KANSAS CITY – Cole Ragans looked like his normal self during his rehab start with Triple-A Omaha on Saturday, providing some optimism about how close he was to returning to Kansas City.
But a minor setback now has changed that trajectory. Ragans “did not recover well” after that start, Royals manager Matt Quatraro said Monday afternoon, and Ragans will be shut down for the next two or three days before he’s reevaluated. If his symptoms resolve, he’ll hopefully resume throwing by the end of the week.
Ragans has been on the 15-day injured list since May 8 (retroactive to May 7) with a left elbow impingement after he exited his start against the Guardians on May 6 after just three innings. More specifically, he was diagnosed with valgus extension overload – a condition commonly called “pitcher’s elbow” that’s characterized by back- and middle-elbow pain related to repetition in throwing athletes.
All seemed to be going well in his recovery over the past few weeks, though, with two bullpen sessions where he felt good and Saturday’s rehab start with Omaha that saw him allow one run in 4 1/3 innings, working his way up to 68 pitches (44 strikes) and flashing consistent 95 mph-plus velocity with his fastball throughout the outing.
Ragans told MLB.com on Monday that he didn’t feel any pain during or right after the outing. But on Sunday, he woke up with his elbow feeling stiff, the same symptoms he felt after that Guardians start.
“I held velo, stuff was fine,” Ragans said of his rehab start. “Pretty similar to where I wanted it to be. I got to where I wanted to in the game, pitch-count-wise, inning-wise. … Just didn’t bounce back well. I woke up feeling stiff.”
Ragans didn’t feel those symptoms after his bullpens in Kansas City ahead of going on a rehab assignment. He didn’t feel them while on the mound in St. Paul, Minn., where Omaha was playing over the weekend, saying that he felt “right where I normally am and should be.”
It was only the day after the start that the inflammation and stiffness returned.
“I’ll give it a few days to see if it’ll chill out,” Ragans said. “... It’s hard to simulate the adrenaline you feel when you start a game, even when it’s a rehab start. It’s hard to simulate that in a bullpen. You can step on it in a bullpen, but it’s not the same. So I don’t know. Give it a few days, ease my way back into it and see what happens.”
To go from thinking Ragans is on the precipice of returning to now not knowing when he’ll be back again is jarring. He has been through two Tommy John surgeries and knows what to expect when dealing with that, but this current elbow injury is different.
But Ragans is hopeful that the short shutdown is beneficial. Unlike the last time he was shut down for the few days after he was placed on the injured list, Ragans doesn’t plan on doing anything to his arm but ice and rest it.
“It’s aggravating,” Ragans said. “I’m so tired of watching baseball. I want to play baseball. I want to play with my guys. I don’t want to sit here and watch it. I want to help this team win, and sitting here, I can’t do that. I’m tired of doing that.”
For now, the Royals are still down two starters with Ragans and Kris Bubic (left elbow soreness) – who has begun playing catch – on the 15-day IL. Stephen Kolek is filling one of those spots, while the Royals have thrown a bullpen game for the other one and will likely do so again on Tuesday when it comes up again on the schedule.