LA Angels Weekend News Crash: Brutal

Nikkan Sports interviewed Dr. Furushima, elbow specialist, (aka Japanese Dr. ElAttrache), of course, regarding Sho.

Q: Ohtani will accompany the Angels to New York and continue to bat. Is that going to affect his right elbow?

A: The risk is different for left or right handed batter. The stress is much less on the lefty hitter with right UCL tear. The reason is the right elbow does not extend at the time of impact with baseball whereas the left elbow does. There is a slight risk when he would hit outside corner pitch, but it is still minimal. If he feels pain doing it, then he should stop to prevent further tear.

Q: Ohtani continued to bat when he tore his UCL the first time in 2018.

A: It must his understanding that batting would not further damage his UCL.

Q: What is the success rate of second TJS?

A: According to American research paper, it is around 50%. With our method, the percentage is not that low. If treated and rehabbed well, the result has been spectacular.

Q: What is your experience when you performed second time TJS?

A: First of all, it is rare that players undergo TJS for the second time. It is only for professional players wishing to play for a long period of time. I have performed second time TJS on Japanese and Korean players, many of them who played in MLB. All of them were able to return to play. I even have Shohei Tateyama (Yakult Swallows), who underwent the surgery three times, and he was able to come back and play.

Q: With making a hole in the bone for placing transplanted ligament , isn’t it more difficult to create another hole?

A: With American method, that could be a concern. With metallic screw, the hole may enlarge. We don’t use metallic screw and do not create a hole in the bone. Thus, we can reuse the same hole and use the contralateral (left) UCL for transplant. (I am assuming he takes just a part of contralateral UCL.)

Q: Are you saying if you remove the old ligament with new one, you can use the same hole?

A: Yes, but the second or third time around, there is going to be scar tissue which needs to be removed, so the procedure becomes so much more complex that requires experienced surgeon.

Q: With unknown degree of tear, is PRP therapy going to be effective?

A: I don’t think PRP will help. I can’t think that torn area of the UCL, especially torn transplanted UCL, would heal with PRP alone. PRP may help alleviating inflammation and pain, but for someone who underwent TMJ, it just does not work.

Q: PRP may help with first time UCL tear?

A: There have been prior successful cases. For professional players, it would be just buying time, but for younger players, middle to high schoolers, it would be a good option.

Q: Ohtani had cramping in various parts of the body prior to the injury. What is your opinion regarding the UCL tear for the second time?

A: I believe that it is from accumulated exhaustion due to lack of rest. I think his whole body was stressed. Just focusing on his right arm, normally muscles around the elbow would protect and reduce stress on the UCL, but with exhausted muscles, there must have been inordinate amount of pressure on the ligament. He was throwing many sliders and cut balls and those tend to exhaust the forearm muscles. Obviously, throwing 100 MPH fastball stressed all of his forearm muscles, much more than throwing 85 to 90 MPH.

Q: In US, throwing splitter is believed to place most stress on the elbow.

A: We have research data which compared fastball, slider, and splitter. The conclusion was that the slider placed most stress on the elbow.

Q: If you were asked for second opinion, what do you recommend?

A: If it is torn, especially the area involves the transplanted area, I would recommend surgery.

Q: You don’t think that it will heal by not pitching for the remainder of the season and off season?

A: Once it is torn, it will continue to weaken his arm. He will probably decide what to do in next few months.