High Risk Starting Pitchers in the Post-Tommy John Surgery Death Zone

Injury prediction and prevention is most likely the next “Moneyball”/“The Extra 2%”/“That 1 Weird Trick to Help Boost Your Testosterone” (hint, it’s HGH) that you don’t really hear teams talk about very much. In fact, there is not a single thing that teams obstruct, mislead, and straight up lie about more than injuries (A.J. Preller says hi). One thing has trickled out, though, and that is conventional wisdom around the league holds that Tommy John surgery has a shelf life of about 7-8 years. This is by no means a fact, and every case is obviously different, but if a pitcher who falls in that range has also been having arm trouble recently, it seems to my civilian mind that is a recipe for disaster. Here are the pitchers who are at high risk for a 2nd Tommy John surgery and/or performance decline:

Steven Matz NYM, TJS date: May 2010 – I drafted Matz as my 4th starter in my latest 12 team redraft league. I say this to highlight the fact I don’t hate these pitchers and I’m not completely avoiding them, especially in redrafts. The risk becomes greater in dynasty and keeper formats for obvious reasons. Matz has long been labeled injury prone, and the concerns have only heightened since reaching the Majors. He underwent arthroscopic surgery this off-season to remove a large bone spur from his pitching elbow, which hopefully helps with the shoulder impingement that was bothering him all year and required a platelet plasma injection of its own. This May will be the 7-year anniversary of his first Tommy John surgery. Draft at your own risk.

Stephen Strasburg WASH, August 2010 – Strasburg was basically shut down in mid-August with a small tear in the pronator tendon, which caused his forearm to tighten every time he threw his slider. In an effort to remain healthy this year he will try to limit his slider usage, and if Spring Training is any indication, it looks like he might pitch exclusively from the stretch. I appreciate the willingness to try new things and recognize the elbow tendon grim reaper is looming, but even if the adjustments minimize the risk of injury, it increases the risk of performance decline. Strasburg’s performance wasn’t the problem when he was on the mound. There are more unknowns here than I am comfortable with when drafting an ace.

Danny Salazar CLE, August 2010 – Salazar’s elbow started bothering him around last year’s all-star break, eventually sidelining him in August after saying, “there’s something in my elbow and I don’t know what it is.” He was later diagnosed with the catchall “elbow inflammation.” His strikeout upside is worth hoping his elbow tendon can continue hanging on by what I’m sure is a thread, and he’s looked great so far this Spring, but don’t tell me you weren’t warned.

Jacob deGrom NYM, October 2010 – deGrom had season ending surgery in late September to repair ulnar nerve damage in his right arm. He had been experiencing forearm soreness for about a month before the surgery and his velocity was down all season from where he sat in 2015. It seems the surgery has worked so far, as he has dominated in Spring, so while he could be worth the risk in redrafts, I would be highly skeptical of him in Dynasty leagues.

Carlos Carrasco CLE, September 2011 – The problems have already started for Carrasco this season, as he experienced swelling in his elbow after his March 13th start. The MRI came back clean and he should return to action later this week, but considering the problems the first 4 guys on this list experienced in their 6th post-TJS year, it isn’t a great sign.

Rich Hill LAD, June 2011 – I don’t think I’ve ever seen a potential ace’s draft stock discounted more due to injury risk than with Hill this year. I’ve been ending up with him everywhere, but am preparing for under 150 IP.

Adam Wainwright STL, March 2011 – The torn ACL that kept him on the shelf for 5 months in 2015 might actually help preserve Wainwright’s elbow longer than expected. The bigger question is how effective he will be, as he took a major step back in 2016, and almost surely looks to be in the back nine of his career. I’m expecting an ERA under 4 this year, but a return to ace status would be a surprise.

Jordan Zimmermann DET, August 2009 – If I had been doing this list for the last two years, Zimmerman would have made the list both times, and both times you would have been keen to stay away from him. His velocity has now dropped two years in a row, and he pitched in only 105.1 innings last season due to injuries, although unrelated to his arm. He’s been getting pounded this Spring too, and even if you don’t buy into the extra injury risk, the performance decline looks to be in full swing.

John Lackey CHC, November 2011 – Lackey’s 2011 Tommy John surgery seemed to give him a late career jolt, as he just finished up his 4th excellent and healthy post-surgery year at the ripe old age of 38. He did hit the 15-day DL in August with shoulder tightness last year, but I’m not sure there is any increased injury/performance risk here that any other 38-year-old pitcher doesn’t already inherently have.

Francisco Liriano TOR, November 2006 – Liriano’s been a high injury/performance risk since going under the knife over a decade ago, and that has never been more true than it is for this season. Considering the very low draft price, though, it might be a risk worth taking.

Wei-Yin Chen MIA, 2006 – Chen’s velocity was down last year and he pitched only 123.1 innings due to a left elbow sprain that held him out for two months. He has already surpassed the 7-8 year timeline, but there are signs his luck is about to run out, if it hasn’t already.

Edinson Volquez MIA, August 2009/Jaime Garcia ATL, February 2008 – The list of starting pitchers who underwent Tommy John surgery before Volquez and Garcia and are still pitching effectively (without needing a 2nd TJS) is very short. Other than Liriano and Chen, the entire list literally consists of Anibal Sanchez and Scott Feldman. And I’m using the word “effectively” very loosely here. Both Volquez and Garcia would have made last year’s imaginary list, and while both stayed healthy, their numbers fell off a cliff.

Dice-K June 2011 – The clock might finally be ready to hit midnight on Dice-K’s long run of stateside dominance 😉

By Michael Halpern (@MichaelCHalpern)
Email: michaelhalpern@imaginarybrickwall.com
Twitter: Imaginary Brick Wall (@ImaginaryBrickW)

2016 Fantasy Baseball Rankings: Top 75 Starting Pitchers

The top 75 starters are a mix between boring mid rotation veterans, and the second tier of high risk, high reward youngsters. Picking the right player or two from this group can really make your draft.

2016 Fantasy Baseball Rankings: Catcher/First Base/Second Base/Shortstop/Third Base/Outfield(Top 25)/(Top 50)/(Top 75)/Starters(Top 25)/(Top 50)/(Top 100)/Closer/Top 250 Overall

51) John Lackey CHI-NL – Put up a career best 2.77 ERA last season as a 36-year-old. Will now have the powerful Cubs offense for run support. 2016 Projection: 14/3.52/1.25/160

52) Scott Kazmir LAD – Ride him in the first half, trade him at the deadline before the inevitable collapse. 2016 Projection: 12/3.43/1.20/164

53) Jaime Garcia STL – Can’t stay healthy, but has a career pitching line of 3.31/1.26/573 in 724.1 IP. He isn’t going to strike many guys out, but the guy can pitch. 2016 Projection: 9/3.38/1.19/128

54) Jordan Zimmerman DET – Was trending in the wrong direction even before the move out of the NL East. Looks like he might get comfortable in this “safe and boring” tier for the next few years. 2016 Projection: 13/3.62/1.24/155

55) Shelby Miller ARI – The centerpiece in the trade heard round the world. Dave Stewart better hope he pitches better than my projection. 2016 Projection: 12/3.61/1.26/162

56) Wei-Yin Chen MIA – Moving from a hitter’s park in the AL East to a pitcher’s park in the NL East. I like. 2016 Projection: 11/3.43/1.20/158

57) Kenta Maeda LAD – Total unknown. Wouldn’t be surprised if he ended up much better, or much worse than my projection. 2016 Projection: 12/3.55/1.23/157

58) Collin McHugh HOU – Came back down to earth last season after a fantastic rookie season in 2014. Gravity’s a bitch. 2016 Projection: 13/3.70/1.24/167

59) Gio Gonzalez WASH – Tried to turn himself into a groundball pitcher in 2015 (with a terrible infield defense behind him), before scraping that plan in the 2nd half (86 K’s in 81 IP). 2016 Projection: 11/3.68/1.30/176

60) Jake Odorizzi TB – The prototypical Tampa Bay starter. Don’t expect him to pitch deep in games. 2016 Projection: 10/3.69/1.22/167

61) Andrew Heaney LAA – Had a strong rookie season in 2015. Doesn’t have the huge K upside, but has all the makings of a very solid pitcher. 2016 Projection: 11/3.66/1.23/152

62) Kyle Hendricks CHI-NL – Struck out 88 batters in 81 IP post all-star break last season. Has a career 3.49 ERA and 1.14 WHIP in 260.1 IP. There is a lot to like here. 2016 Projection: 10/3.72/1.22/160

63) Aaron Nola PHI – Steady young starter without the big K upside. 2016 Projection: 9/3.69/1.23/148

64) Hector Santiago LAA – Fully transitioned into a starter last season, and predictably tired out after reaching a career high in IP. Could be an intriguing sell high candidate if he gets off to another hot start. 2016 Projection: 10/3.69/1.29/158

65) Ian Kennedy KC – The ratios might not look pretty, but he has struck out over a batter per inning the last two seasons. 2016 Projection: 10/3.90/1.28/178

66) Jason Hammel CHI-NL – After stratospheric 1st half in 2015, absolutely imploded in the 2nd half. Still averaged over a K per inning. 2016 Projection: 10/3.81/1.24/165

67) Ervin Santana MIN – You know what to expect at this point. 2016 Projection: 12/3.88/1.28/156

68) Andrew Cashner SD – Looked like a promising young pitcher on the rise coming into last season. Now he looks like an aging has-been. One year can sure change a lot. 2016 Projection: 9/3.71/1.29/161

69) Eduardo Rodriguez BOS, SP – (Update: Will start the season on the DL with a right knee injury. He is expected to make his season debut sometime in May.) Big, strong lefty with tons of potential. Fenway Park and the AL East do not provide the most hospitable pitching conditions, though. 2016 Projection: 9/3.78/1.26/155

70) Jake Peavy SFG – 34 years old going on 40. 2016 Projection: 11/3.71/1.20/140

71) Clay Buchholz BOS – 31 years old going on 25. Are we still waiting on his upside? 2016 Projection: 10/3.74/1.28/125

72) Phil Hughes MIN – Seems to go through a dead arm period every other year of his career. This should be one of the live arm years if the trend holds. 2016 Projection: 11/3.92/1.27/153

73) Anibal Sanchez DET – Still a major health risk, but if healthy, he is a much better pitcher than he showed last season. 2016 Projection: 9/3.75/1.26/150

74) Anthony DeSclafani CIN – Relatively safe young starter with some upside. 2016 Projection: 10/3.89/1.30/161

75) Kevin Gausman BAL – Baltimore’s recent history with developing pitching prospects has been brutal. He was the #4 overall pick in the 2012 draft, though, and has some K upside as well. 2016 Projection: 9/3.82/1.27/148

By Michael Halpern
Email: michaelhalpern@imaginarybrickwall.com
Twitter: Imaginary Brick Wall (@ImaginaryBrickW)