Braves Injury Report: Jonny Venters

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Aug 29, 2012; San Diego, CA, USA; Atlanta Braves relief pitcher Jonny Venters (39) pitches during the eighth inning against the San Diego Padres at Petco Park. Mandatory Credit: Jake Roth-USA TODAY Sports

According to Mark Bowman, MLB reporter for the Atlanta Braves, Jonny Venters was cleared on Tuesday to begin throwing pitches again.  He’s being limited to pitching only from a distance of 30 feet, and Jonny has a goal of being ready to be pitching on the big league level again by June of the 2014 season.

Under normal circumstances, June of 2014 might be a reasonable track, but I wouldn’t want to see Jonny rush things.  One Tommy John surgery is often enough to cause problems for many pitchers, but Venters has had to have two TJ surgeries now, so a touch of caution might be warranted against attempting too soon a return.

Venters first had TJ surgery in 2005 while just a young, 20 year old rookie playing Class A ball.  More familiar to fans now, Jonny had his second surgery this past May after suffering from what was reportedly just a sprained elbow.  After visiting the famed orthopedic surgeon,  Dr. James Andrews, it was determined instead that a second tear had occurred with Venters’ ulnar collateral ligament, and a 2nd surgery would indeed be needed.

Venters began to have issues with his elbow last July, and was placed on the DL for what was termed an “elbow impingement”.  Venters weathered that storm to some degree, but still went on to deliver a career-worst 3.22 ERA in 66 relief appearances, which was a clear step in the wrong direction for the capable reliever.  Venters continued to have discomfort in the elbow this past spring, and in just one appearance on March 13, Venters gave up four walks in one inning.  Venters underwent a platelet-rich plama injection from Dr. Andrews in early April, was rested for a month, but continued discomfort in the elbow led to the verdict for a 2nd TJ surgery.

From 2010 to 2012, Venters made an amazing 230 appearances, but that high number of appearances are only part of the picture when asking why Venters had to have a 2nd TJ surgery.  The question of overuse is a continuing debate.

I read a fascinating article by Will Carroll, Sports Injuries Lead Writer for the Bleacher Report, back in July of this year.  I found the following excerpt from Carroll’s article particularly interesting as it may apply to Venters:

"Research I did in 2006 led me to the concept of the ‘Tommy John honeymoon’. I found that five years after surgery, there were very few additional elbow problems, which indicated the transplanted ligament was stronger. Further research showed that the process called ligamentization was at work.  However, after the five-year period, the tendon becomes a normal ligament, subject to the same kind of overuse injuries. With so many pitchers getting a first surgery, often when they’re quite young, there’s a greater chance a second surgery will be necessary."

Certainly everyone is different, and there are a couple of  pitchers that immediately come to mind who had a first TJ surgery, and are now well beyond that 5 year risk window Carroll speaks of.  Anibal Sanchez and A.J. Burnett (surgeries in 2003) are two I can think of immediately who are well beyond that risk window, and who have not yet had to undergo a 2nd TJ.  There are several others who are just now entering that risk window, including Braves’ veteran pitcher Tim Hudson.

The real question is are there pitchers who have undergone a 2nd TJ and came back strong?  Not many!  Closers’ Joakim Soria and Brian Wilson underwent second surgeries, and it remains to be seen how effective they will be over the long haul.  Chris Capuano is one pitcher who has had two TJs, and bounced back rather well.  He seems to be the exception to the rule though.  There are even reports of pitchers who’ve gone under the knife multiple times, but those are extreme exceptions to the general rule.  Jose Rijo had the surgery five times and was never able to get back to form.

That question remains with Venters as well, and only time will tell.  Certainly the Braves need to have Venters in the bullpen, but there is no real need to rush him back.