Posted: 12:49 pm Thursday, March 20th, 2014

Braves’ Beachy to have 2nd TJ surgery, but not by Dr. Andrews 

By David O'Brien

PORT ST. LUCIE, Fla. – The Braves’ spring of maddening misfortune continued Thursday with the announcement that Brandon Beachy would have Tommy John elbow surgery Friday, the pitcher’s second ligament-reconstruction surgery and third overall elbow surgery in just 21 months.

The surgery will be done by Dr. Neal ElAttrache, the Dodgers team physician, rather than Dr. James Andrews, who did Beachy’s previous Tommy John surgery in June 2012 as well as his arthroscopic procedure in September to remove a bone chip. Andrews, considered a foremost practitioner of Tommy John surgery, performed the procedure Tuesday on Braves pitcher Kris Medlen, also Medlen’s second TJ surgery in 41 months.

Andrews has done virtually all arm surgeries on Braves in recent memory, including both of Medlen’s surgeries and both Tommy John surgeries on reliever Jonny Venters, who is currently recovering from his May 2012 procedure and hopes to join the Braves bullpen in June.

Medlen was just the 25th pitcher known to have had a second Tommy John surgery since 1999, according to research by Dodgers head athletic trainer Stan Conte, and Beachy would be the 26th. Somewhat remarkably, the Braves will have three of those 26 in their clubhouse, at various stages of recovery from the second TJ surgery.

Before Medlen and Beachy, fourteen of the previous 24 had come back to pitch in the majors, with varying degrees of success, and three more — Venters, Randy Wolf, Todd Coffey – are nearing possible returns this season.

Oakland pitcher Jarrod Parker is expected to join the multiple-TJ surgery ranks after being diagnosed this week with a torn UCL. Parker had his previous surgery in 2009. Both Parker and Medlen had been scheduled to start opening day.

Only about 20 percent of the pitchers who’ve returned from a second Tommy John surgery have pitched again at their pre-surgery performance level, and the percentage has been higher for relievers than starters.

The announcement that Beachy would have TJ surgery was expected, as the Braves had said earlier in the week that tests showed damage to Beachy’s ulnar collateral ligament, rather than merely biceps tightness as he’d initially believed when he left his March 10 start against Philadelphia after completing only two of his scheduled four innings.

Beachy and Medlen traveled together to see Andrews earlier this week. Medlen stayed and had surgery at Andrews’ clinic near Pensacola, Fla., while Beachy flew to Los Angeles to get another opinion from ElAttrache about the need for another TJ surgery.

ElAttrache concurred with the diagnosis and surgery recommendation, and Beachy decided to have him do the procedure.

Braves general manager Frank Wren said the team didn’t try to influence the choice of surgeon. Both Medlen and Beachy are under one-year contracts and would remain under team contractual control in 2015, provided the Braves decide to tender them contracts after the season.

“He chose to have it out there” in Los Angeles, Wren said. “The way I look at it, this is his career. He’s got to feel confident and comfortable with how this is going to play out. And if he has a better comfort level with one doctor versus another, that’s OK. That’s all part of the healing process going forward, is that confidence. So if that’s how he feels, that’s OK….

“If they were going to someone who had more of an experimental or an odd procedure, then I think we would try to persuade them a little bit. But Dr. ElAttrache is one of the top guys, as well. And it is somewhat limiting in Medlen and Beachy both in t hat you have to go to a doctor that does the same procedure, because this procedure is not compatible with some other procedures, in a (second TJ surgery).”

Wren said this week that the Braves would evaluate their post-surgery protocol going forward. The team has followed Andrews’ recommendations and not rushed pitchers back ahead of the 12-month-or-more recovery period following Tommy John surgeries, but their recent rash of re-injuries has led them to re-examine how they’re doing things.

Julio Teheran is now in line to start the Braves’ March 31 season-opener at Milwaukee, and be joined in the rotation for the first week by veteran Freddy Garcia, second-year left-hander Alex Wood and rookie David Hale.

Newest Brave Ervin Santana, who was to make his Grapefruit League debut Thurday, could join the rotation on or before the Braves need a fifth starter April 12, the 11th game of the season. The Braves signed the former All-Star last week to a one-year, $14.1 million free-agent contract after the Medlen and Beachy injuries.

30 comments
TreeRollins
TreeRollins

I was just thinking they could save a bundle and just pay me a half Mil a year and I'd even clean the toilets!

TreeRollins
TreeRollins

And we thought McCann was asking too much??

TreeRollins
TreeRollins

Has anybody out there recalculated all the dead money on the Braves now that we're paying UGGLA, BJ, MEDLEN and now BEACHY to not play. I'd call that around $40M of dead money this year. Yikes!

KeepinItSimple
KeepinItSimple


Tree - this is not just hitting the Braves.  There are MANY teams that are blowing out pitchers arms, but most of them are happening even more early than the Braves.  Teams all around baseball are burning up pitchers arms in the minors.  Atlanta seems to have the problem later.


There are many theories on why it is so common, but quite frankly it's nothing new.  For every Cy Young, Warren Spahn, Fergie Jenkins and such that pitched 20 years there were dozens that couldn't go ten due to arm issues.  You don't here about most of them because they don't have the longevity to make it to 200 wins.  So while you may here of a Koufax, Halladay, or a few others than have a dominant enough short run to gain publicity, they simple majority of pitchers with arms troubles are afterthoughts.  Let's not forget Avery, Mercker, Moss, Wohlers, Rocker and many other Braves who burned out early with arm troubles (though Rocker imploded off the field, his arm is what ended his career).


JP0933
JP0933

why can't Leo get a pitching coach job?

TreeRollins
TreeRollins

Finally some sanity! If you keep doing the same thing over and over and expect a different result, that's insanity. The Braves absolutely had to change something ( use a new doctor). Now the next focus should be squarely on Roger McDowell - why does his regimens blow out far more arms than anyone else in baseball? If you think it's all by chance, talk to Leo Mazzone!

BradleyBreeze
BradleyBreeze

You can't blame Beachy for wanting to go with the Dodgers Dr.................he never really did make it back from the first surgery.........had tightness all along...........it's a shame I really did think he would become the Brave's best pitcher after his great start in 2012.........he had a nice fastball and great breaking pitch before the injury.........basically no control over the breaker late last year and this spring.........a total shame!

1995oneyearwonder
1995oneyearwonder

Dr Elattrache has been in practice 29 yrs and is 55 yrs old (per my helth plans web site provider directory). he belongs to renowned Jobe Kerlan clinic. he is as good as Andrews at this stage (if not better)

that was a reasonable decision.


I don't see when he reinjured his elbow as he pitched so little aftre 1st TJ procedure. was the damage there when 2nd procedure for the bone chip was done at end of season ? who knows 

he hasn't pitched more than 141 innings in last 5 years.

this is more worrisome than Medlen's case.

RangeRover
RangeRover

No way I'd have Andrews cut on me again.  The man's 71-72 years old and a surgeons yes and hands began to  decline just like any other profession.


Bottom line, a surgeon is judged based on outcomes and his have been quite poor lately...horribly poor, in fact!.

BravesFan1966
BravesFan1966

Tells me that Beachy don't want Andrews cutting on him again.  Loss of confidence in him I would guess.  Beachy and Medlen are in trouble for coming back.  20% is not good odds.  


FrankC3;  James Andrews is the guru of surgery for professional, college and high school players.  He has been doing this stuff since the 1980s and is one of the first after Dr. Jobe to do them.  This is really chalked up to these guys bodies were not strong enough.  They have to take a part out of his body to make this repair.  Nothing is 100%.  But, James Andrews is one of the very best doctors in the nation for putting players back on the field.  I would suspect he has done hundreds and hundreds of these TJ surgeries over his long career.

ilovetexas
ilovetexas

How many Braves pitchers had one, let alone two, TJ surgeries while Leo Mazzone was the pitching coach?  Detectives don't believe in coincidences...

FrankC3
FrankC3

I don't blame Beachy for getting a 2nd opinion or for having a doctor other than Andrews perform his 2nd TJ surgery.  A case could be made that Andrews (or his surgical team) has screwed up on Beachy twice.  Especially the "corrective procedure" that was done after Brandon had problems trying to come back from the first TJ.

MikeY1959
MikeY1959

It may not be a popular topic, but the Braves will have some tough contract decisions on Meds and Beachy. Meds will be arb-3 in 2015; Beachy will be arb-2. Braves mgt will have to decide about 12/1/2014 whether to offer them contracts for 2015. If they do, both could go to arbitration and it is weird but both might get raises. Meds is making $5.8M in 2014, Beachy $1.45M. Raises for guys coming back off a second TJ and especially at the Meds level of pay are going to be pretty risky.

I am a big fan of both of these guys, and hope they have great recoveries and come back to pitch well sometime in 2015. I am hopeful that the Braves can find a way to avoid the risk of going to arbitration w/ these guys, and can instead sign them to some sort of contract that minimizes the team's risk but allows the pitchers to make good money via incentive clauses and lets them stay Braves.

Go Braves!!

Boxtradamus
Boxtradamus

Please Lord, may the next Brave injured be named Freddie, as in Freddie Gonzalez and may it be a career ending injury.

BulldogBen
BulldogBen

Stick a fork in the Braves. Absolute snake bit. Over before it even started.

TreeRollins
TreeRollins

Good post Keepin. However, I still see more of it here than elsewhere. And under Leo you saw way less of it than now.

KeepinItSimple
KeepinItSimple

As for my thoughts on the cause.  I see it as twofold and both of these have been preached by many others in baseball and on these boards.


1)  Pitchers are groomed differently in today's game.  Starters are built to give it all for six, possibly seven innings.  Relievers are built to pitch to one or two batters or at max an inning (long relievers are typically starters who didn't make the cut, not true relievers).  So, starting pitchers are being asked to go MAXIMUM torque and velocity for around seven innings.  This is just ridiculous.  Look at the forearms on some of the pitchers and you can tell the arm muscles are built for maximum effort instead of longer 90% effort.  Very similar to sprinters legs versus distance runners.  If you asked a sprinter to go maximum effort for 7 straight races instead of run they would break down quickly.


2)  Managers are over-using bullpen pitchers causing them more frequent breakdowns.  This is in direct correlation with the above.  In today's game every run is crucial.  You can't throw a mediocre reliever out there to chew up innings and hope you get to your closer.  If you have a one run lead in the sixth, managers have to play to HOLD that lead with the assumption the other team will be running out 5-6 'matchup' pitchers to keep the lead at one run.  That means both teams are asking guys to pitch every other days at maximum torque again.  Just like the starters, this is going to blow out pitchers arms. 


Medlen and Beachy are both middle velocity maximum torque breaking pitch (Sliders) kind of pitchers. While Medlen doesn't throw as many sliders, you know he is putting maximum effort into them.  If they had thrown at maybe 80-90% torque they would have gotten hit more, but probably saved their arms.  Which tradeoff do they make?  


In today's steroid era pitchers have to try everything they can to avoid the ball being hit.   Steroids are probably leaving the game but these pitchers have yet to realize you can pitch rather than throw.  That's the difference in Maddux and Glavine versus Smoltz.  They learned how to 'pitch' much earlier while Smoltzie just tried to dominate every hitter.  That meant that for the regular season and career longevity Maddux and Glavine had superior methods, but for short term pitching (like playoffs), Smoltzie and Avery were those maximum torque/missyour bat kind of guys.  Sadly they also paid for it with injuries upon injuries.

BradleyBreeze
BradleyBreeze

@1995oneyearwonder  ................I agree, unfortunately I don't believe he will ever pitch for the Brave's again..............he will most likely be in that 80% rate after his 2nd TJ.............a shame a total shame!

scientist2
scientist2

@RangeRover He doesn't operate himself anymore. He oversees it. He's been doing that for years. Get your facts straight!

58Supersports
58Supersports

@ilovetexas You right--not but 1 or 2 and Leo made each pitcher throw every day even after they pitched the day before. He didn't baby them....They didn't like it but it worked. 

BravesFan1966
BravesFan1966

@MikeY1959   I think with a 20% success rate for 2d timers, their arms are going to make those decisions.  If they do not come back to health, I think they are both gone.  Medlen doesn't hard now.  What will a second surgery do?  Beachy could throw hard sometimes before the first surgery.  Most lose some.  A 2d will cause him to lose more.  I think both's careers are in jeopardy right now.

dynesh
dynesh

@Boxtradamus  Lord, please let Boxtradamus and other negative nancy Braves "fans" find another sport, or another team, or maybe take up knitting. Anything to keep their negative attitudes off of these stories.  


In Jesus' name.  

BradleyBreeze
BradleyBreeze

@BulldogBen  ...................the Brave's were snake bit last year BY a couple whiffers named Uggla and Upton...............and BY the New York Mets!

BravesFan1966
BravesFan1966

@BulldogBen  Their pitching right now just does not hold up to the Nats.  I think the Nats win this division by 10 games or more.  The Braves simply don't have a starting staff to stay in there with the one the Nats have.  They were already strong.  But then they basically steal Fister from the Tigers.  He is a good, solid pitcher.  With that team, he will win 14 or so games.  That is their #5 starter winning 14 games.  The Braves will be lucky to get their #1 or 2 starters get that many.  Santana was a good sign for what was out there, and he is pitching for the big contract, but then again, he was a free agent last year and only went 9-10.

theoriginaltruth
theoriginaltruth

@BradleyBreeze @1995oneyearwonder What makes me wonder is WHERE the bone chips come from....especially after having Tommy John and doing little to nothing that would seem to cause the bone(s) to chip. Pretty much all a recovering TJ surgery patient does is rehab and rest.......


So my questions center around some possibility that either the procedure weakens the bone or makes it prone to "fragment" or chip? So if that is the case perhaps there is merit to having a different doctor "practice'  on the potentially golden elbow this time around.

RangeRover
RangeRover

@scientist2 @RangeRover  

You're an idiot, just like I proved in the last post about this  Andrews himself performed LT Surgery on Matt Harvey just last October, 2013.


My facts are facts!

MikeY1959
MikeY1959

@BravesFan1966 I think the problem is that the Braves are going to have to make decisions on whether to retain Meds and Beachy long before they know if their recoveries are going to be completely successful.

Beachy is less financial risk because he makes a lot less. But one scenario is that the Braves offer Meds a contract in December; go to arbitration; he gets $6M for 2015; but never throws a pitch, or comes back and is not effective, or must go to a bullpen role. I'd prefer something like: Braves and Meds cut a deal for $3M for 2015 with incentives that could push that to $7M, with a team option for 2016 (Meds first free agent year) for $8M with a buy-out of .5M. That keeps him in the fold and reduces risk, and gives the Braves an option for 2016 if Meds comes back strong.