Masahiro Tanaka’s Partially Torn UCL & Why You Should Chill the F Out

You know what Daniel Burch hasn’t done in a while? Rant (or talk in the third person while Daniel Burch is on the subject). He hasn’t ranted in a while, although he has come close, but that is all about to change. I have been hearing it for years, and I have argued against it for years, but for whatever reason this is not registering in some people’s heads. I am so sick and damn tired of hearing about Masahiro Tanaka’s partially torn ulnar collateral ligament and I am even more tired of hearing it used as an excuse for every time the guy throws a ball out of the zone, let alone struggles in a start. The partially torn UCL is not the reason for all his struggles and you are not smarter than a team of doctors that advised against him getting Tommy John surgery. Deal with it and get over yourselves people.

Let’s start at the beginning, the diagnosis.

Tanaka was diagnosed back in 2014 with a slight tear of his ulnar collateral ligament. Tanaka visited three different doctors including Yankees team doctor Christopher Ahmad and Tommy John surgery specialist and expert Dr. James Andrews and all three doctors came to the same conclusion, the need for Tommy John surgery and a new ulnar collateral ligament was not needed. While each doctor had their own plan for how to treat and how to rehab the elbow the consensus was the same, no surgery. The Yankees ultimately decided on a platelet-rich injection on the elbow and rest and rehab, a treatment that at least to date has worked for Tanaka’s particular case.

Despite this diagnosis there are still fans, not doctors, who say the most outrageous and off-base things about Tanaka, his elbow, and about Tommy John surgery in general.

“Tanaka cannot pitch at a high level with a partially torn UCL!”

WRONG! Now that this is out of the way let me tell you all a story. There once was a man named Adam Wainwright who not only pitched once with a small tear, like Tanaka’s, in his UCL, but he did it twice. Wainwright dominated Major League hitters for six seasons before needing the surgery which included 182 games, 99 of them as a starting pitcher, 874 total innings including 233 innings pitched in 2009 alone, and a second place (2010) and third place (2009) finish in the National League Cy Young Award vote. Wainwright was first diagnosed with the partial tear in his UCL as a High School pitcher where doctors advised against surgery. Wainwright tore his UCL partially again while in Triple-A and was once again advised against an ulnar collateral ligament replacement surgery. Both times Wainwright took the conservative route, like Tanaka, and came back throwing harder and stronger than ever. Wainwright pitched for six seasons with a partially torn UCL before completely blowing out his elbow and requiring the surgery.

“So, Tanaka will need the surgery eventually.”

No, not necessarily. Tanaka was never ridden like a horse like Wainwright was and has never approached 233 innings in a Major League season. Tanaka also sat out ten weeks after the diagnosis where Wainwright sat out only six weeks while Tanaka also received a platelet-rich plasma injection to promote healing in the elbow where Wainwright did not. Tanaka was closely monitored by a team of doctors and is still monitored closely to this day by the New York Yankees. Tanaka had multiple checkups after the diagnosis and every time he was told that there was no new damage to the elbow or the ligament.

“Why not just get the surgery done, sit out a year and come back strong in the final two seasons of his contract?”

If it were only that simple. While the success rate for Tommy John surgeries are as good as they ever were it doesn’t mean that they are 100%. Not yet, anyway. For every success story with a pitcher coming back in 15 months or so and coming back stronger and better than ever there are horror stories that contradict that line of thinking. It seemingly took Ryan Madson three-or-four years to fully recover from his Tommy John surgery, and he is just a reliever who isn’t relied upon every fifth day like Tanaka. Also, it is worth mentioning that there’s a ton of instances and stories of pitchers NEVER coming back or being the same after a torn UCL surgery. Why just go cutting on a ligament and take that chance when it has deemed unnecessary by a team, not just one, of doctors? Why take the risk? You don’t. Getting what is deemed as an unnecessary surgery like having your tonsils removed or a circumcision is one thing, having the ligament that essentially holds your elbow together ripped out and replaced for no good damn reason is another.

“But, but, but, Wainwright needed the surgery eventually. Tanaka will too!”

Wrong again, Yankees fans. Let me tell you another story. A story about a man many know as “King Felix” but a man I prefer to call Felix Hernandez. Hernandez has been pitching with a torn ulnar collateral ligament for God knows how long. Bob Nightengale of the USA Today has reported on it and Andy Van Slyke opened up about it in that interview about three years back where he claimed the Los Angeles Dodgers wanted to trade Yasiel Puig. It seems to be common knowledge around the league, yet Hernandez has yet to undergo the ulnar collateral ligament replacement surgery. And, FYI, Felix’s velocity did drop to around 92 MPH, yes. It was AFTER his velocity drop that he found his changeup and truly morphed into the “King” that he was nicknamed recently. The velocity drop did not coincide with the partially torn UCL, not even close.

“I know more than Daniel Burch.”

No, you don’t. Next.

Okay, so again on a serious, and less cocky, note you can sum up this entire article in just a few sentences. Every elbow is different, every person is different, and everyone’s body is different. Just because Adam Wainwright was able to pitch through the elbow injury and didn’t immediately require the surgery doesn’t mean Tanaka will, although he has thus far. Just because Felix Hernandez has reportedly a 25% tear in his UCL and has yet to require the surgery it doesn’t mean that Tanaka won’t require the surgery. No one knows. What the point of this post was is to show people that their opinions mean very little in the grand scheme of things. Doctors told Tanaka not to get the surgery, specialists in fact, and I trust them way more than I trust a casual fan. I trust the specialists more than I trust my own knowledge and opinion, so please stop acting like you know more about Tanaka, his elbow, UCL’s, and Tommy John surgery than someone who went to school for the better part of a decade just to learn the trade. You don’t, and neither do I. Thank you for listening to my rant while learning a little bit about Tanaka, ulnar collateral ligaments and the history of pitching with a tear in it.

Daniel Burch out. Oh, and little p…. edgy enough for you?

Quick Hit: James Kaprielian to See Doctor Today on Elbow

Just a quick hit for you guys and an injury update on the Yankees top pitching prospect in their system, righty James Kaprielian. As we all know Kaprielian strained his flexor muscle last season and missed basically the entire 2016 season recovering from the injury only to return for the Arizona Fall League and spring training this season. Kaprielian passed both of those tests with flying colors giving the Yankees zero reason to doubt that his elbow was fully healthy but once again Kaprielian finds himself on the Tampa Yankees disabled list. Kaprielian has seen doctors already but he sees another today which should lead to his final diagnosis. Holding my breath now.

Kaprielian flew to Tampa last week and had an MRI on his troublesome right elbow and also had a dye-contrast MRI on the elbow. The Yankees team physician Dr. Christopher Ahmad has recommended Kaprielian see the doctor that he is seeing today in Los Angeles, Dr. Neil ElAttrache. It’s probably not a good sign when Dr. Ahmad asks another doctor to step in but Kaprielian is not seeing Dr. James Andrews, not yet anyway, so that dreaded three-word term is not being uttered yet. Not loud enough for anyone to hear anyway.

Fingers crossed and with baited breath we wait for the results…. Stay tuned. 

Spring Training Around the AL East: The Boston Red Sox and David Price’s Elbow

So if covering the New York Mets and David Wright is fair game on the site this morning then I think covering the Boston Red Sox left-hander David Price and his ailing elbow also should get at least a mention, don’t you? Price, the Red Sox and his elbow have direct implications to the Yankees since they play in the same division while the Mets third baseman simply shares the spotlight in the same busy city as the Bronx Bombers. Again, new rules. More me. Here we go!

Price was scratched from his first start of the spring with elbow soreness and a sore forearm and has consulted with specialists regarding the elbow including, dun dun dun, Dr. James Andrews and Neil ElAttrache. I don’t have to tell you that it’s probably not great news for the Red Sox or for Price, who just got done saying earlier in the week that the 2017 season was going to be his “best yet” for the Boston Red Sox, if he is having his elbow looked at by Tommy John surgery specialist Dr. Andrews.

Price is coming off a season in which he made 35 starts while posting a 17-9 record with a 3.99 ERA in his first season with Boston after signing a mega deal worth $210 million for seven years. Losing Price for any amount of time would be significant for Boston despite them already having the reigning American league Cy Young Award winner in Rick Porcello and Chris Sale who they acquired from the Chicago White Sox for four top prospects including Yoan Moncada. Not that the Red Sox likely wouldn’t still win what is considered to be a weaker American League East this season with or without Price but still, this can only help the Yankees chances.

Let me be clear. I am not wishing an injury on ANY player no matter what uniform they wear. I don’t want Price to be injured, I am just speaking of the implications that would happen if he were to be injured. Remember that before furiously typing out your hate email that, if I’m being honest, I will likely ignore anyway. I am flushing all negativity out of my life or as close to all as I can... so fair warning. Have a great Saturday everyone.

Pitchers, Tommy John Surgery and the Analysis of Why

I hope you find the topic of Tommy John surgery, who it’s happening to and why it’s happening so frequently in today’s game an interesting subject because it’s going to be the only subject we really talk about today on the blog. I put a lot, and I mean a lot, of research into this blog post and rather than have it buried in the masses here in a couple of hours and pushed to the second page I am going to give this post the time on the front page it deserves. All day long. It may take you all day long to read it so take your time and really let the information soak in as we take a look at the pandemic facing Major League Baseball right now. Tommy John surgery.

For the sake of this post we took the last 100 Tommy John surgery recipients and pooled our data from that. I felt like 100 ulnar collateral ligaments not only gave an ample sample size for any conclusion we could draw but it’s also a nice, even number that didn’t require a $400 graphing scientific calculator to spit out the numbers I wanted. Lazy, yet efficient. After pooling the last 100 Tommy John surgery victims we looked at certain criteria listed below in the excel spreadsheet in order to see if we could find a pattern, common denominator or something that may lead to figuring this whole thing out. Do I expect to change the world with this post? No, but I’m hoping that maybe I can spark the mind that does and that would be payment enough for me.

MLB Player Analysis has a Google Doc that you can reference online and that is where most of the information below both in the chart and written in this blog post came from so kudos to them. I included certain things in the chart like average fastball velocity, build/frame and other materials as well that I thought may piece together the puzzle as well so if you want to see the original document you can find it HERE. Without further ado here is the last 100 Tommy John surgery victims (at the time of this writing) and some pertinent information that we will dissect below.

Here are a few bullet notes from what we found that I think really can help us figure out what is going on here and why this is happening at such an alarming rate:

      84% of the pitchers were born in the United States while 8% were from the Dominican Republic, 5% were from Venezuela, 2% were from Japan and 1% were from Australia.

      82% of these pitchers were age 30 or younger while 18% were above 30-years old.

Now this raises an interesting question. 84% of the last 100 pitchers to get Tommy John surgery (at the time of this writing) were born in the United States. Now Major League Baseball, a sport that thrives on being culturally diverse, has players reach the big leagues from all over the country so why are mainly American born pitchers having the surgery and not players from Mexico, Canada, Korea and other parts of the world having this pandemic with their arms? Why have only two from Japan, one from Australia, 5 from Venezuela and 8 from the Dominican Republic had the surgery?

Is it the throwing at such an early age? Is it the throwing of breaking balls as early as Little League? Is it pitching once every five days in the Major Leagues where Japanese pitchers for example throw once a week? Every pitcher not named Mariano Rivera throws breaking stuff so is it fastball velocity? Or is it merely a coincidence? It’s hard to call 84% a coincidence but let’s keep delving into this and see what we find out.

The final thing I wanted to look at was a pitcher’s frame and how fast they throw a fastball. Some say mechanics may have a lot to do with it but when I see a fluid delivery like Chase Whitley and Ivan Nova undergo the surgery while in Yankees uniforms while pitchers like Aroldis Chapman and Tim Lincecum not going under the knife for elbow ligament replacement surgery I tend to think the windup and delivery has little to nothing to do with it as well. For every Carter Capps on this list you have another 10-20 Nathan Eovaldi’s who simply rear back and throw. Is it velocity? Is it frame? Is it both? Or is there simply no common factor here? Let’s look.

The average height and weight for a man in the United States according to a simple Google search is 5’10” and 195.5 pounds. Common sense would tell you that the higher above that average, up to a certain extent of course, the more “durable” you would be assuming conditioning and such being comparable across the board. Well as you can see there is no rhyme or reason to the pitchers frame either. You have big build undergoing the surgery, where stereotypically the bigger framed pitchers are thought to be more durable, while you also have some, albeit less, smaller framed pitchers undergoing the surgery as well. For the longest times the Johan Santana’s and Pedro Martinez type frames were considered to be a walking time bomb but this excel spreadsheet shows that to not be the case anymore, at least when it comes to Tommy John surgery.

And as you can see, and probably already know without me listing it, you have examples from every part of the velocity map here as well. You have your hard throwers like Nathan Eovaldi and the recently deceased, your soft tossers like Bronson Arroyo and Chase Whitley (and remember Jamie Moyer when you consider whether velocity has any bearing on Tommy John surgery) and about everything in between. They are all throwing off the same mound dimensions, using the same ball, etc. etc. etc. You also have players who have had duplicate Tommy John surgeries, Tim Collins, and players who never spent a day on the disabled list throughout their careers, Bronson Arroyo, on the list showing it’s also not a durability issue. It seems like these things simply just happen. And when you replace the ligament these things can still happen. And happen again.

Onward to the “probably useless knowledge but I wanted to include anyway because I found it interesting” portion of the program ladies and gentleman. Carry on.

      72% of the pitchers were right-handed while just 28% were left-handed.

      46% were from American League teams while 54% were from National League teams.

      28% of players never returned to the Major Leagues after their Tommy John surgery while 19% are still under that 12-15 month window which signifies they are still recovering.

      If 12-15 months is the general and average time to be out after a Tommy John surgery then 25% of pitchers missed that mark (again keeping in mind that 19% are still yet to be determined and 28% never returned). Only 28% of pitchers had the surgery and were back in the Major Leagues in 15 months or less.

      44% of these pitchers had Dr. James Andrews conduct the surgery.

So there you have it folks. Are we any better off or more knowledgeable than we were 20 minutes ago? Maybe not but like I said I don’t expect to change the game or the world with this post but maybe, just maybe, I can spark the mind that does with it. One can only hope. I hope you enjoyed reading and I hope this post wasn’t too awful long. If it was I at least hope you learned something from it. Have a great day everyone.

Oh, and please pass this post along to anyone and everyone you think may be interested in it. I put a lot of work and research into this and I want this post to touch as many people as possible. Thank you.

The Yankees Decision to Forego Tommy John Surgery w/ Masahiro Tanaka. Good Idea or Bad Idea?

When the New York Yankees decided to sign Masahiro Tanaka out of Japan a couple years back I doubt there were many Yankees fans that were happier than I was. I loved the idea of not only getting greedy and getting the top pitching arm on the free agent market but I also loved the fact that he was young, dominant and from Japan. See the Yankees had seemingly shied away from Japanese pitchers after the Hideki Irabu and Kei Igawa debacles and for them to jump back into the pool and jump in face first into the deep end made me happy. So you can imagine how disappointed I was when I learned that Tanaka had a partially torn ulnar collateral ligament in his right throwing elbow, usually a diagnosis like this is followed by the need for Tommy John surgery, and you can imagine how cautiously optimistic, yet extremely skeptical, I was when the team announced they would try a rest and rehab program rather than going under the knife. We are now almost two full seasons removed from that decision giving us enough of a sample size to determine whether the Yankees made the right choice avoiding the knife or if they should have went ahead and got the surgery done. 

I will preface any talk of Tanaka with the fact that every elbow is different, every tear is different and every injury is different. I only use comparisons in this post to show a similarity and possibility that the decision to not undergo surgery could have been the right one. With that said I just want to remind everyone that Ervin Santana had a similar diagnosis and has never required the surgery, the same can be said for the Seattle Mariners ace Felix Hernandez who also pitches with a partially torn ulnar collateral ligament. One pitcher who eventually had the surgery, but it wasn’t until years later, was Adam Wainwright of the St. Louis Cardinals so it’s not like the Yankees just flew by the seat of their pants on this decision, especially considering five doctors including the team doctor and Tommy John specialist Dr. James Andrews suggested the rehab program. 

All that and a buck buys you a coke if Tanaka doesn’t pitch well but thankfully for the Yankees he has done just that. Heading into his start today Tanaka has posted the following stat line in his Major League career via Baseball Reference: 

Year	Age	W	L	ERA	G	GS	CG	IP	H	R	ER	HR	BB	SO	ERA+	FIP	WHIP	H9	HR9	BB9	SO9
2015	26	12	7	3.51	24	24	1	154.0	126	66	60	25	27	139	114	3.98	0.994	7.4	1.5	1.6	8.1
2016	27	8	4	3.32	23	23	0	146.1	136	61	54	14	27	120	127	3.33	1.114	8.4	0.9	1.7	7.4

Provided by Baseball-Reference.com: View Original Table

Do those stats look like the stats of a pitcher who is holding back and nursing an injury to his elbow? If so can you imagine how good he would be if he had undergone the surgery? Which I will also warn you of the fact that no surgery is 100%, see Ryan Madson as a recent example of pitchers who struggle for years to come back from what many fans think is a routine surgery. Every elbow is different, every ligament is different and every injury is different. The rehab program will work for some, and in my opinion has worked for Tanaka, but for others it won’t. That’s life and that’s baseball but I think, for now anyway, we can finally put the rest the debate of whether the Yankees made the right decision or not skipping the surgery. It looks like they did make the right decision and the team, and Tanaka himself, are benefiting from it. 

Jacob Lindgren, Elbows and Masahiro Tanaka

Even before Yankees pitchers and catchers reported down to George M. Steinbrenner Field this week to begin Spring Training camps all the eyes and discussions were on the elbow of Masahiro Tanaka. This is nothing new for Tanaka or Yankees fans but this year it was for a different reason. In years past the discussion and worry has been focused on his ulnar collateral ligament and his “need” for Tommy John surgery despite the fact that five doctors including specialist Dr. James Andrews diagnosis not to have the surgery but this year all the attention is focused on the surgery that Tanaka did elect to have. Tanaka had bone spurs removed from his elbow this offseason after the spurs hampered him and his ability to throw a splitter for much of the 2015 season, the same surgery that ended the season of Yankees relief prospect Jacob Lindgren.

Lindgren had bone spurs removed from his elbow late last June and he said after “about three months” he was feeling “great now.” Tanaka had the same surgery after the season meaning he is pushing the four month rehab and rest window now and yet fans and the organization are still worried and/or holding him back for precautionary reasons. I understand Lindgren is making $525K this season and Tanaka is making in excess of $20 million but the future of both arms should be equally as important, so why hold Tanaka back?

Let Lingo Lightning do his thing this spring and win his spot back into the Cirlce of Trust and let Tanaka do his thing and win the ace spot away from Luis Severino in the starting rotation. It is bone spurs, it’s not Tommy John surgery. Take the diapers off and let the kids throw! Just my two pennies this morning. 

Former Yankees Prospects Turned Top Surgeon

February is Prospects Month here on The Greedy Pinstripes and rather than tell you all about the current crop of Yankees farmhands we see down in the system I wanted to focus on something a little different today. I wanted to talk about a former Yankees draft pick and now one of the better surgeons in the United States, a man by the name of Christopher Luke Wilcox.

Christopher Wilcox was drafted by the Detroit Tigers in the 22^nd round of the 1992 MLB First Year Players Draft and while playing in front of his home crowd in Detroit would have been nice Wilcox decided to head to college and turn down the Tigers off. Detroit wanted Wilcox out of St. John’s High School but Wilcox decided to take his talents to Western Michigan University where he played three seasons in the outfield for the team’s baseball team, the Broncos. It was in June of 1995 that Wilcox heard his name called again in the MLB Draft but this time it was in the third round of the draft and this time it was by the New York Yankees. This time Wilcox was not walking away from his dream of professional baseball and signed with New York.

Wilcox toiled around in the Yankees farm system until the 1997 expansion draft when the Tampa Bay Devil Rays took him and kept him in their system until the Yankees came calling once again. Wilcox had two tenures with the Yankees and was called up to the show once, never getting an at bat and never once getting into a game at all, before deciding to retire from the spot in 2001 to return to WMU. Wilcox returned to school hoping to finish his degree and become an orthopedic surgeon and that Dr. Wilcox did in 2007.

Wilcox went on to work with Dr. James Andrews in Pensacola, Florida as he learned sports medicine from one of the best in the business and from one of the biggest names in orthopedic sports medicine and surgery. There Wilcox learned the Tommy John procedure from Andrews and he perfected the operation under his watchful eye. With the help of MSU and Dr. James Andrews Wilcox has gone from playing inside Yankee Stadium to helping others reach that goal and that’s truly an awesome thing and experience for the doctor. 

Brace Yourselves: The "Masahiro Tanaka Should Have Underwent Tommy John Surgery For No Good Reason" Fans Are Coming...

When news broke that Masahiro Tanaka had a successful, and very routine, elbow surgery this week my mind immediately went to not whether Tanaka would be okay or whether or not he would be ready for Spring Training 2016. No. My mind immediately went to all the garbage, trash and half-truths that I was going to have scattered all over my timeline on Twitter (cheap plug, @GreedyStripes) not only this winter but during the 2016 season as well. Brace yourselves Yankees fans, the group that thinks Tanaka should go ahead and get an unnecessary and potentially career threatening surgery just to make them stop criticizing every pitch he throws and to make them sleep better at night are coming and they are coming in full force.

Many fans will ignore the fact that the Yankees organization stated that the bone spur that Tanaka had removed and cleaned up from his elbow stemmed back from his time pitching in Japan. The bone spur had nothing to do with his partially torn ligament in his elbow that five Tommy John specialist doctors recommended to rest and rehab. The spur is a routine surgery much like Carlos Beltran had before the 2015 season and requires six weeks of rest and rehab before beginning a throwing program. Tanaka will be ready for 2016 and will be fine in 2016, hell he may even be better in 2016. We all saw how much a bone spur affected Beltran at the plate in 2014 imagine what it could do to a pitcher throwing 100+ pitches every fifth or sixth day.

Isn’t October, 23 2015 a little early to be saying that the 2016 season is already over?

I just want to throw this out there, it’s not completely unprecedented for a pitcher to rest and rehab a tear in his UCL that is less than 10%. Ervin Santana did the same thing and never had the surgery to this day while Adam Wainwright pitched for years, longer than Tanaka’s current contract with the New York Yankees, before having the surgery. Another thing is you don’t see an increase in velocity, which Tanaka did in 2015, and you don’t increase your use of breaking stuff and splitters, which Tanaka also did in 2015, if your elbow is a concern or bothering you. Tanaka does not need a surgery that could end his career, and yes even today it is ending the careers of many even with such a high success rate, until and/or unless it is absolutely 100% necessary. The bone spur didn’t cause the tear in the UCL, the surgery to repair the bone spur is not due to the tear in the UCL and it has no bearing whatsoever on the tear (that may not even be there anymore for all we know) in the UCL.

Yankees fans, chill. As much as you don’t want to admit it the Yankees know what they are doing. 

Are We Still Worried About Tanaka in 2016?

The talk of the offseason before the 2015 season around many New York Yankees fans water coolers was centered around all the question marks entering the year. Would Mark Teixeira be healthy and able to beat the shift? Was Carlos Beltran done and would Brian McCann improve? Would the shoulder of Michael Pineda, the elbow of Ivan Nova, the knee of CC Sabathia and the elbow of Masahiro Tanaka hold up? While many of those questions were answered in 2015 a few of them probably still linger into the 2016 season, is Tanaka’s elbow one of them?

First and foremost, before I get bombarded with tweets and emails about how Tanaka needs to get the surgery done to “repair” a ligament that isn’t broken (per five doctors including Dr. James Andrews, not just speculating), Tanaka should not just go get Tommy John surgery just for kicks and giggles. That’s the wrong opinion and there’s no doubt about it. If the ligament tears then you get the surgery, not before. Tommy John surgery has come a long way since becoming so prevalent in Major League Baseball but it’s not 100% effective. Ask Ryan Madson, ask these guys getting their second and third UCL’s replace ask anyone who has had the surgery since Tommy John made it mainstream and never made it back to the mound. That’s like saying we should completely break Mark Teixeira’s leg and start from scratch because the fracture, which is exactly what Tanaka’s less than 10% tear that was treated with rest and rehab, is.

Anyway, sorry I had to get that off my chest. The Yankees pitched Tanaka as often as they could on five days of rest or more in 2015, should we expect the same out of the club in 2016? Honestly I think they will, the team is going to milk Tanaka’s arm out and baby it as long as they can (and again before you flood my email let’s remember that Ervin Santana had a partially torn UCL and never had the surgery and Adam Wainwright pitched for a long, long time before needing the surgery) with the hopes of at least getting him to his 2017 opt-out date healthy.

New York has a laundry list of names that will be vying for a starting rotation spot and once again most of the team would benefit from the extra rest that would come along with a true six-man rotation or an occasional 6^th man. Luis Severino’s innings may become a concern if he makes 30+ starts, Ivan Nova is still recovering from Tommy John surgery himself, Michael Pineda’s shoulder will probably always be a concern, Nathan Eovaldi’s elbow inflammation is scary for a former TJS recipient and CC Sabathia’s knee could break at any second. So if you’re asking me if Tanaka will still be handled with delicate white gloves in 2016 the answer is probably a YES. 

Twitter Poll: Yankees Made Right Decision Not Getting TJS for Tanaka

Yesterday here on the blog I was very emphatic when I said that the New York Yankees made the right decision to forego Tommy John surgery with Masahiro Tanaka and take the advice of five different doctors that suggested a rest and rehab program. This has been going on for more than a calendar year now and the reviews on the decision have been mixed to say the least. There are the pro-surgery crowds and then there is the crowd that trusts the doctor’s decision, which camp are you in? Sounds like the perfect time for a Twitter Poll.

@greedystripes Feels like he will continue to struggle and be mediocre until elbow gets fixed

— Sol Weinreich (@SolfromBrooklyn) August 4, 2015

@GreedyStripes Yes, surgery should always be the last resource. And it has worked so far.

— Alvaro Molina (@a_molinam) August 4, 2015

@GreedyStripes it's looking like a good idea now that we're competing for a playoff spot in August

— sean (@SeanGordon102) August 4, 2015

@GreedyStripes several doctors said it was the way to go. Twitter docs have less credentials.

— Nick Abbate (@PinstripedBX2) August 4, 2015

@GreedyStripes No surgery is a sure thing, when doctors say don't have the surgery listen to them.

— Eliot (@EliotRants) August 4, 2015

@GreedyStripes no I would have liked him to get it over with and on the road to recovery. I hope he is healthy for the final run of the year

— Heart2 (@YDPSHR) August 4, 2015

While many fans blame every ball he throws, home run he allows or loss he accumulates on the fact that Tanaka’s elbow is not healthy and he should have had the surgery rather than considering the distinct possibility that maybe Tanaka was not as advertised I still remain adamant that the non-surgery was the best option for Tanaka. I am very much against undergoing a career altering or potentially career ending surgery if at all possible. If some guy working a drive thru wedding window in Las Vegas said to rest and rehab Tanaka’s elbow then I’d be skeptical but it was five doctors including the Yankees team doctor and the man that has seen more ulnar collateral ligaments than Ron Jeremy has seen female anatomies Dr. James Andrews.

This is not a debate that is going to be won or loss. If Tanaka pitches the rest of his career without issue but doesn’t win 20 games every single season and a Cy Young there will be some out there that say he should have had the surgery. If he blows out his elbow tomorrow there will be the “I told you so” type fans running amok while the rest call for Brian Cashman’s head. There will be no winner, only losers. To be involved in our next Twitter Poll head over to the app and give @GreedyStripes a follow. Once you’re following be on the lookout for our next Twitter Poll tweet, we will not use your responses without informing you first.

Matt Moore & the Cautionary Tale of Tommy John Surgery

The New York Yankees went against the grain a bit last season when they learned that their 25 year old ace Masahiro Tanaka had a less than 10% tear in his ulnar collateral ligament. Instead of putting Tanaka under the knife to get the UCL replaced while having the right-hander miss not only the remainder of the 2014 season but much of the 2015 season the Yankees took the road less traveled. Tanaka and the Yankees, under the advice and supervision of not one but five doctors including the team doctor and Dr. James Andrews, the Tommy John surgery specialist, decided to try and rest and rehab program hoping that the ligament would heal on its own avoiding the surgery. The Yankees were killed for this decision by the media and the fans and every hanging curve ball or every loss for Tanaka leads to outrage about not getting the surgery, even though it was the right decision not to.

There have been more than a few pitchers who have tried to rest and rehab the UCL rather than going under the knife but only a couple have actually had any success with it. Ervin Santana followed the same path and has never needed the surgery to date while Adam Wainwright went years without needing the surgery. Tanaka has been so far so good on the elbow since the rehab, despite what you read on Twitter after a bad outing, making the Yankees and that team of doctors look better and better every single start. The main reason behind the decision, at least in my opinion, was because while the TJS success rate is as high as it has ever been the surgery is far from 100%. Look at Matt Moore of the Tampa Bay Rays.

Moore was demoted back to the minor leagues and Triple-A over the weekend after continuing to struggle on the mound this season. Moore is in his first season removed from the Tommy John surgery and will head to the minors looking to sort out his issues. Moore has posted a 1-3 record in six starts since returning from the DL and has failed to go past five innings in any of the starts. Moore is just the most recent example, Ryan Madson has been trying to work his way back from Tommy John surgery for parts of four seasons now with limited success. The surgery is not 100% and even if it was 99% effective you want to avoid the knife if you can, the Yankees did that and I commend them for it. 

Looking on the Bright Side For Masahiro Tanaka

Masahiro Tanaka has, at least temporarily, avoided Tommy John surgery after four doctors including Dr. James Andrews cleared him to rest and rehab his partially torn ulnar collateral ligament. This week we learned that Tanaka went into the Yankees complaining of a wrist injury that ended up being a “small” forearm strain that landed him on the 15 day DL and will keep him out of the Yankees rotation for at least a month. This much we do know and unlike the many on Twitter who went absolutely ape crap crazy on Tuesday night calling for the head of Brian Cashman because Tanaka did not get Tommy John surgery I am going to try, now that I am calm and had a night or two to sleep on it, to remain optimistic about the whole ordeal because there is plenty to be optimistic about. Keep reading and I’ll try to get there as quickly as I can. 

The Yankees are either going to survive this rest and rehab thing on his elbow or they aren’t and it’s looking more and more likely that it’s going to come to a head sometime during the 2015 season. This can be a good thing or a bad thing for New York when you consider his opt out clause that Tanaka has written into his contract that will allow him to opt out after the 2017 season. If Tanaka ends up going down with Tommy John surgery in 2015 he will miss likely the entire 2016 season due to rehab and will not be the same in 2017. Usually pitchers take a year off to rest and rehab and a year of getting back into the grind that is the Major League season before you see the true finished product two years removed from the surgery. Tanaka may be the exception to the rule, in either direction, but he would be unlikely to put up numbers similar to his first 18 starts in 2014 meaning the likelihood of him exercising the opt out clause has to be low.

If Tanaka can make it through the season without any further problems with the elbow and can make it through the 2017 season without a Tommy John surgery then he may opt out of his contract, and honestly that may be the best thing for the Yankees. Tanaka is signed through the 2020 season and all signs point to this rest and rehab just being a band-aid to his problem meaning that the Yankees simply delayed the inevitable with Tanaka’s elbow. If Tanaka opts out and walks away from the final three years of his contract it may be a blessing in disguise for New York, especially if he succumbs to the surgery in the final three years or beyond like Adam Wainwright eventually did in a similar situation.

There is a lot of “what-if’s” and moving parts in this theory, I know, but it has to be, or should be at least, in the back of the minds of the Yankees brass. It’s either going to work out or it’s not and in a pair of scenarios it could work out for the Yankees so don’t panic and let’s look on the bright side. Either the Yankees will have to pay Tanaka big money to rehab his elbow with a gaping hole in their rotation or it will be someone else’s problem but we cannot predict or prevent either outcome so let’s all take a step back and enjoy him while we have him, shall we?

My Thoughts on Masahiro Tanaka After One Game

The New York Yankees conveniently took the day off yesterday giving me the time to collect myself and collect my thoughts after game one of the 2015 season. By no means am I basing really anything off of just one game in a 162 game marathon but I did see enough to at least throw some of my thoughts onto paper before Game Two kicks off tonight in the Bronx. Let’s start with Masahiro Tanaka and his 4 IP, 6 K and 5 R (4 ER) effort from Opening Day.

Tanaka looked absolutely filthy through the first two innings, enough so that I attempted to get “TanaKa” trending on Twitter. He was moving the ball up and down, left and right and making hitters look absolutely silly. His velocity was down as expected but when your off speed stuff is as good as his was through the first two innings you really don’t need 95 MPH on your heat. Then the third inning came and Tanaka lost control of his slider while the Blue Jays simply laid off of his splitter. Tanaka just didn’t seem to trust his stuff and did not rear back and get that extra tick or two on the gun when he needed to which ultimately doomed him and the Yankees in this contest.

I don’t think his elbow is the issue although I’m sure if you watched ESPN Monday night, Tuesday and if you watch until his next start their “experts” will tell you otherwise. Tanaka had four certified doctors including Dr. James Andrews tell him to rest and rehab the elbow ligament, he’s not taking the advice of a fly by night physician. He may be a little hesitant to really open it up and see what it can do and what it can handle and ultimately he may not trust his stuff because of it but I truly believe the elbow is healthy. I could be wrong but I think with every start Tanaka gets under his belt he is going to get more confident in himself and more sure of his elbow and then, and only then, will we see the Tanaka we saw for the first 18 starts of the 2014 season. 

Do We Have a Clearer View on Tommy John Surgery?

Glenn Flesig is a an in jury expert in the field of sports medicine and has turned his attention to the growing epidemic of the Tommy John Surgery that is ravaging Major League Baseball. Flesig presented his findings at the annual Sloan Sports Analytics Conference that Tommy John surgery may be starting at a very young age. First, who is Flesig and why should we believe a word that he says? Flesig has a doctorate in biomedical engineering and has been working with Dr. James Andrews at the American Sports Medical Institute while gathering information for the presentation.

Flesig has reported that 16% of MLB pitchers go under the knife at least once for Tommy John surgery and has reported what we already knew, the success rate and "back to normalcy" ratio is now through the roof. Flesig notes that youth pitchers who threw more than 80 pitches in a game were four times as likely to require the surgery in their life. Those pitchers who pitched at least eight month a year were five times as likely to require the surgery.

Flesig notes that pitching while fatigued is the biggest factor in the surgery as youth pitchers who admitted to pitching with fatigue are a staggering 36 times more likely to have the surgery. I am a father of two young boys and this is eye opening to me. Some blame the mounds being lowered, some blame the schedule, the ball, the five man rotation, whatever. Me personally though I am going to be safe rather than sorry and teach them how to play shortstop rather than pitching.

Should Masahiro Tanaka Even Come Back?

With the Yankees falling farther and farther behind in the American League East division and second Wild Card race should New York even risk it with their 25 year old stud right hander Masahiro Tanaka? Four doctors, including Dr. James Andrews the Tommy John surgery guru, agreed that Tanaka should rest and rehab his less than 10% tear of his ulnar collateral ligament and use PRP injections to speed up the process. With less than a 10% tear is it feasible that the tear could fix itself and Tanaka could avoid Tommy John surgery altogether so why risk coming back for a team that is seemingly going nowhere but down this season?

I don’t mean for this post to sound negative, not at all, but the realistic chances of the Yankees making the post season and then getting past a Wild Card Playoffs round and the likely probability of facing the Oakland Athletics and the Detroit Tigers on the way to the World Series seems unlikely. Using that line of thinking the risk of Tanaka tearing the ligament and being out for another full season over the chance of another World Series might not be worth it. The Yankees have Tanaka for six more seasons, assuming he doesn’t opt out of his deal, and the team has to think about that more so than an unlikely run at a 28^th championship this season.

If it were me I would shut Tanaka down for the season, apologize to Derek Jeter profusely for not making the postseason in his final year, and begin to build for the 2015 season. Then again every time I write something like this the team goes on a 7-3 or 8-2 stretch so what do I know?

The Masahiro Tanaka Decision To Come Monday

As we all know Masahiro Tanaka has a slight tear in his right ulnar collateral ligament. Tanaka saw four doctors and all four doctors, including Dr. James Andrews, suggested rest and rehab over surgery for now. Tanaka received an injection in the elbow and the magic number all along has been three weeks before re-evaluating and making another decision on the elbow. That three week magic number is Monday so the Yankees should soon know the future of their 25 year old right hander.

If the Yankees get bad news I truly think they will try and add something, however marginal, to replace Chris Capuano. If the Yankees get good news and can get Tanaka back sometime in August along with Michael Pineda the pitching staff begins to look pretty good. With a healthy Pineda and Tanaka you are looking at Hiroki Kuroda, Brandon McCarthy, and Shane Greene filling out the rest of the rotation. That is a pretty gritty and tough rotation. It's not the Oakland Athletics or the Detroit Tigers but it's good enough to win the AL East.

I'm Worried About Tanaka & Capuano Doesn't Help That

It may be time to start getting a contingency plan together for the starting rotation because the Yankees may be without Masahiro Tanaka for a very long time. The 25 year old rookie and Cy Young candidate is still feeling lingering pain in his elbow after shutting down his throwing and receiving a PPR injection. The Yankees are currently treading water with their rotation at this point and patching holes as they find them but it may be time to acquire a real candidate because every day that goes by with pain in Tanaka’s elbow is every day that we are closer to a probably Tommy John surgery.

I don’t claim to be a doctor and I did not stay at a Holiday Inn Express last night, or ever in case you were wondering, so I realize that three doctors plus Dr. James Andrews recommended rest and rehab for Tanaka but all four doctors also failed to rule out Tommy John surgery. All four in fact said that Tommy John would be needed eventually and all four doctors stated that the real telling factor would be about three weeks after the injection and the rest program when he would be reevaluated. No doctor is going to release a client to start even a throwing program while there is still pain in the elbow.

Best case scenario is three weeks was not enough of a layoff for Tanaka and he needs three more before starting his throwing program and rehab, that pushes his date back until sometime in December. I know the Yankees are riding a great streak right now but it’s against teams they should be dominating and September may be too late for New York. The Yankees need someone now if that’s the case and not only for this season but next season as well if the surgery is necessary.

I love the veteran presence that Shane Greene seems to emanate every time the rookie steps onto the mound just like the next guy. I have my doubts on Chase Whitley and him having enough gas to make the rest of the season in the rotation just like the next guy. I will also have my doubts about CC Sabathia in 2015 if he makes it all the way back just like the next guy. I don’t want to have to worry about Masahiro Tanaka or his replacement as well, I have enough on my dish.

Cashman needs to acquire someone big with team control like a David Price has. I know Price is likely a pipe dream to Yankee fans but someone the next tier down from his pedestal would be fine with me at this point. I got enough to worry about, don’t make me worry about Tanaka too. 

CC Sabathia May Need Micro Fracture Knee Surgery

Make sure you guys don't read this until after you have had your family BBQ's and attended fireworks displays because this is going to depress you. CC Sabathia may need micro fracture surgery on his degenerative right knee, although nothing is set in stone. Dr. James Andrews looked at CC today as he was the doctor who did the stem cell injection after an MRI just showed a swollen knee.

This has the potential to hurt the Yankees as he has $23 million on the books for this season, around $11 million left, $23 million next season, and one more season at $25 million before a vesting option goes into effect for 2017. Unfortunately I think technically the option would vest for 2017 since it vests if he does not end the 2016 season on the DL with a left shoulder injury or spend more than 45 days on the DL with a left shoulder injury. The option also specifies that he does not make more than six relief appearances due to a left shoulder injury in 2016 it would also vest. This would cause the Yankees to buy out their injured starter for $5 million for 2017.

Ouch.

Yankees RF Beltran not yet ready to undergo surgery

Don't panic yet, Yankees fans.

According to Mark Feinsand of the New York Daily News, Bombers Right Fielder Carlos Beltran, currently on the DL with a bone spur in his elbow, will attempt to play through the pain when his 15-Day stint ends.

Beltran, who's hit .234/.286/.430 with 5 home runs and 15 RBI so far this season, visited Dr. James Andrews earlier today, with the bone spur diagnosis unsurprisingly being confirmed. 

Despite that, the 2013 NL Champion is apparently still not ready to give up, planning to stay on the field rather than undergo a surgery that would sideline him for at least 2 months.

Currently, #36 has mainly been replaced in the outfield by usual DH Alfonso Soriano, with Ichiro Suzuki also filling in occasionally. Since taking over, Soriano has done pretty well, not making an error while also recording an assist, so in my opinion Beltran's presence isn't completely needed on this team right now. He's undoubtedly still good, but really, the Pinstripes seem to be doing fine without him. 

My point in that last paragraph: Beltran needs to be smart in this situation. If he's not hurt he should play, but if he is then what he's doing here is pretty dumb.

Visit to Dr. James Andrews reveals no structural damage in Sabathia's knee

A recent visit to Dr. James Andrews revealed no structural damage in Yankees Pitcher CC Sabathia's knee, The Star-Ledgers's Jorge Castillo reports.

Sabathia, 33, suffered the injury some time during his last start in Milwaukee, where he surrendered 3 home runs in just 5.1 innings as the Bombers fell to his old team in competetive fashion, 5-4.

On Sunday, the Yanks put the lefty on the 15-Day DL, with #52 requesting the visit the same day. It was never meant to be taken too seriously, as Sabathia has never been legitimately hurt anywhere in his leg, but since he is owed $23 million this year I guess it wouldn't hurt anything to make sure he's healthy. 

The eighth-highest player in baseball has been very un-ace like for the Pinstripes so far this season, going just 3-4 with a 5.28 ERA in 8 starts. Among those eight starts, unbeknownst to some, Sabathia has put up a pair of high quality road performances in Boston and St. Pete, where he gave up just 2 earned runs in 6 innings and 1 earned run in 7 innings respectively.

The point of that last sentence: this guy can still pitch. Don't give up on him yet.