Orioles starter Kyle Bradish will miss start of regular season with UCL sprain

SARASOTA, Fla. — A day after Orioles pitchers and catchers reported to spring training, a potentially major injury blow came to light.

Right-hander Kyle Bradish, who finished 2023 receiving Cy Young Award votes, will start the regular season on the injured list with a UCL sprain, executive vice president and general manager Mike Elias said.

Bradish received a platelet-rich plasma shot in the elbow and is set to start a throwing program Friday, Elias said. At this time, Elias said, Bradish is not expected to undergo surgery.

“Our plans are to get him pitching for 2024,” Elias said. “Pitching is a dangerous business nowadays. You never like to hear anybody have elbow or shoulder or wrist injuries, or what have you, but there are a lot of people who have them and never have to get surgery, and rest and other treatments do the trick. So, hopefully that’s where we’re at with this one.”

Elias also said left-hander John Means, who was shut down before the American League Division Series last October, is a month behind schedule in his recovery. After a 17-month rehabilitation from Tommy John elbow reconstruction surgery and a back injury, Means made a handful of starts in 2023 before feeling tightness in his elbow again. He underwent an MRI and was told it would be best for him to end his season ahead of the playoffs.

While the extent of Bradish’s UCL injury is not fully known, elbow and forearm discomfort has a negative implication. At times, it is a precursor to a pitcher’s requiring Tommy John elbow reconstruction surgery.

“Right now, we’re prepping him for a lot of action in 2024,” Elias said. “We’re getting him ready for that as expeditiously and responsibly as possible, but there’s going to be some time involved.”

Elias said he wouldn’t liken Bradish’s injury to right-hander Félix Bautista’s elbow injury last year, because Bautista’s injury occurred near the end of the season. Baltimore allowed Bautista time to see whether he could pitch through his UCL tear because, Elias said, “with us going into the playoffs, what would be the harm in us testing it out a little bit?”

“I think right now our hopes and focuses are on getting this behind [Bradish] and getting him up and running for 2024,” Elias said. “But we want to do it carefully and safely, and for that reason I’m not ready to slap a timeline on it.”

According to a National Institutes of Health study of 50 athletes who suffered UCL injuries, a PRP therapy injection — the shot Bradish received — is an effective nonsurgical route for partial tears of the ligament. Twenty-four of the 39 players (61.5%) in the study with Type I and II tears, which are less severe, returned to play without requiring surgery. However, the injection was not effective for those with a Type IV injury, which corresponds with a tear in more than one location.

Losing Bradish and Means for any meaningful length of time would be a considerable setback, even after Baltimore secured the services of former Cy Young winner Corbin Burnes in a trade from the Milwaukee Brewers this month. Adding Burnes checked off the Orioles’ largest offseason wish: an experienced starter who can lead an otherwise young rotation.

But Bradish’s injury — which he suffered in January — casts doubt over what the rotation will look like on opening day. The throwing evaluation period for Bradish keeps him out of spring training games, and he will need ramp-up time before returning to the rotation if all goes well.

“Injuries are part of this game, and I feel good about the depth we have, and hopefully he’ll be back soon,” manager Brandon Hyde said. “But it’s just part of it, and that’s why you have a 40-man roster and bring a lot of people to camp, but Kyle had a great year for us last year and hopefully he can join us real soon.”

Hyde said he assumes Means also will not be ready for the season opener on March 28.

Bradish came into his own as a potential ace last year. He pitched to a 2.83 ERA with a 1.043 WHIP in 168⅔ innings. It was a major leap forward from his rookie year, when Bradish posted a 4.90 ERA and struggled against some of the best lineups in the American League East.

Elias reiterated all offseason that a team can never have too much pitching depth, and an injury such as this is a prime example of why that is. Elias didn’t rule out making another pitching acquisition.

Baltimore does have options. Including Burnes, there are Grayson Rodriguez, Dean Kremer, Tyler Wells and Cole Irvin. Right-handers Chayce McDermott and Seth Johnson and left-hander Cade Povich are also available from the team’s farm system.