Cards' Butler latest to go down with elbow injury

CINCINNATI -- A second opinion on reliever Keith Butler's right elbow confirmed a tear to the ulnar collateral ligament and leaves Butler expected to have season-ending Tommy John surgery on his elbow.

Butler, who is on the Cardinals' 40-man roster and was a member of the Opening Day bullpen, went on the Triple-A disabled list on May 14 due to elbow discomfort. He had his elbow examined by the Cardinals' medical staff, and then sought out another opinion from former team orthopedist George Paletta.

General manager John Mozeliak said that Paletta is expected to perform the procedure. The recovery time for Tommy John surgery is typically 12-18 months.

Butler may be the first Cardinals pitcher headed for Tommy John surgery this season, but he is the latest in a growing number of Major League pitchers who are losing a season's worth of time due to a compromised elbow ligament. The high number of players needing Tommy John surgery has caught the attention of the baseball community and has generated many a theory as to why elbow injuries have become increasingly common.

On Saturday, Mozeliak offered his thoughts on the epidemic.

"In the end, I do think there is sort of a usage issue going on, but I'm talking about way before we get them, maybe at the ages of 8 to 12," he said. "Then I also think there's a slight correlation, too, on sort of the strength. Guys are getting stronger and more physical. It's not country strong, it's more weight-room strong. The body clearly can't handle that torque on the elbow.

"I think as our industry tries to get a better grasp on this, we have to look at everything, question everything from usage to strength training to preparation. I do think that when we start to drill on this it has to be a concerted effort and more a group-think approach, because if any one team thinks they're going to find this answer, it's going to be very hard. There's not a lot of data to drive this."

The Cardinals have their own internal system that they use to identify risk factors and injury probabilities. Of that, Mozeliak said: "I'm not going to get into specifics on how we do that, because I do think we have a little bit of an edge there with how we think about things."