At the start of the 2013 MLB season, one-third of all pitchers on an MLB roster had previously undergone Tommy John surgery. If Oregon’s Cole Irvin ever makes it to the big leagues, he’ll join the list of players who have been able to overcome baseball’s most daunting procedure.
Irvin was arguably Oregon’s best starting pitcher last year, posting a 2.48 ERA and 1.09 WHIP during his freshman campaign. In mid-January of 2014, his elbow flared up and he was shut down by the Oregon coaching staff.
After getting an MRI, it was determined he had torn his ulnar collateral ligament, and after getting multiple opinions, he decided to opt for Tommy John surgery. The surgery was performed on Feb. 10 at one of the most respected clinics for the procedure – the Kerlan-Jobe Orthopaedic Clinic.
The general timetable for recovery from the surgery is nine to 12 months, and pitchers often vanish from the public eye during that time. However, the rehab process is one of the most tedious and mentally strenuous times for any athlete.
“It’s nowhere close to what a lot of people have to go through in their lives, but it was definitely the hardest thing that I’ve ever had to mentally go through,” said Arizona Diamondbacks pitcher Daniel Hudson, who is nearly eight months removed from his second Tommy John surgery in less than two years.
The surgery replaces the torn ligament with a tendon harvested from elsewhere in the patient’s body, so the first few weeks following surgery are spent doing exercises that teach the transplanted tendon how to become a ligament.
Former Oregon pitcher Christian Jones underwent Tommy John surgery prior to the 2012 season and recalls doing exercises such as touching his thumb to his pinky, small wrist curls and making the “OK” sign and the “Spiderman hand” sign.
After about three weeks, Jones started range of motion exercises where he would try to touch his shoulders and extend as far as he could. These were done every day for the next three months with shoulder and back exercises gradually built in after about six weeks.
Jones started playing catch at 30 feet four months and 10 days after his surgery and very slowly worked his way up to long toss. He continued to play catch and do rehab exercises until throwing flat ground (pitching, just not on a mound) at about nine-and-a-half months. After starting bullpen sessions at 10 months, he was finally able to pitch in an intrasquad game 10 months and three weeks out of surgery.
A month later he pitched his first post-surgery game for Oregon, throwing three scoreless innings of relief in the February season opener against Hawaii.
While Jones had a successful 2013 season for Oregon, he admits that he didn’t feel completely comfortable pitching until mid-October, about 20 months after his surgery.
“For the longest time, throwing did not feel normal at all,” Jones said. “I thought that I was throwing wrong.”
The reason Jones felt this way was that following surgery he was in the process of regaining proprioception — the body’s ability to sense its position, location and movement.
“The nerves have to learn where things are,” explained Will Carroll, lead sports medicine writer at Bleacher Report. “It took a long time for Peyton Manning to figure out where his hand was because his nerve had been impinged for so long. It’s the same exact thing.”
Individuals regain proprioception at different rates based on their rehab. Hudson says that getting back the feel for his mechanics and pitches has not been a problem.
While the physical effects of the feelings Jones described are significant (Carroll writes, “A 1/8th inch difference in release point can mean an eight-inch difference in pitch location as it crosses the plate.”) there is also a mental toll.
“Your confidence is nowhere close,” Jones said. “If you’re a normal athlete and something tweaks or feels iffy, you kind of stop doing it. But when you’re coming back from surgery, it feels tweaked the entire time.”
For Hudson, the length of the rehab process is the most mentally taxing aspect.
“Every single step (of the process) that you take feels like it takes forever,” Hudson said, “especially when all the guys are getting ready to go out and compete in games and I’m just sitting there playing catch with my trainer.”
The rehab process is so grueling that for a few hours after Hudson found out he’d need surgery for a second time, he was unsure he’d be willing to go through rehab again. Ultimately, the drive to get back on the mound overcame the temporary temptation to walk away from the game.
“After I talked to my wife for awhile and my family they made me realize that if I didn’t try again, I wouldn’t be able to look at myself in the mirror again in a few years,” Hudson said.
The return rate of pitchers from Tommy John surgery is between 85-90 percent, with the majority of failures being cases of young high school or college pitchers who hang up their spikes because they don’t expect to pitch at the professional level. Setbacks during the rehab process happen, but complete failures such as Hudson’s first case are extremely rare. (He required a redo of the procedure.)
The next calendar year will undoubtedly be a dreary and challenging process for Irvin, but those around him are confident that he has the mental makeup to make it back.
“He’s probably as well prepared for this as anybody,” pitching coach Dean Stiles said. “He’s done his research in terms of the whole surgery process. He knows about the rehab process. He’s gone to the finest clinic in the country. So he mentally got himself prepared for this early on and now I think it’s just a matter of supporting him.”
Follow Chris Mosch on Twitter @chris_mosch