In 2014 there were more Tommy John surgeries performed than in the first 25 years of its existence.

The procedure has become so commonplace some parents of minor league prospects are even requesting the eponymous Tommy John before it is even deemed necessary. Is this the new norm, or is this some kind of mass hysteria? Let’s take a closer look at what’s driving the need for Tommy John, and how it affects the fantasy game. 

In recent years, the first few rounds of a Fantasy Baseball draft are like walking through a field of land mines

In 1974, Frank Jobe, team physician for the L.A. Dodgers, performed ulnar collateral ligament (UCL) reconstruction surgery on Dodger’s pitcher, Tommy John. He was 31 yrs. old at the time, and had won 124 games before the surgery. After the surgery he won 164 games, and retired in 1989 at the ripe old age of 46. Tommy John’s post-surgery success on the mound was immediate evidence that the surgery was effective. At the time it was regarded as a one-off chance to prolong the career of one of the game’s better arms. Little did they know just how popular it would become.

Tommy John surgery took some time to attain its eponymity. There was only one more such surgery in the 1970s – Brent Strom in 1978. A second Tom (Candiotti) started off the 1980s, during which 24 players went under the knife. 74 Tommy Johns were performed in the 1990s, giving us a nice neat sum of 100 for the 20th century. The procedure really gained traction in the 2000s, when 419 players had it done. Now, just halfway through our present decade there has already been 351 UCLs performed. And, there are no indications that the number has plateaued, as there were 93 Tommy Johns in 2014 – the most in one year to date. 

I love my stats, but I’ll try not to burden you with too many – just a couple more: the average age for a Tommy John patient in the 1980s was about 27. The average age for the surgery in 2014 was 24. This includes 8 teenagers.

So, what does all this entail for us lot in Fantasy Baseball? Well, let me tell you about a little lesson I learned during the 2014 season.

Last year I went against all that I have ever believed in, and preached, and I took a pitcher in the 3rd round of my 14-team “home” draft. You can probably guess where this is headed. That pitcher was none other than Jose Fernandez, Miami’s young phenom, who wooed me with his eye-popping stats from the previous year. The bromance ended before it could even turn into a summer fling. Fernandez pitched his last game of the year on May 10th. Five days later it was announced that he would undergo season-ending Tommy John surgery.

In recent years, the first few rounds of a Fantasy Baseball draft are like walking through a field of land mines, except the explosions are delayed. The explosions, of course, are the agonizing season-ending injuries that can come on a terrible Tuesday in early May, for instance.

Unfortunately, some of today’s best hitters are “painfully” injury-prone. Cargo and Tulo, for example, have been consistently rated somewhere in the top 2 rounds. Yet they both continuously have injuries. These are the land mines that haven’t been buried deep enough. The wind has exposed them over time, and we simply step around them as we approach them. Right?

Turner Field’s diamond is the Bermuda Triangle for pitchers.

It’s the well-buried land mines that are our biggest concern – the pitchers who go down for the season for Tommy John surgery. It happens every year now. Stephen Strasburg, Adam Wainwright, Brandon Beachy (easy to forget how good he was), Matt Harvey, and Jose Fernandez have all had Tommy John. It reads like a who’s who list. 

The question is: is there a way to detect where these land mines might be? Perhaps, a place where the grass is a little more bare? Well, maybe not, but we do learn of certain safer routes to take after years of trial and error.

Never again. Never again will I take a young phenom pitcher in the early rounds. Yes, the tearing of the UCL can occur at any age, but as the stats above suggest, it’s more likely to happen to a young pitcher whose arm has not been through the stress of a full season (or two) of throwing.

On top of this, you should be wary of pitchers coming off the surgery. They tend to have a slightly tougher time getting back to their optimum performance, especially when they return part way through the season. In even worse scenarios, the replacement tendon/ligament does not always take, and a second Tommy John becomes necessary. 

So, let’s take a look at which pitchers you might want to think twice about in your draft this year because of injury risk or arm fatigue. Please keep in mind that this does not change my overall rankings of each hurler. It’s a list of elite and good arms that I will tend to shy away from when their average draft pick (ADP) number is called. In other words, this is a strategy to step around some of those well-hidden land mines. 

1. Chris Sale – Had an elbow issue early in 2014, and has a fairly violent release for such a lanky frame. He’s an elite ace, but my gut says to stay away, just in case. 

2. Masahiro Tanaka –  elbow almost spells t-r-o-u-b-l-e backwards. Elbow backwards spells w-o-b-b-l-e. Well, it almost works. Anyway, elbow issues are the biggest of all red flags. Let someone else take the chance with Tanaka. He might get back to his 2012 numbers, but is he worth the risk? A pitcher has to be completely on top of his game when he pitches half his games at Yankee Stadium, not to mention against the high-octane offences of the A.L. East.

3. Jose Fernandez – Okay, here’s where I’m admittedly a little biased. He burned many of us last year. It’s tough to say exactly when Fernandez will make his post-Tommy John debut, as his surgery was in mid-May last year. There’s a 12-14 month recovery time for pitchers. So the Marlins have indicated June, but they may just use the All-Star break as an extra crutch. In addition, he may not find his A-game out of the gates. On top of this, Marlin’s management will probably baby him for the remainder of the year, as they probably should. Let the drooler beside you assume the risk.

4. Julio Teheran – Teheran and Alex Wood, who both just celebrated their 24th birthday in January (15 days apart), were the bright spots in an otherwise injury-riddled staff. Brandon Beachy, Kris Medlen and Johnny Venters have now combined for 7 Tommy John surgeries. As a catch-22 result, the workload on the two young standouts will continue to increase, and they may not be ready for it.  

5. Alex Wood – (see above) … then add: Wood already had Tommy John when he was 18 yrs. old. Hmm. There’s a big hex on young Atlanta hurlers. Turner Field’s diamond is the Bermuda Triangle for pitchers. Top prospects just seem to disappear. Of course, if you don’t believe in the Bermuda Triangle “effect”, then you’re thinking, “How much bad luck can the Braves have?” Act accordingly.

6. Sonny Gray - Pitched 219 innings in his sophomore season. This is unheard of these days, as some teams coddle their prospects into their 4th year. Even if there’s no injuries, there is a chance of fatigue setting in. Besides, Billy Beane seems to have traded away most of his run support from last year.

7. Matt Latos – It’s so tempting to target Latos with the native Floridian’s move to pitcher-friendly Marlins Park, and its pitcher-friendly division. Yet we shouldn’t forget he began and ended the season with injuries – elbow-related injuries. He did pitch alright when he could take the mound, but not well enough to tolerate the injury bugs that could follow him into 2015.

8. Yordano Ventura – “Ace” Ventura will be a very good, if not elite, hurler for years to come. The ease of his 100 mph fast ball is tough to fathom, and he’s already being compared to Hall of Famer, Pedro Martinez. However, I reckoned Jose Fernandez in the same vein last year, and I thought he had an indestructible frame. Although the Royals managed to limit him to 183 innings in the regular season, he did pitch another 25 innings right through to Game 6 of the World Series. Arm fatigue or worse could set in this year. 

9. Michael Wacha – Was his season-ending pitch in the NLCS an omen for season-ending surgery this year? Maybe not, but last year he was limited to 19 starts due to shoulder issues. Wacha has yet to prove his arm has the endurance for anything close to a full season. I wouldn’t trust him with a 10-round pole this year.

10. Gerritt Cole – Two trips to the DL for shoulder issues last year are enough of a red flag to let him slide.

 

Bonus Caution 

Michael Pineda – “Pine Tar” Pineda will be under the microscope for many reasons. His ideal frame belies his questionable durability, and a probable innings limit will hurt his Ws and Ks.

 

Special Exemption

Matt Harvey - Harvey is, of course, another elite talent who is returning this year after going under the knife for Tommy John. What is the difference in his case? Well, in a word, timing. His surgery came on October 22, 2013, which has given him a nice cushion of 16 months for recovery, two more than the prescribed upper limit of 14 months. Besides this, he will go through the entire Spring Training schedule, as well. This gives him that much extra time to iron out all the wrinkles, and rediscover his game, instead of coming back part way through the season. I suspect you won’t be able to get Harvey as low as you will be able to this year for a long time to come.