Tommy John surgery giveth, and Tommy John surgery taketh away. Just as the Mets and their fans finally have Matt Harvey back after their ace missed all of last season following October 2013 Tommy John surgery, they learned that Zack Wheeler has a torn ulnar collateral ligament in his pitching elbow and will likely require Tommy John surgery, which would wipe out his '15 season.
The good news for the Mets is that they have tremendous starting pitching depth and are particularly well positioned to absorb a loss like this one. In the short term, Wheeler's injury means that Dillon Gee will be restored to the rotation. In the long term, it creates a greater likelihood of major league opportunities for top prospects Noah Syndergaard (one of the top pitching prospects in all of baseball), Rafael Montero and Steven Matz. As optimistic as the expectations for Wheeler—a former first-round pick and top prospect—may have been heading into the season, he posted a 98 ERA+ last year for a team that has, at-best, fringy hopes of being a factor in the wild-card race. For the coming season, at least, the Mets can survive this loss.
However, over the long term, this is a major setback in the development of a pitcher the Mets had hoped would be a front-end starter for them, one whom they had envisioned partnering with Harvey and Syndergaard atop the rotation as they returned to contention in the coming seasons. Wheeler is unlikely to return to a major league mound until close to his 26th birthday at the end of May 2016 and will likely spend most of next season trying to get back to the point he was hoped to be at coming into this season. It's a bitter irony that pitchers coming back from Tommy John surgery often take longest to reestablish their control, as Wheeler's high walk rates (3.9 walks per nine career) have been his most significant shortcoming in his two big league seasons.
Those walk rates may have played a key role in Wheeler's current predicament. The Mets did attempt to limit Wheeler's workload last year, but those efforts appear to have been undermined to a certain degree by Wheeler's inefficiency. Across 32 starts last year, Wheeler threw 185 1/3 innings, just 16 2/3 more than he had thrown in the majors and minors combined the previous year. However, among qualified starters in the major leagues last year, only Tampa Bay's Jake Odorizzi was less efficient in terms of number of pitches thrown per inning, needing a full 18 tosses to get through a frame to Wheeler's 17.8. The same was true in terms of pitcher per plate appearance, with Odorizzi's 4.21 the only total to best Wheeler's 4.17. As a result, despite ranking 59th in the majors in innings pitched last year, Wheeler ranked 19th in pitches thrown.
Wheeler only reached 120 pitches once in his 32 starts last year and never threw more, but he threw 100 or more pitches 24 times and 110 or more 13 times. Among pitchers age-24 or younger last season, Wheeler was the only one to throw 110 or more pitches in more than six starts. From June 30 through the end of the season, his final 16 starts, he threw 99 or more pitches every time out and averaged 109 per game.
Ironically, that all happened after Mets manager Terry Collins said that the team planned to be "a little more cautious" about Wheeler's workloads following his 111-pitch shutout of the Marlins. Wheeler was knocked out after two innings in his next start, then threw 111 or more pitches in each of his next three turns, failing to complete the seventh inning in all of them. It seems the Mets failed to identify pitch count as a separate area of concern.
Indeed, Collins' talk of caution seemed to be focused on getting Wheeler through a full season without hitting his innings limit. Even then, one wonders why Wheeler so often came back out for the seventh inning. Eight times in those final 16 starts, Wheeler came back out for the seventh inning. Only once did he complete the frame. His average pitch count in those eight starts was a fraction above 112, with his 120-pitch start among them.
Of course, such nitpicking of Wheeler's workload is easy to do in the wake of his elbow injury. What's far more alarming is that this injury did not come out of nowhere. According to the Mets, Wheeler pitched through elbow pain for much of last season, had an MRI in September, platelet-rich plasma injections in the joint in November—a common alternative treatment for pitchers hoping to avoid surgery—and had another MRI after complaining of more elbow pain in January.
"There were a lot of games he pitched with his elbow bothering him," Collins told Newsday's Marc Carig on Sunday when it was announced that Wheeler was being sent for an MRI on the joint. Wheeler added that, had it been the regular season, he would have attempted to pitch through the pain that caused him to be scratched from his scheduled exhibition start on Saturday. "Every pitcher in here pitches through pain at some point, so it's just a matter of dealing with it and going out there," Wheeler told Carig. "It wasn't affecting me all that much so I could go out there and compete like I wanted to. So I was going to do it." He added that his regular-season regimen included "anti-inflammatories, treatment, all kinds of stuff."
Wheeler's approach is clearly part of the problem. He bragged to Carig on Sunday that he "threw every bullpen last year," something Collins and pitching coach Dan Warthen said was not true. Regardless, Mets general manager Sandy Alderson acknowledged in the wake of Wheeler's diagnosis on Monday that "we had been forewarned by the doctors that his elbow was a concern."
So, to put this together: Last year, the Mets had a highly regarded 24-year-old pitcher skipping bullpens and taking anti-inflammatories due to elbow pain, but also had him average 109 pitches per game in the second half of the season and let him make 32 starts despite continuing elbow issues that were severe enough to prompt a September MRI. That MRI supposedly showed no structural damage, yet the Mets still had Wheeler take PRP injections in November, a strong indication that they had reason to suspect there was structural damage in the joint. Then, despite further complaints of pain from the pitcher in January and warnings from their doctors about the health of his elbow, New York had him on schedule with all of the other pitchers in terms of work and workload this spring.
What's more, even when Wheeler was scratched from his start on Saturday and sent for his third MRI in the last seven months, the public face the Mets put on it is that he has some issues with chronic tendinitis and should be fine. Only now are we finding out about this long history of elbow pain, and that apparently only because that latest MRI revealed a torn UCL.
Why the deception? What did the Mets gain by keeping Wheeler's elbow issues to themselves for so long? Did they think it would somehow benefit them in offseason negotiations, the ones which resulted in them adding just three players to their 40-man roster? Were they trying to dodge public pressure to have Wheeler's workload decreased or even have the surgery earlier? Again, hindsight is 20/20, but either one of those would have been preferable to the situation in which the Mets currently find themselves. Even surgery early in the offseason would have been better, as Wheeler would have been as ready for next year's spring training as Harvey was for this year's.
It's worth noting that the Mets have an awful track record when it comes to their pitchers' elbows. Last April, Jay Jaffe compiled the total number of Tommy John surgeries for each organization from 2004 through early '14 and found that the Mets trailed only the Cardinals, Athletics and Braves in surgeries performed on the pitchers in their organization in that span. Among major league pitchers, the Mets were tied for third-most with the Cardinals at ten such procedures. Since, then, Mets minor leaguers Tyler Bashlor, Jeff Walters and Chris Flexen had the surgery, Jeremy Hefner had his surgery re-done in October, and on Sunday, New York announced that reliever Josh Edgin would require the surgery and miss all of the coming season.
To that list, you can add Harvey, closer Bobby Parnell (who had the procedure last April) and Wheeler, who has not yet chosen to have the surgery but seems a lock to do so if he indeed has a full tear of his UCL. All told, the Mets have had eight pitchers in their organization undergo Tommy John surgery since Hefner's initial operation in late August 2013. Given that high rate of incidence, you'd think the Mets would be more cautious about their pitchers when they report chronic elbow pain and favor greater transparency in an effort to increase the chances of identifying the reason for the outbreak, if there even is an identifiable cause. However, that has not been the case.
What is true is that Wheeler fits the profile of a young, hard-throwing American pitcher whose formative years came during the modern era of year-round competition and showcases. Drafted sixth overall by the Giants in 2009, Wheeler went straight from high school to the Sally league, where he was clocked throwing 96 miles per hour. Last year, Wheeler's fastball was tied for fifth-fastest in the majors according to FanGraphs' data, averaging 94.7 mph, the same speed as that of noted Tommy John recipient Stephen Strasburg. It's also true that it is going to be a long time before he throws another pitch.
What we'll never know for sure, however, is whether or not the Mets could have prevented his current injury by responding more proactively to the elbow pain Wheeler experienced last year. Here's hoping the next time a young pitcher comes to them clutching his elbow, they take a more cautious approach.