Texas Rangers

Ohtani needs Tommy John surgery. Here’s why no one should be surprised

Shohei Ohtani will decided next week if he will undergo Tommy John surgery, with the Angels’ team physician recommended for him Wednesday.
Shohei Ohtani will decided next week if he will undergo Tommy John surgery, with the Angels’ team physician recommended for him Wednesday. The Associated Press

The news that turned an ordinary Wednesday into mass hysteria for Los Angeles Angels beat writers and a dozen or so members of the Japanese media was delivered around 5 p.m.

Shohei Ohtani, the biggest free agent last off-season and the player the Texas Rangers wanted more than any other, has been told that the best way to move forward with his right elbow is Tommy John surgery.

He pitched Sunday for the Angels after missing some three months with a Grade 2 strain of the ulnar collateral ligament. He and the Angels decided against surgery then, hoping that a series of injections would gird the UCL.

It did, for a series of bullpen sessions, simulated games and 49 pitches against the Houston Astros. Ohtani’s sharp dip in velocity after the second inning was thought to be related to back stiffness and taking a grounder off his pitching hand.

Ohtani will decide Monday after the Angels finish their road trip whether to have surgery. Until a decision is made, he will continue to serve as the Angels’ designated hitter as he did Wednesday night against the Rangers.

Hitting won’t make things worse as long as the ligament is already torn, and Ohtani twice Wednesday.

If Ohtani has surgery, he will miss all of next season on the mound and perhaps half of the season as a hitter. Many doctors recommend a minimum of 8-9 months to return to hitting, but it could be longer if it is determined that hitting would compromise his comeback to pitching.

The Angels, though, still believe that the 24-year-old can continue as a hitter and a pitcher.

“We do still see him as a two-way player,” Angels general manager Billy Eppler said in a conference call. “Shohei has demonstrated the ability to be impactful on both sides of the baseball, and that is something that we — and I don’t want to speak for every other team — but I think every team would want impact in the batter’s box and on the mound.”

The Rangers, no strangers to pitchers needing Tommy John surgery, were one of seven finalists in December for Othani’s services. The Babe Ruth of Japan signed with the Angels for a bonus of $2.3 million, more than $1 million less than the Rangers could offer, and he is making the MLB minimum salary of $545,000 this season.

His status as a pre-arbitration player with six years of contractual control is part of what made him so attractive to all teams — not just the Rangers.

While the news upended the media’s day, none of them was surprised by the news. The general thought in Japan was that surgery was inevitable based on the June diagnosis and based on the less severe Grade 1 strain Ohtani had after pitching last season in Japan.

No one else should have been surprised by Wednesday’s news, either.

The 2017 tear was made known to all 30 MLB teams before Ohtani hand-picked the seven clubs that most piqued his interest. The Rangers said in the past that they continued to pursue Ohtani despite the strain, but their doctors never performed a physical on him.

No matter the perceived effectiveness of stem-cell injections, platelet-rich plasma injections or months of rest, elbow ligaments often don’t survive after a severe tear. That’s even more the case when part of an arm that pumps 100 mph fastballs as Ohtani’s does.

Eppler said that no mistake was made in allowing Ohtani to pitch again this season after the initial injury.

“Any time a player has an injury to a particular area, and then gets put back out in that activity, you’re always mindful that if it doesn’t go well, that you might be facing having to address that area again or address it with an alternative prescription or treatment protocol,” Eppler said.

“You’re always mindful that’s a possibility or that could become a reality. That is something that comes with it. There’s some risk. Throwing hard helps contribute to that. It was something that we felt could happen, but we wanted to take a more conservative approach at this moment in time and did that.”

Orthopedists evaluate a tear in multiple ways and assess the best treatment based on the tear’s “personality.” The degree of the tear matters. So does the location of the tear, at the top, middle or bottom of the UCL.

A higher-grade tear at the top of the ligament might receive a better prognosis than a lower-grade tear toward the bottom of the ligament.

While elbow injuries vary from case to case, it was almost universally believed that Ohtani would be faced with undergoing Tommy John surgery.

No one should be surprised.

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