Russ Ortiz: Comeback Pitcher?

When the Astros signed Russ Ortiz to a minor league contract during the off-season, I could imagine a collective sigh--or perhaps even groan--around here.  Coming into the spring camp, I would have classified Ortiz as the longest of long shots.  The reason is fairly obvious.  Russ Ortiz--at one time an ace type starter--hasn't pitched well in the major leagues since 2004, when he won 15 games for the Braves.  He pitched less than 200 innings during the period 2005 - 2007.  At the age of 34, a pitcher with those recent stats isn't likely to succeed; in fact, most people would presume the pitcher is done.

Surprise.  Russ Ortiz has the No. 5 rotation slot locked down.  Ortiz has a 3.18 ERA this spring, and leads the Astros' staff in innings pitched.  He has a K/BB rate better than 2:1, and he is giving up less than a hit per inning. Now, don't get too excited about spring numbers just yet.  Ortiz had a sparkling spring performance in his last ML season (2007), a season which ended with arm surgery.  While it's too early to get overly excited about Ortiz's performance, I can see a reasonable basis for some optimism.

In August, 2007, Ortiz came in a Giants' game as a relief pitcher, threw 4 pitches, and then left the mound with the trainer.   He was scheduled for surgery to repair an elbow tendon, and during the course of medical procedures, doctors determined that Ortiz also required ligament replacement surgery, known as Tommy John (TJ) surgery.  Studies indicate that 75% of athletes return to their pre-injury level of performance after TJ surgery.  Players can return to competitive action within one year of the surgery, and a full return to the previous performance level usually occurs after 18 months.

If my calculations are correct, Ortiz is almost exactly at the 18 month interval after his surgery.  In his first live throwing this spring, Lance Berkman said that Ortiz's fastball looked just like he remembered it from the early part of this decade.  Some pitchers claim that TJ surgery increases their velocity higher than they ever pitched.  Surgeons doubt that, and say that it just seems that way.  They theorize that pitchers' attention to conditioning after the surgery may play a role in the high level of performance.  In addition, the deterorating ligament probably had been reducing velocity for several years, and the TJ surgery returned the pitcher to velocity levels from his younger days.

This old Baseball Prospectus article on TJ surgery provides some interesting details.  I find it fascinating that no one knows how the transplanted tendon adapts to a completely different function as a ligament:

Over time, the transplanted tendon "ligamentizes," which basically means it learns to become a ligament. There is a healthy blood supply from the muscle above the surgery site (the one the surgeon had to cut through), and there is also a hope that the drilling will give the harvested tendon access to the vascular supply of the humerus and ulna. It is not completely clear how it is that a tendon becomes a ligament, although Dr. Akizuki thinks that range of motion exercises help the tendon learn that it is being used as a ligament now and that it needs to adopt. Surgeons don't go back in to biopsy the repaired elbow to see how the tissue has changed, but follow-up MRIs do show that the new tissue is maturing and functioning as a ligament should.

There is precedent for top level starting pitchers to undergo TJ surgery in their 30's and return to high performance during their mid and late 30's.  Tommy John, the namesake for the first use of this surgery, is an example.  John's elbow was injured in 1974, 153 innings into the season, after he compiled a 13-3 record.  He didn't return until 1976 at the age of 33, when he pitched 207 innings of 110 ERA+ ball.  At the age of 34, Ortiz's current age, John pitched 220 innings of 138 ERA+ ball.  John continued pitching through the age of 46, and even posted a Clemens-like 140 ERA+ at the age of 43.  Consider a more recent example, John Smoltz, who underwent TJ surgery at the same age as Ortiz  and missed the 2000 season.  Smoltz returned at the age of 34 in 2001 as a closer, posting a 133 ERA+. Smoltz was one of the top closers in the majors, posting an incredible ERA+ of 383 at the age of 36 in 2003.  Smoltz returned to  the starting rotation at the age of 38 in 2005, and has posted ERA+ between 135 and 165 in each subsequent year through age 41. 

Ortiz's projections for 09 are bad (both in terms of expected innings and ERA).  But this is to be expected, based on the terrible drop off that Ortiz experienced in 2005 - 2007.  Looking back, it seems probable that Ortiz's deteriorating elbow had someting to do with that.  It is possible that the sparse innings pitched during that time frame may be something which helps extend Ortiz's career.  For pitchers who have been injured and undergone surgery, projections have limited relevance.  It would be interesting if pitcher projections could be modified to forecast post TJ surgery performance.  The surgeries are common enough and the probabilities known well enough, that one could imagine a forecasting system which uses a data base of ML pitchers after TJ surgery.

I'm not ready to say that Russ Ortiz is all the way back, or that he won't break down sometime this season.  However, I think some people have the tendency to look at his projections for 09 and consider his spring showing to be a fluke.  However, this ignores the possibility that Ortiz's surgery was successful in rolling back the odometer on his arm.