Athletics’ Luis Medina Being Evaluated For UCL Injury

The A’s received a pair of unwelcome injury updates over the weekend, when righty Luis Medina was diagnosed with an injury to the ulnar collateral ligament in his right elbow and outfielder Esteury Ruiz was pulled back from a minor league rehab assignment due to lingering discomfort in his ailing wrist (links to X via Martin Gallegos of MLB.com). Medina is headed for a second opinion on his elbow. Ruiz’s wrist will be reevaluated by a doctor today.

The 25-year-old Medina came to the A’s alongside lefties JP Sears and Ken Waldichuk in the trade that sent Frankie Montas and Lou Trivino to the Yankees. As it’s turned out, four of the five pitchers involved in that swap — Medina, Waldichuk, Montas, Trivino — have incurred significant injuries since the deal came together. Waldichuk and Trivino both had Tommy John surgery. Montas underwent shoulder surgery. Medina is now facing a prolonged absence himself, in all likelihood.

Medina started 17 games for the A’s last season. He struggled to an ERA north of 5.00 on the season as a whole but was generally solid after a shaky start. In his final 80 innings last year, the hard-throwing right-hander posted a 4.39 ERA (3.82 FIP, 4.75 SIERA) with a 22.3% strikeout rate, 12% walk rate and 44.3% ground-ball rate. Command has been an issue for Medina in the majors and upper minors alike, but that decent stretch over the final three months of the ’23 campaign was enough to land Medina a rotation opportunity in 2024.

He missed the first two-plus months of the season after sustaining a Grade 2 sprain of the medial collateral ligament in his right knee during spring training, but upon returning, Medina looked similar to that June through September form from last summer. From June 2 through July 6, Medina pitched 35 innings of 4.37 ERA ball across seven starts. His strikeout rate (15.9%) was down, as was his velocity (only by about 0.4 mph), but neither seemed like a major red flag for a pitcher returning from a notable knee injury. He was pulled mid-inning after giving up six runs in five frames against the Red Sox on July 11, however, and placed on the injured list with an elbow sprain shortly thereafter.

A confirmed UCL injury and second opinion from an external source are never good signs for any pitcher. There’s no indication yet that Medina will require surgery, but a the majority of UCL sprains culminate in Tommy John surgery, an internal brace procedure, or a hybrid of the two. There are certainly cases of pitchers rehabbing a UCL sprain and never requiring surgery — Medina’s own teammate, Mason Miller, missed four months with a sprain last year and has been dominant since returning — but those are more the exception than the rule. If Medina ultimately requires surgery, it could knock him out for a year or more, but he and the A’s will be hoping he can emulate Miller’s path.

As for Ruiz, he swiped 67 bases in 132 games last season but did so with a well below-average .254/.306/.345 batting line. He posted an even rougher .200/.270/.382 slash in 65 plate appearances this season. The A’s optioned him to Triple-A on April 1, and he hit .326/.423/.581 with three homers and seven steals in 11 games before being recalled to the majors and continuing to struggle at the plate. He’s been out since May 22 with a left injury that apparently hasn’t healed all the way just yet.

Ruiz’s gaudy minor league numbers continue to impress, but he’s yet to establish himself as a viable big league hitter (.243/.297/.343) and has thus far looked more the part of a fourth outfielder than a starter. He’s been leapfrogged by fellow trade acquisition JJ Bleday on the center field depth chart. Bleday is hitting .233/.314/.432 (114 wRC+) with a dozen homers in 405 plate appearances.