The Tommy John Files: LHP Zach Duke

Mandatory Credit: Orlando Ramirez-USA TODAY Sports

Tommy John celebrated his 75th birthday on Tuesday, but the surgery that bears his name is well over 40 years old. In fact, enter a room of pitchers and you’ll find that the sampling of those who’ve had Tommy John surgery is akin to going to a fraternity and trying to find a dude who has ever had a hangover.

Orthopedic surgeon Frank Jobe performed the first procedure — also known as ulnar collateral ligament reconstruction — on the Los Angeles Dodgers lefty back in 1974. Ever since, it has not only become more ubiquitous, but also more proven in terms of players returning their previous form after extensive rehab.

With a room full of pitchers who’ve had the procedure and a seemingly different story of recovery from each one, I thought why not give each pitcher a chance to explain what their triumphs and tribulations were like as they battled to come back from the surgery.

Every pitcher is asked the same questions; every pitcher will almost certainly give different answers.

These are the Tommy John Files:

Player – Left-handed reliever Zach Duke

The surgery — when/where/who performed it?

“Dr. James Andrews performed the surgery down in Pensacola, Fla.“

The injury — when/where did it happen?

“So for me, I was diagnosed with a partial (UCL) tear back in 2007. I put in some maintenance exercises and things which held everything in place for a while. Finally, throughout the course of the 2016 season, the ligament completely tore. What happened for me, when I knew I had to have surgery, was that I threw a pitch and felt a different pain. What ended up happening was that the flexor tendon had popped off the bone. So my hand kind of seized up on the mound, and I knew there was something bad going on. So, the MRI a few days later obviously said the ligament was completely gone now. There was some stuff in there before, but it’s completely done and now the flexor tendon needs to be repaired quickly.”

Was the pain instantaneous, or over time?

“It was — because of the flexor tendon coming off — I mean I couldn’t turn a doorknob or squeeze a ketchup bottle without just….pain. When it was just the ligament, there were flare-ups here and there. Some stiffness would creep in. I’d have to manage the pain there. It was just finding a way through managing the range of motion and the pain tolerance. It was kind of always there, though.”


Were there peaks and valleys? What were they like?

“So the approach I kind of took was that I wanted there to be a pretty steady feeling of soreness. I didn’t want it to get too intense to where I had to back off, and maybe stop, or take a break and push the timeline back a bit. I tried to keep it at a constant feel of building. It’s a testament to the program that the Cardinals staff had for me, and Dr. Andrews was in constant contact with us as well. I got back to the big-league mound in nine-and-a-half months, which I guess was the fastest in the last decade or whatever. But for me, I just tried to keep that steady feel.”

Apr 10, 2018; Minneapolis, MN, USA; Minnesota Twins relief pitcher Zach Duke (32) pitches in the eighth inning against Houston Astros at Target Field. Mandatory Credit: Brad Rempel-USA TODAY Sports

What was the pain like during rehab? Were there points where you questioned if you pushed too hard?

“Sure. Sure there are. Obviously when you start throwing and getting into long toss, and that kind of thing. But the thing for me was that I didn’t have pain in the same place I’d had it for the last 10 years. I’d had pain in the same exact place for the last 9-10 years, and that wasn’t there anymore. That was absolutely encouraging for me, just knowing that it feels like my muscles are sore — and it’s a good thing — but it isn’t the pain in the place I can’t get to.”

Recovery timetable

How soon did you start throwing again?

“So I had surgery on Oct. 7., and I started my throwing program at the end of February. So something like four-and-a-half or five months.”

How soon did you throw off a mound?

“I didn’t throw off off a mound until mid-May for a bullpen session.”

How soon did you throw in a game?

“My first rehab game — actual game — was in late June. There were simulated games leading up to that. It’s a long process. A really long process.”

Did you feel tentative at all?

“No, because of the constant climb of work up to that. They’ve done such a good job with this whole rehab process, due to the number of cases of this surgery. There are a lot of instances of seeing how programs work and don’t. They’ve really got it figured out now to where you’re on a steady climb, so each next step you take, your body is prepared for it.”

When did you feel your stuff came back/started to come back? Was it different for each pitch?

“I felt like the stuff came back pretty quickly — as far as movement or velocity. Command is absolutely the last thing to come back. So the location of pitches was the last thing to come back. To be honest, outside of my fastball I didn’t really have good location of pitches when I came back last year. For me, being pretty much an offspeed-heavy pitcher, it was pretty crucial of me to have those. That didn’t come until spring training of this year.”

Apr 20, 2018; St. Petersburg, FL, USA;Minnesota Twins relief pitcher Zach Duke (32) throws a pitch against the Tampa Bay Rays at Tropicana Field. Mandatory Credit: Kim Klement-USA TODAY Sports

When did you feel 100 percent again? This spring?

“Yeah, I think after I took some time off finally in the offseason, and then started a throwing program, I was convinced I was back to normal. Then obviously to come up here and it’s cold, and everything, and the first time dealing it with a new elbow…anytime you have something repaired, the timetable is different for getting it warmed up and getting things loosened up again. It takes more time.”

Did you come back as quickly as you did to show you were healthy to have something on tape for teams to see?

“Absolutely. That was my thinking the whole time. I was going to push it and push it and push it in hopes that I could pitch last season, so that I wouldn’t necessarily have to take a minor-league deal. I knew I was going to be a free agent, and if I could get back on a big-league mound and prove I could still get hitters out, I knew I had a much better chance of getting another MLB deal.”

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