It is inexplicable that on Sunday Yankees pitcher Masahiro Tanaka is tentatively scheduled to start against the Toronto Blue Jays. It is his first start since July 8th against Cleveland, when after his start an MRI revealed a partial tear of his ulnar collateral ligament (UCL) in his right arm. He was placed on the disabled list on July 9th, and has remained there since. When you consider the reality of where the Yankees are in the standings, and the medical prognosis of pitchers with a UCL tear, there is no way to justify his throwing a meaningful pitch until spring training next year.
Following his diagnosis in July, Tanaka began his rehabilitation in the middle of August, following his initial prescribed period of rest, the first step of his non-surgical treatment. After nearly a month of rehab activities, including a throwing program, bullpen sessions, and a recent rehab start against Yankees minor leaguer's, Tanaka’s return is set for Sunday. Even with a minor tear in his UCL, Tanaka and the Yankees have avoided surgery thus far. Surgery has not been recommended, but largely thought inevitable considering the average reaction of pitchers with similar injuries. Throughout the rehab process, Tanaka has not reported any unusual pain or discomfort in his pitching arm. Nor has he been observed in any unexpected discomfort, nor displaying abnormalities in his pitching mechanics. That being said, the foremost medical authorities do not give him much hope of avoiding surgery indefinitely.
According to
Johns Hopkins Medical Center, UCL repair surgery, best known to baseball fans as “Tommy John Surgery,” pitchers with a UCL tear choosing rehabilitation instead of surgery do not often produce a favorable outcome for sufficient healing in the long term. Most times exercising the non-surgical option are for patients who are not constantly using their arm for strenuous purposes. Those patients goals are generally limited to regaining functional mobility, and pain relief. Clearly Tanaka requires a healing outcome that vastly surpasses standard functionality.
Should Tanaka be forced to undertake Tommy John surgery, the process of post surgical rehabilitation for pitchers averages seven months before they’re cleared to return to the mound, and resume full pitching activity. Once a pitcher is cleared to return to mound throwing, Major League pitchers average an additional three to five months of throwing programs and minor league rehab starts. All told, most clubs envision a full 12 month period of recovery before a pitcher will return to the trenches.
What is most troubling about the future of Tanaka's throwing arm is how he developed the injury initially. Most UCL tears are the product of the repeated motion necessary for pitching. During surgery, it is often revealed that the tear being repaired shows damage indicative of a wear and tear on the tendon. As opposed to a clean and complete separation, often the product of a single event. This is problematic given Tanaka’s reputation for endurance. During his time in Japan, Tanaka was legendary for his endurance on the mound, often pitching deep into games. One of the major changes he has undergone in his workload while pitching for the Yankees is his transition from pitching once a week (in his case, every Tuesday) in Japan, to a five man rotation, with four days rest in the U.S. Over the course of a full regular season, Tanaka will go from making roughly 24 starts, to a projected 35. If averaging his seven innings per start from 2014, Tanaka would pitch nearly an additional 80 regular season innings. If you consider a potential full World Series run, consisting of 5 to 7 additional starts, the tally may run as high as 115 to 130 additional innings overall. Such an increase is a profound change from a physiological perspective, and has clear ramifications for his remaining time in the Bronx. If Tanaka’s prognosis suggests eventual surgery, and his injury was most likely caused by a repeated pitching motion which further exacerbates his tear, would it not make the most sense to save as many bullets in his arm as possible? Is it really worth throwing ANY innings during a start in September that will not contribute to a playoff birth? It begs the question of why the Yankees are allowing his return now.
It is difficult to fathom why the Yankees are so supportive of Tanaka’s return to the mound at this time, given the Yankees appear destined to miss the playoffs in 2014. It is also contrary to their usual organizational stance to protect their pitchers under all circumstances, let alone when the games being played will not result in their ultimate goal of a championship. Without a doubt, Tanaka was the Yankees best pitcher prior to being sidelined. In 2014, Tanaka’s first MLB season, he was both a leading AL Cy Yong Award candidate, and potential AL Rookie of the Year candidate. In 18 starts, Tanaka pitched 129.1 innings, producing a 12-4 record, with a 2.51 ERA. He allowed 111 hits, 19 walks, 135 strike outs, and an outstanding 1.0005 WHIP. It is impossible to deny the lure of having such a dominant pitcher return for the Yankees, but not given the aforementioned circumstances, where his number of pitches appear finite before surgery becomes necessary. While the Yankees motives are bizarre regarding his return this season, Tanaka’s are hardly an enigma.
Tanaka’s desire to return this season is far easier to gauge. As a highly successful competitor, it has been torture for him being away from the game. As a young man of 25 years, he is entering the prime of his career, and clearly wants to take advantage of being the ace for New York. Though since it appears that at some point surgery will be necessary for Tanaka, he must be protected from himself. Should Tanaka re-injure himself, the Yankees are fully culpable for the folly. The Yankees are proceeding with the belief that if his tear is not greatly exacerbated over time, and he has nominal strength and range of motion for pitching, Tanaka’s greatest obstacle will be his ability to manage the discomfort associated with a UCL tear. They’re proceeding on the assumption of the best-case scenario, and it is unusually cavalier decision making for the Yankees, as they’re are otherwise shrewd in these matters (Joba Rules anyone?).
Tanaka turns 26 on November 1st, and is emerging into the prime of his career. The Yankees are planning on many strong years ahead for Tanaka as their ace. Tanaka must be protected in all respects, and primarily from himself. In all pragmatism, 2015 and beyond are far more important than the remainder of 2014, which makes the logic of his return so unusual. It is impossible to conceive that the Yankees genuinely believe Tanaka is healthy. The best medical research available suggests that surgery at some point will become necessary, and that there is a limit to how much longer he can endure without it. Even though it is not known exactly how long it may be before surgery will be necessary, there is absolutely no reason to risk the encounter at all this season. Avoid holding your breath on Sunday, over five or six innings you may pass out.
Only a fool...
Doubts his experience.
*Photo's courtesy of The New York Post, and elnuevoherald.com, respectively.
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