On a sweltering June day, Kyle Bradish grabbed his cleats and glove and went to the outfield to warm up for his bullpen session.

It’s a seemingly mundane and boring action, something Bradish has done since he was a child. But just doing that — not thinking twice about going out to throw — is exactly why he got Tommy John reconstructive elbow surgery a year ago, sacrificing a year of his prime with the goals of giving him longevity in his career and pitching one day without excruciating pain.

To get to this point, Bradish has spent a year undergoing long, monotonous days of rehabilitation, of soreness and isolation, as he progressed from learning to do basic life tasks with his new elbow to throwing a baseball.

It was a tedious grind. In an interview with The Baltimore Banner, Bradish explained how he did it.

The decision

Team Bradish — the pitcher, his agent, his two physical therapists and a team of doctors — sat on a call.

It was January 2024, and he had a major decision to make. The season prior, Bradish had cemented his place as one of the best pitchers in the American League, notching a 2.83 ERA and finishing fourth in Cy Young voting. But, while he showed no signs of discomfort on the mound, Bradish was in pain.

So much pain that it took hours of pregame work, including contrast baths — switching between a hot tub and cold plunge — and specialized exercises and stretches, even to get his elbow to a place where he could throw.

It worked, to a degree. But, by the time of that call, his team knew he needed additional intervention. An MRI showed a UCL sprain, and Tommy John surgery was on the table.

He wasn’t ready. He had pushed through the year prior, he said on the call. Why did they have any reason to believe he couldn’t do it again?

“I think there would be some regret doing the surgery before I knew I fully needed it.”

Kyle Bradish

So they settled on a platelet-rich-plasma injection instead. They knew it was just a Band-Aid, but he hoped, just maybe, it would get him through the season.

It helped, some. He allowed just five runs in his first five starts, but in his next two starts the pain was eating at him again. In his eighth start, against the Phillies on June 14, he pulled himself after the fifth inning.

That was the final straw. The next day, he got an MRI. Three days later, he was in Dallas meeting with Dr. Keith Meister to get scheduled for surgery.

“I had been dealing with a lot of elbow pain, so it was just a matter of time,” he said. “I think there would be some regret doing the surgery before I knew I fully needed it.”

The early days

Bradish sat in a hotel room in Dallas, sleepy from the pain meds and anesthesia, with his elbow and leg propped up, not doing much of anything.

A few days prior, Bradish was wheeled into the operating room to have his elbow fixed. Doctors took the tendon out of his leg to use in the repair, so he was on crutches in addition to his arm brace. He couldn’t move his arm. He couldn’t really use his leg. But he felt peace, knowing this was the best decision for him.

“It was a sense of relief, just knowing what I had to do each day to just even go pick up a baseball and throw it,” he said. “It was kind of relief that we were going to get this fixed. Yeah, it’s going to be a long road back, but it’s kind of in the past of doing what I had to do.”

The road back started the week after surgery, when he was cleared to leave the hotel room and travel to the Orioles’ complex in Sarasota, Florida.

His right arm was useless during this period. He tried to use his nondominant arm to accomplish everyday tasks, but that usually resulted in a big mess. When he washed dishes, the kitchen would become a pool of water. Trying to make himself breakfast ended with cracked eggs all over the floor, at a time when bird flu was devastating the egg supply.

“It was $10, and I can’t find any more eggs,” he joked. “It sucked.”

While his teammates up north raced through the season, Bradish’s main goal was to get full extension of his arm back. He’s hypermobile, so that helped, but he was still checking it every day.

“I was just laying in bed, letting gravity get me into that extension,” he said.

By Week 8, he hit that benchmark and was cleared to remove the bulky brace. At 12 weeks, life was pretty much back to normal. He could pick up a glass of water with his surgically repaired arm and cook without disaster.

He still had weight restrictions so, to get his strength back, he used a blood flow restriction machine, which allows for muscle activation without stress.

Rehab, at this point, was boring. Progress was slow, but all of this work was getting him closer to his ultimate goal.

“I think just mentally, just the day to day, you know what you’re going to have to do and it’s the same thing you did yesterday,” he said.

Picking up a baseball again

It was a Wednesday morning in December, six months after his surgery, when Bradish finally got to pick up a baseball.

He had been back in Arizona for two months, Bradish heading to his offseason home after the Orioles were swept in the playoffs. The previous 16 weeks were all about getting to this moment — he could finally start doing lower-body progressions like dead lift, while his upper body work was focused on plyometrics.

As he transitioned to throwing, he was first handed a football, then a plyo ball, before he was allowed to use a 5-ounce baseball.

“It’s heavier, a lot easier to get feedback from it,” said Nick Thurlow, one of Bradish’s physical therapists at Next Era in Arizona. “We’ll use a combination of that, and we’ll use plyo balls. Plyo ball is also a heavier ball, like a 5-ounce baseball, just going to have more proprioception with it. It’s just easier to kind of control and manage right at first, because it’s going to feel like a foreign object if you haven’t thrown in five months.”

His first day of throwing was simple: just a game of catch on flat ground. Still, it’s a major milestone. For the first time in months, Bradish got to feel like a baseball player.

Thurlow thought it looked like riding a bike for him. Dean Kremer, who works out at the same facility, thought Bradish seemed normal and natural, not guarded of the injured ligament as some other athletes are.

Bradish had a different point of view. His arm felt almost stuck, as if he were unable to move it the way he wanted to, and he definitely felt rusty.

“I went back and looked at it, and I was like, that’s tough to watch, but second day was a lot better,” he said.

His main focus for the rest of the offseason was adding volume as he threw at 55-65% intensity. A few weeks into his return to throwing, he could play catch pain free. That was his goal, and after months of work, he finally hit it.

“Kyle’s pretty mainstream, right? He’s just very, he doesn’t get emotional. I think we see that throughout the rehab process,” Thurlow said. “It was like, OK, time to get to work. I’ve got rehab to do. Let’s get it done.”

The last six months have progressed in three-week increments for Bradish, following the plan put in place by his surgeon and physical therapists. First, he increased the distance he threw from — 60 feet, 75, 90, 105, 120 — then the intensity and frequency. They only moved the needle on one area at a time — distance, intensity or frequency — because doing more than one can lead to setbacks. Bradish said he’s thankful he’s had none.

In April, Bradish threw his first bullpen session. And, at the end of June, he traveled back to Sarasota, where he’ll face live hitters for the first time in a year.

If all goes well, he can go on a rehab assignment in late July and make a return before the season is over.

There is no guarantee with a surgery like this. Some pitchers return and are never the same. Others, like John Means, require a second surgery.

So, after a year of relearning how to first extend his elbow and how to throw, does Bradish think it was all worth it and that he can return to, and even exceed, the pitcher he was prior to the pain setting in?

The answer is simple for Bradish: yes. And his teammates agree.

“He’ll throw through anything, so it’s a testament to his bulldog mentality,” Kremer said. “I think he’ll be fine when he comes back.”