KANSAS CITY, Mo. — Further testing on Matt Moore's left elbow Wednesday revealed a tear in the ulnar collateral ligament. The Rays and Moore are deciding on the next step, which is either surgery or rehabilitation.
“Honestly, let's just wait until (today). I don't have everything in,” Rays manager Joe Maddon said after Wednesday's 7-3 loss to the Royals. “It needs to be looked at a little more deeply, because it's not a slam-dunk surgery right now.”
Moore, placed on the disabled list Tuesday with left elbow soreness, could miss at least a month if he chooses to rehab without surgery. If the 24-year-old opts for the reconstructive surgery known as Tommy John surgery, he will miss at least 12 months.
Moore left Monday's loss to the Royals in the fifth inning complaining of pain in his left elbow when he threw his change-up. He said the pain was similar to, but not as severe as, the pain in the same location he experienced last summer that forced him to the disabled list for more than a month.
An MRI taken Tuesday in Kansas City was inconclusive, so Moore flew Wednesday to Pensacola to visit top orthopedic surgeon James Andrews for another MRI.
This time, contrast dye was injected into the elbow for better results, and those results showed a tear.
“I don't think it's fully torn, from what I understand,” Maddon said.
Moore said Tuesday he was hoping the injury was just bruising from the ligament rubbing against something in his arm while he threw the change-up, because the pain did not occur when he threw his other pitches. He also said he didn't feel a pop, which some pitchers experience when they completely tear the UCL.
“Maybe something clicked in there,” Moore said. “Maybe I got little aggressive out front with one of the change-ups and something rubbed wrong or clicked, and once you kind of hit something, it kind of just stays around for a second.”
A tear would explain why the velocity on Moore's fastball has decreased since 2011, when he arrived on the scene in September with a flourish, throwing in the high 90s.
Moore worked on the mechanics of his delivery during spring training, moving the location of his hands back to where he held them during the 2011 season. He worked on getting his front foot down quicker in order to bring his arm through the delivery quicker.
Moore also spent the winter in Arizona working with his former trainer to strengthen his core muscles. He thought his decision to modify his normal offseason workout routine before the 2013 season led to his arm injury.
Maddon said he was hoping to have a relaxing off day today in Cincinnati. Now, he will spend some of it on the phone with Andrew Friedman, the Rays' executive vice president of baseball operations, talking about Moore's long-term future and the short-term future of the rotation.
“What Andrew wanted to do is discuss it in more depth (today) based on the results we're getting,” Maddon said.
Rehabbing a partially torn UCL doesn't always work, and the pitcher usually ends up having the surgery. Opting for the surgery now would mean Moore could return sometime during the early part of next season. Waiting to see if rehab is the solution could result in Moore missing most of or even all of 2015 if the rehab doesn't work.
Meanwhile, Maddon said he will have a decision Friday on who starts Sunday in Moore's place. It will be Cesar Ramos or Erik Bedard, who competed this spring along with Jake Odorizzi for the fifth spot in the rotation.
Bedard had Tommy John surgery earlier in his career.
“We need to get all the facts and decide how we want to proceed with this,” Maddon said of Moore. “See if surgery is necessary, if it's not necessary. We're still waiting to find out.”