Then I suggest you read it again, because the pluses and minuses are not unequal, depending on what lens you choose to read it through. The article was for those unfamiliar with the injury. Wasn’t trying to do diddly for YOUR hope.
I read it through the lens of the author's conclusion but I took your suggestion and just read it again. This paragraph still seems to stand out:
There aren't a lot of pitchers who have had this injury, but the track record isn't good. Counting on a pitcher who has been through this injury is a terrifying proposition, especially considering the fact that the pitchers in this article are some of the most injury-prone players in recent memory. Perhaps Jaime Garcia can break the trend and give hope to pitchers who suffer this injury in the future. His success in seven starts this year defies some of the trends shown by the other pitchers with this injury. Still, until we have a better track record of pitchers returning from thoracic outlet syndrome, it will keep its reputation as one of the worst arm injuries that a pitcher could suffer.
A more optimistic analysis is found here (albeit with a fairly small sample size) and I suppose that earlier diagnosis and improved techniques may enhance the odds as well. But in the article we find that the average rehab time for players who returned to pitching was 325 days which is quite daunting. Matt Harvey and Phil Hughes are some notable pitchers who have had TOS surgery.
https://www.annalsofvascularsurgery.com/article/S0890-5096(16)30628-8/fulltext
Abstract follows
Background
High-performance throwing athletes may be susceptible to the development of neurogenic thoracic outlet syndrome (NTOS). This condition can be career-threatening but the outcomes of treatment for NTOS in elite athletes have not been well characterized. The purpose of this study was to utilize objective performance metrics to evaluate the impact of surgical treatment for NTOS in Major League Baseball (MLB) pitchers.
Methods
Thirteen established MLB pitchers underwent operations for NTOS between July 2001 and July 2014. For those returning to MLB, traditional and advanced (PitchF/x) MLB performance metrics were acquired from public databases for various time-period scenarios before and after surgery, with comparisons made using paired
t-tests, Wilcoxon matched-pair signed-rank tests, and Kruskal–Wallis analysis of variance.
Results
Ten of 13 pitchers (77%) achieved a sustained return to MLB, with a mean age of 30.2 ± 1.4 years at the time of surgery and 10.8 ± 1.5 months of postoperative rehabilitation before the return to MLB. Pre- and postoperative career data revealed no significant differences for 15 traditional pitching metrics, including earned run average (ERA), fielding independent pitching, walks plus hits per inning pitched (WHIP), walks per 9 innings, and strikeouts to walk ratio (SO/BB). There were also no significant differences between the 3 years before and the 3 years after surgical treatment. Using PitchF/x data for 72 advanced metrics and 25 different time-period scenarios, the highest number of significant relationships (
n = 18) was observed for the 8 weeks before/12 weeks after scenario. In this analysis, 54 (75%) measures were unchanged (including ERA, WHIP, and SO/BB) and 14 (19%) were significantly improved, while only 4 (6%) were significantly decreased (including hard pitch maximal velocity 93.1 ± 1.0 vs. 92.5 ± 0.9 miles/hr,
P = 0.047). Six pitchers remained active in MLB during the study period, while the other 4 had retired due to factors or injuries unrelated to NTOS.
Conclusions
Objective performance metrics demonstrate that pitchers returning to MLB after surgery for NTOS have had capabilities equivalent to or better than before treatment.
Thoracic outlet decompression coupled with an ample period of postoperative rehabilitation can provide effective treatment for professional baseball pitchers with career-threatening NTOS.
