Gerrit Cole’s elbow injury: Doctor explains why Yankees ace needs more tests

There’s a perfectly logical reason New York Yankees ace Gerrit Cole flew to Los Angeles for more tests on his injured pitching elbow — even after an initial look at it didn’t reveal a dreaded tear in his ulnar collateral ligament that would require season-ending Tommy John surgery, an orthopedic surgeon told The Athletic.

Even the best tests fail sometimes, and it’s better to be safe.

“In every test, there’s potential — even if it’s tiny, tiny, tiny — for something to be missed,” said Dr. Guillem Gonzalez-Lomas, a sports orthopedic surgeon at New York University Langone Health.

Gonzalez-Lomas, who hasn’t reviewed Cole’s medicals but has treated many elbow injuries, said it would be important to “incorporate everything into the diagnosis,” noting that while MRIs are “very sensitive” at catching ligament tears, “no test is 100 percent sensitive.”

“You really do have to put everything together and sometimes repeat tests in order to arrive at the right verdict,” the doctor said.

“When we have it all then I’ll let you guys know.”

– Aaron Boone on the latest regarding Gerrit Cole during the Yankees-Red Sox game on YES & the YES App ➡️ https://t.co/aRu5PF6iD2 pic.twitter.com/jgMEpz6CLC

— YES Network (@YESNetwork) March 13, 2024

On Wednesday, Cole flew to Los Angeles, where he will be examined Thursday by Dr. Neal ElAttrache — a renowned orthopedic surgeon and expert on elbow care. Manager Aaron Boone told reporters in Tampa, Fla., that Cole had already undergone an MRI, a CT scan and X-rays, and will now undergo “more advanced testing.”

A league source confirmed to The Athletic that Cole is currently expected to miss between one and two months. Boone declined to provide a timeline.

None of the tests found a tear, but they did discover inflammation, Boone said. A source with knowledge of the Yankees’ personnel decisions told The Athletic that Cole was interested in further examination to determine exactly what’s ailing him. Cole has told the Yankees that he was having difficulty recovering between outings this spring.

The source said Cole first felt something after his first spring training outing March 1, when he gave up three earned runs in two innings. In the start, Cole didn’t make it out of the first inning, getting only two outs before re-entering the game in the second inning and also getting the first out of the third frame. That’s when the Yankees began having him pitch only in the controlled environments of live batting practice sessions. He had been scheduled to pitch Monday but was instead put on ice.

The Yankees at the very least expect Cole to start the season on the injured list, and any time he misses will be a huge blow to a team hoping to rebound from a fourth-place finish in the American League East last year. The role of Opening Day starter versus the Astros in Houston could fall to first-year Yankees righty Marcus Stroman. Boone said he was leaning toward keeping Carlos Rodón on schedule to start the second game of the season.

Gonzalez-Lomas said it’s likely that Cole — the reigning AL Cy Young Award winner and 11-year veteran — knows his body well enough to have an idea when something is very wrong in his elbow.

“When you have someone who identifies that they’re not where they should be at this point in spring training, you have to take that seriously, and they have,” the doctor said.

Gonzalez-Lomas added that there’s a long list of things that could be wrong with Cole.

“Everything from tendinitis, bone bruising or issues in the joint itself, just inflammation,” the doctor said. “The joint itself can get inflamed and have no structural damage, but that can have soreness that can affect pitching quality, velocity and recovery.”

Of course, elbow injuries can be complicated. In 2014, a partial tear was detected in then-Yankees righty Masahiro Tanaka’s elbow, and he pitched another nine professional seasons (six in MLB, three in Japan) without Tommy John surgery. But in 2020, multiple MRIs failed to spot damage with then-Yankees righty Luis Severino’s UCL. Then Severino was given a dye-contrast MRI that revealed a partial tear. Severino needed Tommy John surgery, and he didn’t pitch again until late 2021.

So, the Yankees won’t panic until it’s time.

“You just have to rule out the more serious (injuries),” Gonzalez-Lomas said, “and then you’re left with ones that might require rest and rehab, and you’re in a good place.”

(Photo: Brad Penner / USA Today)