When it was announced on Monday that Matt Harvey had a partially torn UCL in his pitching elbow, most people (fans and media alike) immediately predicted that Harvey would need Tommy John Surgery to repair the injury. After nearly everyone erased Harvey from the 2014 roster, he tweeted that he planned to be ready for April 1, 2014, which would only be possible if he opted for a non surgical option.
August 27, 2013; New York, NY, USA; New York Mets injured pitcher Matt Harvey stands in the dugout during the game against the Philadelphia Phillies at Citi Field. Mandatory Credit: John Munson/THE STAR-LEDGER via USA TODAY Sports
Yesterday, Terry Collins chimed in during a radio interview and basically said that the Mets would prefer for Harvey to not jeopardize his 2015 season. Tranlsation: Collins wants Harvey to get the surgery.
The problem here (and it’s a huge one), is that nobody knows the severity of Harvey’s partial UCL tear. Therefore, making reactionary statements at this point regarding the potential need for surgery is a bit foolish.
According to Will Carroll, who’s an expert when it comes to baseball injuries, the decision regarding whether or not Harvey should have Tommy John Surgery will likely be based on the percentage of the tear in his UCL.
Carroll noted after news of the injury broke, that if Harvey’s UCL was less than 33 percent torn (his tear has been reported as being “low grade”), rehab – which could include platelet-rich plasma injections (PRP) – may be a better choice than surgery. The severity of the tear won’t be known until after the swelling goes down and Harvey is examined again (in about two weeks).
Caroll went on to note numerous pitchers who have pitched through the injury Harvey has:
"Several pitchers have been able to avoid surgery after a low-grade UCL sprain. The best known is Takashi Saito, who was the first known MLB player to have PRP therapy. Others include Zack Greinke, Adam Wainwright, Ervin Santana and Scott Atchison, as well as a number of minor leaguers.In the vast majority of cases, the pitcher does end up having surgery. While there are no studies on this that I could find, the rate is probably well above 75 percent. While this doesn’t bode well for Harvey, the chance that he could become one of the successes is certainly worth the effort of the six-week rehab."
As Carroll points out above, while the likelihood of Harvey avoiding surgery isn’t terribly high, he and the team have nothing to lose by holding out hope that he’ll be able to take the rehab route instead.
One pitcher who had an injury similar to Harvey’s, and who Carroll didn’t list, is Roy Halladay. Earlier this week, Halladay reached out to Harvey to discuss the injury with him. Wrote Jim Baumbach in Newsday:
"The Phillies’ Roy Halladay revealed Wednesday he believes that he faced a similar fate at the end of the 2006 season, and he managed to dodge any type of surgery thanks to a long-term strengthening program that was designed to take the pressure off his elbow. ‘And you know,’ Halladay said Wednesday, ‘I’ve had some pretty good years after that…just from him explaining where his soreness is, what he felt and where he felt it, it was very similar to what I felt,’ Halladay said. ‘I’m no doctor. I don’t know what he has, but it just sounded similar to what I went through.’Left unsaid at the time was that Halladay’s MRI results ultimately made its way to noted orthopedic surgeon Dr. James Andrews, who had bad news for the hard-throwing righthander. ‘Andrews had told me that they felt like at some point they would have go in and repair it,’ Halladay said of his elbow, ‘and that was eight years ago and I’ve never had an issue since.’"
Halladay’s story, and the stories of the other pitchers who avoided what was seemingly inevitable Tommy John Surgery, present a glimmer of hope for Harvey.
That’s not to say that opting for rehab over surgery isn’t a risk. However, depending on the percentage of the tear in Harvey’s UCL, rehab might be a smart risk to take.
It’s understandable that the Mets are wary of Harvey potentially jeopardizing his future by not having the surgery now. Still, with the severity of his injury still unknown, now is not the time to pressure him into surgery. Rather, it’s a time to weigh every option before the full scope of the situation is determined.
Harvey clearly wants to pitch next year, and he certainly has the work ethic to rehab in the same manner Halladay did if it comes to it. There’s no need to write him off at this point. Rather, we should be doing the opposite.