The streak is over. Whether you count Jason Isringhausen against the Tampa Bay Rays or not, it's still an incredible streak of health. It doesn't help Matt Moore now, as detailed by USA Today, who tested the elbow out on Monday afternoon and immediately knew that rehab wasn't going to work. He'll now head to Dr. James Andrews for ligament reconstruction and a year of rehab. Sadly, this went exactly how Angel Borrelli expected.
Quick story: Several years back, I was at the ASMI Injuries in Baseball course that Dr. Andrews and Dr. Glenn Fleisig put on. One of the presenters was Ken Crenshaw, then the head athletic trainer for the Rays and now in the same position with the Arizona Diamondbacks. He presented a great case about Tommy John rehab, including some new methods of regaining proprioception earlier in the process.
I caught him after the presentation and asked him how Seth McClung was doing. Ken was a bit surprised, since as with any medical presentation, there were no names and they'd blacked out the pitcher's face in pictures. "How did you know it's McClung?" he asked me. It was simple. They'd had no other Tommy John rehabs in the previous 24 months.
The Rays have been good at this for a while and jealously guard their methods. As I detailed in the article about Moore's injury, there are hints as to what some of these are, but it's not clear how they all come together. One of the biggest questions I have is why the methods don't travel. Crenshaw has been with the Dbacks for a while, and Nick Paparesta, another former Rays AT, has been with the A's for a couple seasons now. Neither team has nearly the same results that the Rays do, despite having great medical staffs.
Moore immediately felt pain during his throwing session, and sources tell me they weren't surprised. Pitchers have to be led to the decision and have to make it themselves. Moore is known as a hard worker, so he should have no real issues coming back from surgery. He also has the security of a long-term deal to help.
The Rays will have to deal with Moore's loss in the short term as they work to get Jeremy Hellickson back from his own minor elbow surgery. They have a number of possible solutions, but none are as good as Moore. Even though modern sports medicine can get players back, the loss is seldom as clear as it might be this season for the Rays.
Moore may well be able to come back and be the ace the Rays are likely to need if they lose David Price, but there's a lot more questions now for Moore, for their young prospect pitchers and for whether anything can help young pitchers avoid surgery.