For the past year and a half, the name
Finding a Tommy John success story is as easy as checking the box scores. There are at least 43 pitchers on active major league rosters who have had Tommy John surgery at some point in their careers, including both starters in Thursday night's game between the Nationals and Cardinals, Washington's
Finding a major league pitcher who was unable to return from the surgery is far more difficult. In a 2009 interview, Red Sox head trainer
For example, former Orioles and Blue Jays closer
Of course, with so few Tommy John failures out there, and more of them being muddled as with Ryan than obvious as with Zimmerman, there's not a lot we can learn from them. After all, the ability to recover from injury, or to avoid it in the first place, has as much to do with genetics as mechanics or conditioning. By looking at some of the successful comebacks, however, we can get a general impression of what the next few years have in store for Strasburg.
To start with, the recovery time for Tommy John surgery, from the moment of the incision to the next major league pitch thrown with that arm, is generally 12 months. Strasburg's teammate Jordan Zimmermann had his T.J. surgery in mid-August of 2009 and made his return Thursday night, August 26, 2010. Reds ace
Given the timing of Strasburg's injury and impending surgery, the Nationals could follow either two courses of action. They can keep him out for all of the 2011 season to avoid rushing him back and give him four more months in the off-season to heal, or, as they did with Zimmermann (who is expected to be the team's ace in Strasburg's absence) can let him make some low-pressure starts in September of next year to get used to facing big league hitters again. Most likely the pace and strength of Strasburg's rehabilitation, not some pre-ordained plan, will set the Nationals' course there.
And what can the Nats expect whenever Strasburg does return? Its is often said that while it takes a year to rehab from Tommy John surgery, it can take another year for the pitcher in question to regain the velocity and command he had prior to the injury. In the case of would-be Twins ace Francisco Liriano, it took even longer. Liriano had Tommy John surgery in November 2006, missed all of the 2007 season, and upon returning in 2008, found he had lost four miles per hour off his fastball and slider, and his slider and changeup were noticeably less effective. Liriano saw only minimal improvement in 2009, but finally this season, more than three years removed from his surgery, Liriano has his fastball back up around 94 miles per hour and is getting the nasty, put-away action on his slider that he had in 2006.
Far more encouraging is the experience of Marlins ace Josh Johnson, who had Tommy John surgery on August 3, 2007, returned to the majors on July 10, 2008 and was immediately throwing harder than had been before surgery. It's a bit of an urban legend that ligament-replacement surgery can add velocity to a pitcher's fastball; more likely the surgery corrects a problem that had been slowing down that pitch. One also has to consider a pitchers' physical maturity. Johnson is 6-foot-7 and broke into the majors at the age of 21 throwing about 91 miles per hour. He increased his velocity a bit in each of the next two seasons even before his surgery, throwing just over 92 miles per hour on average in 2007. When he returned, however, he hit the ground running at more than 93 miles per hour and has had an average fastball speed of roughly 95 mph in the two seasons since. Perhaps more significantly, Johnson's slider, a pitch commonly associated with elbow ligament damage, had lost its effectiveness in 2007, but has again been his bread-and-butter since his return. Johnson has gone 33-11 with a 2.98 ERA, and 3.42 K/BB in 73 starts since returning to action.
Liriano and Johnson are decent comparisons for Strasburg. Both were top prospects (Liriano moreso than Johnson) and both throw in the mid-90s when healthy. Johnson was 23 when he had his surgery, while Liriano was, like Strasburg is now, 22. Assuming Strasburg avoids becoming a rare Tommy John casualty, Liriano and Johnson also likely represent the two extremes of the pace of his recovery. The bad news is that, even if he does come all the way back, on the Liriano plan it could take Strasburg until 2014 to again dominate major league hitters. The good news is that both Johnson and Liriano ultimately did make a full recovery.
Of course, there is no perfect comparison for Stephen Strasburg (quick, name another pitcher with three dominant offering who averages 97 miles per hour with his fastball and thus throws his changeup at almost 90 . . . didn't think so). That makes projecting the post-surgery Strasburg additionally difficult. It seems entirely possible that Strasburg could lose three miles per hour off his pitches and still throw mid-90s heat and dominate in the majors, though he'd seem disappointingly ordinary if he did. Unfortunately, the only way to find out is to wait.