Babe Ruth had a candy bar named after him, Willie McCovey got a cove, and Tommy John... well, he got a career-threatening surgical procedure named in his honor.

This procedure has become synonymous with hard-throwing young pitchers who need to recover from devastating injuries. The procedure is by no means an absolute guarantee to work, as recent data points to a success rate around 80%. "Success" in this case indicates that a player is able to return to a career playing baseball. Even players who do return are not always able to perform at the same level as before.

From a fantasy baseball perspective, how should we treat players facing recovery from Tommy John surgery? It is widely assumed that a one-year layoff and a few games to shake off the rust is all it takes to return to form. What about a player who has yet to even face major league hitting?

 

Rookie Pitchers and Their Pitch Counts

Aaron Blair is by all accounts a top-flight pitching prospect. Ranked #43 overall by Baseball Prospectus for the 2016 season, his first MLB start on April 24th was much anticipated. Blair looked nervous in the first inning, allowing three base hits and a run to score. He settled down nicely though, and proceeded to pitch four straight scoreless innings. Then his outing was cut short in the sixth after throwing only 80 pitches. He had allowed two runs on six hits to that point, and had two men on base with one out.

What does the manager do here? Let the rookie pitch out of it? Walk the next batter and try to force a double play? Nope. Blair was immediately pulled before he could continue. While many will point to the idea that you don't want to hurt the young pitcher's confidence by allowing a big inning, there may be something else in play. Before Blair had even allowed a second run to score, the bullpen started in action. Manager Fredi Gonzalez may have determined before the game that Blair would not go past the sixth inning, regardless of the outcome.

Los Angeles Dodgers pitcher Ross Stripling was making his Major League debut on April 8 against the rival San Francisco Giants in AT&T Park. Late in the game his line read as such: 7.1 innings, 4 K, 4 BB, 0 ER, 0 H. After issuing a walk, there was one on, one out, and backup catcher Trevor Brown coming to the plate. Brown, a rookie himself, had never homered in 43 Major League at-bats and hit a mere .231 in limited time during the 2015 season.

With a no-hitter going in his MLB debut and a seemingly minor threat going, Stripling was removed without hesitation by manager Dave Roberts. Was he really worried that Stripling would suddenly fall apart and cost the Dodgers the game, one week into the season? Or was it the fact that Stripling had just thrown pitch #100 and would have been pulled no matter the circumstance?

Blair and Stripling, like so many young pitchers these days, are emblematic of the increasing emphasis on maintaining strict limits for starters in their early 20s. This is especially prevalent among pitchers who have had ulnar collateral ligament reconstruction, a.k.a. Tommy John surgery. This protocol is in place across Major League Baseball to protect teams' investments in young arms which may one day become the cornerstone of a franchise.

 

The Fantasy Baseball Impact

While this is surely the most sensible course of action to secure a player's future, fantasy owners need to consider how this impacts a player's potential in the short-term. Knowing they will likely never throw more than 100 pitches or seven innings in a game, how much stock should you put into owning a player like Blair or Stripling in 2016?

Nearly every rotisserie and head-to-head league counts Wins or Quality Starts as a category. To post a quality start, a pitcher must complete at least six full innings and allow three or fewer earned runs. Let's return to the earlier example of Blair's debut. Even if the Braves had put up 10 runs before the Mets started scoring again in the sixth inning (when Blair was pulled), he would not receive a quality start because he only completed 5.1 innings. Stripling did post a QS, but as soon as reliever Chris Hatcher blew the lead by allowing a game-tying Trevor Brown homer, he lost his chance at a win.

Could Stripling have pitched out of the jam and secured a victory? Could Blair have finished the inning in just a few pitches, giving his team a chance to come back and earn a win? We will never know. By all accounts, Dave Roberts did the right thing from a moral perspective. Unfortunately, fantasy leagues don't reward moral victories. To see Stripling's efforts wasted was frustrating for Dodgers fans and fantasy owners alike.

The number of elite pitchers who have undergone Tommy John surgery seems to grow every year. The short list reads like an All-Star roster: Stephen Strasburg, Jose Fernandez, Matt Harvey, Adam Wainwright, Jordan Zimmermann, and Yu Darvish. But for every Stephen Strasburg, there is a Josh Johnson - a talented pitcher who could not shake injuries even after successful Tommy John surgery. Even if the procedure itself was considered effective, related issues can crop up in elbows or shoulders as pitchers try to compensate or re-adjust their deliveries.

 

Tommy John Surgery and Future Success

Certainly an 80% "success" rate is encouraging, but how do you determine whether a pitcher will fall in that category and when it will happen?

Research shows that the younger a pitcher is when undergoing the surgery, the higher the number of appearances they are likely to make.

POST TOMMY JOHN SURGERY MEDIANS BY AGE GROUPS, 1974-2009 SURGERIES

Age at Tommy John surgery	Appearances (G)	Innings Pitched (IP)
16-23	93	221
24-27	70	137
28-31	74	130
32-50	29	46

 
More importantly, the length of recovery time is a key factor in determining success upon return.

POST TOMMY JOHN SURGERY MEDIANS BY RETURN TIME TO MAJORS, 1974-2009 SURGERIES

Return, Months after surgery	Appearances (G)	Innings Pitched (IP)	# of Pitchers
1-11	87	106	18
12	124	155	22
13	128	179	19
14-16	129	239	20
17-20	102	254	21
21-24	122	195	18
25-100	49	104	23

 
As intuition tells us, returning too soon (in this case, less than a full year) from surgery is less effective. Exceptionally long returns usually indicate complications from rehabilitation or other factors.

Of course, each case is unique and everybody responds differently. This year, we have seen some aces, who were expected to be fully rehabbed, struggle early in the season. Jose Fernandez came back late last season and looked sharp, but so far this year he has a 4.08 ERA and an uncharacteristically high 4.40 BB/9 ratio. As you can see, even the most established pitcher can have a hard time regaining their magic after such a long layoff. It only gets more difficult with age.

 

Fantasy Conclusion for Rookie Pitchers

So, what to make of young starters like Blair, Stripling, and others? The current trend seems to be in favor of limiting their outings so as to avoid injury. Certainly this is a good long-term strategy for player and team. As a result though, fantasy owners must also take a long-term perspective when evaluating players.

It is tempting to add young pitchers being called up for their first starts and immediately plug them into lineups. The results are not always in line with the hype, however. With the exception of Blake Snell's outing against the Yankees (after which he was immediately sent back to the minors), we have seen more duds than stud performances so far. The nature of rookies is almost always to show inconsistency, which is maddening for fantasy owners.

The increasing emphasis on limited pitch counts may keep ratios down by avoiding late-inning fatigue, but it also lowers the ceiling on potential wins and strikeouts. Rookie pitchers, especially those recovering from Tommy John surgery, are best kept only on dynasty rosters or saved for late in the year as streaming options. As tempting as it may be, us fantasy owners may need to take a real-life approach and actually wait for them to develop.

Major League players are entering games younger and younger, which means they need to be brought along slower. Of all sports, baseball is certainly a game of patience, which in today's culture of instant gratification is easy to forget. As Yogi Berra once said, "The future ain't what it used to be."

Data source: Roegele, Jon. "Tommy John Surgery Success Rates in the Majors." The Hardball Times. The Hardball Times, 23 Mar. 2015. Web. 02 May 2016.

 

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