Masahiro Tanaka still has elbow pain

NEW YORK -- New York Yankees general manager Brian Cashman said Wednesday that Masahiro Tanaka, the ace of his pitching staff, is still feeling discomfort in his pitching elbow despite not having picked up a baseball since receiving a platelet-rich plasma injection 10 days ago.

Speaking on ESPN New York 98.7 FM's "The Michael Kay Show," Cashman gave the following update on Tanaka: "He's improved, but he still feels it, although on a daily basis it decreases. So that's good but it's not good that he's still feeling it at this stage. So it's just day-by-day, week-by-week and we'll adjust accordingly. It's too early to call."

Tanaka was diagnosed with a partially-torn ulnar collateral ligament via MRI after complaining of elbow pain following an ineffective performance against the Indians in Cleveland on July 8.

He was subsequently examined by Yankees team doctor Christopher Ahmad, Los Angeles Dodgers team doctor Neal elAttrache and elbow specialist Dr. James Andrews, all of whom recommended the Yankees attempt to rehabilitate Tanaka's injury with a PRP injection followed by a throwing program, rather than the more standard, and radical, course of action -- Tommy John surgery.

Cashman defended the decision to forego surgery -- which entails a full year of recovery time -- on the basis that Tanaka might not be the same pitcher afterward.

"We get directed by what our medical experts say," Cashman said. "It was a unanimous decision and none of them recommended surgery. There's no guarantee that Tanaka if he has the surgery will be back to what he was."

Cashman cited the case of Manny Banuelos, a left-handed phenom in the Yankees farm system who underwent the procedure in October 2012 and has yet to return to his previous form.

"There's a high rate of success with the surgery," Cashman said, "But certain guys, they're not the same when they come back. Banuelos is coming back from Tommy John and now isn't really back to what he was before the surgery."

Earlier in the day, manager Joe Girardi had brushed aside a question about Tanaka, saying it would take a minimum of three weeks to know if the treatment was having a positive effect.

"He said he feels better," Girardi said. "But I don't think you really know how he's doing until you get him on a mound and you start going forward."

After being signed to a seven-year, $155 million contract this winter -- plus a $20 million posting fee to his former team, the Rakuten Golden Eagles of the Nippon Baseball League -- Tanaka had been one of the few bright spots for the Yankees season. Through June 17, Tanaka was a legitimate AL Cy Young and Rookie of the Year candidate, with an 11-1 record and league-leading 1.99 ERA.

But Tanaka lost three of his next four starts and had a 4.25 ERA in those games, allowing five home runs.

His absence was the latest in a rash of injuries that has decimated the Yankees pitching staff. Previously, the club lost Ivan Nova to Tommy John surgery, Michael Pineda to a lat strain and CC Sabathia to season-ending knee surgery.

The Yankees have filled out their rotation with two rookies (Shane Greene and Chase Whitley), David Phelps, who lost out to Pineda in a spring competition for the No. 5 starter's job, and Brandon McCarthy, a recent trade acquisition.

"This year we have a lot more areas of weakness than we're used to," Cashman said.

Still, Cashman said on the program that his main priority as the July 31 non-waiver trading deadline approaches would be to shore up the Yankees sagging offense, despite spending $283 million on three players -- Jacoby Ellsbury, Brian McCann and Carlos Beltran -- in the offseason.

"I think our offense should be better," Cashman said. "We feel we have personnel in some cases that should be better than what we've seen. It still feels like the pitching needs more help, but honestly, the offense has been consistently poor the entire year."

Among other issues Cashman addressed:

• The health of first baseman Mark Teixeira, who has not played since Sunday with what the Yankees are calling a mild lat strain, for which he received a PRP injection on Monday.

"I can't rule out a DL possibility," Cashman said. "Certainly when this occurred, out first reaction was it would be 4-5 days. Over the course of the next few days if he's not responding well to the PRP injection then I think we'll be looking at a DL situation. The next 24 to 48 hours will tell."

• The odds that Pineda, on the disabled list since May 6, will return this season:

"He's on the verge of his first rehab game (Thursday in Tampa)," Cashman said. "If everything goes right as we stretch him out, you'll see him sometime in August. We do believe we'll get him back."

• The possibility of calling up 2B Rob Refsnyder from Triple-A Scranton, where he is batting .301 with six home runs and 17 RBIs in 39 games:

"We're excited about Refsnyder," Cashman said. "(But) I don't think we would be significantly upgrading right now at second base. He's learning a new position. He's still working on that."

But Cashman did not rule out the possibility of calling Refsnyder up at some point this season.

"If you did see him it would most likely be as an outfielder," Cashman said. "I'm not prepared to say you'll see him in 2014. I'm not prepared to say that you won't. That jump from AAA to the big leagues is larger than it's ever been. But right now, clearly, he's still there for a reason."

• The progress being made by Banuelos, who threw five innings of two-hit shutout ball for the Double-A Trenton Thunder Tuesday night:

"We're not holding him back," Cashman said. "He just hasn't pitched as effectively as we expected. Some of his starts have ended abruptly. He has not had a good year in his first year back from Tommy John surgery."

Banuelos is 0-3 with a 5.20 ERA in 13 starts for Trenton.

"(Tuesday) night was a terrific start so that was encouraging and one that we've been waiting to see and hoping to see," Cashman said. "Right now, he's still knocking off the rust or still adjusting or trying to get consistent and trying to declare himself as to what he is going to be after the surgery."