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Rangers ace Jacob deGrom needs elbow surgery, will miss rest of 2023 season

The Rangers didn’t have the words, but they got the answers they needed about deGrom’s elbow.

Update:
A previous version of this story said deGrom required Tommy John surgery, but the full extent of the surgery needed on his elbow will be determined at a later date. The story has been updated throughout since it was originally published.

ARLINGTON – The Rangers couldn’t even bring themselves to utter the words Tuesday.

Oh, they knew this was a possibility when they signed Jacob deGrom to a $185 million deal as the main thrust in overhauling their pitching staff during the winter. They knew the chances of a traumatic arm injury were real. The only thing equal to his immense pitching talent was the immense injury risk that accompanied it.

Still, when it became real Tuesday, two months and just six starts into deGrom’s five-year deal, GM Chris Young never mentioned the scariest words in the pitching medical dictionary: Tommy John surgery. For the record, it’s “ulnar collateral ligament repair surgery.”

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“I don’t know the specific terminology,” Young said. “Some of that will be determined in surgery, but the latest pictures show we’ve gone backwards in terms of structural damage. And it is significant compared to what we saw originally, which was inflammation.

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“It’s obviously a tough blow for Jacob and certainly for the Rangers, but we feel this is what is right for Jacob and his career. It’s unfortunate, but now we have clarity and can move forward.”

Typically, the repair involves harvesting a ligament from either the wrist or knee area and transplanting it to replace the damaged ligament in the elbow. The procedure was named for Tommy John, the former pitcher whose career was saved by the procedure in the 1970s.

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More recently, some patients have qualified for “internal brace surgery,” which requires less recovery time. Ultimately, Rangers team physician Dr. Keith Meister, perhaps the national leader in performing Tommy John surgery procedures, will make the determination on the table during the surgery next week. Tommy John surgery typically requires 12-15 months of recovery; the internal brace can be half that.

The name of the procedure didn’t matter to deGrom. He’s had Tommy John once before, in 2010, shortly after the New York Mets selected him in the draft. All he knew Tuesday: His season is over. Again. It brought him to tears. It took just one question.

Asked how he was doing, deGrom said: “I’m alright.”

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Then he wasn’t.

Arms crossed, he broke into tears, paused, wiped them away and then started again. But tears kept welling up in his eyes.

“Anytime you are told you are going to be out for a little while, it’s tough,” deGrom said, then sniffled. “But I went through this before and I know what it takes to get back. So that means go to rehab, be around, help anyway I can. We’ve got a special group here and to not be able to be out there stinks. This is what we love to do. You want to be out there helping. It’s a disappointment.”

For deGrom, the disappointment mounts. He won back-to-back NL Cy Young Awards in 2018-19, but he missed most of the last two seasons with the New York Mets with arm issues. His health had become a tension-filled topic in New York. In 2021, acting Mets GM Sandy Alderson said that deGrom had recovered from a UCL sprain and described it as the lowest form of a partial tear. DeGrom took issue with that description at the time.

“I know what was said, but my ligament is perfectly fine,” deGrom told reporters in September of that season. “I wouldn’t be throwing if I had a compromised ligament.”

He did not pitch again in 2021. In 2022, he missed the first four months of the season with a stress reaction in his right scapula. He ended up pitching only 64 innings.

When the Rangers landed him this winter, the five-year, $185 million deal (with a complicated sixth-year option that could have raised the deal’s value above $200 million) raised eyebrows around the game. The Rangers knew the risk. It was virtually impossible to insure the first year of the contract because of his injury history. The Rangers decided to forego that and intended to revisit after the season. Premiums are likely to rise even higher after the latest surgery. The surgery likely puts the sixth-year decision firmly in the Rangers’ hands. The sixth year becomes a club option due to a clause relating to elbow or arm surgery.

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The Rangers proceeded on deGrom because they felt landing deGrom could change other pitchers’ view of the club. As a result, they overhauled the entire rotation. It’s worked. The Rangers began Tuesday with the second-best ERA in the majors at 3.16 and the second-most innings from starters.

The Rangers’ attempt to handle him with care. He arrived at spring training with some side soreness and was put on a very slow track. Though he started the season opener, as planned, he was on a restrictive pitch count. Three starts later, he left an outing against Kansas City with a no-hitter through four innings because of what was termed wrist soreness. DeGrom said at the time that the issue was minor but didn’t want to overcompensate in his delivery and create a more serious physical issue.

He pitched six days later and then against the Yankees before exiting with the elbow issue, bringing him to 30 innings for the season. Over the last month, he had thrown five different bullpen sessions, with wildly differing results. Most recently he threw in Detroit before leaving to attend the birth of his third child. The session didn’t go great, but he didn’t cut it short.

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“I’d have days where I felt really good and days when I didn’t feel great,” he said. “I was kind of riding a roller coaster there for a little bit. I’d have a good bullpen and think I was moving in the right direction. The next day would come, and it didn’t feel great. It was like: ‘This is acting really weird’.”

So, the Rangers and deGrom decided to get more certain answers. They got them on Tuesday. Even if it was impossible for them to say the exact words.

Twitter: @Evan_P_Grant

Correction, 10:50 a.m. Wednesday: A previous version of this story stated Jacob deGrom underwent Tommy John surgery in 2011. He had the surgery in 2010 and missed the 2011 season.

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