Royals closer Joakim Soria is out with an elbow injury. It isn't one of those day-to-day elbow injuries that don't even really count as injuries. Soria's got something nasty going on. Tests showed damage to his ulnar collateral ligament. Further tests showed damage to his ulnar collateral ligament. That's the ligament that comes out and gets replaced by another ligament in Tommy John surgery.
And it does look like Soria is headed for Tommy John surgery for the second time in his career. Writes Will Carroll at SI:
When an exam comes "a couple days" later and is done by Lewis Yocum (or any of the supersurgeons), it's not a good sign. The usual reason is that there's swelling, which makes getting a clear image on an MRI tough, even using advanced magnets and contrast dye [...] Soria had his UCL reconstructed in 2003 and the "honeymoon period," during which the ligamentization process appears to be protective, is gone. A significant tear would cost Soria the season and another run through Tommy John rehab.
Closer Joakim Soria will take a couple of days off to consider what to do about his ailing right elbow, Royals officials said on Wednesday.
Soria has returned from a visit with Dr. Lewis Yocum, an elbow specialist in Los Angeles, after tests showed damage to the ulnar collateral ligament. That's a problem often resolved by Tommy John elbow reconstruction surgery, which Soria already has undergone once in his career.
As suggested by the headline, Soria has options, and while we don't know for sure what those options are, usually in these cases the options are (1) Tommy John surgery, or (2) rest and rehabilitation. If the tear in the UCL is bad enough, the latter isn't an option, so we can guess that Soria is dealing with a partial tear. Even so, players who go the rest and rehabilitation route very often end up having surgery anyway, with the rest and rehab serving more as a delay than anything else. So Soria's going to have to make a difficult choice. Presuming that he has surgery and rehab on the table, he's already gone through the former once before, and obviously recovered quite well. The latter has a chance to lead to a faster recovery, but also runs the risk of delaying recovery.
As is, if Soria has Tommy John surgery, he would miss the 2012 season and maybe the beginning chunk of 2013. Because of his experience that would be a less daunting option than it would be for other pitchers, but it's not an easy thing to choose.