Bad News: Need Tommy John Surgery. Good News: It's Not Your Shoulder

Jerry Crasnick has a great piece on pitching injuries.  Specifically the distinction between elbow and shoulder injuries.  What is that distinction?  Well it's much better to have one and not the other:

If Tommy John surgery is considered a new lease on life for a pitcher, shoulder problems are often viewed as a death sentence. That's a major oversimplification. But if a pitcher is going to incur one or the other, the track record is better and the road map for recovery more defined for elbow patients.

People cringe when they hear news about getting Tommy John surgery, and even though it's not as automatic of a recovery as people may now make it seem, it sure as hell beats shoulder surgery.  For instance, as Crasnick notes, there were 11 pitchers in this years All-Star Game that had Tommy John surgery.  That's pretty astounding, so astounding that its become pretty well known that pitchers come back (relatively) easy from elbow injuries.  And I think that people, unintentionally, have kind of grouped all pitching injuries together with the thinking that they all can come back near full strength.  Obviously, as Crasnick points out, that's not the case with the shoulder.

Josh Johnson and Francisco Liriano had elbow surgery and are still aces, Jason Schmidt and Mark Mulder had shoulder surgeries and are out of baseball.   Strasburg's injury clearly derailed the Nationals but he should have a full comeback from Tommy John surgery, Brandon Webb's shoulder still hasn't thrown a pitch this year  and Mets fans should basically be thankful if they get anything from Johan Santana again.

To take this in a completely different direction, let's see how this relates to fantasy baseball.  Last year I drafted Chris Carpenter as a late round injury risk pitcher and he dominated.  This year I drafted Rich Harden as a late round injury risk pitcher and he's been horrible.  Chris Carpenter had Tommy John, Rich Harden had shoulder problems.  Lesson?  Avoid the shoulder in fantasy!  Brandon Webb Ben Sheets and Erik Bedard were popular potential late round steals in this years draft and they haven't taken the mound this year following shoulder surgery.  Meanwhile, Chris Carpenter along with Liriano and Josh Johnson made for great picks following their Tommy John surgeries.  However, it's important to know that it takes time following TJ to become effective again.  Carpenter pitched at the end of 2008 before his 2009 comeback.  Johnson had 14 starts in 2008 before his breakout last year and Liriano needed a full year and a half being healthy until he regained his ace status. So, injury risk pitchers can become bargains, but it's important not to expect anything from pitchers shoulder injuries, and to make sure the pitcher recovering from elbow surgery has had ample time back in the majors.

What's this mean for next year?  Avoid Jake Peavy and Johan Santana and their shoulder injuries, these former aces will look a lot more like Webb and Bedard than they will Chris Carpenter.