Joel Sherman

Joel Sherman

MLB

Harvey’s rush to return from Tommy John surgery a bad idea

Matt Harvey has stated his desire to speed through rehab and pitch this season in August or September — less than a year after his Oct. 22 Tommy John surgery. I will not put that possibility at absolute zero.

But I do think Omar Quintanilla has a better chance to hit 50 homers this year or Bartolo Colon to win a hunks-of-major-league-baseball contest or Terry Collins to receive a lifetime contract to manage the Mets.

This is more than defying the accepted timeframe to return from Tommy John surgery. Harvey would have to convince the Mets that the small picture of a few starts this year — even if somehow the team has found its way into a pennant race — is worth risking his ace future. He would have to sidestep his agent, Scott Boras, who among other things, was instrumental in having client Stephen Strasburg shut down late in the 2012 season to protect his arm from innings buildup two years after Tommy John surgery — and that was with the Nationals en route to the playoffs.

Most pertinent, though, is the growing belief that rushing back — while showing diligence and a desire to help a team — is counterproductive. It is not just that there has been a rash of Tommy John surgeries this spring (seven) that has the industry wondering if this is a coincidence or a sea change of some sort. But five starters between ages 24-29 — Brandon Beachy, Daniel Hudson, Cory Luebke, Kris Medlen and Jarrod Parker — all needed a second Tommy John in the past six weeks, and in the cases of Beachy, Hudson and Luebke it was within two years of their first. Harvey is 25.

Right now, there are just theories on why the need for surgical redundancy. Just to illustrate how scattered they are, you can find an equal number of caring folks who claim pitchers are throwing too little to build up their arms and those that claim they are throwing way too much in competition before they reach age 25 — particularly on travel and showcase teams in their formative years.

Yankees team doctor Chris Ahmad was one of three authors on a paper — “Public Perceptions of Tommy John Surgery” — that polled coaches and parents of high school and college athletes, and the athletes themselves, and found staggering misperceptions about the procedure.

It included large percentages who believed the surgery should be performed on elbows without ligament problems under what experts say is the faulty belief that pitchers come back stronger and throwing harder after the procedure. This has led to larger numbers of teenagers getting the surgery and, experts say, if the faulty mechanics that caused the first ligament tear are not fixed, then the second ligament will be put under the same stresses and break as well.

There are those who point that many pitchers needing the surgery one or two times are positional switch guys who simply have not built the necessary muscle memory to handle the innings ramp up from a mound or have used their arms in multiple ways. For example, Beachy played third base in high school, and first and third in college and pitched on a limited basis. Medlen was a junior college shortstop. Parker was a middle infielder in high school before becoming a pitcher.

But the most common concept for the repeat Tommy John was essentially that a cockiness has formed around the surgery. The success rate is so good (83-85 percent) that pitchers are more aggressive about getting the procedure with even partial tears — consider that one out of every three active pitchers has undergone the surgery.

In addition, the rehab has become so precise that professional athletes — usually competition junkies — are looking to push the envelope of return time. What not long ago was considered an 18-month rehab became 14 months which became 12 months, and now you have pitchers like Harvey talking about doing it in 10.

Dodgers VP of medical services/head trainer Stan Conte, an authority on Tommy John surgery, said he believes the need for a “revision” — the industry term for a second procedure — of a Tommy John surgery could be the result of one of two items: the surgeons or the rehab. And because, he says, the majority of Tommy John surgeries performed on major leaguers are done by three doctors — James Andrews, David Altchek and Neal ElAttrache — and all three are considered experienced experts, Conte zeroes in on the rehab.

“The rehab might be moving too fast,” Conte said. “One thing with Tommy John surgery is you are [inserting] a tendon, but the body recognizes it as a ligament. It changes from a tendon to a ligament. That takes up to at least a year before you can come back to competition. The graft matures to maximum strength, and if you come back too soon and throw too hard I believe there is a direct relationship. How hard someone throws stresses the ligament. Throwing is not the problem. Throwing too hard is if you do it too soon. The theory is that throwing hard stretches out the ligament again and you have damage near the end of the rehab process.

“As a player feels so good 7-8 months after surgery, it is hard to monitor the player. We with the Dodgers use a radar gun to keep velocity down below a certain level. We are still getting guys back at 12-13 months. We wonder if pushing that envelope [is causing the need for revisions]. But there is no super science behind that theory yet.”

Not counting the five new double Tommy John surgeries, Conte said research shows 24 major leaguers have needed two procedures and 14 have successfully returned (58.3 percent). Boras prides himself on the research and database produced by his staff and has been asking them to compile as much information as possible on the need for surgery and, particularly, the revisions.

He said any decision regarding how quickly Harvey returns would be made jointly with the Mets, Harvey and himself involved. But it was clear from Boras’ words — “there are proper protocols to follow, and I think they will be followed” — that Harvey will not be allowed to air out his arm in August or September, and that caution/wisdom will assure he does not return to the team until 2015.