Thoughts after Luis Severino goes down with Tommy John surgery

(Presswire)

The worst case scenario has arrived: Luis Severino needs Tommy John surgery. Tests in New York earlier this week revealed a partial ulnar collateral ligament tear that is significant enough to require surgery, Brian Cashman announced earlier today. Severino will have the surgery Thursday. The Yankees are down two important starting pitchers and it's not even March yet. As a wise man once said, it's not what you want. Here are my thoughts on the Severino injury and what the Yankees do next. 

1. What took so long? The obvious question. Severino's forearm issue dates back to last postseason and it was serious enough to warrant two MRIs and a CT scan over the winter. It wasn't until Severino underwent a dye contrast MRI earlier this week that the ligament tear was revealed. Here's what Cashman told Mark Didtler:

“My gut is it’s something that dates back to when he started feeling something," Cashman said. “In terms of the declaration of the injury, with the physical testing upon the MRIs and where his complaints were, it didn’t reveal itself. But now as of yesterday for the first time, the physical testing points to the area on the MRI arthogram that shows a problem. The prior MRIs had no problem and the point of injury was not around the ligament."

The last thing I am is a medical professional. If you have a question about what it's like to have your appendix removed, I'm your man, otherwise the only knowledge I have about medical tests and treatment is what I've picked up following baseball. I ask this sincerely and as a layman: why not do the dye contrast MRI right away to rule out a ligament issue? Severino is one of the best young pitchers in the game and a key member of a Yankees team that is trying to win the World Series. You'd think they'd want to inspect the ligament fully as soon as his forearm tightened up last year. On one hand, it's frustrating the injury was not caught and treated earlier. On the other hand, Severino is hardly the first pitcher to go down with a forearm issue and need Tommy John surgery weeks (even months) later, which tells us this is an inexact science. I mean, duh. Medicine is not black and white. It's an art form, truly. It's all open to interpretation and that's why people go for second and third opinions. It absolutely sucks Severino's forearm started acting up four months ago and he's just now having elbow reconstruction. From where I sit, I don't know why the Yankees would not have Severino go through the dye contrast MRI when this first popped up just to make sure the ligament was sound. This injury lingering so long reflects poorly on the medical staff to us outsiders, but is that really the case? I don't know. I don't know anything about MRIs and dye contrast MRIs. I just know a very good and very important Yankee got hurt back in October and he is only now having a major surgery to correct it. It sucks. “It’s so sad. I’ve had Tommy John before and I don’t really know there’s anything you can do to prevent it. In my experience, my arm's feeling great and the ligament just snapped one day. I know he’s really been fighting to get back on the field since last year and struggling with the shoulder thing. I’m sure he’s just devastated to hear the news that he’s going to spend another season out," Kyle Higashioka told Kristie Ackert.

2. 2020 postseason odds. Earlier this week I noted PECOTA and ZiPS had the Yankees as AL East favorites by a lot even after the Paxton and Severino injuries, and that's still true, but now we know Severino will miss the year. That's much worse than getting 120 innings out of him or whatever it could've been. Here, via Dan Szymborski, are the updated ZiPS postseason odds:

Losing Severino equals a 13 percentage point swing in division odds. That is huge. The Yankees are still AL East favorites but not quite as overwhelmingly now. The postseason odds barely move and that's good even though no one wants another Wild Card Game experience. The Wild Card Game should be a backup plan and nothing more. The World Series odds? They drop four percentage points without Severino. That is much more significant than the five percentage point drop in postseason odds. Without Severino, the World Series odds are cut nearly a quarter, and that's the real damage. This year is the Yankees' best chance to win a World Series with this group because the primes align nicely, and because players don't get younger and they don't get less expensive. Now the team's World Series odds have taken a hit. The Yankees will be without a high-end starting pitcher, someone who could potentially overwhelm even elite hitters in October with power stuff, and their short postseason series outlook changes accordingly. Yes, the Yankees have to win the AL East. That's the first step in the process. But the ultimate goal is to win the World Series, and losing Severino lowers the chances that happens by a not insignificant amount. "I don’t want to sugarcoat the fact that being without Sevy, that’s a blow, but it doesn’t change our expectations and what we’re truly capable of. So, no, nothing changes (as far as expectations)," Aaron Boone told Didtler.

3. 2021 impact. Tommy John surgery comes with a 16-18 month rehab timetable. The days of a 12-month rehab are long gone. No matter when he had the surgery, either now or back in October, Severino was going to miss this season, but because of the timing, his rehab will now carry over into next season. In all likelihood we're not going to see Severino until the 2021 All-Star break, and because it can take some time for the pitcher to get all the way back to where he was prior to surgery, we might not see Severino at full strength again until 2022. Yuck. James Paxton and Masahiro Tanaka will be free agents after this season, so the Yankees were already facing major 2021 rotation questions. Now add Severino's injury on top of that. Losing Paxton and/or Tanaka to free agency would stink, but if you have Gerrit Cole and healthy Severino in the top two rotation spots, you're in good shape. You can figure out the rest from there. That is no longer the case now. The 2021 rotation is currently Cole, hope Jordan Montgomery reestablishes himself this year, and, uh? Maybe J.A. Happ's option will vest? Hard pass on that. I don't care how well he pitches this year. (UPDATE: The Yankees will also have Domingo German next year. Oversight on my part. My bad.) Young pitchers in the organization will have a great opportunity to pitch themselves into the long-term picture this season, which is neat. I wish the circumstances were different, but hey, give the kids a chance. They'll surprise you. I think though, because Severino's future is now uncertain (we all hope for a speedy rehab, but who knows?), the Yankees will be in the market for a pitcher with control beyond 2020. Someone like, say, Jon Gray, who can't become a free agent until the 2021-22 offseason. Or Matt Boyd, who is three years away from free agency. That could be their focus at the trade deadline. Tanaka strikes me as someone the Yankees would like to retain long-term (at a lower salary, obviously), but I thought the same about Dellin Betances and Didi Gregorius, so what do I know? First and foremost, losing Severino for this season sucks. The Yankees are in it to win it and their 2020 World Series odds take a big hit without Severino. It sucks. Severino's injury also has a secondary impact on next season. The 2021 rotation picture just became much murkier.

4. In-house rotation candidates. Not surprisingly, Cashman said the Yankees will replace Severino internally. That's what every GM says following a major injury. Other teams know the Yankees are reeling right now and the prices will go up accordingly. Simple supply and demand. Assuming Cole, Tanaka, Happ, and Montgomery are the top four starters, I think the rest of the rotation depth chart lines up like so:

1. RHP Jonathan Loaisiga
2. RHP Mike King
(small-ish gap)
3-6: RHP Chad Bettis, RHP Luis Cessa, RHP David Hale, RHP Nick Tropeano
(medium gap)
7. RHP Deivi Garcia
8. RHP Clarke Schmidt

Boone told Bryan Hoch he sees Cessa in the bullpen, though that was before the Severino news, so I assume that isn't final. (Cashman mentioned Cessa as a rotation candidate earlier this spring.) Garcia and Schmidt are top prospects with development plans. Deivi struggled a bit in Triple-A last season (5.40 ERA and 5.77 FIP) and a 20-year-old kid needing more time at that level is perfectly reasonable. Schmidt reached Double-A late last year and threw 19 innings at the level, including postseason. The Severino injury does not make Garcia or Schmidt more MLB ready, you know? The Yankees have enough other rotation candidates to stick to the development plan with Garcia and Schmidt. That's why I have them at the bottom of that depth chart. We'll definitely see Deivi at some point this year and I think we'll see Schmidt eventually as well. Opening Day though? Eh. That's pushing it. "Maybe their big league career is gonna start a little faster than normal, but we need someone to be there for us," Luke Voit told Ackert. The Yankees love Loaisiga, so much so that they called him up to start two years ago despite very limited minor league experience (and none above Double-A), and I think that makes him the fifth starter front runner right now. King would've gotten a longer big league look last year if not for his spring elbow injury. He's as MLB ready as he's going to get and I think he's right behind Loaisiga on the fifth starter depth chart. I think they're 1 and 1A, really, and the rest of Spring Training will decide that race. The Severino injury creates a huge opportunity for those guys. A potentially career-defining opportunity. As for the guys in the 3-6 spots, I see them as interchangeable, and they're the pitchers I think the Yankees would pair with an opener rather than put in the rotation outright. Using Chad Green as an opener is not ideal -- having to work around his "starting" schedule creates bullpen management headaches -- but neither is Severino having Tommy John surgery. Sometimes you have to call an audible. The Yankees made the opener work well last season and really, the key is not Green. It's the guy who comes in after him. Green got through the top of the lineup, then dudes like Nestor Cortes and Hale did fine work as the bulk innings guy. The Yankees might ask Bettis, Cessa, Hale, Tropeano, or whoever else to do that behind Green this year. It's not ideal but it has to be a consideration. Right now, with the caveat that Opening Day is four weeks away, I'd call Loaisiga the slight favorite to be the fifth starter over King, with an opener situation more likely than Garcia or Schmidt getting the nod. "We're certainly hopeful that we have a lot of hungry, talented personnel wanting to make a name for themselves or continue their journey. Losing high-caliber players like Paxton or Sevy is going to provide that lane or that opportunity for someone to step up and take it. We'll play this spring out and see what it looks like,” Cashman told Hoch. 

4. Free agent candidates. At this time last year the Yankees could've gone out and signed Dallas Keuchel to replace Severino. That is not the case now. The free agent market moved much more quickly this winter and I don't think there is a single unsigned free agent pitcher you can declare a no-doubt MLB caliber player right now. Here are the best available free agent pitchers (2020 WAR projections per FanGraphs):

1. Collin McHugh: +0.7 WAR
2. Clay Buchholz: +0.6 WAR
3. Jason Vargas: +0.5 WAR
4. Andrew Cashner: +0.5 WAR
5. Several tied at +0.4 WAR

I wrote about McHugh a few weeks ago. He finished last season on the injured list with an elbow problem and there has not been an update to his MLBTR archive since Sept. 25th. The MLBTR folks catch everything and the lack of rumors is a pretty good indication the medicals are bad, or at least make teams uncomfortable. McHugh's probably not a realistic option. The Yankees value a strong clubhouse too much to pursue Vargas, who tried to fight a reporter last year, and neither Buchholz nor Cashner moves the needle. Cashner will at least give you innings though, which is not nothing. The Yankees can't even try to lure CC Sabathia out of retirement because he had major shoulder surgery in November is still recovering. There is no readily available (or worthwhile) pitching talent available for cash. The Yankees can't go out and sign a viable big league starter like Keuchel (not that they did last year when they had an obvious rotation need). Signing Buchholz or Cashner is really no different than signing Bettis at this point. They are equally likely to disappoint. I guess there's something to be said for having as many options as possible, but yeesh. Free agency offers no pitching help now. The Yankees had the entire winter to add pitching for nothing but cash, their single greatest resource, and they instead called it an offseason after signing Cole (and re-signing Brett Gardner). It was disappointing over the winter and it looks foolish now, especially since Severino's forearm was barking, Paxton's back was acting up, Tanaka needed bone spur surgery, and German was facing a suspension. That was all known in October. It didn't pop up on them in March.

5. Trade candidates. The free agent market has been picked clean and the trade market rarely offers anything exciting in February and March, especially on the pitching side. Teams with pitching depth are loath to give it up this early in the year. They know they could be the next team to lose a guy to injury and they want to make sure they're covered. The only real trade candidates in Spring Training are out of options players. Those fringe roster guys who might be on the outside of the roster looking in. After scrolling through depth charts, I present to you some potentially interesting out of options pitchers (with their 2020 ZiPS projected WAR):

• RHP Wilmer Font, Blue Jays: +0.8 WAR
• RHP Carson Fulmer, White Sox: -0.2 WAR
• RHP Jeff Hoffman, Rockies: +1.9 WAR
• RHP Walker Lockett, Mets: +1.2 WAR
• RHP Jorge Lopez, Royals: +0.7 WAR
• RHP Alec Mills, Cubs: +1.0 WAR
• RHP Adam Plutko, Indians: +0.9 WAR
• RHP Lucas Sims, Reds: +1.0 WAR

Plutko and Gerrit Cole were rotation-mates at UCLA, which is a fun fact more than a reason to acquire him. Besides, I imagine the Indians will keep Plutko with Carlos Carrasco nursing a hip injury and Mike Clevinger recently undergoing knee surgery. Lopez, Mills, and Sims all have a path to making their team's Opening Day roster, so they may not be available. (Sims in particular looks like a potential impact reliever.) Font seems to be on waivers three times a year. He could hit the wire again soon. Fulmer is a former high draft pick (8th overall in 2015) who is a mechanical mess and hasn't had any success at any level in years. He's not a viable big leaguer. He's someone you pick up on a minor league deal and try to fix in Triple-A. Hoffman is another former high draft pick (9th overall in 2014) with big spin rates. I've mentioned him as a trade target before. The Rockies are holding a fifth starter competition this spring and I have to think Hoffman is the leading candidate given his pedigree. I could see the Yankees having interest in him should he become available given their affinity for former Rockies players (only half joking about that!). Lockett's been horrible as a big leaguer (37 runs in 37.2 innings) and very good in Triple-A, hence the projections love. As always, bet against a Yankees-Mets trade, even for a dude like Walker Lockett. Point is, this is what the trade market has to offer right now. The Diamondbacks are not trading Robbie Ray yet. The Rangers won't start listening to offers for Mike Minor for a few months. The sellers usually don't start to get serious until May, and it's not until after the amateur draft in June that the trade market really picks up. Paxton and German should -- should -- be back by then. My guess is that's how the Yankees are approaching this. Stay above water until German and Paxton return, ideally with internal options. If things go wrong and Paxton has a setback or there's another injury or whatever, they'll adjust and do what they can. For now, expect the Yankees to stay in-house for their fifth starter while keeping an eye on the trade market, which is unlikely to turn up anything useful anytime soon. Free agency? Forget it. Nothing there. "We’re always constantly looking for upgrades anyway, but this time of year you always look from within, and see and give opportunities for what you have. And typically that’s how it shakes out, especially until after the June draft regardless, so you keep relying on depth. So wouldn’t say expect any domino effect or cause and effect in terms of us being able to go to marketplace where a marketplace this time of year typically doesn’t exist," Cashman told Didtler.

6. Dud extensions. The Yankees have been stingy with long-term contract extensions over the years so of course the two they gave out last year have worked out horribly so far. Go figure. Aaron Hicks signed a seven-year, $70M extension, then back and elbow problems limited him to 59 regular season games plus five more in the postseason last year. He had Tommy John surgery in October and will return in June-ish. Hicks might play 150 games in the first two years of the seven-year contract combined. Might. Severino signed a four-year deal worth $40M and he threw 20.1 total innings last season (12 in the regular season plus 8.1 in the postseason) around shoulder and lat trouble. Now he needs Tommy John surgery. Those 20.1 innings are all the Yankees are going to get in the first two and a half years (!) of the four-year deal. Brutal. Absolutely brutal. Now the hope is Severino can be Zack Wheeler, who showed so much promise early in his career, missed two and a half seasons with injuries (including Tommy John surgery), then managed two strong seasons prior to free agency (the Yankees have a club option as part of Severino's extension). That's the obvious comparison. Severino doing what Wheeler did. The Yankees rarely give out extensions -- prior to Severino and Hicks, the last extension they gave out went to Brett Gardner (four years in Feb. 2014), and before that it was Robinson Cano (four years in Feb. 2008) -- and now the two core players they did lock up broke down immediately. What a bummer. This doesn't mean the Yankees should avoid extensions in the future, of course. That's silly. The Hicks and Severino extensions going bad is not a reason not to lock up, say, Aaron Judge. The players have nothing to do with each other. Locking up your best players is good business no matter how large your payroll. Sometimes those extensions go wrong and that's baseball. It doesn't mean you stop. It just really stinks that the Yankees finally got into the business of aggressively locking up their core players, and it immediately backfired. It's almost comical how poorly the Hicks and Severino deals have worked out, and how quickly they went bad.

7. Sad for Sevy. On a personal level, I'm really bummed for Severino. He spent all last year working his way back from injuries and is just about to enter what should be the prime of his career. Rather than have a comeback season and help the Yankees win a World Series, he'll spend another year and a half rehabbing, this time from Tommy John surgery. Here's the statement Severino released last night:

"After much consideration, as well as consultation with the Yankees organization, my family, and my representatives, I have elected to adhere to the advice of the medical professionals and undergo surgery to repair my injured elbow. I am extremely disappointed that I will not be able to put on a Yankees uniform and compete with my teammates this year, but I promise that I will be working tirelessly during this process to come back stronger than ever to make the greatest fans in baseball proud. Thank you to everyone that has reached out during this tough time. My family and I deeply appreciate the kind words and well wishes we have received. Through the long road ahead your continued support means the world to me. I will be back on the mound soon to help bring a championship back to the Bronx!" 

The statement is about as upbeat as you could expect given the circumstances, but still, I'm sure Severino is devastated. How could he not be? At this time last year he was viewed as one of the top young pitchers in the game. Now he's essentially a reclamation project. Three major arm injuries (shoulder inflammation, lat strain, torn elbow ligament) in a 12-month span and two and a half years of rehabbing. For all intents and purposes, his age 25-27 seasons will be lost to injury. He'll go from back-to-back All-Star Game selections and top 10 finishes in the Cy Young voting at ages 23 and 24 to not pitching another full season until age 28 at the earliest. Pitchers break. Getting hurt is what they do, and Severino endured a big workload early in his career and he throws very hard. That put him firmly in the "major arm injury" cross hairs and it's not a surprise his elbow gave out. It still sucks though. Severino was a small bonus international free agent who signed late ($225,000 at age 17) and worked to become one of the game's best pitchers and set his family up financially. I will never blame a player for taking an early career extension, especially pitchers, and this is why. The game can be cruel and rip everything away in a heartbeat. I'm legit bummed for Severino. He was all set up to have a big bounceback season and reestablish himself as one of the game's elite starters. Instead, we won't see him again until 2021 at the earliest.