Thoracic outlet syndrome, and what it means for Matt Harvey and the Mets

Can Mets still contend for World Series without Matt Harvey?
1:21 | MLB
Can Mets still contend for World Series without Matt Harvey?
Thursday July 7th, 2016

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Matt Harvey's already-frustrating season has gotten much worse. In addition to being the subject of tabloid humor in spring training, enduring by far the worst season of his career statistically and landing on the disabled list on Wednesday with right shoulder discomfort, the Mets' one-time ace has now been diagnosed with, according to New York general manager Sandy Alderson, "symptoms consistent with thoracic outlet syndrome" and is considering season-ending surgery.

UPDATE: Harvey's season is in fact at an end, as the righthander has reportedly chosen to undergo surgery that will sideline him for the rest of the year.

Against the Marlins at Citi Field on Monday, Harvey was peppered for 11 hits and six runs in 3 2/3 innings, the second consecutive start in which he failed to make it out of the fourth inning. According to ESPN's Adam Rubin, Mets manager Terry Collins said of the 27-year-old righty, "He came in the training room afterward and said, 'My shoulder is dead. My arm is dead. There's no energy there. I couldn't feel the ball.’" On Wednesday, Newsday reported that a team source had told the paper's David Lennon that the club suspected Harvey had thoracic outlet syndrome, and that the pitcher would be send to St. Louis on Thursday to consult with Dr. Robert Thompson, a vascular specialist who performed the TOS surgery for Cardinals pitcher Jaime Garcia in 2014.

Harvey is the second pitcher in recent days to be connected to thoracic outlet syndrome; just this week, the Twins' Phil Hughes underwent the procedure for TOS, which is caused by a compression of the nerves and/or blood vessels somewhere between the neck and the armpit. It's not uncommon for TOS to present itself as numbness or tingling in the fingers and hands, or fatigue or weakness that doesn't go away with physical therapy and rest. Pitchers tend to be vulnerable to it because of the way their arm muscles build up. The condition is generally remedied by the removal of a cervical rib, but there are a wide range of possibilities as to what comes next. Some pitchers who have had the surgery—including Kenny Rogers (2001), Matt Harrison ('09), Josh Beckett ('13) and Garcia—have recovered to fare well at the major league level. Rogers is perhaps the greatest success story, having made three straight All-Star teams from 2004 to '06 while helping the Tigers reach the World Series in the last of those years. Garcia returned in May of 2015 and posted a 2.43 ERA in 20 starts for the Cardinals that season.