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Posted at 12:59 PM ET, 08/16/2012

Three-time Tommy John surgery survivor Jason Isringhausen on the recovery and Stephen Strasburg


(MIKE STONE - REUTERS)
In calling doctors and medical experts around the country to ask about the impending shutdown of Stephen Strasburg, I came across the case of Los Angeles Angels reliever Jason Isringhausen. You may remember him from his run as one of the game’s best closers while on the St. Louis Cardinals, and who ranks third on the active career saves list.

But he’s also known for another rare distinction: He is in elite company as one of the few players to have three Tommy John surgeries, and he’s still pitching now. He’s weeks away from turning 40. Unusual, huh?

I thought it would be interesting to hear what Isringhausen, although a reliever, felt about the recovery process from Tommy John surgery, if there’s a need to limit a player’s workload as they return and about the Strasburg limit.

After his first surgery in 1998 as a heralded young New York Mets starter, Isringhausen missed that entire season. He returned as a starter only to be pushed into a reliever’s role because his elbow didn’t respond well (“felt jello-y” after 50 to 60 pitches) to the strain of throwing a lot as a starter. He was traded to the Oakland Athletics weeks later, where his career as a closer truly blossomed.

“I felt like I could have thrown towards the end of the [1998] year, but there was no sense in doing it,” he said. “I think it does take three years before you start to feel normal again. You wake up and it’s not sore anymore; the elbow is not sore anymore.”

Isringhausen, who has a history of injuries beyond his elbow, had his second Tommy John surgery in 2008 and the most recent one in 2009. The first two surgeries used tendons from his wrist, and the third one came from a cadaver. With each rehab, even though he knew the routine, it was harder.

“You really have to follow the protocol and do what is asked of you by the doctors and therapists so you don’t re-injure the graft in your elbow,” he said. “I think that’s the main thing: patience. Because you feel really good really quick, and you want to throw, and then all you can do when you do that is tear it up again.”

While Tommy John surgery can be extremely successful, with success rates as high as the 90th percentile, one surgeon said that the second surgery’s success rate can drop to the 60 percent range. A third time, obviously, even less. And another medical expert said that relieving may be tougher than starting in one aspect of the recovery process: Relievers have an irregular schedule, and that can hurt.

Isringhausen has admitted that he has a weaker elbow, but when he was cleared to pitch he said he went “full tilt” and without restrictions.

He understands the Nationals’ position, and who would be better than a three-time survivor to understand the rigors and limits of a recovery.

There is a sentiment shared among veteran players – as evidenced by the outpouring of opinions from across the baseball world – that because opportunities are precious, this may be the only shot the Nationals have at a title. But Isringhausen has more even-handed thoughts on what the Nationals are doing with Strasburg.

“If they’re not in the playoff race, they should have done it, and nobody cares about [if] it’s the right thing to do,” Isringhausen said. “But it’s harder when you’re the ace of the staff and you have the kind of stuff that Strasburg has and you’re in the playoff race. It’s hard to tell the whole team that your best pitcher is done. But they’re thinking of the team’s future. But like many people say, ‘You don’t know if you're going to make the playoffs next year.’ It’s a difficult situation.”

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By  |  12:59 PM ET, 08/16/2012

 
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