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Tommy John veterans fill Giants 'pen

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  • Tommy John veterans fill Giants 'pen

    Recovery from Tommy John elbow ligament replacement surgery isn't a requirement for Giants relievers. It just seems that way.

    Five members of San Francisco's seven-man bullpen -- Alex Hinshaw, Billy Sadler, Jack Taschner, Tyler Walker and Brian Wilson -- endured the reconstructive procedure earlier in their careers. So did right-hander Merkin Valdez, who's on the disabled list with a right elbow strain unrelated to his Tommy John experience. This concentration of survivors is unusual, even with more and more pitchers, amateur and professional, resorting to Tommy John surgery to keep competing.

    Moreover, each of the Giants' Tommy John veterans has been productive. Wilson entered Thursday with a National League-high 19 saves. Walker is the club's top setup reliever. Taschner has emerged as one of the league's most efficient left-handers, recording an 0.60 ERA in his last 15 outings and stranding 25 of 30 inherited runners overall. Rookies Hinshaw, who has struck out 21 batters in 13 2/3 innings, and Sadler, with 17 strikeouts in 19 1/3 innings, have shown promise.

    For now, they're linked with Mariano Rivera, Kerry Wood and John Smoltz, who are among the more prominent pitchers to thrive after electing to have Tommy John surgery.

    Even though Tommy John's failure rate is only 10 to 15 percent, according to a September 2004 Baseball Prospectus article, the Giants don't take their collective success for granted.

    For every Wilson, there's a Darren Dreifort, who needed two Tommy John surgeries and was finished at age 32 with a 48-60 record, well short of the promise that led the Dodgers to draft him second overall in 1993.

    For every Walker, who saved 23 games the year before undergoing Tommy John in 2006, there's a Jeff Zimmerman, a 1999 All-Star with Texas whose seasons (three) in the Major Leagues only exceeded the number of Tommy John procedures he received by one.

    For every Hinshaw, who was 19 years old when a doctor sliced into his elbow, there are hundreds of young pitchers who can't follow the path from college to the Majors that he negotiated.

    "There's another side of it that people don't see too often," Giants head athletic trainer Dave Groeschner said. "No one talks about that. They're out of the limelight. It's kind of like out of sight, out of mind."

    Tommy John surgery repairs the ulnar collateral ligament on the inside of the elbow joint. Typically, a surgeon will fix the torn ligament by removing a tendon from the patient's forearm or hamstring, then grafting it into the elbow. The procedure, developed by Dr. Frank Jobe, is named for left-hander Tommy John, the 288-game winner who first underwent the surgery in 1974.

    The 12- to 18-month recovery time most pitchers need includes range-of-motion exercises for the first four to six weeks, followed by elbow and forearm strengthening for four months. Then the pitcher might begin tossing on flat ground, since throwing off a mound creates more strain on the throwing arm. If everything is going well, pitching off a mound will begin about eight months after surgery. That leads to Spring Training-type preparation -- throwing batting practice, pitching in extended spring training games and progressing to a Minor League rehabilitation assignment.

    Although the operation focuses on a specific body part, a general strengthening program hastens recovery. It's commonly accepted that the diligence a player maintains during his rehabilitation carries more impact than the surgery itself.

    "If you skip any of the steps or if you go too fast or if you don't stay on top of a certain issue like your shoulder, forearm or wrist, you're going to have problems," Walker said. "You have to strengthen your entire arm and body."

    Groeschner suggested that the high success rate for Tommy John veterans stems from the driven personalities most Major Leaguers share.

    "These guys get here for a reason," Groeschner said. "One is great talent. But they also have to have some kind of good work ethic. It's a very tedious rehab. Some guys can't deal with it."

    Hinshaw, who called his recovery "the hardest year of my life," can attest to that.

    "You're going to get out of Tommy John what you put into it," said Hinshaw, adding that he felt like he had to learn to throw all over again after his September 2002 surgery. "There were guys who were rehabbing from Tommy John at the same time I was, and they ended up having another one because they weren't as determined and focused to get back as I was. I've been a baseball player my whole life. That's all I wanted to do. That was the determining factor -- I'm not going to let something like this stop me from pursuing my dream."

    Once the dream's achieved, reality can be exceedingly simple.

    "I wait for the [bullpen] phone to ring," Walker said, "and go pitch."

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