Phillies ace Zack Wheeler underwent surgery to remove a blood clot from his near his throwing shoulder earlier this week, but the right-hander is now facing another serious health setback. As per a team media release today, Wheeler has been “diagnosed with venous thoracic outlet syndrome and the recommendation is to undergo thoracic outlet decompression surgery in the coming weeks.” This naturally ends Wheeler’s 2025 season, and he’ll need roughly 6-8 months to recover from the surgery, according to the Phillies’ projected timeline.
The brutal news adds to a tumultuous week for Wheeler, as it was just seven days ago that he was placed on the 15-day IL due to the blood clot. The successful surgery on Monday at least alleviated the most serious health concerns and put the focus back on when Wheeler might be able to return to pitching, even if getting back to the mound in 2025 seemed unlikely. Details were kept relatively scarce about Wheeler’s status, yet speculation about thoracic outlet syndrome was raised just due to the co-relation between blood clots and the venous version of TOS.
Merrill Kelly is the best-known example of a pitcher who underwent a venous TOS procedure, and Kelly is also the best-case scenario for what Wheeler can hope to achieve in the aftermath of his upcoming surgery. Kelly underwent his surgery in September 2020, was ready to go for the start of the 2021 season, and essentially didn’t miss a beat in the aftermath as the right-hander continued to post solid numbers for the Diamondbacks and Rangers from 2021-25.
This return to form was helped by the fact that a venous or vascular TOS surgery (related to blood clots) is the slightly less serious version of thoracic outlet syndrome, at least in regards to pitching. Jesse Dougherty of the Washington Post wrote a piece a little over two years ago detailing some differences between venous TOS and neurogenic TOS — the latter is the nerve-related version that essentially ended Stephen Strasburg’s career.
“If you had to pick, you’re not really sure which one you’d rather have [between venous and neurogenic TOS],” Kelly told Dougherty. “The blood clot was not fun. They are life-threatening. But for pitchers, TOS surgery to address a blood clot is much more straightforward than nerve issues. The diagnosis is more straightforward. The recovery is more straightforward. I was lucky in that way.”
This provides a bit of a silver lining to Wheeler’s situation, though naturally every person’s body responds to surgery in different ways. Only time will tell if Wheeler’s recovery can be as thorough as Kelly’s, or if Wheeler’s rehab period will extend into the 2026 season.
Losing Wheeler for 2025, of course, is bad enough for a Phillies team that has designs on winning the World Series. Wheeler was in the midst of another excellent season, posting a 2.71 ERA and elite secondary metrics across the board over 24 starts and 149 2/3 innings. Even in his age-35 season, the righty was continuing to add to a resume that will garner some attention from Cooperstown voters when he eventually retires. Since the start of the 2018 season, Wheeler leads all pitchers in fWAR (37.5) and has a 3.11 ERA over 1356 2/3 innings with the Mets and Phillies.
Wheeler has been the anchor of Philadelphia’s rotation since signing a five-year, $118MM free agent deal prior to the 2020 season, and then a three-year, $126MM extension for 2025-27 that was inked in March 2024. While losing Wheeler is a major blow, the Phils at least have a deeper rotation than most, and can still roll out Cristopher Sanchez, Ranger Suarez, Jesus Luzardo, Aaron Nola, and Taijuan Walker as the starting five. There’s extra pressure on the staff now that Wheeler is unavailable, and his sterling 2.18 career postseason ERA will be missed as the Phils try to capture that elusive championship ring.
Looking ahead to 2026, Suarez is a free agent this winter but the other four pitchers will return, plus top prospect Andrew Painter is expected to be ready for his first full Major League season. This gives the Phillies some cover if Wheeler’s recovery does stretch beyond Opening Day, yet adding a depth arm might now be part of Philadelphia’s offseason plans based on Wheeler’s progress.
ahhhhhhhhh
Brewers becoming bigger favorites by the day to get WS #1
Over the Tigers dead body.
You do know getting to WS and winning are two totally different things. Tigers in AL don’t care if Brewers get to the WS.
It doesn’t say get “to” the World Series. It says “get WS,” as in win it.
Besides, the Brewers have been to the World Series before (in 1982), but they have yet failed to win their first Championship. Now that the Rangers are off that dubious list, maybe it’s the Brewers’ turn now (or the Padres or the Mariners)
I wouldn’t say that until I see them win a postseason series.
Did you not see them win the NLDS in 2011 or even 2018?
Unfortunate. I hope he has a full recovery, but most pitchers with this surgery return degraded.
He’s doesn’t have the same condition as the worst-case pitchers.
What condition is that?
Wow
That’s a hit I don’t think anyone was expecting. Hope he recovers well from both ailments.
Nah I mean if you read up about it I would’ve been surprised if he came back this year. As you say though the most important thing is his long term health. Baseball is just a game.
So no remarks from Fever about how Dombrowski should’ve seen this coming and that it was his fault for signing such a high calibur injury prone pitcher?
Oh, wait, that’s right. Fever only saves his trolling for the Red Sox.
Angt – Look at my prior post, I saw it coming.
Devastating news, hopefully he can beat the odds.
So, Fever, since you have me blocked on my other account, please tell me how Craig Breslow and Alex Cora fail to potentially “see” injuries in the Red Sox pitchers that you mention they should notice ahead of time, while your buddy Dave Dombrowski gets off the hook when he didn’t see this coming?…
You have more pity for a team other than the Red Sox.
He just blasts them enough thaton the event of a negative outcome hes got nearly all possibilities covered.
Im blocked by him as well. He spurred out one of his asinine opinions and proclaimed “I won the argument”. He did not like my reply that A) Im here because I like to talk baseball and not on Facebook speaking politics or something equally polarizing. B) When something is not based on fact it is called an opinion and in no way definitive.
Even if he arbitrarily guessed this specific injury outcome or just vaguely guessed he’d need surgery(of any type), what does that matter. Its not as though he based off any facts whatsoever due to him being privy to his medical records.
My experience is anecdotal, but I was first diagnosed with TOS nearly 20 years ago when little was known about it.. and 3 major surgeries later and 1.5 ribs removed and so on, I still have chronic pain and numbness all the way down through my fingers and all sorts of permanent issues in my neck.
I havent met a single person in my journey with a TOS diagnosis that was ever fully cured, and it appears it’s been ruining a lot ot athletic careers in the last decade especially. I wish Wheeler nothing but the best, but sadly much like Strasburg and others this may be the end of the line of his MLB days…
TOS is a pretty terrible thing. Read quite a bit about it. Lingering effects, hope Wheeler doesn’t have any of those.
Andrew….? Andrew!
They still have 5 other starters Andrew isnt needed yet
Firmly aware of that goodsir.
However as Wheeler is clearly a TOR and will be missed into ’26 at least… My call was for Painter to take the bull by the horns and emerge into the pitcher he is destined to be….
Back to my regularly scheduled Sam Adams
Voodoo Ranger here.
@Cpdp – We all need some good news today. While not unexpected given the blood clot in the shoulder, actually hearing it stated was a kick in the nuts.
At least Nola looked better, and yes – here is to hoping to see Painter coming back around and finding that ceiling that we would love to witness.
Painter isn’t ready. He walks way too many batters. His last two starts in AAA, but he got lit up his previous two starts. If he doesn’t learn to limit his walks, he’ll pay for it in majors
@ericl – It is simply the final steps on the way back from TJS. Command is the last thing to arrive; he should be that much further along by next season.
His command at age 19 pre-surgery was rather awesome for such a young kid which bodes well for him getting back to that again It is all normal rehab stuff.
Next season, yes. Right now, no.
Well. If there was ever a pitcher who could rewrite the history on thoracic outlet syndrome or at least salvage a career as a former TOR who become as MRA or BPA or closer I think Wheeler is one of the few who could pull it off.
noooooooooooooo. I might be a braves fan but i love his game he is such a good pitcher. this derails it so much
Nice to see an opposing team’s fan express concern for another team’s player, especially one like Wheeler 🙂
I was going to comment the same thing until I seen yours! Braves fan always, but a bigger fan of MLB all together. This is devastating and he may have been getting close to that first cy young that has eluded him so many times before. I hope he recovers fast, but also comes back pitching as good as he has throughout his career if not even better! Only hiccups I want to see on his stat sheet are the games he faces off against the braves!
I really enjoy watching him pitch. We are from the same neck of the woods too.
Jeez, went from a blood clot to having to have TOS. That sucks Phillies fans…
First jon gray now him. Hopefully they can both come back healthy and better than ever. Maybe andrew painter or Moises Chace will be called up for that
I can tell you do not follow the Phillies.
Chace hasn’t pitched in months. He underwent TJ in June
The name Cardinals are good wasn’t a dead give away already Jbigz?
RIP
That sucks.
Woof. TOS is never good news. I can’t think of anyone off the top of my head who came back as anything other than a fraction of their old self.
Kelly?
There are a few, but yeah, I don’t know any of them off the top of my head.
Hope Zack has a full recovery. He’s a great one.
Glad his life is not in danger.
As for the Phillies in 2025, Sanchez, Suarez, Luzardo, Painter and Walker? Maybe they keep Ranger for 2026?
don’t forget Nola.
Good point! Forgot about Nola. Have to check how he has pitched since he has been back.
Ok, I checked, Nola gave up 20 runs in his last 6 innings.
Ranger is a man in the postseason but I do not trust Sanchez or luzardo in a postseason rotation
I think Sanchez will do ok this time.
Wheeler, Harvey, and me all diagnosed with TOS!
And you never pitched in the MLB again. Doesn’t bode well for Wheeler.
And vTOS is much worse than neurogenic considering that it’s a much more complex surgery. Will most likely need his first rib removed. He’ll probably be dealing with pain for a long time. Hope he recovers quickly, for the sake of the game.
Thank you, doctor, for your opinion. Article mentioned Kelly and Neurogenic Thoracic Outlet Syndrome versus Vascular Thoracic Outlet Syndrome and the ONE example of Kelly doing well after Vascular TOS. Article doesn’t refer to the statistics on surgical outcomes for a large group of patients nor do you. Who are we to believe?
Kelly
I’m def not a doctor but I had surgery for nTOS ¯\_(ツ)_/¯
JE
“…vTOS is much worse than neurogenic…”
That’s contrary to what I’ve read. In fact, what I found said venous TOS is often a less serious version of the condition. It may be a more complex surgery with a potential removal of a rib, but once pressure is relieved on the vein, full recovery can be expected, and is usually 6 to 8 months.
Nerves are much more complex, and that’s what involved in the neurogenic type of TOS.
No one that I can think of has come back from the neurogenic type. Guys who had the neurogenic type like Harvey, Strasburg, and Chris Archer had their careers effectively ended.
While Kelly, who had the venous type, like Wheeler does, made 27 starts in 2021 and 33 in 2022, after having the surgery at the end of the 2020 season.
The vascular system bounces back much better than a nerve. Nerves grow slow.
My meaning with that statement is that a vascular issue is worse than a nerve issue for your body, as vTOS has higher medical risk, such as clotting or embolisms. nTOS patients experience chronic pain for longer since it’s much harder to pin down the root cause.
tosoutreach.com/anatomy
But in terms of a players career, where the neurogenic type is a career ender, the venous type, as evidenced by Merrill Kelly is not.
That is why I took exception to your statement that vTOS was “much worse”. If I’m Wheeler, I look on the diagnosis of vTOS as being far better than had it been nTOS. IMO, it’s much better to get a diagnosis that doesn’t mean the end of a career, and far worse if it does.
It’s the opposite bud.
Wheeler has said he plans to retire at the end of his current contract. I wonder if he is considering pitching through the playoffs and having the surgery in the off season. If that is a possibility. If the ailment can be managed into the off season. Rest for a few weeks, pitch in the playoffs. It hurts his Cy Young bid, Skenes seems to have let the Pirates know that he doesn’t want any innings limits on him because he wants the award.
It is most disappointing for Wheeler in that way, he has been neck and neck with Skenes all season, but if he can pitch and is adamant about retiring, if the TOS can be managed, he could pitch yet again this season.
Sounds dangerous. As I understand it, the syndrome creates the blood clots. He keeps going and one forms, breaks off and ends up in his lungs or brain he is farked. Could easily spoil his retirement.
What is this guy smoking? There is no way in hell Wheeler will be coming back to pitch in the playoffs. This guy has the goofiest takes I swear.
Yeah. I think I’d take the let’s fix this surgery option. Living without a playoff series is doable.
Lol. He does and muted me for calling him out for some other moronic take. Wheeler is dealing with a life/death/permanent disability issue and this buffoon thinks it’s more important for Wheeler to chase trophies for his personal amusement.
Outlandish Takes Guy has had me muted too for awhile. These sort of people are always interesting. It’s like the Samuel Snowflake Club or something.
Blood clots are dangerous. They can cause a stroke if they get to the brain. And if they get to the heart they’ll cause a coronary thrombosis for a heart attack. Not really the sort of risks that anyone should try to pitch through.
Will a blood clot that gets dislodged and travels to the heart ALWAYS become a trombosis that will lead to a heart attack ?? Could another outcome be the lung which is also dire?? (I had a co-worker who was a very fit 48 year old who dropped dead from a blood clot to the lung while jogging. Horrific.)
miller, Unfortunately, Zack Wheeler’s 2025 season is over. There is no way he is coming back for the playoffs. He’s undoubtedly on anticoagulants right now, and that changes everything – including cautions he must take not to get seriously injured, side-effects including easy fatigability from the medications, loss of physical shape due to time off – past, present, and future, and even diet which frequently must be altered with the use of certain blood thinners. What’s more, there’s nothing to guarantee that, if he returned to pitching this season, he wouldn’t develop another clot – possibly even more extensive than the one he just had removed. Blood thinners can help prevent clots, but they are not always 100% effective. Zack Wheeler just went through a potentially life-ending event, and even with rib removal to relieve the thoracic outlet syndrome, there are no guarantees he will return to a big league pitching mound in 2026 – or ever. I sincerely hope he does return to the mound for the Phillies someday soon, but the odds of that happening are decidedly against Wheeler and everyone else who has ever experienced thromboembolic disease of an upper extremity and/or thoracic outlet syndrome. Finally, the more testing that Wheeler has performed, the greater the chances of his physicians discovering other issues which may have contributed to his clot formation in the first place. Other potential medical issues would also weigh against his speedy return to the mound. The 2025 season will be remembered for many things, and there will always be a Phillies Mount Rushmore, Version 2025, to symbolize the players that made the season successful. Zack Wheeler will be first player to be included in that tribute. Get better, Mr. Wheeler, and thanks for being one of the Phillies true class acts.
Disappointed to hear this but not surprised. The history of this in other athletes plus just reading about what recovery would entail, him coming back this season was pretty doubtful. His long term health is the most important thing. Baseball is secondary.
Can’t really backfill one of the undisputed few playoff ace SPs. Good that medically wheels in motion for more important issue.
Brutal, for Zack, Phillies fans, and MLB in general.
Best of luck coming back from it, man.
Why is it brutal for MLB? They will get along just fine without Wheeler.
The on-field product is better when the best players are on the field, not injured.
Yes but you made it sound like the MLB was going to collapse without him. Wheeler isn’t even a star.
Wheeler is absolutely a star. One of the top few pitchers on Earth. What are you talking about?
That doesn’t make him a “Star”
Zack Wheeler is a star.
Since 2018 leads all pitchers in fWAR. Stud. Star. Ace.
Only 3 all star appearances
0 CY Youngs
Not even top 20 in jersey sales
Wheeler is not a star.
Wheeler is one of the very best pitchers on the planet and has been for a long time now, and baseball is worse off without him, and no amount of boring, forced pedantry on the internet can diminish or obfuscate that objective fact.
Postseason ratings won’t go down because Wheeler isn’t pitching.
darren, You’re absolutely right. Zack Wheeler is not a star. He’s a superstar. There are many pitchers in baseball today who are considered stars because of their excellence on the field. Wheeler is better than most other pitchers which clearly makes him deserving of his superstar designation. By the way, since when do jersey sales have anything to do with star status? Performance on the field and performance in the gift shop are not the same thing.
That’s tough news for Wheeler and for Philly. Get well soon. Always want the aces healthy and competing, especially in October.
Such a wide, wide range of outcomes. He could be fine by mid-late 2026, or he may have thrown his last pitch ever a week ago.
As Wheeler said this would be his final contract, his career is as good as over.
Not over. He’ll make 20 starts next season, and continue to pitch to the end of his contract.
TOS ended Stephen Strasburg’s career and it’ll end Wheeler’s too.
this is traditionally a career ending operation. Tyson Ross is the only pitcher in the history of the sport to have a season post-TOS surgery as good as his pre-TOS baseline performance, and even then, it was only for a single season.
Kelly?
I hope he takes him time and we see him by next June 1.
If he has surgery now he could conceivably be ready to start next season or shortly after.
Phillies may need to dip into the starting pitching market this winter
No money for pitching. All money must be used to upgrade the lineup.
Who are you signing if you are Dave Dombrowski? Schwarber and Realmuto are heading for free agency and 3B definitely needs help.
Do you sign Kyle Tucker and push Castellanos to DH?
Schwarber is going nowhere and highly doubtful the payroll dips below 300 million.
The FIghtin’s aren’t about to sign Kyle Tucker. His stock has fallen the last 2 months cos he played with a hairline fracture in his right hand. And he’s hitting under .200 for August.
MLB execs know what kind of player Tucker is when healthy. If his stock has dropped it’s only in the mind of the casual fan. Maybe it won’t be the Phillies, but Tucker will get $400M+, and maybe even $500M, or close to it, this offseason.
Cubs benched Tucker last week cos he wasn’t hitting. Only then did he disclose the hairline fracture in his hand.
Other ballclubs see that and realize they ain’t gonna give him a contract of the size Jean wants.
Two Home Runs tonight with 5 driven in and now 3 Homer’s in his last two games. Maybe that hand is feeling better
Jackson Rubbit: Schwarber has earned the right to become a free agent, sell his services to the highest bidder, and choose his next employer.
No guarantee that will be the Phillies.
I feel for Phillies fans. Losing Wheeler for any extended period of time hurts, but TOS on top of the blood clot issue is really discouraging news.
Always root for this guy. Takes the ball every 5th day and deals. Blow for baseball. I know he intends on retiring after his extension ends, was hoping he pitching long enough to sniff the HoF (would finish with 55+ WAR on pace he was on).
ssowl: It’s certainly a blow for him and for the Phillies.
But please spare us the trite “blow for baseball” nonsense. Players get hurt and leave for one reason or another, and other players get a chance to replace them. The flip side of adversity is always opportunity.
The game and life go on as we know it.
Blue, you really think major league baseball will manage to get along without Wheeler ?? I mean, that’s a big ask and I don’t know how Manfred can sweet talk his way out of this one. Might as well shutdown baseball now and start the labor negotiations early. Go Giants/Jets it’s time to throw the pigskin around!!!
LOL. The brown stinky hyperbole crap really gets laid on thick on these threads.
Paint the town, Andrew.
Can anyone tell me how being a pitcher causes TOS? Or is it that it’s always been present and gets worse from being a pitcher? I’d really like to know. Either way I hope he makes a full recovery, from a non Phillies fan!
I think it’s a body issue. In the tight spots between bones etc, some people have larger spaces than others for vessels and nerves to pass through. I imagine throwing thousands of pitches develops muscles and stuff that makes that particular tight space tighter. Pipes and electrical wires get squashed.
Sorry to hear about this. He was having another great season and chasing that elusive Cy Young award. Hope he comes back and gets one before the end of his career.
Don’t know why people are counting the Phillies out. The Dodgers won a WS last year with 2 1/2 healthy starters. You just have to get hot at the right time.
“from his near his”
I wonder if this is the end for him. TOS can be a career ender anyway and he already said he wants to retire after 2027.
If he misses most of 2026 anyway will he be motivated to come back for one final season or is he just finished and rides into sunset.
I hope not but maybe we have seen his last pitch in baseball.
If it was the same type that Strasburg and Harvey had, he probably would miss 2026. But it’s not. The type Wheeler has been diagnosed with typically has a 6-8 month recovery. There’s reason to believe the surgery will not keep him from pitching most, if not all, of next season.
Wheeler is an ace, but the Phillies might still have the best playoff rotation.
Giant’s fan wishing Wheeler nothing but the absolute best of health and recovery. Really good pitcher and seems like a great teammate.
Sucks for Wheeler and the Phils. Hope he has full and speedy recovery.
well, there goes any chance of winning the World Series in 2025. I know a lot of other Phillies fans are gonna blast me and say have faith and yada, yada, yada.
This turn around for this team is for not. I guess this SHOULD get Painter up to the Phillies soon as the rosters can be extended in September
Brutal. Best wishes to Zach Wheeler for a prompt as possible full recovery. Besides not wanting anyone to undergo such a grueling procedure, the sport is more enjoyable when it has its top players out there.