The baseball world was rocked earlier this month by the news that two-time Cy Young Award winner Jacob deGrom would need Tommy John surgery to repair a torn ligament in his right elbow.
It marked the second time that the 35-year-old deGrom has had the surgery, and it figured to sideline him for at least a calendar year.
The Rangers ace was emotional but predictably defiant after getting the bad news, vowing to take on the challenging post-surgery rehabilitation.
But at least one noted orthopedic surgeon has his doubts about deGrom and the outlook for any pitcher trying to come back from Tommy John surgery -- let alone a second such procedure.
Dr. Richard Lehman, medical director at the U.S. Center for Sports Medicine in St. Louis, addressed the deGrom situation and other baseball injuries on the Audacy original podcast "Baseball Isn't Boring," hosted by Rob Bradford.
Lehman told Bradford that while medical advances have fueled the seemingly common misunderstanding that Tommy John surgery is no big deal -- or that some pitchers actually come back better from it -- a second Tommy John surgery, especially for an older hurler, can be especially difficult.
"The first thing is, about 25% of all Major League Baseball [pitchers] -- 30% -- are going to end up with the TJ -- Tommy John reconstruction. That's a pretty high number. Number two, everybody thinks, 'Hey, if I get Tommy John, I'm going to throw harder,' which is a misconception. And number three, the chances of pitching three years after your second Tommy John is not that great. So, yes, some guys come back and just sail, and then some guys you never hear of again. They just can't make it back, and that number is a higher percentage than you think. So, a second Tommy John's not a good thing."
Lehman believes the rise in Tommy John surgeries in recent decades can be attributed in part to the emphasis on teaching pitchers to max out, or throw as hard as they can, on every pitch.
"I mean, deGrom, this guy was throwing 97 -- he was unbelievable, untouchable. But, again, if you drive your car 200,000 miles as fast as you can, something's going to happen, and that's what's happened.
"But, I think, specifically the second Tommy John surgery is not like the first. It's not, 'Getting it out of the way.' It's, 'Now I'm on the ledge. I may be able to come back. I may not be able to come back. And I'm certainly not going to be able perform as well as I did before I had my second TJ.'"
Of course, there are exceptions to every rule. For deGrom to find inspiration in his comeback, he can look no further than a fellow Rangers starting pitcher. Veteran right-hander Nathan Eovaldi had Tommy John surgery in high school and again as a professional in 2016. Seven years later, at age 33, Eovaldi is now enjoying one of his finest seasons in the Majors.
Still, Lehman urged caution in what to expect of a pitcher trying to return from a second TJ procedure.
"Now, there's going to be outliers, and there's going to be that guy who just lights it up, or changes his pitching pattern, or picks up a new pitch," Lehman said. "And clearly that does happen, but the ability to throw hard and have endurance diminishes after a second reconstruction."
Unfortunately, it seems that cavalier attitudes toward a major surgical procedure like Tommy John have even filtered down to young baseball players and their parents.
Lehman says he frequently receives calls from the parents of high schoolers who are interested in undergoing the procedure in hopes of gaining an increase in arm strength and velocity.
"And then, after you get done scratching your head and dropping the phone, you pick the phone back up and say, 'We can't operate on your son or daughter's normal elbow.' That happens twice a week -- all the time. ... The ligament you have is fine, until you tear it."
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