surgeon at Johns Hopkins, emphasized the need for comprehensive information before determining the recovery approach.

The historical context of Tommy John surgeries, as documented by baseball analyst Jon Roegele, reveals that 2,345 procedures have taken place since the first surgery in 1974. Notably, 148 players have undergone the procedure twice, highlighting the evolving landscape of surgical success. Success rates for revision surgeries have improved, with indications of 60-70% success compared to previous statistics.

Prominent examples of players who have successfully returned from a second Tommy John surgery include Nathan Eovaldi and Jameson Tallion. While challenges persist due to altered anatomy and scar tissue, advancements in surgical techniques have contributed to enhanced outcomes. The process is a delicate balance, considering the healing potential of new tissue in a previously altered environment.

In summary, Shohei Ohtani’s potential for a second Tommy John surgery presents both challenges and opportunities. While the prospect of a more difficult recovery exists, the evolving landscape of medical knowledge and surgical techniques offers hope for successful outcomes. Ultimately, Ohtani’s decision will be guided by consultations with medical experts and a comprehensive understanding of his unique situation.

Frequently Asked Questions (FAQs) about Tommy John Surgery Recovery

More about Tommy John Surgery Recovery

• Tommy John Surgery: Overview
• Understanding Ulnar Collateral Ligament Injuries
• Recovery After Tommy John Surgery
• Training Considerations Post-Tommy John Surgery
• Success Rates of Tommy John Surgery
• Advances in Orthopedic Surgery Techniques