It’s ‘rare’ for an injury like Gerrit Cole’s to require surgery: Doctor

TAMPA — The Yankees and Gerrit Cole believe a few weeks without throwing a baseball and a slow ramp-up process will allow the right-hander to pitch this season.

An orthopedic surgeon reached over the phone this weekend agrees.

Cole has been diagnosed with nerve inflammation and edema in his right elbow and has been told he should not throw for three to four weeks.

Crucially, he has been told after various scans and a visit with Dr. Neal ElAttrache that he should not need surgery to fix the ailment.

“Typically it gets better on its own,” said Dr. Eric Bowman, who is also an assistant professor in the department of orthopedic surgery at Vanderbilt University Medical Center and the head team physician for the Triple-A Nashville Sounds and Vanderbilt. “I’d say 90 percent of the ones I see typically get better. It’s rare that it would move on to needing to be addressed surgically.”

According to Bowman, the nerve is likely the ulnar nerve, on the inside of the elbow. Ulnar nerve issues are common with pitchers, whose motion puts a lot of tension on the nerve.

Edema, meanwhile, is the medical term for swelling and also is common for pitchers.

Edema is “generally a sign of stress — stress in the bone essentially,” Bowman said. “We see it sort of at the beginning of the season, as we start to ramp up and the bone and the supporting ligaments and muscles are adjusting to the stress. And then we see it later in the season, too, when fatigue starts to set in.”

Cole, who had thrown in one Grapefruit League game and one 37-pitch, live batting-practice session, said he got a “little too hot a little too quick in spring,” in explaining the cause of the injury. That sounded right to Bowman.

The two issues conspired to cause discomfort, but no doctor has spotted a tear in Cole’s UCL, which likely would have prompted surgery. There are instances when nerve inflammation and edema can lead to surgery, but those instances are rare, Bowman said.

Bowman, who has not evaluated Cole, said generally pitchers would need two to seven weeks of inactivity before beginning to throw again, depending upon the severity. The Yankees are pinpointing three to four weeks.

Whenever Cole picks up a ball again, he will need about six weeks — essentially a full spring training — to stretch out his arm to where it needs to be. If Cole begins throwing in early April, the earliest he could debut would be at the end of May.

Considering the alternative, the Yankees would gladly sign up for merely two missed months from their ace.

“The good news is that the vast majority of these calm down, given rest and rehab, and they don’t progress on to something else,” Bowman said.