Hey all, this is part two of our two-part series on who is at fault for the long-term injuries we've seen to four MLB-ready starters since the Spring of 2008. In part one we looked at Dustin McGowan and Casey Janssen, our two pitchers recovering from labrum surgery. Today we'll look at Shaun Marcum and Jesse Litsch, who are recovering from ligament-replacement (Tommy John) surgery.
Marcum, who undertook surgery last September, is farther along in his rehabilitation and hopes to be back with the big club in August (though that seems like a stretch to me). Whether Marcum is ready to go in August or September, it would be a remarkable recovery either way. Let's just hope he doesn't put too much pressure on himself to get back too quickly (as I think he did last season).
Litsch, whose surgery took place this past June, is naturally much farther behind Marcum, but is hoping to return at some point in 2010. Everyone's timetable for Tommy John surgery recovery is different and rushing pitchers along is not necessarily the best move. Doctors may know more than we do, but the amount they don't know is greater than the amount they do know. Litsch saw Dr. James Andrews twice this season before it was determined that he'd need to go in for ligament-replacement, so no doctors know everything. B.J. Ryan also went in for Tommy John surgery early in the 2007 season and worked hard to get back early and we all know how well that worked.
Shaun Marcum, who was a shortstop and closer in college, was drafted in 2003. He finished up the season as a reliever in short-season A ball and was converted to a starter the next season, when he made 25 starts and pitched 148 1/3 innings, splitting time between A and A+ ball. He dominated at the AA (4.0 K/B-ratio) and AAA (5.0 K/BB-ratio) levels in 2005, earning himself a callup and pitching a total of 165 innings (157 minors, 8 majors). In 2006, he split time between the majors (78 1/3 IP) and minors (52 2/3 IP) for a total of 131 innings. He finally became a mainstay in the Jays rotation in 2007, pitching 159 innings (a pretty large increase from the previous season, but actually a few less than in 2005). In 2008, Marcum threw a total of 168 1/3 innings (most in the majors, 17 in the minors).Focusing on 2008, Marcum got off to an excellent start (67 K and 22 BB in 78 2/3 IP through the end of May) but was sidelined in mid-June with elbow soreness related to a ligament strain. The Jays DLed him and after a quick rehab he re-entered the Jays rotation a month later. Unfortunately, it may have been too soon as the previously excellent (86 K and 27 BB in 98 2/3 IP before his injury) Marcum struggled mightily prior to being sent back down to the minors in late-August (23 K and 16 BB in 36 1/3 IP). Marcum was recalled in early-September and pitched well in two starts before being removed in the third inning on 16 September with an injury that would end up requiring Tommy John surgery.
Marcum was regularly throwing 100+ pitches early in 2008 (between 10 April and 12 May, he threw 100 pitches every start). As we said in part one, Gibbons rode his starters hard, even his young ones, and Marcum is a prime example of this. After returning from his injury, Marcum was throwing about 90-95 pitches per start prior to being sent down to AAA. When he came back up to the majors in September, his two starts prior to his injury were 103 and 106 pitches. Even though his pitch counts were lower late in the season, because he was ineffective and because of the summer heat, those lower pitches counts were probably at least as tiring as his regular 100-pitch starts earlier in the season. Add in that he was recovering from soreness and it's extremely likely.
When you consider that Marcum was recovering from soreness and was ineffective, I think it is certainly possible that if the Jays had shut him down a bit sooner (or if Cito had at least kept him on a tighter leash), the surgery would not have been necessary. It is also possible that his initial soreness was due to an increase in pitching workload from 2006-2007 (although he pitched more innings in 2005, those innings were at a lower level and his dominance probably put less strain on his arm because he would have laboured less against lower-quality hitters).
Jesse Litsch is a bit of a different case. Litsch, who we projected to accrue the most innings by a Blue Jays pitcher not nicknamed Doc this season, had piled up innings at both the minor league and major league levels since being drafted in 2005. Since 2006, Litsch's innings pitched totals: 158 2/3, 187 1/3, 196. That 2006-2007 jump is somewhat significant, but it is not exactly startling and Litsch did not seem to show any ill effects, as he finished the season pretty strongly. The innings increase from 2007-2008 is almost negligible.
Litsch didn't seem to lose much towards the end of last season striking out 31 (6.7 K/9) and walking 15 (3.2 BB/9) in 41 1/3 IP in September. Although that walk-rate is higher than where he was during the season (just 2.0 BB/9 for the full season), the strikeout rate is also much higher (5.1 K/9 for the full season). Litsch had actually been sent down to the minors for ineffectiveness about a month before Marcum but upon returning to the majors was fine. Cito did ride Litsch quite hard as well. After being recalled, Litsch threw at least 104 pitches each start and during one three-start span actually threw 337, including 112 directly after a 115-pitch start. Before being sent down, Litsch was throwing about 90 pitches per start (with a few starts over 100 including a 114-pitch start, but he only threw 92 the following start and had only thrown 80 in the previous one).
Whether Litsch's injury is related to being overworked towards the end of last season is probably inconclusive. He had shown himself to be capable of throwing lots of innings in previous years, but he was worked harder than ever in August and September of 2008. It is important that we keep this all in mind when we consider that Litsch's recovery in 2010 should not necessarily be done on Marcum's timetable. Marcum seems to be recovering quicker than almost any other starter I've ever heard of. We should not expect Litsch to be ready this time next season, though it would not surprise me if he was able to work some at the minor league level and possibly make a few starts in the majors late in the year. Let's keep it in mind that pitchers who have trouble returning from injuries or reinjure themselves aren't lazy -- in fact, they're probably the opposite of lazy, they're probably pushing themselves too hard.