Johan Santana Has a History Of Elbow Problems

Joseph DelGrippoAnalyst IFebruary 28, 2009

The recent information about Johan Santana having even bigger problems with his pitching elbow has caused quite a stir with New York Met fans on talk radio and in the blogosphere.

There are no reports of bridge jumpers yet, and the word that New York City Mayor Bloomberg posting extra security guards has proved erroneous.

The Mets themselves have said it is not a big deal, and manager Jerry Manuel has said that the team is being cautious with their prized left hander. Teams are generally secretive with injuries, especially with big stars. I don't believe New England Patriots coach Bill Belichick has even come out and said that Tom Brady actually missed the 2008 NFL season!

Problems with injuries behind the elbow such as Santana's recent pain can be troublesome more than just in a temporary manner. For information purposes, acute tendon problems are those last for less than a month, with chronic injuries usually more than a month. 

The tendon in the back of the elbow connects the triceps muscle to the elbow and upper arm, and helps the elbow to move and flex in its hinged manner.

This triceps tendon connects similar to how the bicep tendon connecting the biceps muscle to the elbow and upper arm. Torn bicep tendons are much more severe and have caused professional football players to miss entire seasons.

I remember when Dallas Cowboys linebacker Ken Norton, Jr. played an entire season with a torn biceps tendon and reported he was in constant pain, but played through it.

Now, the triceps tendon is different, but with the constant action on the elbow from throwing, I would suspect that if the pain lingers for more than a few weeks, it will be a chronic condition for Santana and the Mets all season.

This type of injury primarily occurs with severe trauma, like falling down and bracing your fall with your arms, where the jolt to the body pops the tendon. That is good news for Met fans, unless Santana did indeed fall sometime during the winter.

But another reason for this injury is increased weightlifting exercises which places strains on the triceps tendon. Could have Santana’s knee surgery over the winter caused this elbow problem? While unable to perform lower body exercises, did Santana lift more (and heavier) weights for his upper body thus hurting the elbow?

Otherwise, according to an online orthopedic website another known cause of triceps tendon injuries is consistent steroid useand I am not even touching that one.

It is not the first time in his career that Santana has had severe elbow issues, and I am not talking about the “usual spring training tightness” that Johan gets each year. Even though it was 8 years ago, Santana had major elbow surgery to repair a torn flexor TENDON in his elbow.

That pesky tendon word surfaces again. He also had surgery before the 2004 season to remove bone chips in the elbow. Sometimes when the triceps tendon pulls away from elbow joint, bone chips are the result.

Complete and partial elbow tendon TEARS are rare, but will occur more frequently with athletes who have had prior elbow injuries, which Santana has had.

This situation is a tricky moment for the Mets. If the injury is acute, then Santana could come back and pitch during the first week of the season, but if the injury becomes chronic (and the tendon is partially torn), then the Mets must decide whether it is imperative to win in 2009, or wait until 2010. 

Would the Mets allow Santana to pitch the entire season with pain in the elbow, and then address it in the off season?

After two straight seasons of no playoffs, the 2009 season is so important for the Mets psyche and fan base, that Santana could pitch through the pain if he, and the Mets, wanted him to.

This is not a Tommy John surgery type of injury, which is confined to the inside part of the elbow.  

Because Santana is a fastball, change up pitcher with very few breaking pitches, if he continued to pitch the strain on the elbow would be lessened.

If a pitcher like AJ Burnett or CC Sabathia, who throw a lot of curve balls and sliders would have more of an issue because of the constant elbow twisting.


This is something that could possibly be pitched through by Johan.

But, if the pain does not go away by April, would the Mets propose surgery, hoping he could possibly come back later in the year?

The Mets are being cautious and that is good. A bullpen session tomorrow, then if no pain, another one in a few days. If all goes well with no pain, increase his workload, working towards an early April start.

But, if Santana has a little pain then the Mets will shut him down for a month, and retry later, hoping a month of ice and rest will help.

Either way, if Santana misses significant time, the trio of Mike Pelfrey, John Maine and Oliver Perez need to carry the load.

But, each of those have their demons, too. Having been worked hard last year, Pelfrey is coming off the most work in his career, Maine is coming off his own injury plagued season and Perez is, let’s just be polite and say he’s Oliver Perez.

I do believe each of those starters could handle heavier workloads, while Jonathan Niese and Bobby Parnell would be successful if needed a year earlier than the Mets would want.

As I said in my Livan Hernandez piece from earlier in the week, the Mets needed him more last season, but it would be great for the Mets if Livan proved me wrong and became equally important this season.


If Santana NEEDS to have surgery at some point, but can pitch through the injury for a season, then he needs to pitch in 2009, and have surgery after the season.

There are more options going into 2010 with free agents available and trade possibilities. Right before the 2009 season is not the time to get a free agent or make a big trade for a quality starter, unless you want to give up a boatload of talent for Jake Peavy. But, Peavy’s injury risk is also high.

If I were Johan Santana and could pitch through the pain, I would give it a go the entire season with this injurybecause the 2009 season is so important to the Mets.