The Phillies announced this morning that their medical staff has recommended an ulnar collateral ligament reconstruction (i.e. Tommy John surgery) and ulnar nerve transposition procedure for top pitching prospect Andrew Painter. He’ll receive a second opinion from Dr. Neal ElAttrache next week before proceeding with the operation. Assuming he indeed undergoes the surgery, he’ll miss the remainder of the 2023 season and quite possibly the majority of the 2024 campaign.
“Right-handed pitcher Andrew Painter has been undergoing conservative management for a right elbow partial ulnar collateral ligament (UCL) injury since March 2, 2023,” the Phillies stated in a press release. “While he was able to return to throwing bullpens and follow-up imaging has shown interval healing in his elbow, over the last few weeks, he continues to be symptomatic upon examination. Considering the timing of the season and that Painter is still experiencing symptoms, the Phillies medical staff has recommended he undergo a right elbow UCL reconstruction with ulnar nerve transposition surgery. Painter has a surgical consult with Dr. Neal ElAttrache on Monday, July 24, 2023 in Los Angeles, Calif.”
Phillies president of baseball operations Dave Dombrowski indicated last night that Painter was no longer being viewed as a rotation option for the current season, though at the time Dombrowski did not divulge this recommendation. Fans will surely be frustrated, given that Painter’s UCL injury was first diagnosed back in March, but surgery is always a last resort. As common as Tommy John procedures have become, a pitcher’s full recovery is hardly guaranteed. We frequently see pitchers take longer than 12 to 14 months to recover due to setbacks and/or return with diminished stuff. Noah Syndergaard stands out as one prominent recent example of both scenarios.
The Phillies consulted with outside medical experts back in March, and all involved parties agreed on a conservative approach with Painter, knowing full well this could be the eventual outcome. While certainly not unforeseeable, the setback is still a blow to the Phillies’ future.
Painter entered the season lauded as one of the sport’s top prospects at any position. The 2021 first-rounder breezed through three minor league levels last year as a 19-year-old, posting a combined 1.56 ERA through Low-A, High-A and Double-A. Along the way, he fanned a massive 38.7% of his opponents against a tidy 6.2% walk rate.
That huge showing not only catapulted Painter up national prospect rankings — it thrust him into competition to claim the No. 5 spot in the Philadelphia rotation this spring and make his MLB debut before even celebrating his 20th birthday. The spring elbow injury derailed that trajectory though, and Painter’s earliest path to the Majors is now likely in 2025. He’d require at least 12 to 14 months to recover from surgery, and the Phillies would surely be cautious with his rehab and any minor league innings next season as he builds back up late in the summer.
Given Painter’s injury and the struggles of left-hander Bailey Falter, rotation help could be a major focus for Dombrowski and his staff in advance of the Aug. 1 trade deadline. Falter opened the season in the rotation but has since been optioned to Triple-A. Fellow lefty Cristopher Sanchez has performed well in six starts since being given an opportunity, but the Phils have received less quality than hoped from top starters Zack Wheeler, Aaron Nola and Taijuan Walker — all of whom have an ERA between 4.00 and 4.27. Ranger Suarez has fared a bit better (3.84 ERA) but also been limited to 12 starts due to injury.
The Phils have a solid quintet of starters right now, but the depth beyond that group is shakier. Adding a proven starter to stabilize things surely has some appeal — particularly if said starter is controlled beyond the current season. Nola is a free agent at season’s end and Painter isn’t likely to pitch until late next summer, so bringing in some help not just for this year but for next season as well could prove prudent.
should have gotten it as soon as he got hurt the first time. Everyone knew this would be the eventual outcome
It is most unfortunate that this young man’s career is now in limbo. On the bright side, some posters will reach their apex by crowing how they saw this coming.
TJS is not even close to a career death sentence. There are way more success stories than Syndergaards.
What the hell,
Van Gogh gave up his ear
Painter can give his career
“young man’s career is now in limbo”???
I get it’s a minor setback and there is some risk involved, but this is not 1993. We are now living in an age where a TJ-survivor has entered the HoF (Smoltz) and there are guys playing after having it 2x. It’s better for him to have it a younger age (he just turned 20 y/o in April), if at all, where it’s easier for his body to heal and recover. The idea that this is anything but a speed bump is antiquated and denies how far we’ve come in sports medicine.
Run-Losing two years of a limited time career is much more than a speed bump and while most survive many are at least somewhat limited afterwards even at this young age.
Sure, but even 2-year recovery time, he’s still ahead of most’s schedule. And there are plenty that find just as much post-TJ as they did beforehand. Sure, there are adjustments to be made, but it’s almost inevitable for someone that large throwing that hard. Throwing that hard is a violent repetition. Don’t forget about him, he’ll be back striking out my Braves in due time.
The other thing that’s important to take into account is that this didn’t happen at the big league level. Since his service clock didn’t start, the Phillies aren’t losing control time on him.
He will likely be pitching in the pros at age of 21 and about 355 days.
He certainly is talented,and you are right,he is very young,which maximizes several good things.
Another poster said that he only pitched 50+ innings last year,so the hype may have pumped him up enough to get this injury.
But by the time that he comes back the Braves will have churned a fine starting pitcher up each year until then just like they have been doing.
Should have consulted with the TJ experts….
The Angels
Do you believe a player should follow Dr, recommendations? Do you realize a Dr will not do the surgery until he deems it necessary? I ask because…..”Both Phillies doctors and ElAttrache, who works closely with Painter’s agent Scott Boras, recommended in March that Painter, who is the Phillies’ No. 1 prospect and the No. 8 prospect in baseball, try a conservative rehab process first.”
Why he didn’t get this done in the beginning of the season now looks like a bad move by the organization. I know the goal is to avoid surgery if possible, but now he looks like he may not pitch at all next season
I think you just answered your question. Teams shouldn’t jump the gun and put a then-19 y/o under the knife without exploring every avenue just to meet their competitive window.
Exactly. Surgery isn’t fun. You try to avoid it if possible, especially with kids.
We all knew what the end result was going to be. Just saying. I have yet to see an injury like this where they didn’t eventually need TJ. That’s all I’m saying. And it now makes 2024 basically a wash
It was a wash anyway. He’s 19. They aren’t rushing him.
@Jake Biggar.
Seth Lugo partially torn UCL, opted for rehab over surgery.
Thank you. Did not know the Seth Lugo one. Fair enough, just was meaning most end up needing it but good example
Thanks!
Another was Masahiro Tanaka.
@Jake have you had any type of surgery and the accompanying rehab? From my experience I’ve yet to have one that was in anyway pleasant.
Ok…and he’s going to have to do it anyway.
It’s easy to pass judgement in hindsight…
The Phillies wasted 3+ months when it was pretty clear this was gonna be the case.. and instead of potentially getting him some big league experience late next season, the soonest he’ll be back in 2025. Just bad player management.
But you’ll never hear this actual fact pointed out by Phillies fans.
They’re too busy going Lol Mets to notice.
Lol Mets
The Phillies wasted 3+ months when it was pretty clear
===================================
How was this pretty clear? I think a lot of fans thought there was a decent shot at TJS, but unless it was clear to the doctors, and they decided to not tell anyone, then it certainly wasn’t clear to us commoners.
Past that, it probably doesn’t make much difference. It probably takes 16 months to recover from TJS. Painter probably wouldn’t have made any contributions until 2025 in either case.
Oh JoeBrady. You must love beating your head against a brick wall, don’t you. Trying to communicate the idea that tommy John surgery is a complex medical procedure that needs a medical staff to determine whether it’s truly needed or not is not a move likely to succeed. I mean, they probably stayed in a Holiday Inn last night.
It’s one of the these that sets me off. There are a shocking amount of people that will comment on someone’s injury saying ‘they don’t need to sit him tonight” like they have even the first clue of how the player feels.
Sometimes we need to follow the advice of some of the highest paid doctors in the world.
We did that with Fauci, and how’d that work out? We shut down the world for months and it did nothing.
your an idiot comparing a new virus to 15+ years of data.
Disinformation and information silo’s are powerful tools. Hope you find your way out.
You mean the advice that he needs TJS?
You’re*
Did nothing? Really?
It saved millions of lives, and many more from ongoing suffering and disability.
LOL! Took me a minute to realize who you were correcting. Irony is wonderful, isn’t it. >=}
No one wasted anything. This is a 19 year old kid who was under expert care. There’s no rush to get a kid under the knife unless it’s necessary. As soon as hw got hurt there was no chance of him coming up anyway. Fans act like the best doctors in the world aren’t evaluating these guys.
Right? You’re uncle’s lung transplant just took a back seat to this kid’s TJS consultation! Baleedat…
okay, say he gets TJ at the beginning of the year. you think the phillies are rushing to get him back and up into the majors at the end of 2024? no. even if he got the surgery then, as soon as they found out it could be this serious they had pushed his ML timeline back by 2 years minimum regardless. trying to avoid surgery with a 19 year old is not a blatantly obvious missed call for the phillies to make.
Just here for the medical experts saying he should have had the surgery months ago.
How many guys that go on the IL with the same initial prognosis that Painter had don’t eventually need TJ surgery?
I can think of 3 in the last decade. Probably a similar number I missed. 6 out of 600?
I know it’s the player’s decision whether or not to ultimately have the surgery, but the teams and agents should be laying out the odds better. Then maybe less of these guys would be trying the rest and rehab route.
I think what makes it tricky for us looking in from the outside, is that loads of pitchers likely already have malformations in their elbow(s) — or arms in general. Meaning, as fans, we’re not informed of the full scope of players managing existing issues such as a partial tear of their UCL.
Considering that, it may seem foolish to stave off the inevitable, but in reality, there are many pitchers out there avoiding going under the knife that we’re just not privy to.
We’d be privy to it if they were shut down at all. Unless you mean these guys are not only avoiding going under the knife, but also avoiding missing any time.
It’s up to the player to determine how hard to push themselves.
So many of them are auto surgery candidates.
Surprise, surprise, surprise.
The Phillies have already burned this kids arm out at 19. They had him throwing 5+ innings a start, including a complete game in 2022 and then told him he could make the team if he pitched well in spring and he stressed his arm out.
LOL
There is an epidemic of Tommy John surgeries going on that goes all the way back to high schools…Pitchers are getting over worked at a young age.
Painter never pitched more than 53 innings in a high school season and the Phillies asked him to double that in the minors for a season. Then they had him starting spring training games against veteran hitters and he stressed it beyond the limit.
The Phillies blew his elbow and he’ll never throw 99 again in his life.
I’ll take that bet, Fred.
why can’t we have nice things?
No Pain but we have Abel
Feel bad for the young man, but as others said, you could see it coming.
Good luck to him in his recovery.
Hello 2025@
What a shame. Kid won’t pitch till 2025 in a meaningful moment. Good job Follies
*Laughs in pain*
How is it that the fans knew this as soon as it happened, but the front office and doctors didn’t realize it until now?
TJ surgery for a pitcher these days, is like an adult getting their wisdom teeth pulled. If it’s needed, the sooner it’s done the better.
Get it done, so we can get him going
Bc they’re the same group of commenters who will call for TJS every time a player has the slightest elbow issues. They’re never wrong, right? These are only a handful of doctors around to perform TJS. Any dentist can pull a wisdom tooth.
You should ask Harper how his wisdom tooth removal procedure went.
I come for the baseball news but stay for the amateur medical advice.
Great day for MLBTR posters.
You got a like just because of the screen name.
Dan Uggla used to wrestle bears in the offseason. Fun fact.
Forever Giant Dan “frying pan” Uggla?
Phillies fans can’t have nice things.
Sure we can. 2nd place in the NL East. 10 games over .500. One of the best records in baseball since June. It’s a fun season.
3 guys in the top 10 of qualified batting averages in the NL as well.
I’m very pleased with the rebound Castellanos has had this year. I’m also pleasantly surprised with what Stott has been doing at the plate especially in clutch situations.
Big surprise!
Surgery is never the first option for ANYONE. Why does it have to be the first option for athletes?
There are guys that never got the surgery and kept pitching for a long time and never needed it…Ervin Santana, Masahiro Tanaka, Adam Wainwright.
I’m just in here Muting the know all know nothings who have better insight than doctors without actually being involved at all.
To just say cut the 19yr old phenom up for TJ without patience and caution is the height of moronic couch potatoe stupidity rampant in online forums.
Quite well said. Here’s hoping Abel and McGarry both avoid this surgery.
Sorry to read this about Andrew Painter.
Wishing him a successful surgery and a full and complete recovery.
That said,
What would it take to get RHSP Michael Lorenzen
OR LHSP Eduardo Rodriquez from Detroit?!
More than either of them are really worth and I always liked lorenzen
Does this now make him a trade chip for a big acquisition? He won’t be pitching until 2025 most likely. The Phillies window is now. Something to ponder
With DD, I think he was a trade chip already. I think this does hurt his value a bit.
That brings up an interesting question. Are players of all teams covered under same insurance or offered comparable plans by each team per CBA. If offered by each team trading a player such as him in the middle of such a journey could b problematic, I’d see issues as far as the new health carrier. If it’s an all encompassing plan it’s a moot point.
Is it normal to have TJ and an ulnar nerve transposition procedure?
Having had the transposition surgery, this means that he has also had numbness in his fingers.
Lot of hindsight champions here.
You’re most definitely right about that, King Of Cards. Everybody’s a genius, with benefit of hindsight.
This is shocking. At least they waited several months before sending him in for his mandatory Tommy John Surgery.
FREE MICK ABEL
Hey throwing out the Scott Boras effect here.
But first, Nola, not a Boras client had something similar and has flourished w/o it.
Title of this is TJ surgery “recommended”. This is where I wonder what the issue is? If he gets the surgery asap-ish, he’ll slate to be ready to pitch spring of 2025. But he’ll have to ramp up his innings again, so it’ll be in the minors..
Would there be any benefit to waiting these few months? Maybe get in the rotation, then need the TJ to accrue service time? And obviously w/ Boras as his agent, I always expect some sort of shenanagens….?
Maybe I watch too much ancient aliens?
He can’t even get into the AA rotation now.
Same age as Kyle Drabek age when he had his 1st of 2 TJS. Kyle got the Phillies Doc Halladay. Otherwise he was less than a blip on the radar.
If they could get any present value as a component in a trade, they should do it.
Not on the 40 and doesn’t need to be. This is good timing if it has to happen for Philadelphia. Had they pulled him up it would’ve been much worse
wow, I didn’t see this one coming! I’m totally blindsided by this ( eyes rolling) now seem like every normal fan out there that pays remote attention to baseball know what his problem was in the beginning of Spring training and then the first time he had set back as they called it all his fans knew what was coming but not the Phillies and Andrew themselves so now by not getting a surgery done months ago they’ve now completely lost for 2023 season and the 2024 season. so now this one’s top prospect is not going to pitch in 2 years which is going to either derail his career or set him back seriously. I know people say oh when they come back their arms stronger than before well that’s not in all cases and this guy’s so young either it’s going to ruin his career or it’s just going to delay about a few years and with the Phillies luck I’m going to say it’s going to ruin his career
For all the belaboring by those here about the merits of the “web doctors” here, how many players can you all name that were able to make R&R work for UCL injury recovery? I know of two – Tanaka and Nola. By contrast, every year beyond a dozen players get TJS. Rest and rehab, simply put, does not work. Period, end of story.