Mets ace Matt Harvey has a partial tear of the ulnar collateral ligament in his pitching elbow according to an MRI taken Monday morning. He thus will likely be shut down for the remainder of the season, and is at risk of needing Tommy John surgery. In making that announcement at a press conference at Citi Field on Monday afternoon, New York general manager Sandy Alderson wouldn't commit to putting Harvey on the disabled list, but he did admit that he "wouldn't expect him to pitch the rest of the season."
Harvey admitted during the press conference to feeling tightness in his forearm for the last month or two, but said that it wasn't until his last start Saturday (a 3-0 loss to the Tigers) that he felt something "alarming." Harvey visited Dr. David Altcheck at the Hospital for Special Surgery on Monday morning and an MRI revealed his torn UCL. Because the tear is a partial one, Harvey and the Mets retain hope that he will be able to avoid surgery. Alderson said that an upcoming MRI, taken after some of the swelling in Harvey's arm goes down, could help the team make a decision on surgery. But he also said that that decision could be as far as two months away.
This news comes as a shock not only to those outside the franchise, but also to Alderson, manager Terry Collins and Harvey himself, who said he didn't feel any of the typical signs related to a ligament tear -- no shooting pain or tingling, no pop or other sensation -- only a tightness in "the muscle belly" of his forearm, which became significantly worse during his last start.
Indeed, there were no red flags in Harvey's performance nor in his workload this season. While Collins said he noticed that "something was wrong" in Harvey's start against Detroit on Saturday -- due to a lack of fastball command and a couple of hanging sliders in the early innings -- the pitcher nevertheless walked none, turned in his sixth quality start in his last seven games and threw a 97 mph fastball in the sixth inning. Over Harvey's last seven starts, he posted a 2.05 ERA, walked just three and threw his first career shutout.
In terms of workload, Harvey went from 135 2/3 innings in 2011 to 169 1/3 between the majors and minors in 2012, a reasonable 33 2/3 inning increase. He has thrown just 178 1/3 innings this season, on pace for what Alderson revealed today was an intended innings limit of around 210. Harvey threw just 106 pitches in his shutout (a 5-0 win over the Rockies on Aug. 7), and though he did reach 121 pitches twice earlier in the season, he never surpassed that total.
One can't point the finger at the Mets for Harvey's injury. They have handled him perfectly, giving him preventive treatments on his forearm all season, skipping his last start before the All-Star Game and, based on Collins' observations of Saturday's start (which the manager initially attributed to fatigue), had planned to skip Harvey's next start this week.
One hopes that New York will handle what comes next for Harvey equally well. Certainly the temptation to avoid surgery will be great, but if Harvey does need to go under the knife, he's better off doing it now so that he can come back at full strength in 2015. If he puts it off, he would likely lose part of each of the next two seasons.
The best comparison for Harvey, in terms of getting surgery out of the way quickly, is the Nationals' Stephen Strasburg, who was diagnosed with a "significant tear" of his UCL at exactly this point in the season in 2010 (his last start that season was Aug. 21). Strasburg had surgery in early September, returned to the majors for five starts at the end of '11 and was an All-Star in '12.
The contrasting cautionary tale is that of the Dodgers' Chad Billingsley, who was diagnosed with a partial UCL tear after his Aug. 24 start last season and opted for a course of rest, rehabilitation, and platelet-rich plasma injections over the offseason. Billingsley was able to make just two starts this season before going under the knife at the end of April. As a result, he won't be ready to return until after Opening Day next year and will do so without having that extra off-season of rest and rehabilitation.
Every pitcher, and every partial tear, is different, of course, but given Billingsley's case -- as well as those of the Braves' Jonny Venters, and the Orioles' Dylan Bundy, both of whom tried and failed to recover from partial UCL tears without going under the knife -- surgery seems inevitable for Harvey, even if there has been at least one study that suggests otherwise.