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Garrett Richards (elbow) has been cleared to begin a throwing program


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I think Bartolo and Ervin both had UCL damage and either rehabbed or stem celled it and managed to avoid surgery.

He may still be a ticking time bomb, but also working in his/our favor is prior to this, he wasn't feeling any pain or anything unusual. Every pitcher has some degree of UCL damage, and I think they were just being extra cautious with him at the time. 

Hopefully he can get us some innings at least in '17-'18, maybe even enough to turn into trade bait sometime '18 and we can avoid dealing with the surgery.

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Ervin needed TJ surgery and opted against it, and instead rehabbed via stretching and rest. The end result was his fastball going from 94-97 to 92-94. Didn't really affect his slider, he just needed to learn to pitch with less velocity. 

Tanaka did exactly what Richards is doing right now. For a full season there, Tanaka's splitter lost its depth and his fastball lost a tic or two. Since then his splitter has fully recovered and he's learned to succeed without as firm of a fastball.

In all likelihood, I think Garrett comes back with a fastball sitting 94-95 instead of the 96-100 he was used to. He'll likely begin using his two-seamer more, which was 94-97 but now will likely be 92-93. His slider and curve should go relatively unchanged but the change up is a "feel" pitch and as we've seen, those tend to come back last. 

When healthy, Garrett is a top 20 pitcher in baseball, but he's only been fully healthy once. I think his first year back, Richards pitches more like a 3 or a 4 rather than an ace. But after that I think he'll settle back in as a #2 starter. Not as good as he was, but still very good.

Heaney and Tropeano have a more difficult road ahead. By most measures, they'll miss the 2017 season and come back in 2018, but that'll be the year they need to regain their feel, which means those two won't even be back to normal until the 2019 season.

TJ surgery might be a one year rehab, but in reality, before returning to form it's more of a two-year endeavor. I'm glad Richsrds opted against it. 

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On ‎8‎/‎15‎/‎2016 at 9:51 PM, Mr Meeseeks said:

Anyone know how often this shit is actually successful? I feel like it's a ticking time bomb and he's bound to have the same injury sooner rather than later.

I haven't been able to find much info 

Tanaka and Santana for sure.  Read that Roy Halladay had a partial tear (didn't say how severe but Tommy John surgery had been recommended) and pitched another five years and made the All-Star team four times during that span.  Don't think he had a PRP though - just rehab.  David Aardsma did but his finally fully tore. Can't find any others.

Good article on PRP's below:

 

The biggest point in PRP's favor was a medical study published in the American Journal of Sports Medicine last July that offers a favorable opinion on PRP (emphasis mine):

METHODS: Thirty-four athletes with a partial-thickness UCL tear confirmed on magnetic resonance imaging were prospectively followed. All patients had failed at least 2 months of nonoperative treatment and an attempt to return to play. Baseline questionnaires, including the Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow (KJOC) and Disabilities of the Arm, Shoulder and Hand (DASH) measures, were completed by each patient before injection. Baseline ultrasound measurement of the humeral-ulnar joint space was assessed with 10 lb of valgus stress on the elbow. Each patient received a single type 1A PRP injection at the UCL under ultrasound guidance. The same treating physician at a single institution performed all injections with the same PRP preparation used. Patients completed a course of guided physical therapy and were allowed to return to play based on their symptoms and physical examination findings. Outcome scores, including KJOC and DASH scores, were collected after return to play and were compared with baseline scores. Ultrasound measurements were collected at final follow-up and compared with preinjection values.

RESULTS: At an average follow-up of 70 weeks (range, 11-117 weeks), 30 of 34 athletes (88%) had returned to the same level of play without any complaints. The average time to return to play was 12 weeks (range, 10-15 weeks). The average KJOC score improved from 46 to 93 (P < .0001). The average DASH score improved from 21 to 1 (P < .0001). The sports module of the DASH questionnaire improved from 69 to 3 (P < .0001). Medial elbow joint space opening with valgus stress decreased from 28 to 20 mm at final follow-up (P < .0001). The difference in medial elbow joint space opening (stressed vs nonstressed) decreased from 7 to 2.5 mm at final follow-up (P < .0001). One player had persistent UCL insufficiency and underwent ligament reconstruction at 31 weeks after injection.

CONCLUSION: The results of this study indicate that PRP is an effective option to successfully treat partial UCL tears of the elbow in athletes.
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On August 15, 2016 at 8:45 PM, Angelsjunky said:

I think Tanaka is the only one who opted not to have TJS and go this route. I'd say that was pretty successful. His overall performance after coming back isn't quite as good, but it is hard to say if that is just the league figuring him out a bit. His FB velocity is a tad down this year, but it was actually a bit higher last year than before his injury.

Ervin Santana had a similar issue. A tear in his UCL, that he opted to rehab. That was after his near 'ace' caliber season in 2008. His era jumped up about a run and a half the next year. He never repeated that season, as he stopped throwing his slider so much after the injury, and didn't really start throwing it again until after he left the Angels. Of course Ervin didn't have the stem cell therapy that Richards got. Bartolo Colon was the first guy to have that done I believe.

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I don't think our playoff odds are so favorable that it's worth holding onto him before he hits free agency, so I would just be hoping he stays healthy long enough we can cash in on whatever trade value he can build. 

He's going to start earning a pretty high arbitration salary soon, especially with his injury risk. I'm also wary that having him in the rotation will goad the Angels into thinking they're closer to competing than they really are, and I don't want to see us tempted to sign the big FAs or trade prospects until '18 deadline at earliest.

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