“This is tough news for both of these guys,” he said Friday. “They’ve got a lot of time and work ahead of them now. Rehab is very lonely. It’s a lot different than playing up here every day. It’s not something you want to see anybody who plays this game go through. But unfortunately, it’s a big part of being a pitcher right now.”
Reporters, too, know this routine well. Ten years ago, ulnar collateral ligament injuries meant Tommy John surgery, and no one really pried for more specifics. But now, when these surgeries are so frequent — so frequent, in fact, that both Means and Wells have had UCL repair surgeries before — the questions are more specific. Is it an internal brace procedure? Is it a full tear? Did either of them try the platelet-rich plasma injections that saved their teammate, Kyle Bradish, from elbow surgery when he sprained his UCL earlier this year?
In this case, Elias said, doctors wouldn’t know exactly what repairs are required until they perform surgeries. (Means underwent his surgery Monday.) But, no, neither player received PRP injections. And neither player will be back this year, though everyone knew that, too. The 12- to 18-month recovery time is the part of this that everyone dreads, the part that siphons off months and years of pitchers’ brief primes — the part that kills a year of World Series hopes just as they are forming.
At a time when elbows are blowing out at an alarming rate, the Orioles provide an example of just how the frequency of those injuries affects the futures of even the most successful franchises.
Some teams show the effects of the epidemic more clearly: The defending World Series champion Texas Rangers have yet to see Max Scherzer or Jacob deGrom throw an inning, were without Nathan Eovaldi for a substantial period and are toiling below .500 as a result. Elbow injuries to key rotation pieces have the Houston Astros and Tampa Bay Rays staring down disappointing years after recent runs of regular season dominance.
Other teams, such as the surging Cleveland Guardians, have absorbed blows more gracefully: When Shane Bieber went down with a UCL injury this year, it did not seem to slow Cleveland much. The Los Angeles Dodgers seem to lose one or two starters a year to UCL trouble but always seem to build the depth to absorb it.
“It’s something you always plan for. I think, usually, baseball teams try to go into the season with eight or nine starting pitching options,” Elias said. “Now we’re down a couple.”
Fortunately for Baltimore, Elias and his staff have a knack for finding promising arms on the scrap heap and shining them up. This year’s prize is Albert Suárez, who pitched in the Korea Baseball Organization last year and has a 1.57 ERA in 12 outings. The Orioles also have benefited from some injury luck: When Grayson Rodriguez dealt with shoulder inflammation this year, he only missed a few starts. Dean Kremer, who now has a similar issue, is expected to return this month. When Bradish, a 2023 Cy Young candidate, sprained his UCL this winter, he was able to avoid surgery and work his way back to what appears to be full strength. Bradish has a 3.18 ERA in six starts since returning.
Because of that and because of the deal they made to add steady Corbin Burnes to solidify the top of their rotation, the Orioles entered Monday 17 games over .500, three behind the New York Yankees for the American League East lead, firmly in control of a wild-card spot if things ended here. Their chances of reaching the World Series are not, on paper, devastated by the loss of Means or Wells.
Means is a treasured holdover from the bleakest Orioles days, a fan favorite coming back from another elbow surgery that meant the lefty missed the good days for which he toiled so long. Now, with an expiring contract and a twice-repaired elbow, he might not pitch for the Orioles again. He would have helped their rotation but not made or break it. The same is true for Wells, a right-hander who bounced between the bullpen and the rotation in recent years. His presence would have helped the big league roster, but his absence will not devastate it.
But the off-field effects can be costly. About nine months ago, Elias sat here, in this dugout, to announce his untouchable closer, Félix Bautista, would miss the end of an otherwise magical 2023 season because of Tommy John surgery.
That injury meant that instead of pairing the most dominant closer in baseball with an elite young lineup in its prime, the Orioles needed to find a new one. To do that, they committed more to a single player than they have in years when they spent $13 million on Craig Kimbrel this offseason. For a team with the 27th-largest payroll in the sport, that amounts to a seventh of its entire financial commitment to the roster.
And the injuries to Means and Wells probably mean the Orioles will need to pursue starting pitching depth at the trade deadline, though Elias said they were doing that already. The Orioles are well positioned to handle injuries that way, too: If anything, they have too many elite position-playing prospects for too few major league spots, so trades are as palatable as they are helpful. But if another starter goes down, they probably will have to reach more, which could mean spending more in prospect or financial capital than they might like.
“We’re in contact with other teams, clearly, and monitoring what’s going on in the standings in the rest of the league,” Elias said. “ … So we have to see how the whole market evolves. And then we’re also monitoring our own developments internally.”
Those developments include trying to decide whether Cade Povich, Baltimore’s top pitching prospect, is ready to make the jump to the majors. The 24-year-old lefty is pitching to a 3.18 ERA in 11 Class AAA starts, and Elias said that places him “on the tip of our tongues” for a big league call-up. But holes in the big league rotation might force more urgency on the cautious Orioles than they would like. And more holes might emerge with Means and Wells down than they would have otherwise.
Consider this: The Orioles planned to navigate June — a month in which they play such juggernauts as the Guardians, Yankees, Atlanta Braves and Philadelphia Phillies with just one day off — with a six-man rotation. They cannot do that now, which is not necessarily catastrophic.
But it could be significant: Instead of giving a little extra rest to young, recently injured arms such as Bradish and Rodriguez, they will need them more than ever. Instead of shaving a few innings off their summer totals with an eye toward October, they will have to test them.
“It’s sort of a common sense thing to manage innings and manage pitch counts and manage rest to go to a six-man for an extra day of rest, but there’s not really science behind this. You see pitchers get hurt that are handled very, very, very carefully by organizations,” Elias said. “… I think what I’m saying is, at this point, it’s more art than science, and we aren’t really sure about the impact that it has.”
Few general managers are as candid about those unknowns as Elias, who has not been particularly aggressive at trade deadlines when it comes to adding pitching. Then again, he has not seen injuries potentially ruin a season in his promising young team’s prime.
“As we just saw, you’ve always got to be paranoid about injuries when we talk about pitching. What I just described, unfortunately, can change very quickly because of bad luck,” Elias said. “So we’ll keep scouring [the major leagues]. We’ll keep trying to develop guys we have in-house. But this group, if they stay healthy, is a group that is capable of doing what we need them to do.”