The twinge shot up Luke Hochevar’s right arm on perhaps the second-to-last pitch of his checkered Royals career. He finished the frame Monday afternoon, but a subsequent MRI revealed a sprained ulnar collateral ligament in his elbow and strained muscle tissue around the joint, a diagnosis that could result in season-ending Tommy John surgery.
For now, the club has prescribed three weeks of rest. Doctors cannot render a judgment on Hochevar’s condition until this period of inactivity passes, and he resumes a throwing program.
The organization hopes he can return to big-league action by the end of May — and that’s the “best-case scenario,” manager Ned Yost said. Hochevar will visit Neal ElAttrache, the Dodgers’ team physician, for a second opinion Tuesday in Los Angeles.
A sprain means a stretching or tearing of the ligament. The severity of the injury is unclear, although team officials remain hopeful Hochevar can recover during his time off. Multiple messages left for Hochevar’s agent, Scott Boras, went unreturned. But the specter of surgery now looms over Hochevar, a key component of the team’s outstanding bullpen in 2013.
“Hopefully he responds,” general manager Dayton Moore said from Clearwater, Fla., where he attended a memorial service for Jim Fregosi. “We’ll just have to wait and see.”
For Hochevar, the first overall selection in the 2006 draft, the timing is devastating. He will be a free agent after this season. The Royals tendered him a $5.21 million contract for 2014. He had survived six miserable campaigns as a starter and emerged as a relief revelation last season. He posted a 1.92 ERA, the fifth lowest mark among relievers who threw at least 70 innings.
Now his immediate future is unclear. The injury also carries consequences for the team’s roster. Manager Ned Yost reduced the fifth-starter competition to a three-man race among Yordano Ventura, Danny Duffy and Wade Davis. Louis Coleman could fill the void in the bullpen.
On the surface, Yost projected optimism. The diagnosis did not reveal damage that required an immediate operation.
“I think we were a little bit nervous that it could have been worse,” Yost said, before adding the obvious caveat. “But you really won’t know until three weeks, to see where we’re at.”
In the medical community, “sprain” is a vague term, explained Glenn Fleisig, the research director at the American Sports Medicine Institute in Birmingham, Ala.
“A ‘sprained UCL’ doesn’t mean anything — it means everything,” Fleisig said. “A sprain just means it’s injured. So if a guy has a complete tear, and has to have surgery tomorrow, they say it’s a sprain. If the guy is a little sore and he needs a few days off, it’s a sprain.”
Hochevar declined to speak with reporters. He appeared somber in the clubhouse. He conversed with Bruce Chen, who underwent Tommy John surgery in 2008. After a conversation in the morning, James Shields described Hochevar as in “decent spirits.”
“When you get hit with something like that, it’s not very good news,” Shields said. “Hopefully he can get out of this.”
To Moore, Hochevar’s history provided a reason for optimism. During the 2010 season, Hochevar strained the same ligament. He missed 71 games, but returned to finish the season that September. He did not require surgery.
“It’s never good,” Moore said. “The silver lining is Hoch has had some of these setbacks before.”
The organization rejoiced in Hochevar’s performance in 2013. He had suffered through so much as a starter. Now, they can only hope his elbow will allow him to aid the club this season.
“We trust in Hoch,” Moore said. “We trust in him as a person and as an athlete, to do everything in his power to get back on the field for us.”