Matt Harvey Weighing Thoracic Outlet Syndrome Treatment Options

Mets righty Matt Harvey has been found to have symptoms consistent with thoracic outlet syndrome, GM Sandy Alderson told reporters including MLB.com’s Anthony DiComo (Twitter link). Harvey is still weighing whether to have season-ending surgery now or instead to undergo a therapy for the time being. ESPN New York’s Adam Rubin writes that the alternative to surgery would be a nerve-block injection, though that would merely be a temporary fix to the problem at hand. Surgery to alleviate his symptoms are inevitable, but it’s possible that he could delay the procedure until the offseason if he elects the injection route.

Harvey’s dilemma marks a continuation of injury problems that have impacted the Mets’ much-ballyhooed young rotation. Right-hander Noah Syndergaard is pitching through a minor bone spur in his right elbow, while lefty Steven Matz is currently pitching through a bone spur in his own elbow that is said to be larger than that of Syndergaard. And, of course, the Mets have been without the highly talented Zack Wheeler since 2014, as the now-26-year-old righty underwent Tommy John surgery just prior to Opening Day 2015. Notably, DiComo tweets that Wheeler isn’t an option to replace Harvey anytime in the near future, as the club has stopped providing a timetable for his return.

The 2016 season has been a struggle for Harvey, as he’s pitched to a 4.86 ERA with diminished strikeout (7.4 K/9), walk (2.4 BB/9) and ground-ball (40.8 percent) rates while also seeing a 1.5 mph dip in his fastball velocity. Those hardships come on the heels of a 2015 campaign in which his innings total was the source of a prolonged controversy. There was talk of shutting Harvey down for the year, as he had undergone his own Tommy John surgery in 2014, but he ultimately tossed a combined 216 innings between the regular season and the playoffs — the highest total ever for a pitcher in his first full season back from Tommy John. Of course, it’s not clear that last season’s workload had any direct impact on his new injury.

From a replacement standpoint, the Mets have a number of options, as can be seen on their depth chart. Logan Verrett will start this weekend in Harvey’s place and could be a rotation option alongside Syndergaard, Matz, Jacob deGrom and Bartolo Colon. Alternatively, Sean Gilmartin could make some starts for the club after enjoying a successful 2015 run as a member of the bullpen following his selection in the Rule 5 Draft (he’s been starting at Triple-A this year). Rafael Montero could again be an option, though he’s struggled tremendously in the minors this season. Right-handers Robert Gsellman and Gabriel Ynoa are in the Triple-A rotation and already on the 40-man roster. And, the Mets have also already brought Seth Lugo up to the Majors once this season and could turn to him for spot starts or long relief work if needed.

While surgery to alleviate thoracic outlet syndrome isn’t as common as Tommy John surgery, there’s no shortage of pitchers that have elected the procedure in recent years. Twins right-hander Phil Hughes had this exact surgical procedure earlier this week, and Royals righty Chris Young credits this surgery for revitalizing his career. Others that have undergone the operation include Mike Adams, Jaime Garcia, Shaun Marcum, Chris Carpenter and Josh Beckett. There are varying levels of success in the treatment, as explored by Nick Lampe of SB Nation’s Beyond the Box Score last summer.