After consulting with Dr. James Andrews for an additional opinion regarding his partially torn ulnar collateral ligament, Matt Harvey announced his decision to forego surgery for the time being. In the weeks since Harvey’s initial examination by the Mets’ team physician, Dr. David Altchek, one of America’s top sports surgeons, and his diagnosis of a low-grade sprain of the UCL, amateur orthopedists throughout the blogosphere and sports talk radio have clamored for Harvey to bite the bullet and elect to have Tommy John surgery. This despite the fact that the accepted medical protocol is to avoid surgery whenever possible. There is absolutely no evidence that Harvey is ignoring medical advice and making this decision emotionally.
According to Harvey, Dr, Andrews performed tests to evaluate the stability of his elbow, and found no reason to mandate surgery now. Harvey’s decision will involve rest, a graduated throwing program, and rehabilitation over the next 6 to 8 weeks. At the end of that time, Harvey’s elbow will be reevaluated for a final decision on the TJ surgical procedure. Although it is estimated that only 1 in 8 pitchers with a similar injury is able to ultimately avoid surgery, it is prudent to wait the extra few weeks to make a final decision since those weeks will make no difference in when Harvey will be ready to resume pitching. Whether he undergoes surgery now or two months from now he will be out for the 2014 season, while avoiding surgery means he would probably be the Mets opening day pitcher next April.
The list of players who have successfully avoided surgery is fairly long. The most impressive of these is Roy Halliday, who experienced pain similar to Harvey’s in September 2006, and was told he would almost certainly require surgery. After the inflammation and swelling had subsided, it was found that his tear was not that serious, and so Halliday performed strengthening exercises and a modified throwing program during the winter and into spring training. Between 2007 and 2011 Halliday averaged 32 starts/239 innings a year and was a regular contender for the Cy Young Award, winning it one year. Apparently, Harvey spoke to Halliday immediately after his diagnosis, and the veteran related his experience and seemingly advised Harvey to proceed with caution. Other pitchers in similar circumstances who avoided Tommy John successfully include Zach Greinke, Takashi Saito, Ervin Santana, Adam Wainwright, and Harvey’s teammate Scott Atchison. Wainwright, who suffered his tear as a minor leaguer in 2004, did finally succumb to TJ surgery in 2011 after 5 major league seasons, 3 of them with more that 200 innings pitched.
It is apparent to this writer that Harvey’s decision to postpone a decision on surgery is a wise one.
Is it a strain or a partial tear? If its a strain, I feel a whole lot better.
ReplyDeleteHerb,
ReplyDeleteGreat article. I couldn't agree more with Harvey's approach or your conclusions. Despite the advances with TJ surgery, it is not like getting a cavity filled.
Darnell, I said sprain, not strain. Interestingly, the definition of a sprain I didn't know that until doing a little research on Harvey's condition. is a stretched or torn ligament.
ReplyDeleteThanks, TJ. But isn't TJ surgery sort of like having a cavity filled. The tear in the ligament creates a cavity that reconnecting the tissue fills. (lol) I only wish it were that simple.