- 6,460
- 1,841
- Joined
- Dec 5, 2008
That was nuts 
2023 MLB Thread; Say Hey, Charlie Hustle: Rest In Power, Willie. RIP, Pete.
- Thread in 'Sports & Training' Thread starter Started by CP1708,
- Start date
- 58,335
- 29,819
- Joined
- Feb 12, 2005
Schedule evened out...Twins finally pulling away from the Indians again. Now, it's a matter of Yankees or Astos in the divisional round. Flip a coin, really. Twins will be underdogs regardless.
- 7,498
- 5,069
- Joined
- Sep 17, 2013
Need this dude to keep it for the fantasy playoffs. Such a beast.
- 74,754
- 24,151
- Joined
- Apr 4, 2008
Brodie needs to lose his job for cano and Diaz
wheres that other homie
Monsieur.Relier
at who would post phils updates. Hope all is well Nola on the mound tonight should get another W
- 12,364
- 4,743
- Joined
- Mar 30, 2004
Interesting story. There's an alternative surgery to Tommy John which allows players to heal/return to play faster. Still relatively new but it seems promising. Only performed on 2 major leaguers thus far.
https://theathletic.com/1181903/201...to-mlb-after-having-new-ucl-repair-procedure/
GIVE A GIFT EARN $25
Following Cities Fantasy Football NHL MLB NFL NBA CFB CBB Soccer Motorsports MMA • • •
An alternative to Tommy John surgery? Royals’ Jesse Hahn returns to majors after having new UCL-repair procedure
By Alec Lewis Sep 3, 2019
29
In August 2018, right-handed pitcher Jesse Hahn hopped in his car and drove across Missouri, from Kansas City to the St. Louis area. It was morning when the journey began; the sun was shining, and the interstate was relatively empty. On his mind was the next morning’s appointment with well-known orthopedic surgeon Dr. George Paletta, whose diagnosis had the potential to change Hahn’s baseball life.
The Kansas City Royals had scheduled the appointment for Hahn after months of failed attempts to heal his injured right elbow. Hahn had tried simple rest. He had tried therapy work. Doctors had even given him an injection. But the razor-sharp pain had persisted throughout. Seeing Paletta, the medical director/head team physician for the St. Louis Cardinals from 1998 to 2013 and then an orthopedic surgeon for the team, to assess surgery possibilities was (and usually is) the last resort.
During the afternoon and evening leading up to the next morning’s appointment, Hahn had flashbacks of the Tommy John surgery he had undergone in 2010. But by the time he walked into the Orthopedic Center of St. Louis in Chesterfield, Mo., he had a clear and open mind.
Hahn had already undergone MRIs in Kansas City, and the outlook was not great.
“His MRI showed the graft had torn right off the humerus bone,” Paletta says, “which is the most common place a reconstruction can re-tear.”
Typically, Tommy John surgery is required for a diagnosis such as this one, requiring the athlete to rehab for more than a year and in some cases for 17 or 18 months. Hahn was 29 and felt he did not have the kind of time to put forth that effort again. Hence the reason he was there.
Perhaps there was an alternative?
A select few doctors had performed a new procedure in recent years called “primary repair with internal brace,” which involves repairing the ligament with strong sutures that serve as a scaffold and can cut the Tommy John surgery rehab time in half. The only current professional pitcher reported to have undergone the operation is Texas Rangers minor leaguer Seth Maness. As Hahn was aware, Paletta had performed that surgery.
After looking at the MRIs, Paletta sat in the room and told Hahn he could be a candidate for the procedure, but the surgeon wouldn’t know for sure until he digs into the patient’s arm, makes an incision into the ligament and dissects the tissue. Hahn, wanting to pitch again in the majors for those family and friends who have followed this career and for his own love of the game, agreed to sign a waiver, allowing Paletta to operate on his arm days later in the best way Paletta saw fit.
“Whatever was best for me, I wanted to have that done,” Hahn says. “When I woke up, I was going to deal with it.”
Jesse Hahn grew up in Groton, CT, a town along the Connecticut shoreline between New London and Mystic. His dad, Fred, played baseball as a youth, and Jesse followed suit. One year in Little League, Fred remembers, Jesse pitched six innings and recorded 18 strikeouts.
“You could almost see it then,” Fred says. “He was something a little special.”
A teammate named Matt Harvey felt that way as well. Harvey played alongside Hahn at Fitch Senior High School in Groton, and the two fed off each other. A number of scouts and coaches would come to Fitch to see Harvey, but also notice the lesser-known 6-foot-4, 170-pound kid named Hahn. The latter pitcher threw 40 innings in his senior year and went 5-1 with 65 strikeouts. More notably: He set a then-state record (minimum 35 innings pitched) with a 0.17 ERA.
Both picked Atlantic Coast Conference (ACC) schools, with Harvey headed to the University of North Carolina and Hahn choosing Virginia Tech. The two would face each other, Hahn thought. They’d continue to push each other, inspire each other. Not that Hahn needed much inspiration. His sister Melissa, who has cerebral palsy and followed his every outing, fueled him every day.
“If any kid had half the heart she has,” Fred says, “they’d be a major league pitcher.”
Being a major league pitcher was Hahn’s goal, but first he needed to pitch well in college. After posting a 4.64 ERA in nine starts as a freshman at Virginia Tech, he filled out, putting on 30 pounds. The Hokies elected to move Hahn to the closer role his sophomore season, but he struggled to command his pitches. That summer (in 2009), he pitched in the Cape Cod League. His velocity touched 100 mph. Before long, Hahn was being mentioned in the same breath as Chris Sale in terms of big league potential.
Hahn’s climb up scouts’ rankings continued throughout his junior season, and many thought him to be a sure-fire first-round draft pick. Then came the first big obstacle: Hahn suffered an elbow injury late in the season. His draft stock fell. Still, the Tampa Bay Rays had enough confidence in Hahn’s future to select him with their sixth-round pick in the 2010 draft. They even paid him second-round money despite knowing he needed Tommy John surgery.
In July 2010, Dr. James Andrews performed the operation.
Tommy John surgery has been ingrained in the fabric of Major League Baseball since 1974, the year Dr. Frank Jobe first utilized the procedure on Dodgers left-handed pitcher Tommy John. But there’s a misconception about the operation and its beginnings. It wasn’t an immediate success.
During the course of his rehab, John’s left arm would sting with pain. He returned to Jobe, who determined another surgery would be necessary because scar tissue had grown over the ulnar nerve.
Jobe went in and cleaned up the area, but even he was skeptical John would be able to return.
“I didn’t do any more [surgeries] for two years to see how [John] came out,” Jobe said. “Then I started doing a few more. At that time, I thought I shouldn’t do this on anyone who’s going to be a pitcher, due to the year of rehab.”
John finally returned to pitching, and by the time he had won more games than he had prior to the surgery, the operation had become more widespread.
“From there, things kind of exploded,” says current orthopedic surgeon Dr. Jeffrey Dugas, who works with Andrews Sports Medicine in Birmingham, Ala.
According to Dugas, in 1992, Dr. John Conway, who was Jobe’s assistant during the beginnings of ulnar collateral ligament reconstruction, wrote the first academic article about Jobe’s first group of 70 athletes. Of them, 56 received full reconstruction surgeries. The other 14 received repairs, in which Jobe sewed the ligament back down and re-anchored it.
As has been written and published by Dugas, “only seven of the 14 of those who underwent repair were able to return to the same level of play,” compared to a nearly 75 percent return rate for those who underwent reconstructions.
“On the basis of that,” Dugas says, “Jobe rightfully concluded that repairs were a bad idea.”
In 1995, Dugas says, Andrews published a report confirming Jobe’s conclusion. So reconstruction surgery — Tommy John surgery — emerged as the primary option for athletes of all levels who suffered UCL tears. By 2010, Dr. Lyle Cain and Dugas had seen 1,281 reconstructions and concluded the procedure had a 75-92 percent rate of return to competition, which they outlined in a report with the American Sports Medicine Institute.
Having seen that quantity of UCL tears, Dugas also had another conclusion.
“Not all Tommy John injuries are the same,” he says. “You get some that are blown in half, and the tissue is just crap. And then you get injuries that you cut into the ligament, and you think, I’m not even sure I’m operating on the correct elbow. The spectrum is so vast.”
Fifteen years had passed since Jobe and Andrews’ conclusions. In that span, new technologies had permeated the medical field. There had been advances in suture material. There had been developments in biological additives such as collagen-dipped tape.
A number of orthopedic surgeons recognized what this might mean, including Dr. Felix “Buddy” Savoie, the Chairman of Orthopaedic Surgery at Tulane University.
In the mid-2000s, Savoie published an article in the American Journal of Sports Medicine about his having done a direct repair of the UCL using new technology, one with a high success rate and quick rehab times for athletes.
“Not a lot of people paid attention to that,” Dugas says.
But as time passed, Dugas thought more and more about possibly utilizing primary repair with an internal brace. At one point, he called Savoie to get his thoughts.
“What do you think about this option?” Dugas asked Savoie.
“Jeff, you’re on the right track,” Savoie said. “People don’t believe the outcomes we’re getting with this. If you add the internal brace, you’re changing the game.”
Dugas used primary repair with internal brace in a basic-science study on cadavers to confirm the idea that it could work as well as reconstructions had. In August 2013, he performed the first real operation.
By this time, Paletta had also begun utilizing this procedure, particularly on high school and college athletes who injured themselves late in their careers and wanted to come back and play their senior seasons. As Dugas saw positive results, he expanded his use of the operation to collegiate athletes and minor-league players.
“I could legitimately look them in the eye and say, ‘I’ve done enough of these that it’s successful and can work for you,’” Paletta says.
In 2016, Paletta viewed the medicals of major league pitcher Seth Maness. Maness had pitched well as a steady reliever for the St. Louis Cardinals. But early in 2016, his arm did not feel the same. Maness didn’t feel up to the arduous rehab process associated with Tommy John surgery. Paletta knew this, but he also knew the right-hander wouldn’t be able to avoid it if that was what was best for the patient.
Seth Maness, right, was a workhorse reliever for the Cardinals, making 215 appearances from 2013-15. (Jasen Vinlove/USA TODAY Sports)
Until Paletta saw the quality and quantity of tissue within Maness’ elbow, he could not tell Maness upfront what operation he would perform. Maness was OK with this. He signed the waiver and woke up as the first known big leaguer to have undergone the procedure.
“The decision to operate on Seth,” Dugas says, “it had to be the right person.”
Seven months after surgery, Maness was back throwing as hard as he had prior. The Royals signed him in 2017. Maness threw 9 2/3 innings that year and posted a 3.72 ERA (he has been in the minors since).
One year later, he met Jesse Hahn.
In February 2018, Hahn stepped on the mound in spring training in Surprise, Ariz., ready to make his Royals debut.
At the time, his arm felt great. The Athletics had traded him to the Royals nearly a month prior after Hahn had struggled to stay healthy, but that day Hahn threw three innings and “felt fine.” The 28-year-old walked off the mound feeling like the pitcher he was while emerging as a rookie in 2014 with the San Diego Padres, then pitching well in 16 starts for the A’s the following season.
In his next start, he felt fine at first, but after two innings, he did not. His elbow was hurting in the same way it had in 2010.
“I didn’t know how serious this injury actually was,” Hahn says.
But he knew he had to leave the game.
He underwent MRIs in the following days, but the images did not reveal much. The prescription was rest, so that’s what Hahn did. Months later, he began throwing again. And when he did, similar to the beginning of spring training, his arm felt fine.
By July, he was ready to pitch again. He had two outings in the Arizona Rookie League and didn’t give up a run, so the Royals transferred him to Double-A Northwest Arkansas, where Hahn made three more outings and still didn’t give up a run. Triple-A Omaha was the next stop. Hahn knew he was close.
On Aug. 7, 2018, at Werner Park in Papillion, Neb., Hahn arrived at the mound to pitch for the Omaha Storm Chasers. He struck out the first two batters then gave up a single. The coaches pulled him after he reached his pitch count, and the outing was considered a success.
But not to Hahn. His elbow was hurting again.
After the game, Hahn immediately called Royals head athletic trainer Nick Kenney.
“Hey Nick, I don’t think I’m going to be able to throw a baseball anytime soon,’” Hahn said to Kenney. “This kinda took a turn for the worse. I think I’m going to have to shut it down.”
Kenney, not having seen any MRIs, trusted Hahn’s judgement. But because the pitcher was in Omaha, Kenney recommended Hahn drive the three hours to Kansas City for further evaluation with Dr. Vincent Key. A day later, he underwent the MRIs that Paletta later would see.
“We just knew it wasn’t functioning right,” Hahn says. “Something was obviously wrong.”
In conversations with Kenney and Key, Hahn considered his options. He had already undergone one Tommy John surgery, so he knew it would require about 17 months of rehab. Not only did he love the game too much to quit, but he also knew those at home, such as his sister Melissa, were cheering him on to return.
It was then that he remembered conversations he had had with Maness about a procedure Maness had undergone. The Royals knew Paletta had performed that procedure and Hahn wanted to see if it was an option for him. So he drove to St. Louis, spoke with Paletta and signed the waiver.
“I was just going to accept it,” said Hahn, who gave Paletta permission to speak to The Athletic about the details of the surgery. “No matter what the surgery was, I was very confident I would overcome (it) and be out there pitching again. It was just a matter of what date it was going to be.”
Hahn woke up in a daze. His wife, Jessica, stood over him.
“Check your leg,” she said.
Hahn felt down with his left hand and noticed his leg felt normal. This was significant. It meant Paletta did not have to take a graft from there to do a full reconstruction. Semi-realizing the situation, Jesse smiled.
“Yeah,” Jessica said. “You had the repair.”
The Hahns stayed in St. Louis for a couple days so Jesse could recover and relax. Then they returned to Arizona with a couple specific requests from Paletta. For the first eight weeks, Hahn was to let his arm rest, quite similar to Tommy John rehab, then he would begin the strengthening phase. Where the rehab really differed was 4 1/2 months into the process.
That’s when the long-toss program would begin. The program would last for six weeks, then Hahn would throw from the mound for six weeks. At that point, he could be back pitching again.
Some of the process went as planned after Hahn returned to Arizona; some of it did not.
Every morning during rehab, Hahn would wake up and walk to the coffeemaker in the kitchen. Above it hung a message board, and each day Jessica put together a new quote.
“That would motivate me for that day,” Jesse says, “and keep me positive. It went a long way. One of the things that goes unnoticed in the rehab process is the mental side of it. Believing, trusting, staying positive … it’s a grind. The messages really went a long way.”
About five months into the recovery, Hahn was back throwing and right on schedule. Until he wasn’t.
“The problem in Jesse’s case,” Paletta says, “is he had complications with nerve issues. That slowed his recovery. That’s a complicating factor that may make the return time seem longer than if it was just the repair. … Nerves recover at a much slower pace than most other soft tissues in the body. The expectation is that the nerve will recover fully. Jesse came into the surgery with the nerve issues, and those nerve issues are not immediately or easily cured by the surgery.”
Still, Jesse pushed through because that’s what he had done his whole life. And the Royals, who had placed him on the 60-day injured list, stuck with him. At long last, on Aug. 21, just shy of a full year since the surgery, Jesse took the mound in competitive competition for the first time. He pitched an inning of rookie ball and emerged unscathed, with two strikeouts on nine pitches.
“The feeling, it sounds cliche’, but I couldn’t describe it,” Hahn says. “After I walked off the mound that night, I was all smiles. I couldn’t stop smiling the entire night. I couldn’t wait to move forward and go on to the next one.”
Over the years, Dugas says he has received a number of questions from baseball executives — including well-known general managers — about the primary repair with internal brace procedure and which players qualify.
“I honestly don’t think it makes any difference what level of player you are,” Dugas says. “I don’t think it matters how hard you throw. That has nothing to do with it. It has to do with what your injury is.”
Since 2017, the procedure has become more recognized. Paletta says he has done nearly 150 of them in total.
After rejoining the Royals on Tuesday, Hahn now has the chance to re-establish himself in the majors after having undergone the new procedure.
“When you’re dealing with a professional athlete,” Paletta says, “it’s on a more magnified stage. I don’t read about my high school or college kids. But with guys like Jesse, it’s right there in front of you. These guys are pitching at the highest level.
“If you can get them back to that, it’s gratifying and rewarding.”
Jesse told his story one late-August morning. He’d pitched well a few days prior at High-A Wilmington, striking out all three batters he faced with a flaming fastball, deceptive changeup and hard slider.
Jesse is now 30 years old, and he still dreams of pitching in the playoffs and the World Series, things he has not done yet.
Those dreams and his love of the game are what pushed him to sign the waiver to allow Paletta to perform the Tommy John alternative. Not to mention the support from those back home. His father and mother. His sister Melissa, who has followed every game since he’s been back.
“I love the game, and I have zero quit,” Hahn says, “But I believe this is bigger than me.”
(Top photo: Jennifer Stewart/Getty Images)
https://theathletic.com/1181903/201...to-mlb-after-having-new-ucl-repair-procedure/
GIVE A GIFT EARN $25
Following Cities Fantasy Football NHL MLB NFL NBA CFB CBB Soccer Motorsports MMA • • •
An alternative to Tommy John surgery? Royals’ Jesse Hahn returns to majors after having new UCL-repair procedure
By Alec Lewis Sep 3, 2019
In August 2018, right-handed pitcher Jesse Hahn hopped in his car and drove across Missouri, from Kansas City to the St. Louis area. It was morning when the journey began; the sun was shining, and the interstate was relatively empty. On his mind was the next morning’s appointment with well-known orthopedic surgeon Dr. George Paletta, whose diagnosis had the potential to change Hahn’s baseball life.
The Kansas City Royals had scheduled the appointment for Hahn after months of failed attempts to heal his injured right elbow. Hahn had tried simple rest. He had tried therapy work. Doctors had even given him an injection. But the razor-sharp pain had persisted throughout. Seeing Paletta, the medical director/head team physician for the St. Louis Cardinals from 1998 to 2013 and then an orthopedic surgeon for the team, to assess surgery possibilities was (and usually is) the last resort.
During the afternoon and evening leading up to the next morning’s appointment, Hahn had flashbacks of the Tommy John surgery he had undergone in 2010. But by the time he walked into the Orthopedic Center of St. Louis in Chesterfield, Mo., he had a clear and open mind.
Hahn had already undergone MRIs in Kansas City, and the outlook was not great.
“His MRI showed the graft had torn right off the humerus bone,” Paletta says, “which is the most common place a reconstruction can re-tear.”
Typically, Tommy John surgery is required for a diagnosis such as this one, requiring the athlete to rehab for more than a year and in some cases for 17 or 18 months. Hahn was 29 and felt he did not have the kind of time to put forth that effort again. Hence the reason he was there.
Perhaps there was an alternative?
A select few doctors had performed a new procedure in recent years called “primary repair with internal brace,” which involves repairing the ligament with strong sutures that serve as a scaffold and can cut the Tommy John surgery rehab time in half. The only current professional pitcher reported to have undergone the operation is Texas Rangers minor leaguer Seth Maness. As Hahn was aware, Paletta had performed that surgery.
After looking at the MRIs, Paletta sat in the room and told Hahn he could be a candidate for the procedure, but the surgeon wouldn’t know for sure until he digs into the patient’s arm, makes an incision into the ligament and dissects the tissue. Hahn, wanting to pitch again in the majors for those family and friends who have followed this career and for his own love of the game, agreed to sign a waiver, allowing Paletta to operate on his arm days later in the best way Paletta saw fit.
“Whatever was best for me, I wanted to have that done,” Hahn says. “When I woke up, I was going to deal with it.”
Jesse Hahn grew up in Groton, CT, a town along the Connecticut shoreline between New London and Mystic. His dad, Fred, played baseball as a youth, and Jesse followed suit. One year in Little League, Fred remembers, Jesse pitched six innings and recorded 18 strikeouts.
“You could almost see it then,” Fred says. “He was something a little special.”
A teammate named Matt Harvey felt that way as well. Harvey played alongside Hahn at Fitch Senior High School in Groton, and the two fed off each other. A number of scouts and coaches would come to Fitch to see Harvey, but also notice the lesser-known 6-foot-4, 170-pound kid named Hahn. The latter pitcher threw 40 innings in his senior year and went 5-1 with 65 strikeouts. More notably: He set a then-state record (minimum 35 innings pitched) with a 0.17 ERA.
Both picked Atlantic Coast Conference (ACC) schools, with Harvey headed to the University of North Carolina and Hahn choosing Virginia Tech. The two would face each other, Hahn thought. They’d continue to push each other, inspire each other. Not that Hahn needed much inspiration. His sister Melissa, who has cerebral palsy and followed his every outing, fueled him every day.
“If any kid had half the heart she has,” Fred says, “they’d be a major league pitcher.”
Being a major league pitcher was Hahn’s goal, but first he needed to pitch well in college. After posting a 4.64 ERA in nine starts as a freshman at Virginia Tech, he filled out, putting on 30 pounds. The Hokies elected to move Hahn to the closer role his sophomore season, but he struggled to command his pitches. That summer (in 2009), he pitched in the Cape Cod League. His velocity touched 100 mph. Before long, Hahn was being mentioned in the same breath as Chris Sale in terms of big league potential.
Hahn’s climb up scouts’ rankings continued throughout his junior season, and many thought him to be a sure-fire first-round draft pick. Then came the first big obstacle: Hahn suffered an elbow injury late in the season. His draft stock fell. Still, the Tampa Bay Rays had enough confidence in Hahn’s future to select him with their sixth-round pick in the 2010 draft. They even paid him second-round money despite knowing he needed Tommy John surgery.
In July 2010, Dr. James Andrews performed the operation.
Tommy John surgery has been ingrained in the fabric of Major League Baseball since 1974, the year Dr. Frank Jobe first utilized the procedure on Dodgers left-handed pitcher Tommy John. But there’s a misconception about the operation and its beginnings. It wasn’t an immediate success.
During the course of his rehab, John’s left arm would sting with pain. He returned to Jobe, who determined another surgery would be necessary because scar tissue had grown over the ulnar nerve.
Jobe went in and cleaned up the area, but even he was skeptical John would be able to return.
“I didn’t do any more [surgeries] for two years to see how [John] came out,” Jobe said. “Then I started doing a few more. At that time, I thought I shouldn’t do this on anyone who’s going to be a pitcher, due to the year of rehab.”
John finally returned to pitching, and by the time he had won more games than he had prior to the surgery, the operation had become more widespread.
“From there, things kind of exploded,” says current orthopedic surgeon Dr. Jeffrey Dugas, who works with Andrews Sports Medicine in Birmingham, Ala.
According to Dugas, in 1992, Dr. John Conway, who was Jobe’s assistant during the beginnings of ulnar collateral ligament reconstruction, wrote the first academic article about Jobe’s first group of 70 athletes. Of them, 56 received full reconstruction surgeries. The other 14 received repairs, in which Jobe sewed the ligament back down and re-anchored it.
As has been written and published by Dugas, “only seven of the 14 of those who underwent repair were able to return to the same level of play,” compared to a nearly 75 percent return rate for those who underwent reconstructions.
“On the basis of that,” Dugas says, “Jobe rightfully concluded that repairs were a bad idea.”
In 1995, Dugas says, Andrews published a report confirming Jobe’s conclusion. So reconstruction surgery — Tommy John surgery — emerged as the primary option for athletes of all levels who suffered UCL tears. By 2010, Dr. Lyle Cain and Dugas had seen 1,281 reconstructions and concluded the procedure had a 75-92 percent rate of return to competition, which they outlined in a report with the American Sports Medicine Institute.
Having seen that quantity of UCL tears, Dugas also had another conclusion.
“Not all Tommy John injuries are the same,” he says. “You get some that are blown in half, and the tissue is just crap. And then you get injuries that you cut into the ligament, and you think, I’m not even sure I’m operating on the correct elbow. The spectrum is so vast.”
Fifteen years had passed since Jobe and Andrews’ conclusions. In that span, new technologies had permeated the medical field. There had been advances in suture material. There had been developments in biological additives such as collagen-dipped tape.
A number of orthopedic surgeons recognized what this might mean, including Dr. Felix “Buddy” Savoie, the Chairman of Orthopaedic Surgery at Tulane University.
In the mid-2000s, Savoie published an article in the American Journal of Sports Medicine about his having done a direct repair of the UCL using new technology, one with a high success rate and quick rehab times for athletes.
“Not a lot of people paid attention to that,” Dugas says.
But as time passed, Dugas thought more and more about possibly utilizing primary repair with an internal brace. At one point, he called Savoie to get his thoughts.
“What do you think about this option?” Dugas asked Savoie.
“Jeff, you’re on the right track,” Savoie said. “People don’t believe the outcomes we’re getting with this. If you add the internal brace, you’re changing the game.”
Dugas used primary repair with internal brace in a basic-science study on cadavers to confirm the idea that it could work as well as reconstructions had. In August 2013, he performed the first real operation.
By this time, Paletta had also begun utilizing this procedure, particularly on high school and college athletes who injured themselves late in their careers and wanted to come back and play their senior seasons. As Dugas saw positive results, he expanded his use of the operation to collegiate athletes and minor-league players.
“I could legitimately look them in the eye and say, ‘I’ve done enough of these that it’s successful and can work for you,’” Paletta says.
In 2016, Paletta viewed the medicals of major league pitcher Seth Maness. Maness had pitched well as a steady reliever for the St. Louis Cardinals. But early in 2016, his arm did not feel the same. Maness didn’t feel up to the arduous rehab process associated with Tommy John surgery. Paletta knew this, but he also knew the right-hander wouldn’t be able to avoid it if that was what was best for the patient.
Seth Maness, right, was a workhorse reliever for the Cardinals, making 215 appearances from 2013-15. (Jasen Vinlove/USA TODAY Sports)
Until Paletta saw the quality and quantity of tissue within Maness’ elbow, he could not tell Maness upfront what operation he would perform. Maness was OK with this. He signed the waiver and woke up as the first known big leaguer to have undergone the procedure.
“The decision to operate on Seth,” Dugas says, “it had to be the right person.”
Seven months after surgery, Maness was back throwing as hard as he had prior. The Royals signed him in 2017. Maness threw 9 2/3 innings that year and posted a 3.72 ERA (he has been in the minors since).
One year later, he met Jesse Hahn.
In February 2018, Hahn stepped on the mound in spring training in Surprise, Ariz., ready to make his Royals debut.
At the time, his arm felt great. The Athletics had traded him to the Royals nearly a month prior after Hahn had struggled to stay healthy, but that day Hahn threw three innings and “felt fine.” The 28-year-old walked off the mound feeling like the pitcher he was while emerging as a rookie in 2014 with the San Diego Padres, then pitching well in 16 starts for the A’s the following season.
In his next start, he felt fine at first, but after two innings, he did not. His elbow was hurting in the same way it had in 2010.
“I didn’t know how serious this injury actually was,” Hahn says.
But he knew he had to leave the game.
He underwent MRIs in the following days, but the images did not reveal much. The prescription was rest, so that’s what Hahn did. Months later, he began throwing again. And when he did, similar to the beginning of spring training, his arm felt fine.
By July, he was ready to pitch again. He had two outings in the Arizona Rookie League and didn’t give up a run, so the Royals transferred him to Double-A Northwest Arkansas, where Hahn made three more outings and still didn’t give up a run. Triple-A Omaha was the next stop. Hahn knew he was close.
On Aug. 7, 2018, at Werner Park in Papillion, Neb., Hahn arrived at the mound to pitch for the Omaha Storm Chasers. He struck out the first two batters then gave up a single. The coaches pulled him after he reached his pitch count, and the outing was considered a success.
But not to Hahn. His elbow was hurting again.
After the game, Hahn immediately called Royals head athletic trainer Nick Kenney.
“Hey Nick, I don’t think I’m going to be able to throw a baseball anytime soon,’” Hahn said to Kenney. “This kinda took a turn for the worse. I think I’m going to have to shut it down.”
Kenney, not having seen any MRIs, trusted Hahn’s judgement. But because the pitcher was in Omaha, Kenney recommended Hahn drive the three hours to Kansas City for further evaluation with Dr. Vincent Key. A day later, he underwent the MRIs that Paletta later would see.
“We just knew it wasn’t functioning right,” Hahn says. “Something was obviously wrong.”
In conversations with Kenney and Key, Hahn considered his options. He had already undergone one Tommy John surgery, so he knew it would require about 17 months of rehab. Not only did he love the game too much to quit, but he also knew those at home, such as his sister Melissa, were cheering him on to return.
It was then that he remembered conversations he had had with Maness about a procedure Maness had undergone. The Royals knew Paletta had performed that procedure and Hahn wanted to see if it was an option for him. So he drove to St. Louis, spoke with Paletta and signed the waiver.
“I was just going to accept it,” said Hahn, who gave Paletta permission to speak to The Athletic about the details of the surgery. “No matter what the surgery was, I was very confident I would overcome (it) and be out there pitching again. It was just a matter of what date it was going to be.”
Hahn woke up in a daze. His wife, Jessica, stood over him.
“Check your leg,” she said.
Hahn felt down with his left hand and noticed his leg felt normal. This was significant. It meant Paletta did not have to take a graft from there to do a full reconstruction. Semi-realizing the situation, Jesse smiled.
“Yeah,” Jessica said. “You had the repair.”
The Hahns stayed in St. Louis for a couple days so Jesse could recover and relax. Then they returned to Arizona with a couple specific requests from Paletta. For the first eight weeks, Hahn was to let his arm rest, quite similar to Tommy John rehab, then he would begin the strengthening phase. Where the rehab really differed was 4 1/2 months into the process.
That’s when the long-toss program would begin. The program would last for six weeks, then Hahn would throw from the mound for six weeks. At that point, he could be back pitching again.
Some of the process went as planned after Hahn returned to Arizona; some of it did not.
Every morning during rehab, Hahn would wake up and walk to the coffeemaker in the kitchen. Above it hung a message board, and each day Jessica put together a new quote.
“That would motivate me for that day,” Jesse says, “and keep me positive. It went a long way. One of the things that goes unnoticed in the rehab process is the mental side of it. Believing, trusting, staying positive … it’s a grind. The messages really went a long way.”
About five months into the recovery, Hahn was back throwing and right on schedule. Until he wasn’t.
“The problem in Jesse’s case,” Paletta says, “is he had complications with nerve issues. That slowed his recovery. That’s a complicating factor that may make the return time seem longer than if it was just the repair. … Nerves recover at a much slower pace than most other soft tissues in the body. The expectation is that the nerve will recover fully. Jesse came into the surgery with the nerve issues, and those nerve issues are not immediately or easily cured by the surgery.”
Still, Jesse pushed through because that’s what he had done his whole life. And the Royals, who had placed him on the 60-day injured list, stuck with him. At long last, on Aug. 21, just shy of a full year since the surgery, Jesse took the mound in competitive competition for the first time. He pitched an inning of rookie ball and emerged unscathed, with two strikeouts on nine pitches.
“The feeling, it sounds cliche’, but I couldn’t describe it,” Hahn says. “After I walked off the mound that night, I was all smiles. I couldn’t stop smiling the entire night. I couldn’t wait to move forward and go on to the next one.”
Over the years, Dugas says he has received a number of questions from baseball executives — including well-known general managers — about the primary repair with internal brace procedure and which players qualify.
“I honestly don’t think it makes any difference what level of player you are,” Dugas says. “I don’t think it matters how hard you throw. That has nothing to do with it. It has to do with what your injury is.”
Since 2017, the procedure has become more recognized. Paletta says he has done nearly 150 of them in total.
After rejoining the Royals on Tuesday, Hahn now has the chance to re-establish himself in the majors after having undergone the new procedure.
“When you’re dealing with a professional athlete,” Paletta says, “it’s on a more magnified stage. I don’t read about my high school or college kids. But with guys like Jesse, it’s right there in front of you. These guys are pitching at the highest level.
“If you can get them back to that, it’s gratifying and rewarding.”
Jesse told his story one late-August morning. He’d pitched well a few days prior at High-A Wilmington, striking out all three batters he faced with a flaming fastball, deceptive changeup and hard slider.
Jesse is now 30 years old, and he still dreams of pitching in the playoffs and the World Series, things he has not done yet.
Those dreams and his love of the game are what pushed him to sign the waiver to allow Paletta to perform the Tommy John alternative. Not to mention the support from those back home. His father and mother. His sister Melissa, who has followed every game since he’s been back.
“I love the game, and I have zero quit,” Hahn says, “But I believe this is bigger than me.”
(Top photo: Jennifer Stewart/Getty Images)
- 80
- 89
- Joined
- Jul 31, 2019
- 58,335
- 29,819
- Joined
- Feb 12, 2005
Mookie just gotta go MVP mode today, I guess.
GreenNGold89
formerly bbllplaya23
- 6,571
- 2,114
- Joined
- Apr 5, 2005
Welcome to the bigs Murphy
- 35,006
- 16,905
- Joined
- Aug 4, 2005
My boys cousin. Dudes a stud
- 26,978
- 63,957
- Joined
- May 10, 2006
I had no idea Soler had 40 HR
- 58,335
- 29,819
- Joined
- Feb 12, 2005
Twins clutch tonight. Gonna need that coke October.
Edit: cant believe this post said 'need that coke" for over an hour w/o comment. Football must've started.
Gonna need that come October.
Edit: cant believe this post said 'need that coke" for over an hour w/o comment. Football must've started.
Gonna need that come October.
Last edited:
- 12,426
- 2,239
- Joined
- Dec 14, 2001
- 106,979
- 79,234
- Joined
- Jun 1, 2011
- 28,829
- 17,439
- Joined
- Mar 22, 2003
MLB Shop has a promo
Copped a Torres authentic for 175
Copped a Torres authentic for 175
Last edited:
- 58,335
- 29,819
- Joined
- Feb 12, 2005
Stars are always mashing against the Twins. Lindor, Mookie, now Lindor again, among others.
I guess they do that to everyone though, to a degree.
I guess they do that to everyone though, to a degree.
- 58,335
- 29,819
- Joined
- Feb 12, 2005
Nice little trivia nugget for y'all here...
jpzx
Supporter
- 57,526
- 27,215
- Joined
- Feb 7, 2008
We just like taking pictures of our TVs dude
- 58,335
- 29,819
- Joined
- Feb 12, 2005
No. I thought that was an interesting stat. Especially for the particular Rendon fan in here.
- 20,401
- 15,014
- Joined
- Apr 1, 2008
