The elbow debridement surgery Grayson Rodriguez underwent Monday officially ends his 2025 season before he could throw a meaningful pitch for the Orioles, but the operation wasn’t an overly intrusive one and Rodriguez should be available to return ahead of spring training in 2026.
The operation, which removed a bone spur, was performed by Dr. Keith Meister in Dallas, the club announced — the same surgeon who often performs Tommy John elbow reconstruction surgeries for Major League Baseball pitchers. The Orioles consider it successful.
An elbow surgery for a pitcher tends to worry a fan base about a lengthy absence for a player. But a debridement surgery is much different than the ulnar collateral ligament operation known as Tommy John.
As explained by Dr. Bashir Zikria, an orthopedic surgeon specializing in sports medicine at Johns Hopkins, most pitchers who undergo an elbow debridement surgery to remove a bone spur can begin their throwing program within three months.
Zikria hasn’t personally worked with Rodriguez. But from his experience as a team physician for the Orioles from 2008 to 2019 — and through work with other professional athletes — Zikria spoke generally about the construction of a pitcher’s elbow and how the taxing act of throwing a baseball can lead to bone spurs.
Zikria said bone spurs develop in response to stress on certain parts of the body. For instance, if the ulnar collateral is ”stretching a little bit,” he said, “the bone spur’s trying to stabilize the elbow a little bit.”
It’s a phenomenon called Wolff’s Law: “You make bones in response to stress,” Zikria said.
“The elbow is not used to throwing 90-plus, and nowadays they’re throwing 95-plus for 100 pitches a game, right?” Zikria said. “That’s a completely abnormal physiological mechanism for the elbow.”
Often, athletes will start with physical therapy to see if they can take the stress off the bone when spurs develop, Zikria said. And if that doesn’t work, there’s the procedure to remove them.
“Now, you have to balance it between the bone and ligament. If you take too much bone, the ligament takes too much force,” he said.
In an appearance on Foul Territory, Rodriguez said he has dealt with this elbow impingement for three to four years.
“And now it’s just to the point where you can’t really push through it,” Rodriguez said. “You don’t want to play through an injury and then it starts to turn into something else that’s something severe. Obviously, it’s frustrating. … We have to get this thing fixed and do everything we can to get back out there and get back to being healthy.”
During spring training, Rodriguez stopped throwing after he began to feel an elbow impingement. He received a cortisone shot and underwent physical therapy before beginning a throwing program once more.
In general, the cortisone shot is a “Band-Aid,” Zikria said.
“You’re just putting cortisone to decrease the inflammatory response,” Zikria said. “The cortisone is just to help him get through the therapy and get through the throwing program. If you have a bone spur, you can’t get rid of it unless you have surgery, right? But maybe they were trying to get him through the season and reevaluate it in the offseason.
“Just like a lot of guys we see in football. I cover football, too, and we see them in the middle of the season, they dislocate their shoulder. We would do some therapy, give them anti-inflammatories and try to get them through the season. If we can’t, then they need surgery just like him.”
Rodriguez was further set back by a lat strain — a recurring issue throughout his career — that prevented him from making progress with his elbow. But once healthy, Rodriguez’s elbow discomfort appeared once more.
Interim manager Tony Mansolino said in July that Rodriguez would be pulled back from his rehab process due to the discomfort.
After further imaging, surgery was recommended. At the beginning of August, general manager Mike Elias said the surgery wasn’t done earlier because physicians opted “to treat the injury conservatively before we go diving into an elbow surgery.”
It became clear to Rodriguez, however, “that I can’t pitch through this,” he said on Foul Territory.
“Rehabbing through the first half of the season, you kind of get to a point where it’s like, ‘OK, I’ve dealt with this for three or four years now, and now it’s just to the point where it just sucks, it just won’t go away,’” Rodriguez said. “I have to get it taken care of in order to be who I want to be next season.”
The lat and elbow issues could be related, Zikria said, given the kinetic chain required to hurl a baseball.
“If the lat is hurting him, then his elbow slot and elbow mechanics are going to be off,” Zikria said. “It can be the other way around. Now, the elbow mechanics get off, it makes the lat worse. They’re related. It’s the kinetic chain. It starts from your lower body all the way up through the upper body, and the last part of the kinetic chain is when the ball releases. … Right when the ball releases, during the follow-through, if the lat doesn’t slow your arm down, the inertia is going to keep taking you. Even the posteromedial impingement is during the follow-through, too. So, this is all related.”
But in the grand scheme of surgeries, what Rodriguez underwent Monday is not extreme. It still carries inherent risk, but from Zikria’s outside perspective, Rodriguez will be ready for next season.
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