MLB.com Columnist

Joe Posnanski

Despite optimism, Reyes dealt arduous challenge

Cards phenom no sure thing to reach stardom after Tommy John

Despite optimism, Reyes dealt arduous challenge

In the minutes after the sad news reverberated on Wednesday that St. Louis phenom Alex Reyes would have to undergo Tommy John surgery and miss the year, there was a wave of forced optimism.

"Hey," we told each other, "Tommy John surgery is as common these days as having a tooth pulled."

"Hey," we told each other, "lots of young pitchers come back from Tommy John better than ever."

"Hey," we told each other, "Reyes is only 22, he still has every chance to become a superstar."

The hard question, though, is this: "Are we just fooling ourselves?"

* * *

The recent history of Tommy John surgery is a muddled one. You look at the long list of pitchers who have gone through the surgery -- take a tendon from somewhere in the body and use it to replace the ruptured ulnar collateral ligament -- and, sure, there are a few happy stories. But there are more gloomy ones. Reyes was brilliant in 12 big league games last year, enough to make any baseball fan dream about Cy Young Awards and dominant seasons.

The hopeful view is that those dreams are still out there.

The hard truth is Reyes faces a perilous and difficult road ahead.

People sometimes overlook this -- some will say things like, "Oh, that guy should just have Tommy John surgery, get it over with." You know, like it's a colonoscopy or something.

But there are two things to consider about the realities of Tommy John surgery.

One is that just about every terrific pitcher of the last decade did not go through Tommy John surgery. It's striking: There are very, very few exceptions. The past 10 Cy Young Awards winners are Max Scherzer, Rick Porcello, Jake Arrieta, Dallas Keuchel, Clayton Kershaw, Corey Kluber, R.A. Dickey, David Price, Justin Verlander, Roy Halladay and Felix Hernandez. Not one of them had Tommy John surgery. Then you throw in other pitchers who have had dominant seasons -- Madison Bumgarner, Zack Greinke, Cliff Lee, Chris Sale, Cole Hamels and so on. None of them had Tommy John surgery, either.

This probably shouldn't be a surprise … but it is. There is this sense you get sometimes from people that Tommy John surgery is no big deal in the grand scheme of things, that it is just a year-long delay on the road to greatness. But almost without exception, the very best pitchers in the game manage to avoid serious injury when they are young.

Reyes to undergo Tommy John

The second thing to think about is when a pitcher has Tommy John surgery. There are those who have had it mid-career -- think John Smoltz, David Wells, Tim Hudson, John Lackey, Chris Carpenter and others -- who do come back and pitch well. That was true of Tommy John himself. And while that's encouraging, it is not of much use when talking about a breathtaking young pitcher like Reyes, who was just beginning his big league career.

So let's look at some of the promising pitchers who had Tommy John when they were 22 and younger.

Darren Dreifort (1994)
Dreifort was 22 and perhaps the best pitching prospect in baseball when he had Tommy John surgery. He worked his way back to the big leagues and made 113 starts, but ultimately, he has to be considered a disappointment.

Eric Gagne (1996)
At just 20, Gagne was an unknown when he had the surgery, so he's not like Reyes. But on the plus side, he did return well. The Dodgers made Gagne a reliever, and he won the National League Cy Young Award as a reliever in 2003. The Cardinals certainly hope that Reyes does not have to become a reliever.

Odalis Perez (1999)
A scary comparison to Reyes. Perez was a big-time prospect who had Tommy John surgery just after making his big league debut. He did have a couple of bright moments afterward, like in 2002 when he won 15 games and made the All-Star team. All in all, though, Perez was pretty middling after that.

Kerry Wood (1999)
Wood won the NL Rookie of the Year Award as a 21-year-old, blew out his arm and then came back to have a fascinating, spotty, sometimes brilliant and sometimes difficult career. He led the league in strikeouts once. Wood became an All-Star closer later. Still, in retrospect, most baseball fans would say that his career is one of the all-time great "What Ifs."

Anibal Sanchez (2003)
Sanchez had the surgery before his Minor League career began. He bounced back well enough to make 245 big league starts so far, and he led the American League in ERA in 2013. Sanchez's story is different from Reyes', but all in all, it's a success story.

Dustin McGowan (2004)
Another scary comparison to Reyes. McGowan, like Reyes, was one of the top pitching prospects in the game when he had Tommy John surgery at 22. McGowan made it to the big leagues, but he never really found his rhythm.

Jaime Garcia (2009)
Cardinals fans certainly remember Garcia's story as a promising young pitcher who had Tommy John surgery before he could get started. He has been a solid, but unspectacular, big league pitcher since returning.

Jordan Zimmermann (2009)
Similar to Reyes, Zimmermann was a good prospect who made his big league debut and then had Tommy John surgery. He's come back with an excellent career, leading the league in wins in 2013 and making a couple of All-Star teams. Zimmermann might be someone Reyes seeks out to talk with.

Steven Matz (2010)
Matz was the second-round pick of the Mets in 2009 and almost immediately had the surgery. He moved his way up nicely through the Minors, wowing scouts, and now at age 25, Mets fans are hoping for him to become a star.

Jacob deGrom (2010)
deGrom had the surgery immediately after being drafted by the Mets in the ninth round of the 2010 Draft. He bounced back beautifully, won the NL Rookie of the Year Award when he was 26 and has been a very good pitcher in the big leagues.

Stephen Strasburg (2010)
Ah, and here we finally come to the best comparison -- a dominant prospect who wowed everyone in his brief debut and had Tommy John at 22. What do we make of Strasburg's return? Certainly he has had some spectacular moments; he led the NL in strikeouts in 2014 and has made two All-Star teams. But Strasburg has also struggled to stay healthy (just one season with 200-plus innings pitched).

Jose Fernandez (2014)
If you want a success story, it would have to be Fernandez, who won the NL Rookie of the Year Award in 2013, had Tommy John surgery in May 2014 and then came back last year and pitched better than ever with 253 strikeouts in 182 innings. His tragic death still haunts the game.

There are various other examples, but you get the idea of what now faces Reyes. It's certainly not impossible for him to come back and be a terrific pitcher. But it's no sure thing, not even close. Sometimes around baseball, you will hear a bit of a casual response to Tommy John surgery, like it's just a normal part of the game. Well, yes, it has become a more normal part of the game, but it is easy to miss just how daunting it is to come back.

Put this this way: I once asked a trainer what is the best way to come back from Tommy John surgery. He gave what remains the best answer.

He said: "Don't have it."

MLB.com columnist Joe Posnanski is a No. 1 New York Times best-selling author, an Emmy Award-winning writer and has been awarded National Sportswriter of the Year. This story was not subject to the approval of Major League Baseball or its clubs.