A’s closer Rosenthal could require thoracic outlet surgery

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After opening the season on the injured list due to a shoulder problem, Athletics closer Trevor Rosenthal could now require thoracic outlet surgery to address the injury, manager Bob Melvin announced to reporters Wednesday (Twitter link via Shayna Rubin of the San Jose Mercury News). It’s a sudden and troubling development for a struggling A’s club. The procedure would come with “at least” a 12-week recovery time, Matt Kawahara of the San Francisco Chronicle tweets. The right-hander is weighing his options and is expected to make a decision in the near future.

Rosenthal, 30, spent much of the offseason seeking a lucrative multi-year deal after turning in an absolutely dominant performance between the Royals and the Padres last season. However, when he wasn’t able to find a long-term deal to his liking, the hard-throwing righty opted for a one-year deal at a strong $11M rate to serve as the closer at the pitcher-friendly O.Co Coliseum.

It was a surprise investment for an A’s club that spent most of the winter idling on the sidelines as teams throughout the league sifted through the free-agent market. Only after the A’s were able to shed a notable portion of Khris Davis’ contract did they enter the free-agent waters, and even then, their initial expenditures were modest, one-year commitments to Yusmeiro Petit, Sergio Romo and Mitch Moreland. Rosenthal was an entirely different type of spend, and it’s now an open question whether they’ll get any real return on what was a major splash by their standards.

Thoracic outlet syndrome is the latest in a series of setbacks for Rosenthal, who broke into the league as one of the game’s most dominant young relievers with the Cardinals but has since struggled to stay healthy. Tommy John surgery wiped out Rosenthal’s entire 2018 season, and when he returned with the Nationals in 2019, he developed a sudden case of the yips. Rosenthal walked 26 of the 85 batters he faced between Washington and Detroit that season. He also hit another four batters and snapped off nine wild pitches in just 15 1/3 innings. He tried to find himself with the Yankees’ Triple-A club but faced just five hitters with Scranton, issuing three walks, hitting a fourth batter and throwing another wild pitch.

Those immense struggles made Rosenthal’s comeback in 2020 all the more remarkable. Not only did he rediscover some big-league success, he emerged as one of the most dominant relievers in all of baseball. Through 23 2/3 innings between Kansas City and San Diego, Rosenthal notched a 1.90 ERA with an overpowering 41.8% strikeout rate, a strong 8.8% walk rate and a fastball that averaged 98.1 mph. It was vintage Rosenthal.

From here, the future is sadly muddied once again. The track record for pitchers coming back from thoracic outlet surgery is generally poor, and few pitchers have undergone both Tommy John surgery and a TOS procedure in such close proximity. Matt Harvey is the most prominent example of a pitcher to undergo both operations in a short time, missing the 2014 season due to Tommy John and then undergoing TOS midway through the 2016 campaign. Obviously, he’s been unable to rediscover the dominant form he displayed early in his career.

There are certainly success stories among pitchers who’ve had surgery to correct thoracic outlet syndrome. Recently retired righty and current Rangers general manager Chris Young credited the procedure with saving his career, and Rosenthal’s former Cardinals teammate, Jaime Garcia, enjoyed a productive three-year stretch upon returning from his own TOS operation.

For the Athletics, the new development on Rosenthal means they’ll be extra reliant on veterans like Romo, Petit and Jake Diekman in the late innings. Right-handers Lou Trivino and J.B. Wendelken have had their share of success in the big leagues as well; Wendelken in particular has been quietly dominant dating back to 2018. The A’s also have a former top-10 overall pick, left-hander A.J. Puk, as an intriguing option in the ’pen this year as he looks to put his own injury woes in the rear view mirror.