Medlen to undergo Tommy John surgery

KISSIMMEE, Fla. -- Braves pitchers Kris Medlen and Brandon Beachy received the news they were expecting when they visited Dr. James Andrews at his Pensacola, Fla., office on Monday.

Medlen will undergo season-ending Tommy John surgery for the second time in less than four years on Tuesday afternoon. While Beachy seems to still be staring at the likelihood of undergoing this procedure for the second time in less than two years, he will first travel to Los Angeles to get a second opinion from Dr. Neal ElAttrache.

Before making the six-plus hour drive with Medlen from the Orlando area to Pensacola on Sunday, Beachy indicated that he would be seeking a second opinion regardless of what Dr. Andrews found during his evaluation.

"The news is obviously very tough, but I knew when I walked off the mound mid-inning what I had felt," Medlen said in reference to his exit from a March 9 game against the Mets. "The love and support I've felt from my family/teammates, [they go hand in hand], the Braves organization and Braves fans everywhere really mean the world to me and will definitely help me through all this."

As Medlen and Beachy spent Monday waiting for Dr. Andrews to confirm what had seemingly become inevitable last week, the Braves were in the process of evaluating why so many of their pitchers have recently undergone Tommy John surgery.

"I think we're always evaluating and looking at how we do things and why we do them and do we need to make changes," Braves general manager Frank Wren said. "That's an ongoing process. I think you are probably tempted to look more deeply when something like this happens."

Within a span of 24 hours last week, the Braves saw Medlen and Beachy make early exits from their respective starts because of pain and discomfort around their surgically repaired elbows. Medlen immediately knew he was destined to undergo a second Tommy John surgery. Initially optimistic, Beachy was staring at this same likelihood a few days later.

Along with losing two of the top members of their starting rotation, the Braves now have to evaluate what might have led these pitchers to both potentially have to undergo this procedure for a second time in less than four years.

"There are a lot of factors involved and every rehab is different," Wren said. "It's unfortunate. I don't think we'll ever stop researching and analyzing. But I can't tell you today that we feel there is a common link [between Medlen and Beachy] other than that they're wearing the same uniform."

Unfortunately for the Braves, this sudden turn of events conjures memories of what they experienced just 10 months ago, when just a few days separated the revelation that both of their top two projected setup men, Jonny Venters and Eric O'Flaherty, would need to undergo Tommy John surgery.

While O'Flaherty endured the rehab that followed for the first time, Venters had the surgery for the second time since 2005.

Venters at least had the good fortune of seeing his elbow remain structurally sound for at least seven years following the initial procedure. Medlen and Beachy are now staring at the possibility of repeating this procedure much earlier than they could have ever envisioned.

After not pitching much in college and being signed as an undrafted free agent in 2008, Beachy made an unexpected rise to Atlanta's rotation during the final weeks of the 2010 season and spent the first two months of the 2012 season establishing himself as one of the game's top pitchers. But his storybook journey was abruptly halted when he was forced to undergo Tommy John surgery on June 21, 2012. Beachy made just five starts last year and eventually had to undergo a cleanup surgery in late September, during which Dr. Andrews removed a floating bone chip from his elbow.

As Beachy made three starts during this year's Grapefruit League season, he was plagued by the same elbow inflammation that caused him so much frustration last year.

Medlen was at least a little more fortunate given that he was able to pitch two full seasons following the 13-month rehab that followed the Tommy John procedure he underwent on Aug. 18, 2010. But it is safe to say he never envisioned Dr. Andrews performing this procedure on him again so soon.

Medlen understands statistics have shown that only 20-30 percent of pitchers who undergo a second Tommy John surgery make a successful return to the Major League level. But at the same time, he can look at Dodgers reliever Brian Wilson as one of the most recent pitchers who have beaten the odds.

"I approach this process with the same drive that I've had my entire life and will do everything I can to come back from this 'thing' twice," said Medlen, who was touched by the outpouring of support he received from baseball fans that extended beyond Braves supporters.

Over the past week, Medlen has determined that before attempting to return, he will evaluate his mechanics with the intention of doing whatever is necessary to lessen the strain placed on his elbow.

The Braves plan to evaluate a range of potential factors including the treatment their trainers and physical therapists provide to pitchers coming off Tommy John surgery. There will also be an analysis of the strength-and-conditioning activities some of the rehabbing pitchers have done outside of the team's care.

"When you have a cluster of Tommy Johns like we've had, there's no question you do an internal audit of how you are doing things," Wren said. "All of our rehab protocols are based primarily on Jim Andrews' protocol. It has been for years and we've had great success with it. We're very comfortable with that and we won't deviate from it even if a guy is doing exceedingly well and he seems to be ahead of schedule, we don't let him get ahead of schedule because we want to make sure we stay on that protocol because we've had success with it."