DETROIT \u2014 As Tarik Skubal sat in an interview room Monday and discussed his own upcoming arm surgery, there were questions not even he could answer.<\/p>\n
Some of them start with the basics. Skubal has loose bodies in his throwing arm. It\u2019s a fairly common injury and considered a minimally invasive procedure. But what exactly does this funny-sounding injury entail?<\/p>\n
\u201cI\u2019m not sure I\u2019m the best person (to explain)\u201d Skubal said. \u201cI\u2019m a player.\u201d<\/p>\n
Some of the queries venture so much deeper. Skubal, for the record, said he is not overly worried. He hopes to return at some point later this season, \u201cand get back to pitching in the big leagues for the Tigers.\u201d<\/p>\n
But for a pitcher of Skubal\u2019s stature \u2014 a back-to-back Cy Young Award winner in the middle of a contract year \u2014 there are other questions that flow through the minds of so many watching along.<\/p>\n
Some of the questions are answerable. Others will take time to fully unpack.<\/p>\n
What exactly are loose bodies?<\/b><\/p>\n
In the words of Dr. Robert Grumet, an orthopedic sports medicine surgeon with the Hoag Orthopedic Institute, loose bodies are common in high-level pitchers. Hunter Greene of the Reds, Spencer Schwellenbach of the Braves and Edwin D\u00edaz of the Dodgers are among pitchers who have already had similar surgeries this season.\u00a0<\/p>\n
\u201cA lot of pitchers throwing many innings over many years of their life develop a lot of wear and tear in their elbow,\u201d Grumet said. \u201cOver time, they typically get little pieces of cartilage that will break off in the elbow just from repetitive use. Those little pieces will calcify from time to time, moving around inside the elbow. A lot of pitchers can get by OK with them, especially if they\u2019re small. As more accumulate or they start to get a little bit bigger, they\u2019ll start to get caught, kind of like a stick in your bike tire. It will stop that elbow from the ability to move.\u201d<\/p>\n
What does the surgery entail?<\/b><\/p>\n
Skubal is set to have an arthroscopic procedure Wednesday to clean out his elbow. It\u2019s unclear where Skubal is having the surgery or which physician he will work with.\u00a0<\/p>\n
The good news is the surgery is considered simple as arm as arm procedures go. Grumet said the arthroscopy consists of, \u201cLittle keyhole incisions, about a centimenter. Several of them are done on the elbow. They put a little camera on the elbow. They put some fluid inside to insufflate the joint. And through that they can see these loose pieces and be able to grab them and pull them out or use a little shaving device to suck them out.\u201d<\/p>\n
How long does it take to recover?\u00a0<\/b><\/p>\n
The Tigers have declined to share the expected recovery timeline for Skubal. The industry consensus suggests 2-3 months should be typical. But the exact timeline can vary depending on the patient and the extent of the loose bodies in the arm.\u00a0<\/p>\n
\u201cI think 2-3 months is probably reasonable,\u201d Grumet said. \u201cIt could be on the longer end, pushing 3 or even 4 (months) depending how much velocity that particular athlete is trying to get back. I think velocity plays a role. Some of these guys that throw in the high 90s, it might take a little bit longer to get back.\u201d<\/p>\n
Said Shahryar Ahmadi, an orthopedic surgeon at MemorialCare Long Beach Medical Center: \u201cThe spectrum of this one can be all the way from a few weeks to six months. If it involves a big part of the joint and has more extensive arthritis and loose bodies, it can be three to six months. If it\u2019s just a couple of tiny loose bodies, it can be six weeks to a maximum of three months.\u201d<\/p>\n
Could there be complications?<\/b><\/p>\n
Chances are Skubal\u2019s procedure will go smoothly. But any time you open up a pitcher\u2019s arm, greater concerns can arise.<\/p>\n
\u201cThe main thing is you have to know what\u2019s causing all of this,\u201d Ahmadi said. \u201cFor example, a baseball player may have some (ligament) instability that may be causing this. If it\u2019s just some simple arthritis not due to other things, basically just cleaning up is enough. If it\u2019s associated with other stuff like instability, it could be a different story.\u201d<\/p>\n
The fact Skubal previously had Tommy John surgery in 2017 and a flexor tendon surgery in 2022 raises natural concerns. Although it\u2019s impossible to know exactly what Skubal is dealing with from afar, Grumet said initial MRIs likely would have revealed any more substantive damage.<\/p>\n
\u201cThese can happen in isolation. He would have had an MRI in this case that would have shown the integrity of his UCL and his previous Tommy John surgery,\u201d Grumet said. \u201cIt\u2019s unlikely there are any concerns from that perspective. \u2026 Generally speaking, if someone has an unstable UCL, in time they can develop more of these loose bodies. But that doesn\u2019t sound like the case here.\u201d<\/p>\n
What does this mean for Skubal going forward?<\/b><\/p>\n
On MLB Network, former major-league pitcher Dan Plesac put it simply: \u201cIf you\u2019re going to have surgery on your elbow or shoulder, this is the one you would sign up to have.\u201d<\/p>\n
Cleaning up loose bodies generally has a favorable outcome in terms of returning to a previous level of play. So long as there are no larger structural issues in Skubal\u2019s arm, it\u2019s fair to assume he can return to his dominant self once he is cleared to pitch again. Grumet compared it to a meniscus surgery in an athlete\u2019s knee, in that there are generally few, if any, long-term concerns.<\/p>\n
\u201cThis is one of the more predictable surgeries to get back to play,\u201d he said.\u00a0<\/p>\n
Is there any chance Skubal could be traded?<\/b><\/p>\n
The medical portion of Skubal\u2019s return is scientific. The implications of the injury and what it means are left more to speculation.<\/p>\n
Let\u2019s say Skubal returns to the major leagues exactly three months from the date of his surgery. That would be Aug. 6, three days after this summer\u2019s trade deadline.<\/p>\n