Tommy John surgery used to be viewed as a risky procedure. The rate at which players returned from the surgery wasn’t great. It still was better than shoulder surgery, but the rate of recovery today is so much different. Today we, the general public, tend to think that everyone comes back from Tommy John surgery and returns to form with time. Fangraphs has posted two articles related to Tommy John surgery over the past few days and they both got me to thinking.

This morning Travis Sawchik wrote an article named”Have We Passed Peak Tommy John?”, and it notes that Tommy John surgeries have declined each of the past two seasons. In 2014, then in 2015, the surgery peaked at record highs. The 2017 season was the lowest total since the 2011 season. The decline could simply be random variance, but perhaps teams are doing things a little better overall in injury prevention, too.

With all of the injuries to elbows these days, Tommy John surgery is rather common. We usually see guys come back from the injury, and while plenty of guys will have some “rust” when they return, particularly with control, a lot of the guys do come back to close to who they were. But, most of the guys we see return are the Major Leaguers. The guys that were already among the best pitchers on the planet.

What we don’t always see is guys in the minors return to form. On Sunday at Fangraphs, David Laurila talked about and with Brady Aiken about his career. For those who don’t know, Brady Aiken was the #1 overall draft pick in 2014. The Houston Astros selected him and then during his physical noticed that his UCL was abnormally small. They, in turn, decided to drastically lower their offer of a signing bonus to Aiken, almost cutting it in half. He stood his ground and the two sides never agreed on a contract.

The next spring he was pitching for IMG Academy in Florida, preparing for the 2015 draft, and in his first game he tore his UCL. The Cleveland Indians would take a chance and draft him with the 17th overall pick later that summer despite the injury. He would miss the entire 2015 season, of course.

In 2016 Brady Aiken didn’t return to the mound until the rookie season began. The Indians took it slow as he didn’t pitch beyond the 3rd inning until his 7th outing. In his 9th start he threw 5.0 innings, and reached at least the 5th inning in five of his final six innings. There were some stumbles along the way. He posted a 5.83 ERA in 46.1 innings and gave up more hits than he had innings. But, he struck out 57 batters. His walk rate was high, but not insanely high, giving up 21 free passes on the year in his limited inning.

In 2017, things were a bit different. Pitching in rookie ball is a lot different than pitching in full-season baseball. Out in spring training, where the Reds and Indians share a facility, I had heard someone talking about Brady Aiken and how his stuff just wasn’t where it used to be. That held up during the season, too. He spent the entire season in the Midwest League, where the Dayton Dragons play. I spoke with a few people who see the league throughout the year and the reports on his stuff were mostly iffy. Fastball in his high 80’s. Inconsistent offspeed stuff, but a good breaking ball when he’s at it’s best. Poor control.

His stats during the season were poor, to say the least. His ERA was 4.77, which wasn’t terrible, but not good. It was the rest of the numbers that were concerning. In 132.0 innings he allowed 134 hits. That also came with 101 walks and just 89 strikeouts. There’s still time, but this far out beyond Tommy John surgery, most players are back up to their past velocity. They are also beyond the “rust” portion of working through control battles.

While I certainly don’t want to write off a guy like Brady Aiken, it does just bring me back to the original point I was shooting for: Not every Tommy John surgery is a fix-all. The surgery has come a long way since it was originally performed. It’s come a long way in the last 20 years. The recovery methods and rehab have also come a long way. Those are both reasons that the recovery rates are much higher these days. But, it’s not a guarantee for anyone. Some guys don’t recover like we expect them to.

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Doug Gray is the owner and operator of this website and has been running it since 2006 in one variation or another. You can follow him on twitter @dougdirt24, or follow the site on Facebook. and Youtube.

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