Harvey first experienced issues with his elbow in early August. However, he was able to pitch through it for a couple of starts before noticing something "alarming" in his last start. He was immediately sent for an examination with Dr. David Altchek, the Mets' team physician and one of the top elbow orthopaedists in the game.
At that point, it was suggested that Harvey undergo Tommy John surgery, but he elected to wait after consulting with advisors, physicians and other pitchers who have gone through the process. Harvey said that he was convinced in large part by Roy Halladay, who rehabbed an elbow injury in 2006 and went on to have some tremendous years. His visit with Dr. Andrews kept him on that path.
(One note here: I looked back at my articles from 2006, when Halladay had his issue. None of my information at that time indicated an elbow problem. Halladay had forearm issues that were associated with the development of a cutter and with a comebacker that hit him near the elbow. I took a lot of flak from the team for suggesting that forearm issues often morph into elbow issues. Nice to know I was right at the time!)
The positive here is that Harvey must have a very low-grade sprain of the ulnar collateral ligament.
The majority of surgeons will advise surgery when the tearing is between 25 and 33 percent. Most that go under the knife have very significant, if not complete, tears. If Harvey is able to avoid surgery by strengthening the elbow and letting the ligament heal, he will have bought time while retaining only the limited downside of losing a year to surgery and rehab.
In essence, rehab may buy six free months of Matt Harvey. Imagine what that could be worth.
Harvey becomes the latest in a long line of young power pitchers who have faced Tommy John surgery. Pitchers have had success through rehab, including Adam Wainwright and Nolan Ryan. Both pitched for years without further problems, enjoying plenty of success before the ligament failed.
There is no downside here besides the potential for a lost year. Pitchers tend to come back virtually unchanged. The velocity is at the same level. The pitching repertoire is no different, and significant modifications to the mix of pitches aren't required. Suggestions that the slider or cutter contribute to the problem don't seem to subside, though the data is admittedly shaky.
Overall, there's no reason that Harvey won't return to his "ace" form the same way that so many others have.
The biggest issue for the Mets is that despite doing everything within their power to keep Harvey healthy, it was an unreasonable task.
While he may come back the same pitcher, that is the same pitcher that got hurt. Harvey did not have high pitch counts, was thought to have good biomechanics and is in excellent physical condition. The same was true for Stephen Strasburg and top prospect Dylan Bundy, who had Tommy John surgery earlier in 2013 after trying to rehab through a forearm issue.
Harvey avoids becoming the latest statistic in the saga of Tommy John surgery. Research done earlier this year for my series on Dr. Frank Jobe and Tommy John surgery showed that one in three current major-league pitchers has had the surgery. Anecdotal research indicates the numbers are comparable in the minor leagues.
While I understand why fans and the Mets front office may want a definitive answer, it's Harvey's arm and Harvey's decision. Tommy John surgery is not an easy process, nor is it perfect. Ask Daniel Hudson, who underwent a second Tommy John surgery after reinjuring the ligament in rehab, or Ryan Madson, who still hasn't made it back after two lost seasons in the wake of surgery.
It remains to be seen whether the rehab process will work, but in the meantime, Mets fans can hold out hope for 2014 while knowing that 2015 is a sure thing. There's no question that Matt Harvey will be back to being a top young pitcher, but the question is when.
For more on Matt Harvey's injury, please read this piece that I wrote at the time of the first announcement.
Will Carroll has been writing about sports injuries for 12 years. His work has appeared at SI.com, ESPN.com and Baseball Prospectus.
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