Tanaka partially torn UCL; out minimum of 6 weeks

derekson

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Sprowl said:
 
He threw the splitter more than 25% of the time. Yes, he has other pitches, but the splitter was clearly his best pitch, and everybody knew to wait on his fastball. It's not that easy to replace a pitcher's best pitch, even assuming that you believe that it was the splitter (and not general overuse) that frayed his UCL to the point of diagnosis.
 
Well sure. Even Terry admitted that Tanaka won't be anywhere close to the same pitcher if he can't fall back on his splitter. But the post I replied to bolded the five pitches part.
 

TheYaz67

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So apparently he threw 3 innings of a simulated game in Detroit the other day, and they say they want to repeat this process twice more (maxing out at 75 pitches) before bringing him back to pitch later in September.  Used all his pitches, but admitted he wasn't very sharp with them yet due to the layoff. 
 
What do they do with Tanaka if they finally get him "ready" to come back and it is mid-September and they are still say 3 to 5 games out of the last WC with 2 teams ahead of them (and completely out of the AL East race)?  Do you just shut him down, or do you pitch him anyway to see how the UCL reacts?
 

terrynever

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Speculation from Yankee beat reporters is he will pitch one of the two games in Baltimore on Sept. 12, assuming he feels no pain during next two simulated games. No minors for him. They do want to resolve the issue of his UCL before the current season ends. So I guess that means, let's see him pitch and if the tendon further tears, then do the surgery. If it doesn't tear, maybe they prolong surgery for a few years. It's pretty risky business.
 

TomRicardo

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terrynever said:
Speculation from Yankee beat reporters is he will pitch one of the two games in Baltimore on Sept. 12, assuming he feels no pain during next two simulated games. No minors for him. They do want to resolve the issue of his UCL before the current season ends. So I guess that means, let's see him pitch and if the tendon further tears, then do the surgery. If it doesn't tear, maybe they prolong surgery for a few years. It's pretty risky business.
 
And people complain about the Red Sox medical staff
 

glennhoffmania

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How likely, or how often, has a pitcher had a partially torn UCL and come back at 100% without surgery and without eventually needing surgery?  If that's a reasonable scenario then I understand what they're doing.  But if they're basically delaying the inevitable I don't understand the plan.
 

rembrat

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I don't think that scenario happens enough where someone has crunched the data and given the thumbs up to the Yankees. And even if that were the case why would you risk it with your best pitcher?
 

glennhoffmania

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I wouldn't do it personally, but I'm not a number cruncher or a surgeon.  I think at least part of this is due to NY's philosophy that they have to win every year or it's a failure.  They see a fairly small opportunity to win a WS and they're willing to risk Tanak's elbow to get there.  I'd think that most teams in their position and with the amount they invested in Tanaka would shut him down without a second thought.
 

jon abbey

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There is zero chance (yes, IMO) that they sign two high-end FA starters this season, I'm starting to think they might not even sign one. Too much money already committed going forward, too many other holes, and too much experience with how little huge FA deals generally help, but we should keep this thread to Tanaka. 
 

jon abbey

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glennhoffmania said:
 I think at least part of this is due to NY's philosophy that they have to win every year or it's a failure.  
 
I think this 'philosophy' died with Steinbrenner, let's not forget that NY just let Matt Thornton go when he was their main LH reliever solely to get out of paying him for 2015, even though he was helping them this year. 
 

glennhoffmania

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jon abbey said:
 
I think this 'philosophy' died with Steinbrenner, let's not forget that NY just let Matt Thornton go when he was their main LH reliever solely to get out of paying him for 2015, even though he was helping them this year. 
 
I respectfully disagree.  They may have let Thornton go but they just spent half a billion bucks last winter to fill holes after a disappointing 2013, just like they did after 2008.
 

rembrat

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I believe they asked Lackey to continue to pitch hurt and he obliged them or am I misremembering?
 

EvilEmpire

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Hard to know how foolish the Yankees are or aren't being without knowing how much of a tear Tanaka has, or knowing exactly what the doctors are telling them.
 

glennhoffmania

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I think the difference between Lackey and Tanaka is that Lackey getting TJ was certain, just the timing was in question, right?  With Tanaka I still haven't heard that he'll definitely need surgery at some point.
 

jon abbey

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There is a good amount of info and discussion on this if people just go back a page or two. For instance:
 
RedOctober3829 said:
After saying what I said last night about just getting the surgery, I was intrigued by this subject so I did some research on PRP.  It turns out that the success rate of this procedure is higher than I thought.  This is an excerpt from a paper penned by, among others, the late Dr. Yokum.  They ran a study on 34 people who had partially torn UCL's(16 of them pitchers).  All of them went through approximately 2 months of treatments outside of surgery to try to get back on the field.  The doctors ran them through a battery of tests to get a baseline reading on their injury then ran them through PRP treatments. 
 
On average, it took the players an average of 12 weeks to get back on the field and only one of the 34 ended up needing TJ.  They followed up on all of the 34 players over a span of 70 weeks and 30 of the 34 returned to the same level of production they had before their injury.  
 
The link to the paper is here if anyone wants to read it.
http://ajs.sagepub.com/content/early/2013/05/10/0363546513487979.abstract
 
Baseball Prospectus summarizes it here.
http://www.baseballprospectus.com/article.php?articleid=21067
 
So, this is what Tanaka faces.  If the average is 12 weeks that puts him in the start of October to get back on the field.  Based on this information, it would be best if they just shut him down for the rest of the season.
 

soxhop411

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http://hardballtalk.nbcsports.com/2014/08/29/masahiro-tanaka-experiencing-general-arm-soreness/
 
Jack Curry ‏@JackCurryYES  36m
Tanaka is experiencing general arm soreness. He will return to NY to do some strengthening exercises. No appointments scheduled with doctors
 
 
Curry reports that the tentative plan was for Tanaka to throw a simulated game on Tuesday. But those plans are now on hold. In subsequent comments, Tanaka said that he was being “cautious” and that the pain could just be a function of his lack of arm strength after a layoff. But other reports are saying that the pain is focused in his forearm. Which tends to bode ill for pitchers.
That he’s not going to see a doctor is probably a good thing, but at some point soon it’s possible that the Yankees are going to have to decide if their outside shot at a chance to play a one-game play-in game is worth risking the six years remaining on his deal.
 

Plympton91

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He was going to miss all of 2015 whether he got the surgery on July 15th or October 15, so trying to rehab it makes sense. What you don't want to do is wait until next spring training and then find out he needs the surgery after all. So that means he has to pitch at some point this year, because otherwise you don't know.
 

TheYaz67

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So there was a suggestion last week that Tanaka would start an instructional league game in Tampa today, since he has been working out and rehabing down in FL now since the minor league seasons have ended.  Only 14 MLB games left, so assuming normal rest he may take Capuano's start on the 20th against Toronto at home?  Then perhaps a final start against Baltimore at home or the Sox in Fenway.... I guess two games will be the small sample size for determining surgery or no in the offseason.
 

Lose Remerswaal

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Only one rehab start and then the bigs after missing 10 weeks seems unlikely to me.  Maybe two or three seems more likely.  If he's going to need surgery they can tell pretty quickly based on velocity, location, and reports of pain, from a minor league start or even from a simulated game.
 

glennhoffmania

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Masahiro Tanaka pitched five scoreless innings in today’s instructional league game. He struck out four, gave up six hits and was hit hard several times while playing with and against a group of mostly teenagers, including several of this year’s international signings.
 
“Feels good,” he said. “I feel alright.”
 
Although Tanaka sounded satisfied that he’s generally healthy, he seemed less sold on the idea that his stuff is ready to pitch well in a big league game. He said his fastball topped
out at 92 mph. Asked whether he would tell Joe Girardi that he’s ready to pitch for the Yankees this weekend, Tanaka was noncommittal.
 
“I don’t know,” he said. “It’s hard to say.”
 
 
Link
 

Morgan's Magic Snowplow

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I'm no doctor but it seems like the whole "Let him pitch and see how he feels" approach as a way to determine whether or not to have surgery only works if he's going to air it out with his full repertoire in a hyper competitive setting. His velocity is currently down but that could mean a lot of things for a pitcher that hasn't pitched regularly in several months. And maybe he's not feeling any pain after this simulated game but what will he feel after throwing 40 splitters as hard as possible in one night?
 

glennhoffmania

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JimD said:
Just seems like they're delaying the inevitable TJ surgery.
 
Didn't Schilling say the same thing on the ESPN broadcast?  I was only half listening but I thought he said he's never seen a pitcher with this injury who hasn't ultimately needed surgery.
 

TheYaz67

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Just a few posts up is a discussion about plenty of players with partially torn UCLs who went the rehab route successfully instead of opting for the surgery.  Obviously if it is badly torn surgery is the only option, but Tanaka's has always been reported as fairly small/they caught it early....
 

JimD

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This has the potential to be really ugly, given what the Instructional League teenagers were able to do against him.
 

TheYaz67

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Lose Remerswaal said:
Wow. Last home game of the season. No one will notice with the Jeterfest going on.

What could possibly go wrong?
 
Well, last game of the series against Toronto - their last home game is the following Thursday against the O's.
 
And yes, the Jays have a few guys who can launch the ball, so could get interesting real fast if he's not throwing many splitters / they ain't doing what the splitter is supposed to do....
 

LeoCarrillo

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Tanaka not throwing the splitter = likely the best moment of the Sox's 2014 season: shaking off McCann and throwing a fastball to Napoli with two strikes, a homer deliciously just into the first row of the short porch, Nap being heard on TV calling Tanaka an idiot, and a 2-1 win for Lester in an epic pitcher's duel.

More, please.
 

Lose Remerswaal

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TheYaz67 said:
 
Well, last game of the series against Toronto - their last home game is the following Thursday against the O's.
 
And yes, the Jays have a few guys who can launch the ball, so could get interesting real fast if he's not throwing many splitters / they ain't doing what the splitter is supposed to do....
 
Ahhh, thanks for the correction.  It'll be the first under 30K crowd at New Yankee Stadium then, as the Yanks play at 1PM . . . same time as the Giants, who haven't quite been mathematically eliminated yet.
 

Rough Carrigan

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The other night on espn, in response to the claim that it was too many splitters that got Tanaka hurt, Curt Schilling said it didn't make sense to him.  He claimed that the splitter was easy on his arm. 
 
Could Tanaka be throwing it in a different way?
 

jon abbey

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Tanaka pitching today, looks pretty good through 2. Worth checking out the Adam Wainwright quotes from today's NY Times:
 
"Masahiro Tanaka is set to return to the mound for the Yankees on Sunday, seemingly with the threat of Tommy John surgery hovering over his every pitch. Tanaka has not pitched in the majors since July 8 because of a partly torn ulnar collateral ligament, and he has rehabilitated the injury rather than undergo the surgery widely believed to be inevitable.
 
Perhaps it is, but the Cardinals’ Adam Wainwright is proof that elbow reconstruction may indeed be far in the future. Wainwright said he first felt elbow pain in middle school, then was found to have a partial U.C.L. tear as a high school junior. A strengthening program allowed him to pitch without pain for six years, he said, until doctors discovered another partial tear while he was in Class AAA. He never felt inhibited from using any pitches.
 
“The second time I did it, I was given like a 60 percent chance to come back healthy and pitch like I was pitching,” Wainwright said. “The rehab was great, I healed up — and six years is six years.”
 
Wainwright finally underwent Tommy John surgery in 2011 and missed that season. But he was 29 then — a long way from high school — and said he was glad he did not rush to the operating table. 
 
“You don’t want to have surgery unless you have to,” Wainwright said. “We’ve been given ligaments and tendons that are much better than repaired ligaments and tendons. Any time they’re drilling holes in bones and putting things in, there’s risk involved. So don’t get it unless you need it.”"
 
http://www.nytimes.com/2014/09/21/sports/baseball/on-cue-the-cardinals-rise-in-september-.html?ref=sports
 

Rough Carrigan

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I was at yesterday's game with a buddy and we were both watching Tanaka very closely.  His velocity seemed like it was down, but not more than 1 mph or maybe 2.  His stuff seemed a little erratic.  He looked like he threw mostly good splitters but a few that were bad, one for a ball high, another that looked like a cookie.  He got a couple swings and misses on sliders.  Even though his line for the game looks terrible you could sort of see the guy who was so good earlier this season plus a bit of rust.  I lean toward saying that they made the right choice going the Wainwright route.