Shortly after 9:00 A.M Wednesday, Mo sent me this statement:
"Adam Wainwright experienced discomfort in his elbow after throwing on Monday. He is being sent to St. Louis to be evaluated and may seek a second opinion. As of now, it does not appear to be a good situation."
Tommy John elbow ligament replacement surgery, formally known as ulnar collateral ligament (UCL) reconstruction, seems to be implied. It may be the culmination of problems that initially surfaced late last season.
On September 27, it was disclosed that Wainwright had been dealing with right elbow stiffness in his prior two starts. The next day, the soreness and stiffness was labeled as not being serious, and was attributed to Wainwright having slept awkwardly on his arm.
After an MRI and examination by team physician Dr. George Paletta, it was decided that Wainwright would skip his last start of the season scheduled on Thursday, Sept. 30, due to what was called a right forearm muscle strain. A slight tear remaining in the elbow ligament was also noted, a problem first identified in 2004.
During the Winter Warm-Up in mid-January, Wainwright disclosed he adjusted his weightlifting routine and improved his diet during the off-season. He also noted a fall examination of his elbow indicated no structural problems, but acknowledged what he called a partial tear of the ligament.
Earlier this month, Wainwright told the Post-Dispatch that scar tissue had built up around his previous elbow strains, making his joint sound. He was named the spring training opening day starter, scheduled on February 28.
Obviously, now all bets are off.
If Tommy John surgery is required, Wainwright would have missed the entire 2011 season either way, but early October 2010 surgery would have given him a five-month head start on his 12-month minimum rehab.
Other Cardinals starters having had Tommy John surgery previously include Chris Carpenter (2007), Jake Westbrook (2008) and Jaime Garcia (2008). If Wainwright requires the procedure, it would leave Kyle Lohse as the only TJS-free member of the regular rotation.
Former pitcher-turned outfielder Rick Ankiel (2003) and current Cardinals left fielder Matt Holliday (2001) are also TJS survivors. Same with relievers Kyle McClellan (2005) and Brian Tallet (2003).
Late Wednesday afternoon update: Cardinals team physician Dr. George Paletta examined Wainwright and recommends surgery. MRI film is being sent to Dr. Lewis Yocum in California for a second opinion. Further information is expected Thursday.
Thursday morning update: Per Mozeliak, Yocum has confirmed the need for Tommy John surgery. Paletta will perform the procedure at a time to be determined. Paletta previously did both Carpenter's and Garcia's TJS surgeries.
Brian Walton can be reached via email at email@example.com. Also catch his Cardinals commentary daily at The Cardinal Nation blog. Selected TCN content appears at FOXSportsMidwest.com. Follow Brian on Twitter.
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