OC Register: Keynan Middleton added to list of Angels pitchers with UCL injuries

[AngelsWin.com]

ANAHEIM — A day after Keynan Middleton walked off the mound with a sore elbow, the MRI exam came back with the bad news.

Middleton has a damaged ulnar collateral ligament and will seek a second opinion, the Angels announced on Monday.

Pending that opinion, there is no prognosis for the type of treatment or the amount of time Middleton will miss. Depending on the type of damage to his UCL, Middleton could be headed for Tommy John surgery and a rehab of 12 to 18 months.

“It’s tough news, but let’s not get ahead of ourselves,” Manager Mike Scioscia said. “Let’s take it one step at a time.”

Even if the Angels opt for non-surgical treatment, like stem-cell therapy, Middleton would be out for a matter of months.

Middleton is the sixth Angels pitcher to have some degree of UCL damage since August 2014, when Tyler Skaggs underwent Tommy John surgery. In April 2016, both Garrett Richards and Andrew Heaney suffered UCL injuries and underwent stem-cell therapy.

In Richards’ case, it successfully healed the ligament, although he came down with a separate injury the next year. Heaney ended up having Tommy John surgery. Nick Tropeano, who was diagnosed with a damaged UCL in July 2016, ended up having Tommy John surgery in August.

Last year, JC Ramírez was injured in August. He appeared to be a stem-cell therapy success story until last month, when the ligament gave way and he succumbed to surgery.

Although at first blush it seems the Angels have had a poor track record with keeping their pitchers healthy, it’s an industry-wide issue. General Manager Billy Eppler last year cited statistics that the Angels were in the middle of the pack with regard to pitching injuries.

The Angels have tried changing personnel with the medical and training staffs, including a significant staff makeover between 2016 and 2017.

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“I know our medical department is on the cutting edge of everything that’s out there,” Scioscia said. “Since I’ve been here, the first 12 years really no Tommy Johns, and in the last couple years we’ve got hit with some. Billy is looking into everything. The medical department is looking into everything, as all of baseball is.”

Middleton’s absence, for however long, is a blow to a bullpen that has been in flux. Middleton has a team-leading six saves and a 2.04 ERA. He had emerged as Scioscia’s preferred closer, although the manager had never publicly named him the closer.

Jim Johnson, Cam Bedrosian and Blake Parker have all closed games at various times for the Angels. Even rookie Justin Anderson, who has been dominant at times, got an opportunity to close, but he couldn’t convert.

“I think we have a lot of guys,” Scioscia said. “I don’t think we ever had one guy that was the ninth-inning guy. We’ve got some guys in the back end who are going to have to get outs for us. How they line up in a certain game will be dictated by how the game unfolds and the match-ups. We’re confident we have the arms down there that will get the outs we need.”

If the Angels look outside the organization for bullpen help – as they might have done even before Middleton’s injury – pitchers like the Kansas City Royals’ Kelvin Herrera and the Tampa Bay Rays’ Alex Colome figure to be available. Generally, it’s difficult to make those type of trades this early without overpaying, though.

ALSO

The Angels recalled right-hander Felix Peña from Triple-A to take Middleton’s roster spot. Peña had competed for a spot in the bullpen during spring training, but the Angels moved him to the rotation at Triple-A last month. “He’s throwing the ball very well,” Scioscia said. “There is no doubt he can come in and give us the two-plus, three-plus innings to give us a bridge to get to certain match-ups later in the game.” …

Blake Wood (elbow impingement) pitched a scoreless inning in a rehab assignment for Class-A Inland Empire on Monday. Wood could be activated any day, or he might pitch again in the minors. …

Parker Bridwell (elbow inflammation), who has been on the Triple-A disabled list, pitched on Saturday at extended spring training in Arizona. He is scheduled to return to action at Triple-A on Friday, according to Eppler. …

Matt Shoemaker said he has two days worth of appointments scheduled with a nerve specialist in Missouri, on Wednesday and Thursday.

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