This past November, Downs underwent a relatively minor procedure known as ulnar nerve transposition.
"I'm doing well," Downs said from Cubs Minor League Spring Training in Mesa, Ariz. "I've had no setbacks. I'm about five or six days behind the pitchers that showed up for mini-camp. I should be able to make it up by the second week of Spring Training."
In four seasons with the Cubs, the 22-year-old Downs has logged 194 innings, going 15-14 with a 5.34 ERA. Most of his time on the Cubs' minor league circuit has been spent in the Northwest League at Boise, and Downs admits the pain in his elbow had been present for much of that time.
"I've said lately that you don't really know how bad it affects you until you get it fixed," Downs said. "I'm 100 percent now and I look back and realize just how much it affected me and how I threw overall."
Downs can tell the difference in his throws already.
"I'm a lot looser with my throwing now," he said. "I don't feel anything in my elbow. Before, even those first few warm-up tosses would hurt."
But there was also a Catch-22 to Downs' condition. He'd been pitching with the pain for so long that he had started to think of it as second nature.
"It got to the point where I really didn't think it affected me," Downs said. "But looking back, I know the whole time I was throwing that something was bothering me. Before the surgery, I didn't really know what it was like to feel healthy."
With the worst of Downs' health issues hopefully behind him, the southpaw expects to break camp with one of the Cubs' full-season affiliates.
If so, he believes it will be in a relief role.
A starter throughout the first three years of his professional career, all but three of Downs' 11 appearances a season ago were in the bullpen.
"I've actually enjoyed the bullpen more than starting," he said. "I'm assuming, especially after my surgery, that I'll be in the bullpen. I hope so because I enjoy it. We'll just have to wait and see."