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Tommy John's Shadow

With the trade of Johan Santana, eyes now turn to rehabilitating pitcher Francisco Liriano as the next great Twins starter. But what are his chances of escaping Tommy John's shadow?

About the only dark cloud to mar the otherwise magical blue skies of the 2006 AL Central pennant race was the news that Twins rookie pitcher Francisco Liriano was being shut down for the season, and eventually underwent ulnar collateral ligament replacement surgery -- a.k.a. Tommy John surgery. Twins fans were keeping an eye on Liriano's progress during the traditional 18-month rehab from the surgery, but now with Johan Santana no longer with the club, that eye will focus far more intensely as Twins fans hope that Liriano can replace the departed Santana in more ways than one.

It's clear that Twins fans want to be optimistic -- and more than one member of the blogosphere has pointed to the Hardball Times 2007 study on pitchers who've received the surgery to suggest that most pitchers who have it come back, if not better than new, at least not significantly worse than they went in. However, having found a (likely incomplete) list of pitchers who've undergone the procedure, I thought I'd do my own more casual analysis.

The only sure thing I found was that the best chance Liriano has of pitching for a good long time in the major leagues is to avoid a second surgery. Some examples of guys who didn't really recover from TJ surgery:

Brian Anderson - A left-hander who pitched in the rotation for the 2001 World Series-winning Diamondbacks, Anderson injured his UCL pitching for the Royals in 2005. He rehabbed the arm and attempted a comeback with the Texas Rangers in 2006, but re-injured the elbow and decided against a second surgery, instead retiring at 35.

Andy Ashby - Acquired by the Phillies from the San Diego Padres; the Phillies thought they were getting an ace, but Ashby's chronic injury woes prevented him from fulfilling that role. (Most folks who likely remember Ashby remember him for his cussing-out of Phillies fans before being dealt to Atlanta.) Ashby underwent the surgery in 2005, and though it could be argued that he regained his pre-surgery form, his pre-surgery form in 2003 was a 3-10 record with a 5.18 ERA; not enough for a team to take a gamble on a 38-year old pitcher.

Kris Benson - A player some Twins fans will remember as a pitcher the Twins were said to be interested in during their AL Central championship days, Benson was the #1 overall pick in the 1996 draft. He underwent the surgery in 2000, missing all of the 2001 season, and though it's not absolutely clear that he hasn't regained his effectiveness, given that he'd only thrown 400 major-league innings prior to the surgery, it's true that Benson hasn't matched his pre-surgery ERA or K/9 rates in any major league season since. He's been essentially a league-average pitcher since the surgery, which for a former #1 pick, has to be considered a disappointment.

Dewan Brazelton - If it's hard to gauge what Benson's caliber was prior to the surgery, it's even harder to gauge Brazelton's, since he had the surgery at 15. However, given that Brazelton was the #3 overall pick in the 2001 draft, either his upside was still considered good (in which case his 8-25, 6.38 career marks have to be considered disappointing) or the Devil Rays really are that incompetent as an organization (which doesn't say good things for the Twins' acquisition of Delmon Young).

Paul Byrd - Simply looking at the numbers, it would seem that Byrd is in fact one of those pitchers for whom TJ surgery allowed him to come back better than ever.  However, his presence in the Mitchell report suggests that steroids are as much if not more responsible for his resurgence than the surgery.

Jorge DePaula - Another pitcher for whom it's hard to get a handle on - he underwent TJ surgery in 2004, and has a total of 20 1/3 major league innings prior to the surgery and 6 2/3 major league innings afterward. To suggest that the surgery didn't hurt DePaula is to suggest that he was never going to be a big-league pitcher anyway.

Jesse Foppert - A second-round pick in the 2001 draft, Foppert immediately had the look of a prospect with potential; reporting to short-season A ball after his college season ended, Foppert went 8-1 with 35 hits allowed and 23 walks in 70 innings while striking out 88 and posting a 1.93 ERA. Baseball America named Foppert the best pitching prospect in baseball prior to the 2003 season. Foppert moved quickly through the Giant organization, making his debut in 2003 with resonable numbers for a 22-year old starter (103 H and 101 Ks in 110 innings over 21 starts), but went in for TJ surgery in September. Since the surgery, Foppert has thrown 11 1/3 major league innings, allowing 12 hits and 13 walks. The Giants tried to bring him back again in 2007, but after he walked four men while getting only three out in three appearances in rookie ball, Foppert was released and is now out of baseball at 27.

Pat Hentgen - A 20-game winner for the Blue Jays in 1996, Hentgen underwent TJ surgery in 2001 after signing a big free-agent contract with the Orioles. He came back to pitch reasonably well (but not to his previous standard) in 2003, but was let go as a free-agent and went back to the Blue Jays, where he struggled in 2004 and eventually announced his retirement shortly after giving up Gary Sheffield's 400th career home run.

Steve Karsay - Karsay had TJ surgery in 1996 at the start of an 11-year major league career that saw his numbers swing wildly from good to poor and back again; I put him in this category because his TJ surgery didn't end his injury troubles which eventually forced his retirement in 2006.

Joe Mays - The pitcher I'd expect most Twins fans to think of immediately when they think of 'Tommy John surgery'; Mays underwent surgery in 2003 and missed the 2004 season after struggling with arm troubles following his breakout 2001 campaign. Mays never again came close to his 2001 form, even after the surgery, and pitched just over 200 ineffective innings (in a career of just under 1000 innings) after the surgery before retiring.

Mark Wohlers - Yet another pitcher who would make a limited study of TJ pitchers look good without really intending to, Wohlers had already suffered a significant decline in effectiveness (based on a syndrome called 'Steve Blass disease') before his first TJ surgery in 1999. Wohlers came back and pitched reasonably well after his TJ surgery with the aid of counseling and other treatments, but when the grafted tendon from his '99 surgery ruptured in 2004, Wohlers chose to retire from baseball rather than attempt a second comeback after TJ surgery.

Kerry Wood - The consensus 1998 Rookie of the Year after putting up nearly obscene K numbers for the Cubs, Wood missed all of 1999 recovering from TJ surgery; he and Mark Prior constitute the second 'wake up call' that made pitch counts a thing of the present. Though Wood struggled in 2000, it appeared that he'd made a full return to form, including an even better season in 2003 than the one that won him RoY in '98. Since then, however, other arm troubles have cropped up and sapped Wood of his ability to stay healthy: after throwing 211 innings in 2003, he pitched just 140 innings in 2004 and just 110 innings in 2005-2007. The surgery may have gotten Wood back temporarily to where he was beforehand, but in what has to be the scariest possible parallel to Liriano, was considered a Hall-of-Fame potential pitcher as a rookie and ended up being paid about $30 million over three years for basically a season's worth of pitching and is still headed downhill.

Victor Zambrano - No, not Carlos Zambrano -- Victor Zambrano; V Zambrano had his first TJ surgery in the minors, then broke out with the Devil Rays in 2001, though it looked as though wildness, not arm strength, would be his undoing in the big leagues. V Zambrano made some slow progress in improving his control before more arm troubles put him back under the knife in 2006; since then, he's pitched just 23 or so ineffective big-league innings (ERA over 9.00) and is on the verge of being out of baseball.

Jeff Zimmerman - Zimmerman's numbers look oddly like Jesse Crain's prior to his first TJ surgery in 2002; Zimmerman didn't manage to get back to the majors before suffering additional arm troubles, including a second TJ surgery in 2006. Zimmerman took the 2007 season off but does not consider himself retired, and he's said to be looking for his chance to prove himself to the Rangers organization come this spring.

Just so the essay isn't all doom-and-gloom, here are some examples from the same list of guys who seem to have been helped by the surgery:

A.J. Burnett - Dealt from the Mets to the Marlins as part of the latter's fire sale in 1997, Burnett seemed on the road to big-league stardom after he throw a no-hitter in 2001, then followed it up with an extremely solid 12-9, 3.30, 1.189 WHIP season in 2002 as a 25-year old. Burnett suffered the UCL injury in 2003 and underwent the surgery almost immediately, missing the Marlins' 2003 World Series run. Burnett's performance since the surgery has largely matched his pre-surgery performance, especially last season for the Toronto Blue Jays.

Chris Capuano - Another pitcher who underwent the surgery before ever reaching the big leagues, Capuano's minor league numbers suggest a power pitcher (his K/9 ratio was over 9 in both A and AA prior to his surgery), Capuano has found big-league success by re-inventing himself as a finesse pitcher with a deceptive delivery and excellent change-up.

Manny Delcarmen - Another pitcher who underwent TJ surgery in the minor leagues, Delcarmen is said to have actually gained velocity from the surgery, and is currently enjoying some success in limited action as a setup man/middle reliever for the Red Sox.

Ryan Dempster - Dempster underwent the surgery in 2003 and converted from a league-average (at best) starter to an outstanding closer. However, since there are other examples of mediocre-to-decent starters becoming outstanding relievers and closers (see Dennis Eckersley, Rick Aguilera, Eddie Guardado, Jason Isringhausen, etc.), it's hard to say if the surgery was responsible for his success. Certainly, it hasn't hurt him any.

Jason Isringhausen - One of a trio of young pitchers known as 'Generation K' when he came up with the Mets in the early '90s, injuries devastated all three pitchers (and this is considered in some circles the initial 'wake up call' that led to the establishment of pitch counts, especially for young pitchers), and it took until 2000 until Isringhausen achieved big-league success as a closer in Oakland. Again, hard to say if his success was due to the surgery or his change in role, but the surgery clearly didn't hurt once he adjusted to it.

John Lieber - Another pitcher who seems to have been unequivocably helped by TJ surgery, Lieber was also at the end of a big-league career -- his excellent 2004-2005 seasons are now a distant memory after poor 2006 and 2007 campaigns (at ages 36 and 37 respectively).

At this point, anything can happen, but even if Liriano pitches well in 2008, it's still not the end of the road (see Wood, Kerry).

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