Lewis has a torn flexor tendon in his right elbow and will undergo season-ending surgery to repair it later this week. While the news is not as dire as if it were a Tommy John procedure, there is still a lengthy rehab and recovery process, and it is still an injury to his throwing elbow. The flexor tendon attaches on the inner aspect of the elbow, serving as the anchor for the (wrist) flexor muscle group. These muscles literally flex the wrist but also function to assist with grip and ball control for a pitcher.
The location of the tendon renders it vulnerable to the stresses of pitching, and many throwers will deal with episodes of tendinitis and potentially some wear and tear of the tendon over time. According to ESPNDallas.com, Lewis had experienced prior episodes of forearm discomfort in years past, but it would always resolve on its own. This June he had soreness in the forearm, landing him on the DL, and at that time he was made aware of a small tear in the tendon.
Sometimes a period of rest will allow a pitcher to continue, despite the defect. In other cases, as with Lewis or Scott Baker of the Minnesota Twins, the tendon will fail under the stress of throwing and require surgery. Naturally, the proximity of the tendon to the ulnar collateral ligament raises some concern, primarily whether that ligament has been subject to additional stress given the damage in the area, or whether damage to the ligament has contributed to wear and tear of the tendon. Some pitchers have required that both structures be repaired simultaneously, a more significant procedure and a lengthier rehabilitation. Just ask Ben Sheets, now of the Atlanta Braves, who in 2010 underwent a combined Tommy John reconstruction and flexor tendon repair. His first pitch in the majors since surgery didn't happen until just a couple of weeks ago, nearly two years later.
According to ESPNDallas.com, Lewis said doctors told him it could be nine to 12 months before he's fully healthy and ready to return to major league pitching. While it certainly could be that long and the timetable depends on many factors, including the specifics of what takes place during surgery, the time frame could be less if all goes well. In isolated flexor tendon repairs with good healing, athletes often are cleared to resume throwing after about three to four months, and some return to the mound within six months.
We don't have the benefit of all the specifics related to Lewis' specific situation, but it seems that if all goes smoothly, the Rangers could have him available to pitch at or near the start of the 2013 season.
Meanwhile, Roy Oswalt was scratched from a Monday start due to stiffness in his back. While this wasn't good news, it certainly couldn't have been surprising to the Rangers. After all, Oswalt's chronic back troubles were spotlighted last year while he was with the Phillies. An episode of pain in the middle of last season was so frustrating for Oswalt that it sounded as if he might contemplate retirement. That thought seemed to pass quickly, and instead Oswalt labored his way back, finishing the season. The Rangers acquired him through free agency in late May, hoping they could get 4.5 months without incident. Unfortunately, the back issue resurfaced in less than two months.
Oswalt received an injection Monday after visiting his doctor in Houston, and the team is hopeful that he will only miss one start. According to the Fort Worth Star-Telegram, Oswalt informed the Rangers that he was susceptible to "flare-ups" but that they typically did not last long. Of course, the Rangers' medical staff would have done their own assessment of Oswalt's situation and clearly determined the risk was worth the reward. Even if he is able to take his next turn in the rotation, the risk remains.