The Yankees and Gerrit Cole are optimistic that a few weeks without throwing a baseball, followed by a gradual ramp-up process, will allow the right-hander to pitch this season.
An orthopedic surgeon consulted over the phone this weekend concurs with this approach.
Cole’s diagnosis includes nerve inflammation and edema in his right elbow, with doctors advising him not to throw for three to four weeks.
Importantly, after undergoing several scans and a consultation with Dr. Neal ElAttrache, it has been determined that surgery should not be necessary to address the issue.
“Typically, it gets better on its own,” said Dr. Eric Bowman, who is an assistant professor in the department of orthopedic surgery at Vanderbilt University Medical Center and the head team physician for the Triple-A Nashville Sounds and Vanderbilt. “I’d say 90 percent of the ones I see typically get better. It’s rare that it would move on to needing to be addressed surgically.”
According to Bowman, the affected nerve is likely the ulnar nerve, located on the inside of the elbow. Ulnar nerve issues are common among pitchers, whose throwing motion places significant tension on the nerve.
Edema, on the other hand, is the medical term for swelling and is also common among pitchers.
“Edema is generally a sign of stress — stress in the bone essentially,” Bowman explained. “We see it at the beginning of the season as we start to ramp up, and the bone, along with the supporting ligaments and muscles, adjusts to the stress. We also see it later in the season when fatigue starts to set in.”
Cole, who had participated in one Grapefruit League game and one 37-pitch live batting-practice session, attributed the injury to getting “a little too hot a little too quick in spring.” Bowman agreed with this assessment.
The combination of nerve inflammation and edema caused discomfort for Cole, but no tear in his UCL has been identified by doctors, which would likely necessitate surgery. While there are rare instances where nerve inflammation and edema lead to surgery, Bowman stated.
Bowman, who has not examined Cole, mentioned that pitchers typically require two to seven weeks of rest before resuming throwing, depending on the severity. The Yankees are aiming for three to four weeks.
Once Cole resumes throwing, he will need approximately six weeks, essentially a full spring training, to build up his arm strength. If Cole starts throwing in early April, the earliest he could return to action would be at the end of May.
Given the alternative, the Yankees would willingly accept just two months without their ace.
“The good news is that the vast majority of these calm down, given rest and rehab, and they don’t progress to something else,” Bowman explained.
