Diamondbacks Reliever Waits for Dreaded 2nd Opinion on Shoulder MRI

The outlook for a healthy return in 2026 continues to dim.

Apr 4, 2025; Washington, District of Columbia, USA; Arizona Diamondbacks pitcher A.J. Puk (33) looks on during the eighth inning against the Washington Nationals at Nationals Park. Mandatory Credit: Reggie Hildred-Imagn Images | Reggie Hildred-Imagn Images

It's been a tough series of health updates for A.J. Puk and the Diamondbacks in recent days. Just a few days ago we learned that Puk had to be shut down from his rehab assignment and needed to get an MRI on his left shoulder.

The news has gotten worse since then.

A.J. Puk to Receive Multiple Opinions on His Shoulder MRI

Jul 5, 2025; Phoenix, Arizona, USA; Arizona Diamondbacks pitcher A.J. Puk gets ready to play the Kansas City Royals at Chase Field. Mandatory Credit: Rick Scuteri-Imagn Images | Rick Scuteri-Imagn Images

During his pre-game press conference at Chase Field, manager Torey Lovullo told Diamondbacks On SI and other reporters that Puk was still waiting for further information and a second opinion on his MRI.

"There's going to be first and second opinions that we're still waiting for. And where that takes us, I'm not sure," Lovullo said.

Speaking to reporters a day earlier in Cincinnati, including the Arizona Republic's Nick Piecoro, Lovullo said: “We’re going to keep our fingers crossed, but it’s going to be a little bit longer of a shutdown than most anticipate."

Lovullo said that he would remain hopeful that Puk would return to pitch for the team in 2026.

Needing to get a second opinion often means that the player and team are trying to make sure the pitcher does not require surgery, although that's not always the case.

Regardless if Puk needs surgery or not, he's clearly not coming back any time soon. And just how effective he'll be, or what kind of workload he could sustain during a pennant drive or even a Postseason run is very questionable.

Puk came to the Diamondbacks in a deal with the Miami Marlins prior to the 2024 trade deadline. He came with an injury history. A shoulder injury sidelined him for the entirety of the Covid-shortened 2020 season while with the then-Oakland A's.

He missed three weeks with an elbow injury in 2023, and landed on the IL once again in 2024 for three weeks with a sore shoulder. Despite this history, Mike Hazen made the deal to bring Puk into the organization.

For a while it worked out great. He was nearly untouchable in 2024, posting a 1.32 ERA and a 1.63 FIP in 27.1 innings, including 43 strikeouts versus just five walks. Puk wasn't quite as dominant to start 2025, allowing three runs in eight innings (3.38 ERA), but managed to lock down five saves.

He was shut down with an elbow injury in Mid April, however, and ultimately needed to have an Internal Brace Procedure that is an alternative to Tommy John ligament replacement surgery. The brace procedure allows for a 12-13 month return, as opposed to the typical 14-18 months for Tommy John.

Puk is in his final arbitration season and will be a free agent at the end of the season. He is earning $3.1 million in 2026.

Other injury notes: James McCann, Justin Martinez and more

May 10, 2026; Phoenix, Arizona, USA; Arizona Diamondbacks pitcher Eduardo Rodriguez (left) fist bumps James McCann at the end of the second inning against the New York Mets at Chase Field. Mandatory Credit: Mark J. Rebilas-Imagn Images | Mark J. Rebilas-Imagn Images

Lovullo gave a positive update for Diamondbacks' backup catcher James McCann.

"James McCann is starting to ramp up his overall activity, starting to really create a little bit more intensity with his running," Lovullo said.

McCann has been out with a quad injury since May 19. Lovullo said that he will begin a rehab assignment in the Arizona Complex League the week of June 22nd. The schedule for McCann has been a late June, early July return since the onset of this injured list stint.

Justin Martinez will throw his eighth bullpen on Tuesday. The program is for the rehabbing pitchers to throw about 17 or 18 bullpens before facing live hitters, so that is probably still a month or so away for Martinez.

Martinez told reporters he did not expect to be back until mid or even late August, but an early August return seems like a possibility.

Carlos Santana is continuing his rehab assignment with Triple-A Reno on Tuesday night. It is not clear how long he will remain there. Position players are allotted 20 days for a rehab assignment.

Due to his previous setback to his strained right adductor while with Reno on May 10, it's possible the D-backs were able to get the rehab clock reset. He resumed playing games in the Arizona Complex League June 5, and for Reno on June 10. It's therefore likely the D-backs have the option to keep him on that assignment until the near the end of June.