8:34PM: As per a statement released by the A’s, Dr. James Andrews has recommended that Puk undergo Tommy John surgery to correct UCL damage in his throwing elbow. Andrews provided the second opinion after Dr. Doug Freedberg made an initial diagnosis. The procedure would put Puk out of action for an estimated 12-15 months, and it seems likely that Oakland would err on the longer side of that timeline for precautionary reasons.
6:28PM: A’s manager Bob Melvin confirmed that Puk is getting a second opinion but didn’t provide details on the specifics of the injury, MLB.com’s Jane Lee tweets.
5:45PM: Athletics left-handed pitching prospect A.J. Puk was shut down last week due to biceps soreness, and now there are concerns that Puk may have a ligament problem in his throwing elbow, according to FanRag Sports’ Jon Heyman. Puk “was thought to be” looking for second opinions after initial meetings with doctors since his shutdown, which would hint at a larger issue. Another possible ominous sign, as noted by Susan Slusser of the San Francisco Chronicle (Twitter link), is that the A’s themselves have yet to go on record about Puk’s injury, not even to confirm the initial diagnosis.
The worst-case scenario for ligament issues, of course, would be Tommy John surgery, which would sideline Puk until midway through the 2019 season. The A’s have already lost Jharel Cotton to TJ surgery this spring and Paul Blackburn has also been sidelined with a forearm strain, though Puk going on the shelf would represent a big setback for both the club and for one of the game’s best prospects.
Puk entered the spring as the consensus pick as Oakland’s top minor leaguer, with ESPN.com’s Keith Law ranking the southpaw 13th on his list of the top 100 prospects in baseball. (Baseball America, Baseball Prospectus, and Fangraphs all had Puk 30th, while MLB.com ranked him just behind at 32nd on their top-100 lists.) Puk only added to his stature with a strong showing in Oakland’s spring camp, though a rough performance in his final appearance led to the shutdown, and Heyman observes that Puk’s velocity had dropped over his last two outings.
Drafted sixth overall in 2016, Puk had already reached Double-A last season and it was expected he would make his MLB debut at some point this season. After his good start in spring camp, there was even some chatter that the A’s would give him an aggressive promotion right to the big leagues, though obviously now the team will be as careful in possible in getting Puk back onto a mound at all, if possible.