Elbow rehab timing works best for Chandler Hamilton baseball pitcher Patrick Murphy

Elbow rehab timing works best for Chandler Hamilton baseball pitcher Patrick Murphy


Elbow rehab timing works best for Chandler Hamilton baseball pitcher Patrick Murphy


Initially, Patrick Murphy tried to just rehab his sore right elbow in the hope that things would get better with time.

But time doesn’t really heal all wounds.

Then a junior, the Chandler Hamilton pitcher had suffered a partial tear of his ulnar-collateral ligament right before the 2012 state baseball playoffs in late April.

Murphy faced two options — rest the elbow and hope it healed enough to pitch his senior season, or undergo Tommy John surgery, in which the ligament is replaced with one from another part of the body.

Having Tommy John surgery, named after the former major-leaguer who first had the surgery in 1974, meant an 83 percent chance of a full recovery but also entailed a year of meticulous rehab.

Without it, Murphy’s arm could give out at any moment.

After two months of fruitless rest, Murphy changed his mind and underwent the knife.

His future college coaches at the University of Oregon were happy with the decision.

“They said it’s all up to me, but they wouldn’t have been mad if I had surgery,” Murphy said. “They supported whatever decision I made.

“But once I decided to go for surgery, they were happy I got it out of the way.”

Good timing?

Oregon is happy because, in all likelihood, Murphy will be ready to pitch his freshman season with the Ducks.

The Hamilton senior had enough hype behind him as a junior phenom to garner offers and the timing to suffer the injury more than a year out from when his collegiate career would begin.

Other pitchers who need the surgery might not be so lucky. At the collegiate level, Division I programs have only 11.7 scholarships to dole out among a 25-man roster. A pitcher slated to be on the shelf for his freshman season recovering from reconstructive elbow surgery won’t get many offers.

“It’s really, really critical that the money that we spend is being used well,” said Ken Knutson, Arizona State’s associate head coach and recruiting coordinator. “We just run out of it so fast. Literally, if you have six or seven scholarships on your pitching staff and a big scholarship is tied up on a kid that can’t perform, that’s like the Yankees losing $20 million in a year or something like that.”

Knutson said no one on his staff has had to undergo Tommy John surgery for at least 10 years, something he chalks up to superior strength and conditioning for his pitchers.

Maximizing the three years a program will receive from a top prospect is the most important factor when it comes to recruiting. That means minimizing risks, which means minimizing exposure to Tommy John surgery, as far as Knutson is concerned.

“I’d stay away from them,” he said. “I wouldn’t be that interested in a guy that had Tommy John surgery. I really wouldn’t.”

Time as a luxury

The view at the professional level, however, is different. Any team that drafts a high school prospect who either needs Tommy John surgery or recently underwent it has the luxury of recovery time.

The minor-league system is designed to develop prospects, not win immediately as in college baseball. If a hot prospect needs a year to recover from the procedure, so be it.

“Youth is on their side,” Diamondbacks Scouting Director Ray Montgomery said. “They have the ability to go through a pretty structured regimen and rehab. Fortunately a lot of them do come back OK.”

Still, Montgomery would rather have a pitcher who hasn’t had the surgery than one who has. The recovery outlook is brighter for pitchers than it was 20 years ago, but it’s still not something to take lightly.

You have to go under anesthesia. One part of your body is taken and grafted to another. It’s not exactly getting a cavity filled.

Montgomery would just as soon a player not have to go through that, and just as soon sign a player who hasn’t.

“All things being equal, I’d rather have the car that hasn’t been in a car accident than the one that looks just like it did when I bought it but has been in an accident,” he said.

Back to natural

Side by side, those two cars do not look exactly alike. The brand new one is spotless. The one that has been repaired has a 3-inch scar on its elbow.

But is there any difference in performance or likeliness to break down?

The verdict is out on that subject for at least another six months, when the American Sports Medicine Institute will complete a study on the re-injury rate of pitchers who have had Tommy John surgery.

Advancements in both the surgical and rehab process have made recovery a less daunting task, thanks to the limited movement of the elbow joint. Recovery from knee injuries has made similar progress, whereas shoulder injuries continue to confound those afflicted with them.

That doesn’t mean a high school pitcher should go under the knife simply to avoid the perceived inevitability of the need to do so later. Tommy John surgery does not prevent future elbow injuries, ASMI Research Director Glenn Fleisig said.

“Saying everyone’s going to have it, so why not get it out of the way doesn’t make any sense,” Fleisig said. “It’s not like everyone has one injury stored in their elbow.”

Fleisig admits that many Tommy John patients do end up pitching better than before their injuries, but said that has more to do with a streamlined and strictly supervised rehab process. A healthy elbow undergoing the same year of a working vacation from baseball would see similar effects.

The goal of the surgery is a return to normal form, not a bionic arm.

“(A surgeon’s) goal is simply to return it to as good as natural,” Fleisig said. “There’s no aim to make it better than normal.”

Happy either way

Ten months after having Tommy John surgery, Murphy only began throwing from a mound last week, and only with the catcher standing up. Most of his days consist of plyometric exercises to increase range of motion and forearm workouts with small dumbbells.

“It started with one-pound dumbbells for little things,” he said. “You won’t believe it, but those one-pound dumbbells will get you good.”

Murphy understands the risks he took having his surgery. When he decided in favor of the procedure last July, he knew he’d miss his senior season, one in which Hamilton could win a state title.

He knew he may never get back to normal, although feels confident he’ll be in the 83 percent of patients who do. The fact that Oregon never wavered in its commitment to him helped as well.

How it affects his draft prospects, he doesn’t know.

“I initially wanted to get drafted,” Murphy said. “I still do, but it’s affected the draft a little bit. I’m hoping there’s still a chance. We just have to see.

“I’m happy with college. I’m happy either way.”


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