If you search “MLB labrum surgery” on Google, you’ll quickly learn that hurting your labrum is no joke. Articles call it the “career ender,” “the death sentence,” and any other negative idiom you care to spend the time to create. For the Milwaukee Brewers, a push into the playoffs could greatly hinge on the recovery of Jimmy Nelson from one of the most detrimental injuries in baseball.
It’s not just that labrum surgery is bad, it’s that rotator cuff damage with it is worse. Nelson had some rotator cuff damage on top of the labrum damage.
In 2017, Nelson broke out to become the Brewers’ staff “ace,” putting up a 3.49 ERA, 3.45 DRA and 3.9 WARP in 175 1⁄3 IP. Numbers like those had never previously been touched by Nelson in the major leagues. Not only was he keeping runs off the board, but he improved his BB/9 to a 2.5 from 4.3 the year before and was striking out more than 10 batters per game. That was, before his injury while running the bases in September prematurely ended his season.
The team is doing it’s best to make sure he comes back as healthy as possible. To protect the 28-year-old Nelson, he was restricted from throwing until Spring Training despite quick progression through rehab.
However, there’s still an excitement about what Nelson can accomplish in 2018. Part of this is from comments like Derek Johnson’s at On Deck when he announced Nelson could return by June. Another part is from the previously mentioned quick progress through rehab. Finally, Nelson was a huge bright spot in a very bright 2017 campaign who fans rallied around.
It’s not fair for Nelson to face high expectations in his return from a daunting procedure that has ruined better pitchers. So, how has this injury affected other pitchers before him?
A recent study found that successful return to form for baseball pitchers after anterior or posterior labrum surgery is very rare. The study, conducted by a collection of doctors, found that only 62.5% of pitchers return to play after the surgery. Of those 62%, only 87% returned to “form.” The definition is a pretty broad scope as the group counts “return to form” as a performance within 2 full runs on ERA and within .500 WHIP of the player’s previous career averages.
Outside of those numbers, let’s look at some real world examples of players who had the surgery. For this article, I tried to stick with pitchers who were able to have a substantial sample size (at least two full seasons) before the surgery. Because of this, most of the pitchers examined are pre-2010. Medical science is a quickly evolving field and it’s not unreasonable to assume Jimmy’s treatment cannot accurately be compared to the pitchers on this list.
First, let’s look at MLB pitchers with a track record who more or less lost their career due to the surgery.
One of the most prominent and extreme examples of labrum surgery resulting in the end of a career is Brandon Webb. In 2006, 2007 and 2008, Webb was one of the most dominant pitchers in baseball. He won the Cy Young award in ‘06 and finished in second in ‘07 and ‘08. In 2009, he required labrum surgery and never returned to big league baseball. Webb only pitched 12 more innings at AA after his surgery. He also needed rotator cuff surgery on top of repairing the labrum. Nelson did also have some fraying of his rotator cuff that was addressed but Webb seems like a more extreme case study on the matter.
Next is Erik Bedard. Bedard amassed more than 800 innings with a 3.70 ERA in 141 starts over six seasons. The promising pitcher went under the knife in 2009 at age 30. Over the next five seasons, Bedard would only manage 480 major league innings to the tune of a 4.47 ERA in 89 GS. He also saw his velocity drop by a mile per hour in three of the following four seasons. The performance dip is a debatable issue. It could be connected to the labrum surgery, but it could also be connected to age. One thing is for certain, after the labrum surgery Bedard struggled with injuries annually.
More recently is San Diego Padre Clayton Richard. Richard is still an active player for the Padres, but his potential was substantially higher before his labrum surgery. Before his injury, Richard’s statline looks very similar to Nelson’s: 720 IP, 4.13 career ERA, 3 BB/9 average, but Clayton wasn’t nearly as capable of getting the strikeout as Nelson. Unlike Nelson, Richard had more damage in his rotator cuff and even his bicep. In 2013 at 28 years old, Richard went under the knife. He missed all of 2014 and only pitched in 59 games (predominantly as a reliever) in 2015 and 2016 combined. Finally, last season he actually pitched as a full-time starter and was moderately successful with 197 IP, a 4.79 ERA (4.23 FIP), and the highest K/9 of his career at 6.9. It took him three full seasons and most of 2013 to finally somewhat resemble the player he was. Unlike Bedard, there is not a substantial change in velocity.
A slightly more positive example is Anibal Sanchez. Sanchez went through surgery in 2007 at 23 and, prior to these last two seasons, was one of the best pitchers in baseball for a long time. The only time Sanchez saw a truly detrimental impact to his stat line was the year he returned from surgery, where he only started 10 games and had a 5.57 ERA in just more than 50 innings. In 2009, Sanchez saw much better results but still didn’t manage to surpass 100 IP. Then he went on to be one of baseball’s most reliable pitchers from 2010 to 2014 and only recently started having consistently poor performances.
There’s other famous examples that end in positive notes, such as Roger Clemens, Curt Schilling and Chris Carpenter, who all had fantastic careers after their surgeries. Schilling is the only pitcher mentioned so far who pitched more than 100 innings the year following his surgery, and did so with great success.
For every great story, there’s 10 more bad ones, like Mark Prior, Mark Mulder and Kerry Wood. Prior and Mulder would both struggle to even attempt playing baseball again, and Wood would find success as a reliever down the road. None of the three would ever pitch more than 100 innings again.
Some of the most recent cases we’re still seeing play out. Michael Pineda had a great season returning from surgery (didn’t pitch more than 100 innings) but has since struggled with performance and injury. Glen Perkins was one of the best relievers in baseball. Since his surgery he has pitched seven innings over two seasons.
So, what should we expect from Jimmy? Certainly not more than 100 innings. To be fair, I don’t think many were expecting that considering his rumored June return time. Every pitcher, even the great ones also saw a performance dip in the year after their surgery, so it’s more likely than not his numbers will more closely resemble a 2015 Nelson than his 2017 version. Depending on who is added this offseason, the team might even think the most valuable and healthy role for Jimmy is out of the bullpen. This seems to be where most pitchers have found success in performance immediately following surgery.
It’s unrealistic to expect Nelson to return to 2017 numbers this season. It’s possible that he’ll struggle to return at all. I, for one, hope he is just a productive innings eater who can stabilize the back-end of the rotation and help this team get back to the playoffs. Perhaps it’s more realistic to hope that in 2019 he can come back and be the Nelson many people grew to love.
Stats provided by Baseball Reference, FanGraphs and Baseball Prospectus.