Andrew Painter Diagnosed With UCL Sprain; Ranger Suarez Dealing With Forearm Tightness

Phillies top prospect Andrew Painter, who underwent imaging on his elbow over the weekend after reporting discomfort, has been diagnosed with a “right proximal ulnar collateral ligament sprain,” per the team. He sought a second opinion from surgeon Dr. Neal ElAttrache, who confirmed the diagnosis. Both the Phillies medical staff and Dr. ElAttrache recommended a four-week shutdown from throwing, after which Painter will begin a “light tossing progression.”

On the one hand, any injury to a pitcher’s UCL is a brutal and ominous blow. The ulnar collateral ligament is the ligament that is replaced during Tommy John surgery, and a sprain indicates some degree of stretching and/or tearing, by definition. That said, surgery for Painter shouldn’t be considered a foregone conclusion just yet. Dr. ElAttrache is one of the sport’s most prominent surgeons and orthopedic experts, and both he and the team apparently agree that the extent of the sprain is not severe enough to require immediate surgery. Time will tell whether Painter is able to avoid going under the knife, but it’s at least relatively good news that he hasn’t suffered a significant enough tear to wipe out his entire 2023 season just yet.

There are plenty of examples of pitchers avoiding surgery even after being diagnosed with UCL damage — Masahiro Tanaka, Ervin Santana, Anthony DeSclafani and Painter’s own teammate Aaron Nola among them. Of course, it’s only fair to point out that the majority of UCL sprains do ultimately lead to surgery, be it a Tommy John procedure (ligament replacement) or an internal brace of the current ligament, which comes with a shorter recovery time but is only possible for certain sprains (depending on the placement of the tear within the ligament and the severity of the tear).

For now, Painter’s shutdown takes him out of the running for the Phillies’ Opening Day rotation — a competition in which he was a prominent factor despite being just 19 years of age. Painter was the No. 13 overall pick in the 2021 draft and has soared through the Phillies’ system to the cusp of MLB readiness in less than two years’ time. He pitched across three levels in 2022 — Class-A, Class-A Advanced and Double-A — working to a combined 1.56 ERA with a massive 38.7% strikeout rate, a strong 6.2% walk rate and a tiny 0.43 HR/9 mark through 103 2/3 frames. Both Baseball America and MLB.com rank Painter as the game’s best pitching prospect and one of the top six overall prospects in the sport.

It’s not the only bad news on the Phillies’ rotation front, either. Left-hander Ranger Suarez, who’d been on Team Venezuela’s roster in the World Baseball Classic, has left the tournament and returned to the Phillies due to tightness in his left forearm, MLB.com’s Todd Zolecki tweeted this morning. The Phillies believe the injury to be minor and merely exercising caution, but it’s still a notable situation that bears monitoring. He’ll undergo treatment with the club for the time being.

Suarez, 27, has solidified himself as a quality middle-of-the-rotation arm behind aces Nola and Zack Wheeler in recent seasons. He started 29 games for Philadelphia in 2022, pitching to a strong 3.65 ERA with a 19.5% strikeout rate, 8.8%  walk rate and 55.4% ground-ball rate.

With Painter sidelined, left-hander Bailey Falter becomes the clear front-runner for the fifth spot in the Philadelphia rotation behind Nola, Wheeler, Taijuan Walker and — assuming he’s healthy enough come Opening Day — Suarez. If Suarez and Painter are both sidelined to begin the season, the Phillies will likely choose among a group including Cristopher Sanchez, Michael Plassmeyer, James MacArthur and prospects Mick Abel and Griff McGarry. MLBTR’s Anthony Franco took a look at each pitcher earlier in camp when profiling the Phillies’ fifth starter candidates.