West undergoes Tommy John surgery

Right-handed reliever Matt West recently underwent Tommy John surgery on his right elbow, ending his 2012 campaign. Lone Star Dugout profiles West's frustrating year while talking to his pitching coaches about his injury, the surgery, and upcoming rehab process.

Coming into spring training this past March, right-handed reliever Matt West appeared to be on the fast track to the major leagues.

West entered his first big league camp as a member of the Rangers' 40-man roster. After beginning the previous spring training as a position player, he was moved to the mound in late March 2011. It didn't take long for him to stand out.

The former second-round pick––as a third baseman––showed promise during an experimental bullpen session near the end of camp last year, throwing his fastball up to 94 mph and showing a repeatable delivery. Within a month, he was pitching in extended spring training games and flashing mid-to-upper 90s heat while spinning a plus breaking ball.

West ended up making 23 relief appearances at short-season Spokane and one with High-A Myrtle Beach last summer. In 27 innings, he yielded 26 hits, walked just one, and struck out 35. But most importantly, he showed an almost immediate feel for pitching on top of his two wipeout offerings.

West was so impressive on the mound in 2011 that the Rangers were forced to place him on their 40-man roster, protecting him from last offseason's Rule 5 Draft––despite the fact that he'd pitched only one inning at the full-season levels. With dominant stuff and strike-throwing ability, he looked like a pitcher who could fly through the system in 2012.

But West's 2012 campaign never got off the ground. The 23-year-old prospect was scratched just prior to his first spring training outing and diagnosed with a sprained UCL in his right elbow on March 3. He was initially shut down from baseball activities for six weeks of elbow strengthening.

Injuries are often an issue with position players-turned-pitchers. A number of pitchers suffer at least one setback after converting, including current Rangers right-hander Alexi Ogando. Although Ogando hasn't experienced any arm troubles in three seasons with the big league club, he missed the entire 2008 campaign in the Dominican Summer League while nursing an injury.

"(Injuries) happen most to converted pitchers," Rangers rehab pitching coordinator Keith Comstock said during a June interview. "It's not the normal pitchers that we see with the big setbacks or step-backs that we have.

"Some of those setbacks are caused by when we get into a slider––by the time we work into a slider. Then the new muscles start kicking in. Or he starts throwing it properly and it hurts. So we do have those kind of things. But when it's a converted guy, then we have to really watch it because it's a new arm. I don't care if he's been in pro ball for five years, but it's a new pitcher and it's a new pitching arm."

Comstock says he has experienced at least one injury setback with nearly every converted pitcher he's worked with.

"You name all our converted guys, and at some point, we've had issues with them," he said. "Some have been long term, and some have been real short. You stop throwing, pick up a ball, and say, ‘Hey, you're doing this wrong.' Sometimes it can be a PFP arm path that's messing them up."

In addition to the breaking ball often being an injury risk for converted pitchers, Comstock also believes West's changeup may have played a role in his elbow issues.

"His changeup, we've kind of modified," he said. "That might have been causing some of his issues, so we've had to back off on that. He had a great changeup. When you take away a weapon from a guy like that, then he had to understand that part of the game."

West remained in Arizona with Comstock until mid-June, when he shipped out to High-A Myrtle Beach. Before joining the Pelicans, he didn't have an opportunity to work out the kinks in game action because of the break between extended spring training and the rookie-level Arizona League.

The 6-foot-1, 200-pound hurler ended up making 17 appearances for Myrtle Beach between June 17 and August 12. During the two-month stretch, he was shut down a handful of times in an effort to both rest his elbow and get his mechanics back on track.

"Just right now, I don't think it's coming as natural and as easy for him," said Pelicans pitching coach Brad Holman in July. "But I think we've definitely made some strides in the right direction. It's just a matter of him throwing pain-free. He's getting a little jab in his elbow. So to get that out of there is our first course of action."

West's occasional elbow pain and struggle to repeat his mechanics led to some command issues in High-A. After walking just one batter last summer, he issued 16 walks (and allowed 16 runs) in 20.1 innings for Myrtle Beach. While his fastball reached up to 98 mph at times, he most often pitched in the 92-95 mph range.

Rangers minor league pitching coordinator Danny Clark says that when West initially injured his arm in March, the MRI didn't show that he would require surgery at that time.

"Matt obviously came out of spring training, where he had basically strained (his elbow)," Clark said. "The doctors and our medical staff didn't feel like it was, at the time, where we felt like he needed the surgery. When he came back to Myrtle Beach, he said he kept feeling something in his elbow."

But after his most recent DL stint in Myrtle Beach, the Rangers sent West to the Metroplex to meet with Rangers team doctor Keith Meister.

"We went and got a second––basically got a new MRI with Dr. Meister," Clark said. "And then obviously when Dr. Meister went in and looked at his elbow, he felt we needed to––and I reckon he talked with Matt––he and Matt decided that they wanted to go ahead with it."

The former third baseman went under Dr. Meister's knife on August 22. He'll now spend the entire offseason and––at the very least––most of the 2013 campaign rehabbing his elbow at the Rangers' minor league complex in Arizona.

Counting the 2012 season, West figures to lose practically two full seasons because of his elbow troubles. But Clark believes the rehab process could become a positive in the long haul––if West takes the entire rehab process seriously.

"I think it's going to be an advantage for Matt," he said. "When we flipped him to a pitcher last year, he was basically just picking the ball up and throwing it as a third baseman. To be able to understand his body, to get to understand the throwing program––basically being able to take it at a slower pace and being able to learn things as he goes to being a complete pitcher.

"I think it's going to help him in the long run. Obviously I know Matt is frustrated right now, and rightfully so. But in the same regard, I think if he takes the rehab the way we hope he takes it, then I think it's actually going to bring him back as a better, complete pitcher."

Only time will tell if West ultimately makes a full recovery from the Tommy John surgery and returns to his 2011 form. If he does, he still has a chance to work in the back end of a major league bullpen. But it's no certainty, and the 2012 season has been an all-around frustrating grind for a prospect who appeared on the fast track just five months ago.

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