St. Louis Cardinals pitcher Miles Mikolas will start season on the injured list
The St. Louis Cardinals announced Tuesday morning that starting pitcher Miles Mikolas would receive a platelet-rich plasma injection in his right elbow in order to address lingering flexor tendon soreness.
Mikolas will not throw a baseball for 3-4 weeks and then begin a program to prepare for the regular season. He will open the regular season on the injured list.
Mikolas, who has thrown 384 2/3 innings across 64 regular season starts in the last two seasons, came into camp heavily penciled into the club’s presumed starting rotation. That competition now takes on a new dimension with this new layer of uncertainty.
Mikolas was not available for comment on Tuesday morning.
“It’s something that he just continued to have a little bit of discomfort in that area, that tendon that he’s had historically,” Cardinals manager Mike Shildt said Saturday. “He pitched through it last year. He’s been able to pitch through it. He would prefer not to have to pitch through it. It got to the point where he said, ‘you know what, let’s just look at it a little deeper, a little closer, make sure.’”
Mikolas received a similar injection at the end of the 2019 season to promote healing in the area. He was pain-free throughout a “nice, easy” winter throwing program, but noticed irritation upon throwing higher effort sessions after arriving at Cardinals camp.
On Saturday morning, Mikolas described, “just a little soreness. Better to take care of it in spring and not push it, try not to really hurt myself. If you’re a little sore in spring training it’s pretty normal at this point.”
The little soreness was a big enough concern that Mikolas was sent for magnetic resonance imaging on his right elbow on Saturday morning. Those images showed his ulnar collateral ligament — the ligament which is repaired by Tommy John surgery — to be fully intact, along with a lack of any damage in the arm save for the tendon.
The Cardinals intend for Mikolas to continue to prepare with the team in much the same way as reliever Jordan Hicks, as Hicks continues his recovery from Tommy John surgery. That includes defensive drills and conditioning as well as providing feedback to other pitchers as they throw. On Tuesday, Shildt praised Mikolas for his full engagement in camp despite his physical limitations.
“I can go in there and lift and do all that stuff,” Mikolas said. “I can throw my kids in the pool and do all that stuff. It’s just when I try to crank a ball loose, it’s a little uncomfortable.”
Mikolas described the end of the 2019 postseason as the time last season at which he was feeling the greatest amount of discomfort in the tendon, and said that his performance in the playoffs should be proof that he was able to handle the issue at the time. Indeed, Mikolas was perhaps the club’s best pitcher in the playoffs, allowing only two earned runs in 12 innings pitched across three appearances (two starts).
Mikolas injury an opportunity for other pitchers
The Cardinals have touted their starting pitching depth as one of the team’s greatest strengths, and it now seems to be on the cusp of facing this season’s first major test. Lefty Kwang-hyun Kim and righty Carlos Martínez were projected to be competing for the same potential spot in the St. Louis rotation, but Mikolas’s injury likely provides room for both.
Opportunities may also arise for pitchers such as John Gant, Austin Gomber, Daniel Ponce de Leon, or Alex Reyes.
“We have a lot of depth,” Shildt said. “We know the names. And we don’t want to draw from it but it’s there if we have it.
“The thing about having depth, it’s not only depth. You have the bodies, but you also have the quality of depth, the people with experience that have done this and are more than capable of being there if and when we need them.”
Shildt said Tuesday that he was “relieved” that Mikolas’s baseline testing hasn’t shown any structural degradation since the end of the 2019 season. While the Cardinals have yet to see the healing they prefer, Shildt said that the organization is confident that another course of PRP treatment and rest should allow Mikolas to move past recurring discomfort.
At the moment, no surgical intervention is believed to be necessary.
“Whatever’s new and healed in (the arm) hasn’t been throwing a baseball for 30 years. It’s kind of new,” Mikolas said Saturday. “So it just needs to adjust. It needs time to, ‘ooh, this is throwing a baseball? This is pretty tough.’ So now it just needs maybe a couple days to strengthen up, get its R&R, some TLC, and then come back strong.”
