Mets general manager Sandy Alderson announced on Monday that Harvey has a partially torn ulnar collateral ligament (UCL) in his right elbow, a dreaded injury for pitchers that, in Harvey's case, may require Tommy John surgery. Whether Harvey needs surgery or opts to rehab the injury without it will be decided in the coming weeks. For now, Harvey will be shut down immediately, headed to the disabled list and likely won't pitch again this season.
"This was a surprise to all of us," Alderson said at a Monday press conference. "Especially Matt himself. He has not had any elbow pain. Forearm pain can foretell problems with the elbow, but in this particular circumstance there had been no indications of that. It's not good news, obviously."
Harvey added later: "It was the last thing I was expecting when I went in this morning."
Harvey has been the bright spot for the Mets this season and one of the breakout MLB stars of 2013. He pitched 178.1 innings with a 2.27 ERA and 191 strikeouts, the fourth most in baseball. Harvey started the All-Star Game for the National League and was a Cy Young candidate.
As Harvey spoke at Monday's press conference, he often referred to getting ready for next season, which signals two things: He knows he's done for 2013 but he's not in a surgery mindset, since Tommy John would put him on the shelf for a full year.
"I'm going to do everything I can so I don't have to get surgery," Harvey said.
The forearm issues have been relatively recent — at least a month or two, Harvey said, but couldn't pinpoint exactly. Harvey had been undergoing routine elbow treatments since spring training aimed at preventing injuries like this one.
"This weekend it was more discomforting than any previous start," Harvey said.
After seeing surgeon Dr. David Altchek (who performed Mariano Rivera's ACL surgery), Harvey had an MRI on Monday, which revealed the partial UCL tear. Now, Alderson said, the Mets will wait a few weeks before determining what happens next.
"The determination will be made by Matt himself with advice from Dr. Altchek and perhaps a second opinion," Alderson said. "These injuries are often progressive, and so it is conceivable that surgery will be necessary. It's conceivable that no surgery will be necessary at this time and may be necessary at some point down the road. We just need to take the time to see how those facts resolve themselves."
If you're looking for a recent parallel case, it's Los Angeles Dodgers pitcher Chad Billingsley, whose season ended last September with a partial UCL tear. Instead of surgery, he rehabbed the injury through the offseason, went through spring training and attempted to pitch this season. He lasted a couple starts before re-injuring himself and opting for Tommy John surgery. Another example, however, is Adam Wainwright who pitched for more than five years after a partial UCL tear.
One surgery-preventing treatment Harvey may seek is platelet-rich plasma (PRP) injections — something that Tommy John-bound pitchers have turned to in the past. There's debate about whether PRP injections help or postpone the inevitable surgery. Baseball Prospectus has a good read about the process. It points that we often hear about when PRP injections don't work (see Orioles top pitching prospect Dylan Bundy) but we don't always hear about when they do. To hear Harvey talk is to hear someone who might seek the help of PRP injections if they can get him back on the mound quicker.
"The last thing anybody wants to do is have surgery if you don't have to," Harvey said. "I know the studies and the history of this type of injury, that usually leads to having the surgery, but everybody's different."
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