Shohei Ohtani intends to be in the Angels’ lineup Friday night at Citi Field against the Mets, according to a source familiar with Ohtani’s plans, an indication that he will continue to play as the team’s designated hitter this season as he considers options to repair his torn ulnar collateral ligament.
Ohtani learned of the tear between games of a doubleheader Thursday and played in the second game. Should he undergo a second Tommy John surgery in five years, Ohtani would probably be ready to return to hitting by May of next season and to pitching in 2025. Second Tommy John surgeries typically require longer rehabilitation periods and normally lead to a reduced workload.
Ohtani seemed surprised by the diagnosis of a tear, an indication that he did not experience severe pain entering or during his start Thursday. Similarly, Nathan Eovaldi pitched a scoreless inning in August 2016 when Yankees pitching coach Larry Rothschild noticed his stuff did not look the same. Eovaldi responded by saying his arm “hurt a little bit.” New York pulled him from the game. Upon examination, Eovaldi learned his flexor tendon had torn off the bone and his UCL was damaged.
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Eovaldi underwent his second Tommy John surgery, which is known as a revision. (His underwent his first in high school, nine years earlier.) Eovaldi took 21 months before he was back on a major league mound. Since then, Eovaldi has had one qualified season and has not approached his career-high 199 2/3 innings from 2014.
If there is a common denominator to causes of Tommy John surgery, it is velocity more than workload. Over the past three years, Ohtani has averaged 96.5 mph on his four-seam fastball, sixth highest among MLB starters (min. 2,000 fastballs).
Glenn Fleisig, research director at the American Sports Medicine Institute, has said advances in training and mechanics still leave tendons vulnerable in high velocity pitchers.
“The problem is as [pitchers] get faster and faster, they are getting stronger and stronger with their muscles and their mechanics are getting more finely tuned,” he says. “[But] the weak links are the ligaments and tendons. ... So what we've got is a situation now where by good mechanics and good strength conditioning, the muscles and the mechanics are overpowering the ligaments and tendons.”
Since 2018, 17 starting pitchers have averaged 96.5 mph with their four-seam fastball in a season of at least 2,000 pitches, including 500 four-seamers. Twelve of those 17 high-velocity pitchers have had Tommy John surgery, including two-time surgery recipients Eovaldi, Jacob deGrom and Walker Buehler.