Jose Fernandez heads to DL with elbow sprain, may face Tommy John surgery

Marlins' ace Jose Fernandez could be the next marquee starter lost to an elbow injury. (Juan Salas/Icon SMI) Another day, another elbow injury, another bright

Marlins' ace Jose Fernandez could be the next marquee starter lost to an elbow injury. (Juan Salas/Icon SMI)

Another day, another elbow injury, another bright young star whose season hangs in the balance. On Monday, the Marlins placed 2013 NL Rookie of the Year Jose Fernandez on the disabled list with a right elbow sprain. The severity of the injury is unknown at this writing, but if it's bad enough, the 21-year-old righty could become the latest pitcher to undergo Tommy John surgery.

Indeed, the Marlins appear braced for such an outcome. From Juan C. Rodriguez, the beat reporter who covers the team for the Sun-Sentinel:

https://twitter.com/JCRMarlinsbeat/status/466012405445959680

Not good. Fernandez first complained of elbow discomfort to manager Mike Redmond following last Friday's start, one in which he was rocked for six runs (five earned) in five innings by the Padres. The five earned runs he allowed tied his major league career high, while the two homers he yielded marked the first time he had been victimized twice in one game. At the time, his uncharacteristically rough outing was explained away by his having dealt with an upset stomach prior to taking the mound, and neither he nor Redmond reported any arm trouble in the wake of his outing.

For all of that, Fernandez's velocity did take an alarming dip over the final innings of Friday's outing. Via the park-corrected PITCHf/x data at BrooksBaseball.net, through the first four innings, his four-seam fastball averaged 95.6 mph, while in the fifth and sixth (when he failed to retire any of the four batters he faced), it dipped to 92.2 mph; his last fastball of the fourth and first of the fifth were a whopping 8.0 mph apart (98.0 to 90.0). Those last two innings are based on small sample sizes, but as this inning-by-inning graph from Brooks shows, in his brief major league career, Fernandez had never failed to generate so little heat with his heater.

With the Marlins in Los Angeles to play the Dodgers, Fernandez underwent an MRI on Monday morning at the Kerlan-Jobe Orthopedic Clinic under the care of Dodgers' team physician Dr. Neal ElAttrache. He has since returned to Miami, where his MRI will be evaluated by Marlins medical director Lee Kaplan. Note that the injury has been reported as a sprain, meaning that a ligament — such as the ulnar collateral ligament, the one whose damage leads to Tommy John surgery — is involved; if it were a strain, it would involve muscles and tendons but not ligament, suggesting that Tommy John surgery was not a possibility. Whether or not he actually needs the surgery will depend on the extent to which the ligament is damaged.

If he does, that's a crushing blow not only to the Marlins, who after losing 99 games last year are off to a surprisingly solid 20-18 start, but also to the baseball world in general, for Fernandez had shown himself to be one of the game's brightest young stars, the mound match for the Trouts, Harpers and Machados. Last year, he finished second in the NL with a 2.19 ERA and 9.7 strikeouts per nine in 172 2/3 innings, a performance that not only garnered him NL Rookie of the Year honors but placed him third in the NL Cy Young voting. Prior to Friday, he looked to be an even stronger Cy Young candidate this year, posting a 1.74 ERA while striking out 12.5 per nine. Even after getting roughed up, he still leads the league in strikeouts (70), strikeout rate (12.2 per nine) and FIP (2.14), though his ERA ballooned all the way to 2.44.

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The Marlins have handled their young ace with care since drafting him with the 14th overall pick in 2011. He threw 134 innings in the minors in 2012, his age 19 season, and was shut down after his September 11 start last year, when he reached his 170-inning target. As a rookie, he averaged 93.2 pitches per start, topping 100 just eight times in 28 turns and maxing out at 109 pitches. This year, he had averaged 98.4 pitches per start, topping 100 three times in eight starts and going as high as 114 in his May 4 start against the Dodgers. The team's eye on his workload goes beyond the number of pitches; via the Miami Herald, here's what Redmond had to say after Fernandez struck out 14 Braves without a walk on April 22:

"Like I said, it just kind of goes from start to start, see how he feels and how effective he is in the zone and how hard he has to work. Sometimes 109 pitches is a max effort for some guys. Sometimes 109 pitches is easy. Last night was an easy 109 pitches. Had he been at around 100 I might have let him go out there to finish the game. We didn't have to make that decision obviously."

If Fernandez does need Tommy John surgery, it would come after he has just 36 major league starts under his belt, the same number as Matt Harvey, the Mets phenom who went under the knife last October after being shut down in late August. He would be the 18th major league pitcher to undergo the procedure this year, matching last year's total; I delved into the numbers and the reasons underlying the trend more extensively here. Via the disabled list data Baseball Heat Maps, here are the previous 17 from 2014:

Pitcher	Team	Date
Cory Luebke	Padres	2/18/14
Luke Hochevar	Royals	3/18/14
Kris Medlen	Braves	3/18/14
Brandon Beachy	Braves	3/21/14
Jarrod Parker	Athletics	3/24/14
Patrick Corbin	Diamondbacks	3/25/14
Bruce Rondon	Tigers	3/29/14
Peter Moylan	Dodgers	4/1/14
David Hernandez	Diamondbacks	4/1/14
Erik Davis	Nationals	4/2/14
Bobby Parnell	Mets	4/8/14
Cory Gearrin	Braves	4/16/14
Matt Moore	Rays	4/22/14
Josh Johnson	Padres	4/24/14
Ivan Nova	Yankees	4/29/14
Pedro Figueroa	Rangers	4/30/14

Such a surgery would end Fernandez's season and knock him out for at least part of 2015, though without any major setbacks he could be back in the majors by next May or June.