What Are Johan Santana’s Chances of Recovery?

On Saturday, Steve Popper and Bob Klapisch of the Bergen Record dropped the bomb that Johan Santana’s 2011 season might be in jeopardy.

Well, it’s only a bomb if you don’t read MetsToday; we wrote off Johan’s 2011 way back in early September. But that’s just me being all “gloom and doom” … or a realistic view of the situation, depending on your outlook. Personally, I tend to have low expectations for pitchers returning from serious shoulder injuries, and didn’t see any reason to view Santana’s injury any differently. It made more sense, to me, to plan the 2011 Mets pitching staff without Santana — and if by some small miracle he made a comeback, it would be a wonderful and welcome surprise.

But planning without Santana doesn’t sell tickets, and the Mets are desperate for revenues. So, the team will continue to spin the fantasy of Johan’s return at some point in 2011.

Putting that aside for a moment, we must wonder if Santana will be able to return by 2012 — and if he does, will he be anything near the ace starter he was before shoulder surgery? The odds are stacked against him, heavily — if history is any indication.

This isn’t more “gloom and doom” from your pessimistic blogger. Again, I look at the facts. Shoulder surgery is nothing at all like elbow / Tommy John surgery. Pitchers generally take much longer to return from even minor shoulder surgery, and rarely return to be as effective as they were before. But don’t take it from me; Jerry Crasnick wrote an article about it last September. Also, consider the number of pitchers who had success after shoulder surgery, compared to those who were never the same. Following is an unofficial but somewhat reliable sampling of pitchers who have suffered major shoulder injuries in the last decade or so:

Successful:

Chris Carpenter
Freddy Garcia
Kerry Wood
Roger Clemens
Jesse Crain
Ted Lilly
Jon Rauch

Somewhat Successful:

Scott Olsen
Pedro Astacio
Rich Harden
Pedro Martinez
Joe Nelson
Orlando Hernandez
Aaron Sele
Gil Meche
Joey Hamilton

Unsuccessful:

Gil Meche
John Maine
Kelvim Escobar
Jason Schmidt
Mark Mulder
Paul Wilson
Mark Prior
John Smoltz
Curt Schilling
Brian Lawrence
Tanyon Sturtze
Mike Sirotka
Gary Majewski
Cliff Politte
Joey Eischen
Erik Bedard
Ben Sheets
Ramon Martinez
Yhency Brazoban
Chuck James
Henry Owens
Tony Armas, Jr.
Jaret Wright
Orlando Hernandez
Bartolo Colon
Jason Jennings
Matt Clement
Kris Benson
Matt Morris
Scott Elarton
Dave Fleming
Matt Anderson
Casey Fossum
Justin Thompson
John Rocker
Carlos Hernandez
Ryan Anderson
Chad Cordero
Rich Hill
Rocky Biddle
Casey Janssen

Jury is Out:

Chien-Ming Wang
Jake Peavy
Juan Cruz
Ron Mahay
Dustin McGowan
Jeff Francis
Chris Young
Brandon Webb

(You may notice that El Duque and Gil Meche are on two lists; that’s because they suffered major shoulder injuries at two different times in their lives — with the second time contributing to the end of their baseball careers.)

I certainly missed many pitchers who never made it all the way back from a major shoulder injury. I might have missed a few success stories — please add them in the comments. The point is, full recovery and true “success” is a rarity when it comes to major shoulder injuries and shoulder surgery in particular. What makes this more dismal is that nearly all of the pitchers on these lists suffered less-damaging injuries that required less-invasive surgeries; in almost all cases, the pitcher had a frayed labrum and/or torn rotator cuff that required arthroscopic surgery.

From Crasnick’s article:

“Superficially, 90 percent of scopes or rotator cuff surgeries are just a cleanup,” said Jamie Reed, the Rangers’ medical director and head athletic trainer. “You’re not repairing or fixing anything. It’s like when you take a rope and go over the corner of a table, back and forth, and get all that fraying. It’s the same when you get inside a shoulder. It starts to clog up and get inflamed, and that’s where a lot of guys have shoulder pain and discomfort. You’re basically getting that tissue that needs to be debrided out of the way.”

With the “typical” surgery performed above, it takes most pitchers a minimum of 10 months to a year to get back on the mound. Mind you, that doesn’t necessarily mean that they’re pitching effectively off of a mound; Freddy Garcia is a very typical example of the normal course of action. Since he’s a success story, and we want to be optimistic about Johan Santana’s future, let’s delve into the Garcia story.

Ironically, Garcia and Santana have a lot in common. Both are Venezuelan, both were originally signed by the Astros, both were dominant pitchers in the AL Central, and both were befelled by shoulder injuries that required surgery. Garcia had his surgery in late August 2007. Garcia finished his rehab and began showcasing his talents to MLB teams in August 2008 — just short of a full year later. At that time, his velocity topped out in the mid-80s and he signed with the Tigers, pitching 15 innings before leaving a game with a “stiff” shoulder and ending his season. You may remember that Garcia’s comeback continued unsuccessfully in Port St. Lucie the following spring, nearly retired after struggling to keep his velocity in the 80s, and was eventually released after pitching terribly in AAA Buffalo. A few months later he signed with the White Sox, was called up in August, and finally began pitching effectively again in the last month of the season. Mind you, that was September 2009 — a full two years after his shoulder surgery.

Something to consider with the case of Freddy Garcia: despite making 28 starts and going 12-6 last year, he wasn’t nearly the pitcher he was before, and his velocity was in the 85-86 MPH range. There are reports that he’s up to 89 MPH in Yankees camp this spring, and if so, that’s great — but it also means it took him over 3 1/2 years to get there. Also, I haven’t been able to pinpoint what type of surgery Garcia had; meaning, whether it was a simple arthroscopic procedure or a more invasive one, such as what was done to Johan Santana.

I’m fairly sure that all of the other success stories occurred after comparatively minor arthroscopic procedures, and only Garcia and Lilly were over 30 at the time of the surgery (Santana is 31 going on 32). Additionally, Clemens might have had some “special help” for all we know. If Garcia’s example is a point of reference, Santana will not be a reliable MLB starting pitcher until sometime in 2013, or possibly 2014. In case you’re wondering, Santana’s contract expires at the end of ’13, though there is a $25M option for ’14 that the Mets may exercise.

There are two players — both catchers — who reportedly suffered similar injuries to what Santana sustained, and who had similar procedures: Jorge Posada and Gregg Zaun (Santana himself made the Posada comparison). If you saw Posada play last year, you know he couldn’t throw out the garbage, much less opposing runners, and is slated to be a full-time DH this year mainly because he can’t throw. And as for Zaun, his shoulder wasn’t quite right after surgery and he retired last week because of it.

Sorry for the gloom and doom, but personally, I think it’s best to just write off Johan Santana for the rest of this year and hope he can make a return at some point in mid- to late 2012 — though with what effectiveness, no one can guess.

While researching the risk/reward articles posted earlier this winter, I couldn’t help but notice all the pitchers who were trying to come back from shoulder problems. I combined that list with others from the past, to try to get a handle on the recent history of pitchers returning from shoulder surgery.