For Shuhei Ohtani, regaining promotional greats could mean no success in 2024

Perhaps the most important question facing Shuhei Ohtani is: How important is it to him to continue as a two-way star? Because if Ohtani chooses to have Tommy John surgery to repair a torn ligament in his throwing elbow, his best chance of returning as a first-class player could come at a short-term cost.

long-term? He might be better off skipping the 2024 season altogether.

If Ohtani picks Tommy John as he approaches the most anticipated free agency in MLB history, orthopedic surgeons believe he could return in time to contribute next season exclusively as a pinch hitter. But these doctors also said the athlete Doing so may increase the risk of his rehab process, which is more complicated as this will be Ohtani’s second elbow ligament reconstruction.

“If I say: What’s the best way to make it into a pitcher?” It would be to avoid disrupting his progress and throwing him (in rehab), said Dr. Chris Ahmed, the Yankees’ chief physician who performed the Tommy John surgeries. to other major leagues.

Whichever rehab path Ohtani chooses, should he get a Tommy John, he will likely not participate again until the 2025 season.

“It is impossible for him to run in 2024,” Dr. Chris Geary, an orthopedic surgeon at Brockton Hospital in Massachusetts, said of the scenario in which Ohtani goes in for the surgery. Jerry and Ahmed spoke to the athlete As medical experts, they do not treat Ohtani.

Complicating matters is Otani’s prowess. In his 29-year-old season, he’ll likely still be a key hitter if he returns as a DH sometime next year, following a scheme put in place by Bryce Harper this season.

“If he’s doing something like Bryce Harper where he plays first base and occasionally plays first base, I’d be shocked if he doesn’t come back by June,” Jerry said. “That’s a longer timeline than Harper’s.”

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At least for now, Ohtani is continuing in DH this season. the athleteSam Blum confirmed.

When Ohtani went in for his first Tommy John surgery, in October 2018, he appeared in 425 plates as a DH the following season. But choosing to play again as a hitter while also rehab can add more complications to an already fraught process.

“It’s very little precedent for his situation,” Jerry said. “Like, nothing.”

The second Tommy John operations — the reviews, as they’re called — have a lower success rate than the first. Playing in any capacity in 2024 is likely to mean interrupting or significantly revising the typical recovery schedule.

“There will be some compromises in his rehabilitation process if he becomes a position player, depending on his workload, if he returns next year,” Ahmed said. “Especially in the second Tommy John revision, you want the rehab to go perfectly. And the rehab, by design, as the throw progresses, is designed to have very strategic incremental building loads on the ligament, so that it gets stronger and stronger over the longer rehab period .

“For a second surgery – especially for a strong and effective player, who has a lot of career left – would like to see the rehabilitation process go smoothly with a dedication to progress. Having said that, it’s not impossible to do (rehabilitate differently) It just means that you have to build the strategy to get a lead in the pitching, and that will almost certainly happen in the off-season and through the following spring.

Ohtani says little in public, but one of the things he talks about over and over again is his desire to win. Of course, not playing next season to focus on his rehabilitation as a pitcher means sacrificing trying to get in the ring, at his best, nothing less. This is a tough thing for anyone to do, especially for someone who can still make a huge difference – but it’s also completely understandable given what might be at stake in the long run.

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Now, we don’t know yet, but it’s possible that Ohtani himself may not have considered this decision. His dual roles thus far are rooted in his legacy and other position in the sport and its history. Why isn’t he doing everything he can to promote again? A unicorn doesn’t usually decide one day, “You know what? I guess I’d rather not be a unicorn anymore.”

Regardless, there are a lot of factors influencing it.

Ohtani’s approach could affect the money offered to him in the winter, or at least the teams most interested in him. Losing an entire year to baseball’s MVP is equivalent to more than just a peanut, and you can be sure the front offices are counting every grain and legume. But the unorthodox approach to rehab could cause the team to underestimate its long-term prospects for Ohtani Karami, and perhaps even as a batsman as well, to adapt to the risks.

Now, could Ohtani be able to avoid Tommy John altogether? Unless the injury was really mild, or unless Ohtani was content with a full-time DH on a more sustainable basis, doctors thought it would be difficult for him to return to full fitness without him.

When asked about possible alternatives, Ahmed said: “It depends on some factors, namely the severity of the injury and the location of the injured ligament.” “Because there are some non-surgical options besides surgery, and we have used PRP (Platelet Rich Plasma Injection) in the past and had some success. But the injury has to be very mild.

“The way modern baseball is played now, the outfielders and outfielders pitch hard. They don’t have as much repeat (as pitchers).”

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A newer procedure, endoprosthetics, is also gaining popularity, and it can be done in conjunction with or separately from Tommy John surgery.

“If that tear is in a very central location… you don’t have to take the whole engine back out and replace it,” Ahmed said. “You can only patch the broken parts.”

But it will not work in all cases.

“If the tear pattern leads to damage to the entire ligament — it’s not a focal tear, it’s a diffuse tear — then they’re not candidates for that, and they’d have a better success rate with the Tommy John review,” Ahmed said. Who conducted a 2016 review by Nathan Iovaldi. Eovaldi subsequently made two All-Star teams.

Ahmed noted that sometimes players can change the force they apply to the elbow to avoid surgery. He noted that in one extreme example, someone could become a footballer.

This may be the only plot Ohtani doesn’t hold up.

“Ohtani is a very unique player and there is no sample size to guide and control what would be the ideal bounds of safety for him,” Ahmed said. “Every option has to be discussed, because it’s unique. After discussing it, the decisions become more clear. It probably doesn’t make sense for him[to get to 2024]because he wants to be a pitcher, and he still has a lot of baseball left to do.”

(Top photo: Mark Cunningham/MLB Images via Getty Images)

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