Major Leaguers’ Tommy John Surgeries Trending Down
Many people use the word “epidemic” when referring to the rate at which baseball players, from the professional ranks down to high school, have been undergoing ulnar collateral ligament (UCL) reconstruction surgeries, more commonly known as Tommy John surgeries.
While torn elbow ligaments have been problematic at all levels of baseball, this article will focus on the latest statistics, trends and information with respect to Tommy John surgeries in major league baseball.
MLB Surgeries
There was promising news regarding the number of Tommy John surgeries performed on major league players in 2016.
Year | MLB TJ Surgeries |
2016 | 15 |
2015 | 27 |
2014 | 31 |
2013 | 20 |
2012 | 36 |
2011 | 17 |
2010 | 17 |
2009 | 20 |
2008 | 15 |
2007 | 22 |
This year saw the lowest number of Tommy John surgeries of any year in the past decade. The one disclaimer is that the year is not over yet, so there may yet be additional surgeries to add to the tally. In particular, Oakland right-hander J.B. Wendelken is to get a second opinion this week on his injured right elbow, and is not optimistic he can avoid a UCL reconstruction.
While some or maybe even most of the reduction in surgeries observed in 2016 could be just random year-to-year fluctuation, there were also more public signs of players trying alternative therapies than in prior seasons.
Garrett Richards is the most prominent example of a different course of action looking so far so good, as after a stem cell injection in mid-May in the area of his partially torn UCL, he has progressed to the point where he threw 25 pitches in an instructional league game last week and came away feeling healthy.
Here is a partial list of major league pitchers who have attempted platelet-rich plasma (PRP) and/or stem cell injections specifically for their UCL injuries (i.e. not flexor tendons or other parts of the arm or body).
Player | PRP Injection Date | Stem Cell Injection Date | MLB Return Date | TJ Surgery Date | Injury Description |
Takashi Saito | 7/1/08 | 9/15/08 | Partial tear, starting to come off bone | ||
Carl Crawford | 4/1/12 | 7/16/12 | 8/23/12 | Partial tear | |
Chad Billingsley | 9/1/12 | 4/10/13 | 4/24/13 | Partial tear | |
Jonny Venters | 6/1/14 | 9/17/14 | Soreness during TJ rehab | ||
Masahiro Tanaka | 7/14/14 | 9/21/14 | Partial tear (10%) | ||
Tyler Thornburg | 8/1/14 | 4/7/15 | Weakness, slight tear (may be from 2004) | ||
Brandon Workman | 4/15/15 | 6/15/15 | Partial tear | ||
Alex Cobb | 5/6/15 | 5/14/15 | Partial tear | ||
Michael Lorenzen | 4/1/16 | 6/24/16 | Mild tear | ||
Andrew Heaney | 5/1/16 | 7/1/16 | Some degree of tear | ||
Sean Nolin | 5/1/16 | 8/1/16 | Partial tear | ||
Garrett Richards | 5/16/16 | Partial tear | |||
Jon Edwards | 6/1/16 | Wear | |||
Aaron Nola | 8/17/16 | Low-grade tear | |||
Colin Rea | 8/18/16 | Partial tear | |||
Rubby De La Rosa | 7/1/16 | 9/27/16 | Stretch |
Clearly the results have been mixed, as some players have returned successfully after the injection and rest and rehab, some have returned but then shortly thereafter been re-injured, and others have not progressed well enough to return and ultimately required Tommy John surgery anyway.
Given that there is some level of success with these injections, and when successful they lead to quicker return times, I expect this trend to continue next season. The potential for success is also backed by this recent published article on the subject.
These injections are likely to be especially popular if a pitcher has a low-grade UCL injury, and even more so if that injury occurs at a time in the year where the potential of delaying surgery by a few months while a preferred alternative avenue is explored does not much impact the expected return date of the player.
Major League Pitchers
In the 2016 regular season, 742 players threw at least one pitch in a major league baseball game. Of those, 22 were position players mopping up in blowout games or forced into action in long, extra-inning affairs. Of the 720 true pitchers who appeared in a game this season, 190 have had Tommy John surgery. This group makes up 26.4 percent of all active major league pitchers.
In addition, 18 pitchers who ended the season on the major league disabled list but did not see any game action in 2016 have also had Tommy John surgery. These 18 made up 62.1 percent of pitchers who concluded the year on the DL without appearing this season, and when we include these pitchers to arrive at a percentage of all major league pitchers who have had Tommy John surgery, it brings the rate to 27.3 percent.
Here is a full list of major league pitchers who have undergone this surgery, broken down by team. Note that there are 13 pitchers who appeared for two teams during the season. These pitchers are listed for both teams, but counted only once in the major league total.
Team | Pitchers Used | Pitchers | Pitchers Not Used, on DL | Pitchers on DL |
Reds | 13 | Steve Delabar | 0 | |
Jumbo Diaz | ||||
Josh Smith | ||||
Dayan Diaz | ||||
Alfredo Simon | ||||
Layne Somsen | ||||
A.J. Morris | ||||
John Lamb | ||||
Blake Wood | ||||
Timothy Melville | ||||
Matt Magill | ||||
Homer Bailey | ||||
Jon Moscot | ||||
Athletics | 11 | John Axford | 2 | Jarrod Parker |
Andrew Triggs | Felix Doubront | |||
Jesse Hahn | ||||
Daniel Coulombe | ||||
Rich Hill | ||||
Ryan Madson | ||||
Eric Surkamp | ||||
Fernando Rodriguez | ||||
Dillon Overton | ||||
Raul Alcantara | ||||
Chris Bassitt | ||||
Royals | 10 | Edinson Volquez | 1 | Tim Collins |
Joakim Soria | ||||
Danny Duffy | ||||
Matt Strahm | ||||
Alec Mills | ||||
Brooks Pounders | ||||
Luke Hochevar | ||||
Kris Medlen | ||||
Peter Moylan | ||||
Jason Vargas | ||||
Tigers | 10 | Anibal Sanchez | 0 | |
Dustin Molleken | ||||
Logan Kensing | ||||
Alex Wilson | ||||
Shane Greene | ||||
Drew VerHagen | ||||
Jordan Zimmermann | ||||
Mike Pelfrey | ||||
Bruce Rondon | ||||
Bobby Parnell | ||||
Blue Jays | 9 | Jason Grilli | 0 | |
Scott Feldman | ||||
Francisco Liriano | ||||
Joseph Biagini | ||||
Arnold Leon | ||||
Dustin Antolin | ||||
Drew Hutchison | ||||
Gavin Floyd | ||||
Roberto Osuna | ||||
Braves | 9 | Jason Grilli | 3 | Paco Rodriguez |
Matt Marksberry | Jesse Biddle | |||
Jason Hursh | Andrew McKirahan | |||
Arodys Vizcaino | ||||
Casey Kelly | ||||
Eric O’Flaherty | ||||
Chris Withrow | ||||
Daniel Winkler | ||||
Shae Simmons | ||||
Giants | 9 | Albert Suarez | 1 | Ray Black |
George Kontos | ||||
Josh Osich | ||||
Hunter Strickland | ||||
Matt Reynolds | ||||
Cory Gearrin | ||||
Matt Moore | ||||
Derek Law | ||||
Joe Nathan | ||||
Indians | 9 | Jeff Manship | 0 | |
Cody Allen | ||||
Dan Otero | ||||
Joseph Colon | ||||
Danny Salazar | ||||
Joba Chamberlain | ||||
Carlos Carrasco | ||||
Michael Clevinger | ||||
Josh Tomlin | ||||
Marlins | 9 | Chris Narveson | 0 | |
Jo-Jo Reyes | ||||
Fernando Rodney | ||||
Dustin McGowan | ||||
Wei-Yin Chen | ||||
Bryan Morris | ||||
Brian Ellington | ||||
A.J. Ramos | ||||
Jose Fernandez | ||||
Pirates | 9 | Ryan Vogelsong | 0 | |
Mark Melancon | ||||
Francisco Liriano | ||||
Arquimedes Caminero | ||||
Neftali Feliz | ||||
Drew Hutchison | ||||
Cory Luebke | ||||
Jameson Taillon | ||||
Ivan Nova | ||||
Dodgers | 8 | Chin-hui Tsao | 0 | |
Hyun-Jin Ryu | ||||
Adam Liberatore | ||||
Alex Wood | ||||
Rich Hill | ||||
Brett Anderson | ||||
Ross Stripling | ||||
Brandon McCarthy | ||||
Rockies | 8 | Jake McGee | 1 | Jairo Diaz |
Scott Oberg | ||||
Jorge de la Rosa | ||||
Justin Miller | ||||
Jason Motte | ||||
Jeff Hoffman | ||||
Tyler Chatwood | ||||
Adam Ottavino | ||||
Angels | 7 | Al Alburquerque | 1 | C.J. Wilson |
Javy Guerra | ||||
Andrew Bailey | ||||
Cam Bedrosian | ||||
Tyler Skaggs | ||||
Andrew Heaney | ||||
Nick Tropeano | ||||
Diamondbacks | 7 | Keith Hessler | 0 | |
Andrew Chafin | ||||
Rubby de la Rosa | ||||
Kyle Drabek | ||||
Daniel Hudson | ||||
Patrick Corbin | ||||
Vicente Campos | ||||
Nationals | 7 | Mark Melancon | 1 | Aaron Barrett |
Shawn Kelley | ||||
Stephen Strasburg | ||||
Koda Glover | ||||
Sammy Solis | ||||
Lucas Giolito | ||||
Sean Burnett | ||||
Phillies | 7 | Andrew Bailey | 0 | |
Alec Asher | ||||
Elvis Araujo | ||||
Vincent Velasquez | ||||
Charlie Morton | ||||
Frank Herrmann | ||||
David Hernandez | ||||
Rangers | 7 | Colby Lewis | 0 | |
Shawn Tolleson | ||||
Matt Bush | ||||
Sam Dyson | ||||
A.J. Griffin | ||||
Martin Perez | ||||
Yu Darvish | ||||
Astros | 6 | Scott Feldman | 0 | |
Tony Sipp | ||||
Kevin Chapman | ||||
Pat Neshek | ||||
Will Harris | ||||
David Paulino | ||||
White Sox | 6 | Miguel Gonzalez | 0 | |
Michael Ynoa | ||||
Scott Carroll | ||||
Matt Purke | ||||
Nate Jones | ||||
Daniel Webb | ||||
Yankees | 6 | Kirby Yates | 1 | Nick Rumbelow |
Conor Mullee | ||||
Nicholas Goody | ||||
Ivan Nova | ||||
Branden Pinder | ||||
Nathan Eovaldi | ||||
Mets | 5 | Erik Goeddel | 1 | Zack Wheeler |
Jacob deGrom | ||||
Steven Matz | ||||
Matt Harvey | ||||
Josh Edgin | ||||
Padres | 5 | Matt Thornton | 1 | Carter Capps |
Fernando Rodney | ||||
Keith Hessler | ||||
Leonel Campos | ||||
Robbie Erlin | ||||
Rays | 5 | Eddie Gamboa | 0 | |
Tyler Sturdevant | ||||
Matt Moore | ||||
Alex Cobb | ||||
Chase Whitley | ||||
Cardinals | 4 | Seung Hwan Oh | 1 | Lance Lynn |
Miguel Socolovich | ||||
Jaime Garcia | ||||
Adam Wainwright | ||||
Twins | 4 | Andrew Albers | 0 | |
Kyle Gibson | ||||
Alex Wimmers | ||||
J.T. Chargois | ||||
Brewers | 3 | Wily Peralta | 1 | Sean Nolin |
Chris Capuano | ||||
Sam Freeman | ||||
Cubs | 3 | Hector Rondon | 1 | Dallas Beeler |
John Lackey | ||||
Joe Nathan | ||||
Orioles | 2 | Brian Duensing | 0 | |
Dylan Bundy | ||||
Mariners | 3 | Adrian Sampson | 1 | Charlie Furbush |
Arquimedes Caminero | ||||
Joe Wieland | ||||
Red Sox | 2 | Junichi Tazawa | 1 | Brandon Workman |
Carson Smith | ||||
MLB | 190 | 18 | ||
Percentage | 26.40% | 62.10% | ||
Overall | 27.30% |
MLB Games
With more than a quarter of all pitchers having had UCL reconstruction surgery, and ever-growing bullpen specialization increasing the number of pitchers used in each game, it seems not a game goes by where broadcasters aren’t mentioning the surgery in discussing a player as he works from the mound.
In fact, I calculated the percentage of regular season major league games in 2016 featuring at least one pitcher who has had Tommy John surgery, and the result was a quite staggering 86.4 percent! This means on a typical night with all teams in action, you could expect that 13 out of the 15 games will involve a pitcher whose career has been extended with the help of this surgery.
I know there are fans who lament how often broadcasters mention Tommy John surgery, but at least it is apparent just how often pitchers dealing on your screen have undergone this procedure. Here is the breakdown by team of how many games this season they played in which one or more pitchers (on that team or the opponent’s team) have had Tommy John surgery.
Team | TJ Games | TJ Games % |
Indians | 158 | 98.1% |
Marlins | 157 | 97.5% |
Athletics | 157 | 96.9% |
Royals | 154 | 95.1% |
Rockies | 154 | 95.1% |
Rangers | 153 | 94.4% |
Tigers | 152 | 94.4% |
Nationals | 152 | 93.8% |
Cardinals | 151 | 93.2% |
Braves | 150 | 93.2% |
Phillies | 149 | 92.0% |
Giants | 149 | 92.0% |
Mets | 148 | 91.4% |
Astros | 148 | 91.4% |
Pirates | 146 | 90.1% |
Diamondbacks | 143 | 88.3% |
Reds | 143 | 88.3% |
Blue Jays | 142 | 87.7% |
White Sox | 141 | 87.0% |
Angels | 133 | 82.1% |
Cubs | 130 | 80.2% |
Dodgers | 130 | 80.2% |
Padres | 129 | 79.6% |
Twins | 125 | 77.2% |
Yankees | 124 | 76.5% |
Red Sox | 120 | 74.1% |
Orioles | 118 | 72.8% |
Brewers | 118 | 72.8% |
Mariners | 114 | 70.4% |
Rays | 110 | 67.9% |
MLB | 4,198 | 86.4% |
Note that Cleveland played only 161 regular season games this year, meaning the Indians finished only three games all season in which no pitcher appeared who’d had Tommy John surgery. Those games were June 11 at the Angels, then back-to-back on June 21 and June 22 versus the Rays. In those latter games, the Indians received complete game efforts from Corey Kluber and Trevor Bauer, helping to reduce the total number of pitchers entering the game and hence the likelihood of involving one who’d recovered from a UCL reconstruction.
Major League Returns
There were 20 players who returned to the majors this season after playing their last game prior to Tommy John surgery at the major league level.
Player | Position | Return Date | Recovery Time (months) |
Tyler Chatwood | P | 4/6/2016 | 20 |
Cory Luebke | P | 4/7/2016 | 47 (1st), 26 (2nd) |
Dylan Bundy | P | 4/7/2016 | 33 |
A.J. Griffin | P | 4/8/2016 | 23 |
Chris Withrow | P | 4/10/2016 | 22 |
Christian Vazquez | C | 4/15/2016 | 12 |
Yu Darvish | P | 5/28/2016 | 14 |
Brandon McCarthy | P | 7/3/2016 | 14 |
Adam Ottavino | P | 7/5/2016 | 14 |
Don Kelly | OF | 7/6/2016 | 12 |
Joe Nathan | P | 7/24/2016 | 15 |
Tyler Skaggs | P | 7/26/2016 | 23 |
Homer Bailey | P | 7/31/2016 | 15 |
Josh Edgin | P | 8/3/2016 | 17 |
Frank Herrmann | P | 8/17/2016 | 41 |
Shae Simmons | P | 9/1/2016 | 19 |
Alex Cobb | P | 9/2/2016 | 16 |
Sean Burnett | P | 9/3/2016 | 27 |
Chase Whitley | P | 9/11/2016 | 16 |
Jason Vargas | P | 9/17/2016 | 13 |
Cory Luebke returned to the majors close to four years after his original Tommy John surgery failed: The tendon graft became “yellow and mushy,” forcing him to undergo a revision surgery and restart his rehab clock. Frank Herrmann is also a nice story, finally getting back to the bigs after more than three years and time spent at Triple-A in four different organizations.
Jason Vargas returned just days early enough to break a trend that I’d noticed in recent seasons: Starting pitchers have not been returning until 14 months or more (rounded to the closest month) after having Tommy John surgery. Here are the numbers by year of surgery:
Year of TJ | 13 months or fewer | 14 months or more |
2015 | 1 | 5 |
2014 | 0 | 11 |
2013 | 1 | 5 |
2012 | 7 | 9 |
2011 | 4 | 3 |
2010 | 2 | 2 |
2009 | 4 | 3 |
Only two pitchers (Gavin Floyd and Jason Vargas) out of 22 who were major league starting pitchers at the time of their Tommy John surgery since the start of 2013 have returned to the major league level in fewer than 14 months. This represents just 9 percent of all starting pitchers who had the surgery between 2013 and 2015. By contrast, 50 percent of starting pitchers who had the same surgery between 2009 and 2012 returned in 13 months or fewer.
This 2013-2014 period roughly lines up with a time in which multiple major league pitchers were forced to undergo quick second Tommy John surgeries (Daniel Hudson, Cory Luebke, Brandon Beachy, Jarrod Parker, Jeremy Hefner, Kris Medlen and Jonny Venters twice). Perhaps organizations (and agents) put the brakes on rehab schedules in response, in an effort to prevent revision surgeries for their players.
References & Resources
- Jon Roegele Tommy John Surgery Database
- Joey Kaufman, The Orange County Register, “Angels pitchers Garrett Richards, Andrew Heaney hoping stem-cell treatment helps them avoid Tommy John surgery”
- Pedro Moura, Los Angeles Times, “Garrett Richards is encouraged by outing in Arizona”
- Phillip Williams et al, American Journal of Orthopedics/NCBI, “Platelet-Rich Plasma Can Be Used to Successfully Treat Elbow Ulnar Collateral Ligament Insufficiency in High-Level Throwers.”
- Corey Brock, MLB.com, “Luebke optimistic after second Tommy John surgery”
I only really know the story of how the Jays got their pitchers, but it seems like only Hutchison (now former Jay) was homegrown- though I’m not sure when he had his. I believe Osuna had his before he came to the Jays. Everyone else had theirs before coming to the Jays.
Could the Jays know something no one else does? Or just luck of the draw?
Antolin too- don’t know my prospects like I should.
Is there another Carl Crawford, that I can’t find on baseball-reference, who was a pitcher?
No you’re right he’s the outfielder. That table should say MLB Players. But he did have a PRP injection, and ultimately had Tommy John surgery.
Wow. I totally forgot about Jonny Venters.
Is it a coincidence that the Biogenesis scandal broke in 2013, or could alternative treatments have shortened the rehab times for surgery in the 2009-12 sample?
The article headline is misleading. There needs be to at least another year to really make any statement about what direction the rate of surgeries is headed.
Completely agree, article shows 2016 was a down year, but rates seem to be mostly random noise, certainly not a trend towards decreasing. The Pearson R value is 0.2675 which is not significant but actually suggests a increasing trend over the 10 years mentioned.