Shohei Ohtani’s pitching future? How starters have fared following second Tommy John surgery

Shohei Ohtani might be facing an obstacle few MLB pitchers have overcome.

The Los Angeles Angels‘ two-way superstar tore his UCL and could require Tommy John surgery for the second time in his career. Ohtani’s first UCL procedure occurred in September 2018, and it effectually kept him from pitching until the start of the 2021 season.

The three-time All-Star has been one of the game’s top hurlers since his return. While 2022 was his best season on the mound, he currently sports an MLB-best 5.8 hits per nine innings and American League-best 143 ERA+. Whether that version of Ohtani ever resurfaces is just one of the many questions the baseball world is wondering as he seeks further opinion about having Tommy John again. 

[Everything you need to know about Shohei Ohtani’s UCL tear, what’s next, free-agency impact]

Many pitchers have fully recovered from one TJ surgery, as Ohtani has brilliantly demonstrated the past few years. But about only two dozen starters have had to work their way back from two, and the results following the second one have been mixed. It’s an endeavor Dodgers ace Walker Buehler appears close to completing, and Rangers ace Jacob deGrom recently began.

Below is a summary of the most notable cases in MLB history (listed in chronological order).

Steve Ontiveros 

• Before second Tommy John surgery: Ages 24-34; 656.1 IP, 204 apps/72 starts, 33-30, 3.62 ERA, 19 saves
• After second Tommy John surgery: Age 39; 5.1 IP, 3 apps, 10.13 ERA

Ontiveros is effectually the first example of a starting pitcher coming back from two Tommy John procedures, and his career took a major downturn following the second one. After winning the AL ERA title in 1994 and being named an All-Star with the A’s in 1995, his second UCL repair in 1996 sidelined him for four seasons. He pitched in only three more games upon his 2000 return.

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José Rijo

• Before second Tommy John surgery: Ages 19-30; 1786 IP, 332 apps/260 starts, 111-87, 3.16 ERA
• After second Tommy John surgery: Ages 36-37; 94 IP, 44 apps/9 starts, 5-4, 4.60 ERA

Rijo was one of baseball’s best pitchers from 1988 to 1994, earning World Series MVP honors, a strikeout crown and All-Star selection and twice finishing top five in the NL Cy Young vote as a member of the Reds. That was all before his first Tommy John surgery, in 1995. He underwent another, in 1997, and was ultimately sidelined for five consecutive seasons. He’d appeared on the Baseball Hall of Fame ballot (and received a single vote) before admirably making it back to the majors in 2001. The return lasted just two seasons, however, and the former star mostly pitched in relief.

Darren Dreifort

• Before second Tommy John surgery: Ages 22-29; 761.2 IP, 103 starts, 43-52, 4.38 ERA
• After second Tommy John surgery: Ages 31-32; 111 IP, 70 apps/10 starts, 5-8, 4.22 ERA

The onetime star prospect of the Dodgers underwent Tommy John surgery for the second time in his career in the middle of the 2001 season, shortly after signing a five-year, $55 million deal. He briefly returned as a starter during the 2003 season before moving to the bullpen in 2004, where he appeared in 60 games in what ended up being his final season. 

Víctor Zambrano

• Before second Tommy John surgery: Ages 25-30; 683.1 IP, 174 apps/96 starts, 45-41, 4.45 ERA
• After second Tommy John surgery: Age 31; 23 IP, 13 apps/4 starts, 0-3, 10.17 ERA

Zambrano’s career hit a halt when he needed a second Tommy John surgery in 2006. He returned a year later but struggled with the Blue Jays and then Orioles and did not appear in the majors again after the 2007 season. 

Brian Anderson

• Before second Tommy John surgery: Ages 21-33; 1,547 IP, 245 starts, 82-83, 4.47 ERA
• After second Tommy John surgery: Age 34: Didn’t pitch again in the majors

Anderson is really an exception in this group. The journeyman lefty didn’t pitch in the majors following his first Tommy John surgery in 2005. He did try, however. Anderson signed a minor-league deal in 2006, only to re-injure his arm and go back under the knife. Two years later, Anderson signed another minor-league but tore his UCL a third time.

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Chris Capuano

• Before second Tommy John surgery: Ages 24-28; 711.2 IP, 116 starts, 42-48, 4.39 ERA
• After second Tommy John surgery: Ages 31-37; 718 IP, 109 starts, 35-44, 4.37 ERA

The lefty showed great promise in his first few seasons with the Brewers and earned an All-Star selection in 2006. A second Tommy John surgery ahead of the 2008 season sidelined him for two years. Capuano returned to pitch seven more seasons, posting a sub-4.00 ERA as a starter in 2012. He was used mostly as a reliever for the last three years of his career.

Randy Wolf

• Before second Tommy John surgery: Ages 22-35; 2268 IP, 368 starts, 132-117, 4.20 ERA
• After second Tommy John surgery: Ages 37-38; 60.1 IP, 11 starts, 1-8, 5.82 ERA

Wolf was a true innings-eater and even made an All-Star team prior to his first TJ procedure. The injury made him less effective but only briefly interrupted what was still a long career. Wolf needed a second surgery relatively late in his career and didn’t pitch much after that. 

Kris Medlen

• Before second Tommy John surgery: Ages 23-27; 512.2 IP, 152 apps/61 starts, 34-20, 2.95 ERA
• After second Tommy John surgery: Ages 29-32; 86.2 IP, 22 apps/15 starts, 7-6, 5.61 ERA

Medlen was one of the game’s best pitchers in his first full season as a starter in 2013. But he needed Tommy John surgery for a second time in spring training the following year and made only 21 appearances in the majors over the 2015-16 seasons. He pitched in the minors in 2017 before making just one appearance with the Diamondbacks in 2018, announcing his retirement later that season. 

Torn UCL takes Shohei Ohtani out of the Angels’ season early

Jarrod Parker

• Before second Tommy John surgery: Ages 22-24; 384 IP, 62 starts, 25-16, 3.68 ERA
• After second Tommy John surgery: Age 25: Didn’t pitch again in the majors

Parker’s promising career ended quickly after two strong seasons as a starter. He underwent Tommy John surgery at the start of the 2014 season and never made his way back to the majors. He announced his retirement in 2018.

Josh Johnson

• Before second Tommy John surgery: Ages 21-29; 998 IP, 160 starts, 58-45, 3.40 ERA
• After second Tommy John surgery: Age 30: Didn’t pitch again in the majors

He dazzled as a 22-year-old with the Marlins, had Tommy John, and then earned two All-Star nods and was the NL ERA champion. But other injuries limited his availability and effectiveness before another Tommy John surgery was needed. He signed with the Padres following the second procedure but never appeared in a game for them and underwent a third surgery in 2015. 

Nathan Eovaldi

• Before second Tommy John surgery: Ages 21-26; 739 IP, 127 starts, 38-46, 4.21 ERA
• After second Tommy John surgery: Ages 28-33; 642.1 IP, 113 starts, 40-25, 3.81 ERA

No pitcher has been better following a second Tommy John surgery than Eovaldi. After missing all of 2017, Eovaldi was traded to the Red Sox in the middle of the 2018 season and played a pivotal role in their World Series title run that fall. 

A disastrous 2019 (5.99 ERA) was wiped away by three above-average seasons, including an All-Star campaign in 2021. He’s currently in the midst of a career year with the Rangers (which earned him another All-Star selection), though an extended stay on the injured list has likely cost him a chance at the AL Cy Young award he was in strong position to contend for. 

Edinson Volquez

• Before second Tommy John surgery: Ages 21-34; 1524.2 IP, 269 starts, 93-87, 4.42 ERA
• After second Tommy John surgery: Ages 35-36; 21.2 IP, 18 apps/4 starts, 2-2, 6.65 ERA

Volquez was an All-Star at 25 and looked like a future longtime ace before his first Tommy John surgery in 2009. That version never returned, although he was instrumental to the Royals winning the 2015 World Series. In 2017, just two months after pitching a no-hitter, Volquez needed Tommy John again. He made it back to the majors two years later but his career was effectually over. 

Drew Rasmussen

• Before second Tommy John surgery: Didn’t pitch in MLB before second surgery
• After second Tommy John surgery: Ages 24-27; 282 IP, 83 apps/46 starts, 20-10, 2.97 ERA

Rasmussen, who had two Tommy John surgeries while in college, has been a key arm for the Rays‘ rotation over the past couple of seasons. He underwent a different elbow surgery (UCL repair) in July, which will sideline him until at least midway through the 2024 season. 

Jameson Taillon

• Before second Tommy John surgery: Ages 24-27; 466 IP, 82 starts, 29-24, 3.67 ERA
• After second Tommy John surgery: Ages 29-31; 437.1 IP, 84 starts, 29-19, 4.49 ERA

The former No. 2 overall pick didn’t reach the majors until after undergoing Tommy John surgery in the minors. He developed into an above-average starter before needing a second UCL operation in 2019, effectively ending his time with the Pirates. After sitting out 2020, Taillon has assumed a heavy workload in three consecutive seasons. He just hasn’t been good with the Cubs in 2023, thus far posting a 5.60 ERA.

Hyun Jin Ryu 

• Before second Tommy John surgery: Ages 26-35; 1003.1 IP, 174 starts, 75-45, 3.27 ERA
• After second Tommy John surgery: Age 36, 19 IP, 4 starts, 2-1, 1.89 ERA

Ryu, it’s worth noting, had his first TJ surgery when he was still a teenager back in 2004. The veteran lefty had his best full season with the Dodgers in 2019 and finished as the AL Cy Young runner-up in the abbreviated 2020 season while with the Blue Jays. He then struggled over the next year-plus and needed his second UCL procedure last summer. Ryu returned to action earlier this month and has been sharp thus far for Toronto. 

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