SAN FRANCISCO -- Right-hander Matt Cain is on his way to see Dr. James Andrews, according to a team source.
Cain has not pitched since July 9 because of inflammation related to bone chips floating in his right elbow. His condition has not improved in recent days, and the Giants were so concerned that they moved quickly to acquire right-hander Jake Peavy over the weekend and now have sent Cain for a second opinion.
Dr. Andrews is known primarily for performing Tommy John surgery on pitchers, but Cain has told teammates in recent days that he doesn't believe he has ligament damage. When he was put on the disabled list July 21, Cain said an MRI on his elbow revealed no damage to the ulnar collateral ligament. But a team source said the bone chips could be a precursor to a more serious procedure. The worst case scenario is what happened to Detroit Tigers closer Joe Nathan several years ago; he had bone chips removed in October, 2009 and then had Tommy John surgery the following March after his ligament tore.
The loose bodies in Cain's elbow were discovered in 2010 but he has pitched through the injury -- and pitched well. That changed in 2013, when Cain had uncharacteristic struggles in the first half before finding his old form after the All-Star break. This season, Cain is 2-7 with a 4.18 ERA. Cain's strikeout rate (7.0) is the lowest since his rookie season and his walk rate (3.2) is his highest since 2008.
In announcing the Peavy deal, Sabean said the Giants were not seeing improvement from Cain.
"The longer he goes in this dormant stage, the more we're probably going to have to seek second opinions or more diagnostics, and thus the timeline gets stretched out, or there may be a worst case," Sabean said Saturday. "We haven't gotten to that point yet. The impetus to act as quickly as we did (with Peavy) was we really felt that (Cain) is going to be out for a while no matter what, and we didn't want to stay as constituted."
A ligament injury would end Cain's season and likely put him out all of 2015, too. The Giants hope that Cain only needs to have the bone chips removed at some point, although even that procedure would end his 2014 season. Cain is said to have a "significant" number of chips floating in his elbow and any procedure to have them removed would sideline him for at least three to four months, per a source. For the Giants, the most important thing may just be getting Cain healthy once again. He is owed $20 million in each of the next three seasons.
Former Giant Shawn Estes first reported the Dr. Andrews visit while on the air with 95.7 The Game.
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