Right-hander Felipe Paulino was hoping to be back in the Kansas City rotation Monday but instead likely won't return to the mound until July 2013.
Paulino has a torn ligament in his right elbow and is apparently headed for Tommy John surgery. He will see Dr. Lewis Yocum for a second opinion.
If Paulino has the season-ending surgery, he would be the fourth Royal to require such a surgery this season. Left-hander Danny Duffy, right-handed closer Joakim Soria and right-handed reliever Blake Wood have already had the surgery, all performed by Dr. Yocum.
Paulino said he would opt to have the surgery.
"I don't know why there's such a big number of guys going down with Tommy John surgeries this year, but we're not immune to it by any stretch of the imagination, and our numbers have added greatly to it," manager Ned Yost said.
Paulino was 3-1 with a 1.67 ERA in seven starts this season. He suffered a strained left forearm in spring training and began the season on the disabled list. He suffered a groin strain June 6 and went back on the DL.
Paulino made a minor league rehab start Wednesday for Class AA Northwest Arkansas and left after three innings and 54 pitches when he felt pain in his elbow.
"It really surprised me," Paulino said. "I was just on my rehab, getting ready to make my start Monday, and it just happened. I never felt that before. I was supposed to go three innings, four innings, and in the third inning, something happened."