Collette Calls: Uh Oh-tani

The sun also appears to be setting on Shohei Ohtani's amazing 2018 season as well. We got the depressing news that he now has a grade 2 UCL sprain and that the Angels tried Platelet Rich Plasma injections. They will then evaluate things in a few weeks before deciding whether the he needs Tommy John surgery. Whether you own shares of him or not, the news is terrible. I do not have him in any of my leagues, but it has been fun to watch him pitch when he is dominating a lineup, and I even got to see him hit a home run in person in May. If you do own him, you are upset and wondering what to do with him. In a reset league, I am pessimistic he will have any value the rest of this season.

Keeper league payers and dynasty players have to consider what the future holds for Ohtani as he travels down one of two paths: the one he is currently on, or the one that results in Tommy John surgery. Let's look at the data around both paths, beginning with the current path of PRP injections.

All of these names and associated data comes from Joe Roegale's excellent list as he tracks all of the news around elbow issues.

The first documented case of a pitcher having PRP injections was Takashi Saito in 2008. He had the injection in mid-July that season and came back to pitch that September. He went on to pitch effectively in 2009 and 2010 before seeing his 2011 season shortened by injury and his career end in 2012. In total, 17 players have received PRP injections from 2008-17, four of whom ultimately ended up having Tommy John surgery:

The table below shows how the pitchers fared after the PRP injection and avoided Tommy John surgery:

That is the list of pitchers who have made it back to pitch a decent amount of baseball post-PRP injection. In the case of Thornburg, he is still trying to make it back to the major leagues after missing 2017 with Thoracic Outlet Syndrome surgery. However, there is an even split among the other pitchers on the list. The first three, all pitchers with extensive experience overseas, did not bounce back to the same level of success they had pre-injection. The US-based pitchers, all younger pitchers, have had better numbers post-injection. Ohtani did pitch overseas, but not as extensive as Chen, Tanaka or Saito, and is younger than any other pitcher on this list.

The best-case scenario for Ohtani would be what has happened to Aaron Nola, but Nola was also recovering from a low-grade tear. The more likely case could be what his teammate Garrett Richards has gone through, where it takes him longer to come back because of the severity of the tear. In that case, we would be looking at a return to the major leagues about mid-May 2019.

The other path will lead to a longer delay. Through the 2015 season, 267 major league pitchers have had Tommy John surgery. The average recovery time – as in returning to the major leagues to pitch in a game – is 18.6 months.

Some of the more extreme cases on the low end of the spectrum include names such as Ken Dayley, Mike Bielecki, John Tudor, Zach Duke, Scott Williamson, Jason Grimsley and Mike Fetters, who each made it back to a major league mound fewer than 10 months from their surgery date. On the high end, we have Jose Rijo, Jonny Venters, Cory Luebke, Neal Cotts and Ryan Madson to name a few.

If there is a silver lining to Ohtani having Tommy John surgery, it is the fact that the odds of returning to the major league level are very much in his favor given his youth. But it is important to remember there are no 100 percent success rates for surgeries and that pitchers do not "come back throwing harder" as much as they come back healthier than they were before the surgery.

Roegele's data shows that at least 82 percent of pitchers ages 20-25 return to pitch in the majors. The total sample is 119 pitchers with the average recovery time 19.5 months and the average return to the majors 84 percent.