St. Louis Cardinals’ general manager John Mozeliak confirmed reports Thursday that starting pitcher Adam Wainwright will miss the entire 2011 season after suffering a Tommy John injury. Sources reported Monday that Wainwright was experiencing discomfort in his elbow. He returned to St. Louis to be examined by team physician Dr. George Paletta. He then went to Los Angeles to receive a second opinion with Dr. Lewis Yocum. Mozeliak made the announcement after the second opinion that Wainwright would miss the season after undergoing surgery.
The injury, which has been named for the first professional pitcher to successfully undergo the operation over two decades ago, involves tearing of the ulnar collateral ligament on the inside of the elbow. This ligament almost never heals, so most high-level pitchers and other throwing athletes undergo surgery. The surgery involves taking a tendon, usually the palmaris longus tendon from the wrist, and using it to make a new ligament.
Recovery and rehabilitation from the surgery are lengthy. First, efforts will be made to regain range of motion of the elbow while protecting the ligament. Strengthening of not only the elbow but also the shoulder is then emphasized prior to allowing the pitcher to start a long-toss program. Overall, it takes approximately 12 months to get back to pitching. Most professional pitchers, however, notice that it is the second season back to baseball before their pitching elbow feels normal.
There has been speculation among baseball media about the nature of the injury and possible contributing factors. Buster Olney of ESPN mentioned on Twitter that he had talked to several scouts who noticed that Wainwright’s arm angle was dropping toward the end of last season. Presumably that could be a sign that Wainwright was having trouble with his elbow. According to Olney, Wainwright threw 1,471 breaking pitches in 2010, which was the third-highest percentage among major league pitchers. Also, Wainwright is one of four pitchers in the majors who pitched at least 230 regular-season innings in each of the last two seasons. While typically this is an injury that occurs over time, whether overuse contributed to his injury is impossible to say.
With Wainwright suffering the injury so early in spring training, it is likely that he will undergo surgery very quickly in order to give himself as much time as possible to rehabilitate the elbow and possibly be ready for the 2012 season.