A one-year recovery is hard enough.
It takes a minimum of 12 months for a full network of blood vessels to form around a replacement of an ulnar collateral ligament — aptly known as the UCL, in baseball and medical circles. You cannot expedite this process: don’t expect to work ‘ahead’ in rehab for this very reason.
This is the basis of Tommy John surgery and rehab, a one-year minimum process where a torn UCL is replaced with a graft and fortified into game action again. Light to moderate bullpen work will get an arm through months 8-9; simulated games might be mixed in during months 11-12.
Don’t expect the arm to be 100% on day 365, though. It can take up to 18 months for a cut-into flexor mass to regain the ‘touch’ of pitching.
We’re a long way from July 1974 when Tommy’s arm was cut into by Frank Jobe in an experimental procedure. We’re still a long way from pitcher sanity in this practice — and we’re an even longer way from sanity if this MLB lockout continues.
It’s enough of a challenge to undergo this surgery, and the post-recovery landscape should be much clearer for these patients than it currently is. Even if a UCL recovery has been 100% healed, those pitchers didn’t go through it to face the uncertainty of a work stoppage.
Tommy John surgery: Is there a ‘best’ time?
(No. There isn’t a good time at all.)
April, May or June is arguably the worst time to have Tommy John surgery. A pitcher has geared up for a full season at this point and is beginning to ‘peak’ in daily workload. Going under the knife at that time means saying goodbye to spring training action the next year, and hoping a modified gear-up is good enough to succeed in games the following season.
July or August surgery could put the next season of action in question altogether, depending on how cautious an organization might be. A half-season of work might at least be collected before the surgery.
September or October surgery will almost surely push an arm out of action the next year. Physically, this can be the safest, most effective, least-rushed timeframe — but mentally, it can be extremely difficult to handle a 16- or 17-month return to action.
Colorado’s TJ scars
Let’s have ourselves some case studies, Rockies fans.
Jose Mujica
UCL reconstruction was Mujica’s fate on September 11, 2018. A September incision suggests a 17-month recovery process; this meant Mujica could expect a full-strength Cactus League in 2020.
That spring training was perhaps the most depressing ever.
MLB shut down on March 12, 2020, while Mujica was 18 months post-surgery.
He was ostracized to the Rockies’ alternate site that summer, where he geared up for an MLB debut on September 8. Mujica was deprived of any minor league build-up, and had a forgettable first outing that immediately sent him back to the alternate site.
He would go on to pitch 4 1⁄3 innings in the big leagues that year — and hasn’t returned to the big leagues since.
Mujica elected free agency on October 13, and has yet to be picked up by another organization. He did have his taste of the minors this year, but it was hardly a return to normal after his routine was so heavily disrupted — for two years in a row.
The MLB lockout has the baseball world waiting with anxious breath. The mid-February report date for pitchers and catchers is now tentative, and until it is confirmed, the latest wave of UCL scars has less certainty than they did... after the surgery itself?
The minor league schedule is still on, but if a lockout keeps somebody from getting called up to the big leagues, it’s hardly a consolation for arms like Mujica. They have already been deprived of enough opportunities.
For now, he’s forced to showcase his stuff in winter ball and hope it’s good enough to put him back in an affiliate uniform.
Peter Lambert
UCL reconstruction was a product of ongoing forearm discomfort for Peter Lambert during 2020 spring training. He would miss all of the COVID shutdown that year, but wouldn’t undergo surgery until late July of 2020. This meant his 2021 action was in question, but he did return for 5 2⁄3 innings in the big leagues this year (and 10 1⁄3 minor league frames).
Lambert now returns to a ‘standard’ phase of offseason preparation, elbow willing. He sees the departure of Jon Gray opening up a spot in the Rockies’ rotation — but an MLB lockout could make Triple-A Albuquerque the highest possible destination in April.
The Rockies are in need of a proven starter to fill some Jon Gray-sized shoes. This arm is somebody that may expect a heavy workload, which is something a delayed start can make difficult to time up. (Remember when 2020 Opening Day happened in July?) It’s easy to expect the season to be business as usual and to prepare as such, but it’s a new game if the MLB season isn’t starting in April. In-game rigors are a completely different animal than simulated games.
Mind games
A mental hurdle exists, and it’s only getting bigger for as long as the lockout continues. Blocking it out is far easier said than done, and especially when Tommy John rehab already blocks out so much action.
This isn’t to accuse any pitcher of caving to mental strain, but to deny it exists is to discredit the mental challenges they have already overcome in their return to action.
It’s hard enough to be uncertain for the years following Tommy John surgery. It’s even harder when some uncertainty has nothing to do with your arm.
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Dustin May updates recovery from Tommy John surgery | True Blue LA (SB Nation, Los Angeles Dodgers) *Published Nov. 28
At least Mujica and Lambert are finished with their UCL rehab. The Dodgers’ Dustin May underwent Tommy John surgery a few weeks into the 2021 season, and was “progressing in Arizona” at the Dodgers’ spring training facility before the lockout commenced. He can no longer rehab under that same level of club control for as long as the lockout continues.
Even more thoughts on the ongoing MLB lockout | Bleed Cubbie Blue (SB Nation, Chicago Cubs)
Our friend and SB Nation colleague Al Yellon gives us his thoughts on the lockout uncertainty, as each unresolved minute leads us closer to missed action. “If I had to guess now? We won’t hear much about negotiations until at least January, and maybe mid-January,” he said.
Coors Field Cat Is Cancer Free! | CBS Denver
A big shoutout is in order for Shannon Hurd, looking out for the beloved Coors Field Cat and helping coordinate some medical treatment for our feline friend at 20th and Blake.