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 2^nd Tommy John surgery and/or performance decline:

Steven Matz NYM, TJS date: May 2010 – I drafted Matz as my 4^th 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 13^th 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 6^th 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 4^th 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 2^nd 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)