Evaluating the Complications of Shohei Ohtani’s UCL Injury

When rookie phenom Shohei Ohtani was pulled from his start against the Kansas City Royals in early June due to a blister, the Los Angeles Angels grew weary of his status. The team had already ruled out multiple pitchers for the season due to injuries and could not afford to lose any more key players for a significant amount of time. More importantly, a potential long-term injury to Ohtani would dampen the Angels’ window to contend in the American League.

Team doctors evaluated Ohtani and concluded that he had an issue far worse than a blister. The Angels announced that Ohtani was diagnosed with a Grade 2 ulner collateral ligament sprain in his right elbow. The evaluation of a Grade 2 is important considering a Grade 1 sprain would be seen as a mild injury while a Grade 3 sprain would undoubtedly lead to Tommy John surgery. Multiple reporters across the country began to speculate that Tommy John surgery would be on the horizon for Ohtani regardless of the severity of his UCL sprain.

Ultimately, the Angels decided that it would be best to shutdown Ohtani for three to four weeks while going through a conservative route of providing him with stem-cell treatment and platelet-rich plasma injections in hopes of a rapid recovery. And miraculously, Ohtani returned to the lineup a month later and is now slated to return as a starting pitcher later this season after being cleared by team doctors.

While team officials are pleased with his recovery, there is still a cause for concern. First and foremost, UCL injuries do not always just go away with treatment. Sometimes pitchers are lucky enough to avoid any further damage to their elbow while others eventually decide to undergo Tommy John surgery.

For instance, Yankees starting pitcher Masahiro Tanaka was diagnosed with a partially torn UCL in 2014. Yankees GM Brian Cashman and team officials decided that it was best to rehab his elbow rather than elect for Tommy John surgery and since then, Tanaka has not had any significant setbacks. But in contrast, Angels starting pitcher Garrett Richards did not have the same fate. Richards elected to bypass Tommy John surgery in 2016 and instead, decided to undergo stem-cell treatment to relieve the damage to the elbow. And just two years later, Richards agreed to Tommy John surgery after MRI results revealed that damage to his elbow resurfaced once again.

But for Ohtani, his case is much more compelling and worrisome to the Angels. A couple of weeks after the Angels signed Ohtani, reports began to surface that Ohtani had significant damage to his UCL. Now while it did not affect his performances during the first half of the season, the Angels still monitored his elbow in hopes of the injury not coming back to haunt him.

In the case of the star rookie's UCL sprain, the @Angels and Shohei Ohtani must proceed with caution.Click To Tweet

As it stands, the Angels are willing to take the risk and avoid having Ohtani undergo Tommy John surgery, but it is a decision that could have major implications based on the outcome.

In the case that the treatment succeeds, then the Angels can breathe a big sigh of relief and refocus on building a perennial playoff contender. The Angels will pencil in Ohtani for more starts as a pitcher, DH, and potentially in the outfield in the coming seasons as the team will not have to be concerned over his workload management.

But if the treatment fails and Ohtani eventually has to undergo Tommy John surgery, then it would result in major setbacks for both the Angels and also for Major League Baseball.

From the Angels’ standpoint, it will force the team to head into the upcoming free agency period looking for reinforcements. Losing both Richards and Ohtani for the 2019 season will force the team to sign a starting pitcher while also looking to bolster the DH position since both Albert Pujols and Luis Valbuena have struggled with runners in scoring position over the past two seasons. For a team that is already committed to $20M+ contracts for Trout, Pujols and Upton for the 2019 season, Angels GM Billy Eppler will have a tough time signing players while avoiding the luxury tax threshold.

And more importantly, the Angels window to contend would take a drastic hit considering how valuable Ohtani has been to the Angels. The team holds a 32-27 record when he plays and he has sported an impressive 145 wRC+ and a 3.10 ERA.

Not only would a potential Tommy John surgery hurt the Angels, but it would also send rippling effects to MLB. For a league that has undeniably struggled to market some of its biggest and brightest stars, Ohtani has proven to be a talent that does not need any personal advertising, endorsements or commercials to market himself. Months before the season even began, Ohtani was being branded by ESPN and many of the other major sports media outlets as the next superstar in baseball. He was getting more coverage across the country than Mike Trout and Bryce Harper typically get.

And once he made his debut for the Angels earlier in the season, he immediately became a must-watch talent. Fans in stadiums across the league stopped to watch in admiration when Ohtani stepped into the box to begin an at-bat or as he jogged to the mound to warm-up before the start of an inning. From his electric fastballs to jaw-dropping home runs, Ohtani resembles everything MLB has ever wanted in a global superstar. Losing him for at least a season would setback the momentum generated from the Ohtani hype that garnered the interest of many people that do not usually follow baseball.

Ultimately, the Angels must be cautious in every decision in regards to Ohtani’s health. The team must do all that they can to compete while they have Mike Trout but need to also keep a close eye on the long-term picture of Ohtani’s health. The Angels will have Ohtani under team control throughout his prime years and it can only take one careless decision to derail his career. Ohtani made the decision to come to the majors a year earlier than expected while bypassing a potential $200M deal so the Angels must respond with a cautious approach to his UCL injury.

For now, the Angels have three options on the table: immediately elect for Tommy John surgery, postpone the surgery until the off-season while he spends the rest of the season as a hitter or avoid the surgery altogether. If the Angels and Ohtani both agree that it is best to elect for surgery, then he will be scheduled to miss an entire season — not ideal for his growth and development as a two-way player.

Whatever the Angels end up choosing, it will be a franchise-altering decision that will change the landscape of the team’s immediate future.

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