Before suffering a torn ulnar collateral ligament that required Tommy John  Surgery, Stephen Strasburg  was pitching at a level that few men have been able to match. Now nearly 19 months removed from surgery, the Nationals are hopeful that their ace will be able to match his previous dominance and establish himself as one of the National League’s best starting pitchers.
Is that a realistic goal for a pitcher in his first season after returning from elbow surgery? To examine that question, we will look at six other starting pitchers who are Tommy John survivors, and we will measure their performance in year one after surgery against their performances in the season preceding the year in which they went on the DL and their second year after coming back from injury.
While we would generally like to have a larger sample to draw off of, we also have to be cognizant of the fact that medical technology has advanced in this area, and going too far back into history could introduce cases where the rehabilitation procedures were not very similar to what Strasburg went through. We also want to pick younger pitchers so as to not introduce age-related decline into the results. For these reasons, we’ve limited ourselves to just starting pitcher candidates under age 30 who have had Tommy John surgery in the past 10 years.
For each pitcher, we’ll list his innings pitched total as well as his FIP-, which is an index metric that scales a pitcher’s FIP to league average in that season. 100 is league average, and just like ERA, higher is worse.
Adam Eaton , 2002
Last Healthy Season (2001): 116 IP, 111 FIP-
First Season Back (2003): 183 IP, 101 FIP-
Second Season Back (2004): 199 IP, 106 FIP-
Like Strasburg, Eaton was at an early point in his career when he needed elbow surgery. He returned to the mound in his age 25 season and performed not only better than he had prior to the surgery, but his first year back was actually the best season of his career. He regressed slightly in year two, and then continuing arm problems derailed his season in 2006.
Chris Carpenter , 2003
Last Healthy Season (2001): 216 IP, 101 FIP-
First Season Back (2004): 182 IP, 89 FIP-
Second Season Back (2005): 242 IP, 69 FIP-
Carpenter is the poster child for how successful one can be after having Tommy John surgery – injuries cost him most of 2002 and all of 2003, but when he returned to the mound at age 29, he was back to performing at a level equal to his career best up to that point, and better than he had performed in his last healthy season prior to the injury. He would go to have the best year of his career in his second season back and remain a dominant – if not always healthy – starter for most of the last decade.
A.J. Burnett , 2003
Last Healthy Season (2002): 204 IP, 79 FIP-
First Season Back (2004): 120 IP, 75 FIP-
Second Season Back (2004): 209 IP, 75 FIP-
After a breakout season as a 25-year-old, Burnett went under the knife and missed nearly all of the 2003 season. He returned in June of 2004 and looked like he hadn’t missed a beat, performing just as well in his first season back as he had before surgery. He sustained that excellence in year two, and showed that he could once again handle a full season’s workload. Despite some later inconsistency, Burnett has remained one of the more durable starters in baseball ever since.
Francisco Liriano , 2006
Last Healthy Season (2006): 121 IP, 58 FIP-
First Season Back (2008): 76 IP, 91 FIP-
Second Season Back (2004): 136 IP, 112 FIP-
Liriano burst onto the scene in ’06, putting up the kind of season that matched what Strasburg did as a rookie, but persisting arm problems cut his season short and forced him to miss the entire 2007 campaign. When he returned in 2008, his velocity was down significantly, and the Twins had him spent the first few months of the season in the minors. Once they did call him up, he showed that he could still get hitters out, but was nothing close to the dominant ace he’d been before. He regressed even further back in his second season after surgery, and has been up and down ever since.
Chris Capuano , 2008
Last Healthy Season (2007): 150 IP, 100 FIP-
First Season Back (2010): 66 IP, 107 FIP-
Second Season Back (2011): 186 IP, 108 FIP-
This was actually a second go-around for Capuano, who had his first elbow ligament replaced when he was in the minor leagues in 2002. While the average timeframe for recovery is 12-18 months, Capuano ended up missing all of the 2008 and 2009 seasons due to his injury, and had to pitch his way back to the big leagues in 2010. Once he did land a job back in a Major League rotation, he was only slightly worse than he had been before his second surgery. Last year, he showed that was still able to handle a full starter’s workload, and was rewarded with a two year contract from the Dodgers this winter.
Ben Sheets , 2009
Last Healthy Season (2008): 198 IP, 79 FIP-
First Season Back (2010): 119 IP, 117 FIP-
Second Season Back: Out of baseball
And now, for the cautionary tale. Sheets was one of the premier pitchers in baseball early in his career, and even while he battled health problems from 2006-2008, he remained excellent when he was on the mound. His elbow finally gave out after the 2008 season, and he spent the entire 2009 season working his way back in rehab. The success of prior recoveries gave the A’s enough confidence to sign him to a $10 million contract for 2010, but he simply wasn’t the same pitcher he was before the surgery, and his elbow gave out again in July of that year. Barring an unforeseen comeback, Sheets’ career may be over.
The results for these six pitchers should be mostly encouraging for Strasburg. While Sheets and Liriano weren’t able to match their prior form, both had extensive injury issues even before they underwent Tommy John surgery. The successful returns of Carpenter, Burnett, Capuano, and Eaton all suggest that the time spent on the sidelines won’t necessarily result in a lesser pitcher, even in his first year back on the mound. Strasburg is unlikely to repeat his 2010 performance for the simple reason that no pitcher could be expected to be that good for any sustained period of time, but recent performances by Tommy John survivors suggest that Strasburg could be expected to be among the best pitchers in the game this year.