Walker Buehler is uncertain about second Tommy John rehab

Walker Buehler awoke last month after surgery, received the news he had been quietly looking forward to, and then settled back into a familiar state of mind.

For the second time in his career, the Dodgers pitcher underwent Tommy John surgery when a damage to his ulnar collateral ligament was discovered and repaired on August 23 during season-ending elbow surgery.

He wasn’t officially diagnosed until after he woke up from anesthesia because pre-surgery MRI scans could not conclusively determine the full extent of an elbow injury that had kept him off a hill since June.

Still, he had prepared for the worst-case scenario anyway, knowing that a full reconstruction of his UCL was possible in addition to a flexor tendon repair.

“I just felt like it was important for me to be able to go under anesthesia and know what I was going to bring out,” Buehler said. “I didn’t really want to be surprised.”

Buehler spoke publicly about the injury for the first time on Sunday and was already looking at the long road ahead of him.

He is well acquainted with the process, having undergone his first Tommy John surgery in 2015, shortly after the Dodgers drafted him from Vanderbilt in the first round.

He wasn’t ready to rule out a possible return during the 2023 season, although he noted the odds are slim and that he almost certainly won’t be back as a regular starter until 2024.

“You come out of surgery, you get the cast off and some positive things happen,” said Buehler, sitting near his locker in the Dodger Stadium clubhouse. “I just have to put together 12 to 14 to 16 months of positive results and hope it works on the back.”

Buehler knows it won’t be easy.

Even the most routine Tommy John rehabs can be complicated. Going through it a second time leads to a new set of variables, something Buehler was still struggling with Sunday.

“I’ve obviously done this rehab quite successfully before, so I think that gives you some confidence,” he said. “But at the same time, it’s the second, so the numbers aren’t quite as clear or in your favor as the first.”

According to data compiled by MLBReports.com, Buehler is the 70th pitcher to undergo Tommy John’s second surgery as a major league.

While the majority of the previous 69 returned to the big leagues, many were never the same and often had short and ultimately ineffective returns.

Granted, most of them weren’t as talented either as Buehler, a two-time All-Star who has a career 3.02 ERA despite 12 erratic starts this year that may have been marred by his unruly elbow.

Still, the pitcher acknowledged the inevitable uncertainties that accompany his current predicament.

“I’m very proud of my career so far and hopefully this isn’t the end,” he said, his mild tone belying the seriousness of his words. “I certainly don’t think so. But it kind of changes in the long run.”

There are several pitchers who have had success after two Tommy John surgeries.

Left-hander Chris Capuano was an early career All-Star before undergoing a second Tommy John surgery in 2008.

Right-hander Jameson Taillon has re-established himself in the New York Yankees rotation for the past two seasons after undergoing his second Tommy John surgery in 2019.

Boston Red Sox right-hander Nathan Eovaldi is perhaps the most optimistic example. After having his second Tommy John surgery in 2016 as a 26-year-old, he came back to help the Red Sox win a World Series over the Dodgers in 2018 before winning his first All-Star selection in last year received in his career.

Nathan Eovaldi plays for the Red Sox.

Red Sox pitcher Nathan Eovaldi beat the Royals on a pitch last season.

(Associated Press)

Buehler referred to Eovaldi by name on Sunday and said Eovaldi recently reached out to him upon hearing about Buehler’s second Tommy John surgery.

“He comes to mind first [of guys] the two of them went through and then succeeded,” Buehler said. “Seeing that in 2018 and across the field since then, I think his arm is fine. That’s nice and obviously really cool for him to reach out.”

Two of Buehler’s current teammates have undergone multiple Tommy John surgeries.

Daniel Hudson had the procedure twice in two seasons in 2012 and 2013 while he was with the Arizona Diamondbacks.

“I just felt like it was one big ordeal instead of two separate ones,” Hudson said. “Obviously it’s not like a death sentence or anything. It’s just the amount of time, how tedious the rehab is, how long the throwing program takes… the biggest thing is just staying mentally engaged.”

Caleb Ferguson’s experience is more similar to Buehler’s.

Like Buehler, Ferguson’s first surgery came before he ever threw a professional pitch, and underwent the procedure as a senior in high school.

Like Buehler, Ferguson’s second Tommy John surgery didn’t come until years later when his promising 2020 season in the Dodgers’ bullpen was cut short by another UCL tear he brought back from that season.

For Ferguson, the experience of one successful rehab made it easier to settle into the second.

“You just know what to expect more,” Ferguson said. “I knew my body better, so I knew exactly what would work and what wouldn’t work when it came to trying to recover or eliminate inflammation. It’s not all trial and error anymore.”

The Dodgers hope Buehler can make a similar recovery.

At the time of Buehler’s surgery, Andrew Friedman, president of baseball operations, said the team considered the two-time Tommy John Pitchers’ data to be “actually really good” — particularly as Dr. Neal ElAttrache, who also performed Buehler’s first surgery, Tommy John Surgery, and has earned a reputation as one of the top orthopedic surgeons in the sport.

“We know Walker will do everything in his power to come back and will be really smart about it,” Friedman said. “We saw him attack the process in 2015. So we’re glad that whenever he can, he steps right back in and does his bit.”

Buehler echoed similar sentiments Sunday, doing his best to find silver linings ahead of another extended rehab trial.

“When you have the best surgeon in the world who says he feels really good about it, along with an organization like this that cares about their players, it will help me get the best rehab possible,” Buehler said. “[They’ll] make sure that I’m still fine mentally and that I can still enjoy my life a bit. That’s what you want. If you need to get yourself a second Tommy John, I’m in as good a position as can be.”

https://www.latimes.com/sports/dodgers/story/2022-09-05/dodgers-pitcher-walker-buehler-tommy-john-rehab Walker Buehler is uncertain about second Tommy John rehab

Emma Bowman

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