TAMPA, Fla. -- The Yankees were well aware that Masahiro Tanaka had a bone spur in his right elbow when they signed him in 2014 to a seven-year, $155 million deal and paid a $20 million posting fee to the Rakuten Golden Eagles, his former Japanese club.
But they took the chance anyway.
"When he had his physical here in the States and his findings were presented to all clubs through Dr. [Neal] ElAttrache, every team received [the information] that there was a bone spur sitting there in waiting," said Yankees general manager Brian Cashman on Friday. "And if it ever reared its ugly head, it would have to come out.
"We didn't have any qualms. If we did, we wouldn't have signed him for all that money."
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The bone spur was removed Oct. 20, and for the third time since he joined the Yanks, Tanaka is working his way back from an arm injury.
On a more global basis, Tanaka is just another example of the elbow issues that have plagued some of the more high-profile Japanese pitchers after they arrived in the Major Leagues. Yu Darvish and Daisuke Matsuzaka suffered a similar fate.
Darvish is currently working his way back to the Rangers after Tommy John surgery. Matsuzaka's career ended in 2014 because of an elbow injury.
The Dodgers recently signed right-hander Kenta Maeda to an incentive-laden eight-year contract because of his history of elbow problems.
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Shohei Ohtani, the 21-year-old who throws 100 mph and pitches for the Nippon-Ham Fighters, is watching all this and trying to avoid the same kind of arm problems when he moves to the Major Leagues. Darvish once played for the same team.
"As far as injury prevention is concerned, that's something I've been working on all my life," Ohtani said earlier this month while his team was training in Peoria, Ariz. "Having spoken to Darvish and getting advice from him is definitely a big deal. I'm not saying it won't happen, but having guys like him around who have been through it definitely helps."
After going 12-4 in his first 18 big league starts through July 8, 2014, Tanaka didn't pitch again until Sept. 21 because of a partial tear of the ulnar collateral ligament in his right elbow. Last year, he missed a month because of an injury to his right wrist and forearm.
Tanaka has averaged 22 starts for his first two big league seasons, which is not what the Yankees were hoping for. It's hindsight now, but the 2014 medical report was a portent of all the arm problems to come.
"I think it's all related," Cashman said.
Tanaka threw his second Spring Training bullpen session Thursday, and by all accounts, he is progressing nicely. There's some talk about him graduating to batting practice and eventually throwing in a Grapefruit League game, but right now, there's no rush. Whether Tanaka will be ready for the start of the regular season is unknown.
Whether Tanaka will ultimately need Tommy John surgery to replace the ligament is also an issue that just won't go away.
Tanaka is certainly not the same pitcher who arrived with so much fanfare. His fastball doesn't have nearly the same pop, and when he throws it up in the strike zone, opposing hitters crush it for homers -- as Carlos Gomez and Colby Rasmus did when the Astros eliminated the Yanks in the American League Wild Card Game on Oct. 6 at Yankee Stadium.
Tanaka pitched five innings in the 3-0 loss. Was he ready to pitch that night? Tanaka made one very shaky regular-season start after Sept. 18 with what the club called a hamstring injury. Two weeks later, the bone spur was removed.
Tanaka said on Friday that he worked around the elbow issue all season because he didn't want to undergo surgery. This year, he decided to go into the season with a clean slate. But thus far, Tanaka's entire experience with the Yankees has been frustrating, to say the least.
"Every time I think I'm about to make it back, something else happens -- especially last year," Tanaka said. "I was building up to a pretty decent point and then a hiccup occurred. Obviously, it's very disappointing."
And it begs the big question: Why are so many Japanese starters having injury problems?
"For me, that's hard to answer," Tanaka said. "Pitchers get injured for different reasons. You really can't pinpoint anything as being a general reason why Japanese pitchers seem to get hurt when they come here."
Certainly, workload may have something to do with it. The big league season in Japan is shorter: 146 games as opposed to 162, and starters work only one day a week rather than every five days as they do in the Major Leagues.
Yet pitchers have a tendency to toss a lot of pitches before leaving high school. They start early. Ohtani, for example, is already heading into his fourth season with the Fighters.
"Their throwing programs are much more extensive and their amateur programs are much more exhaustive," Cashman said. "They may not be having as much wear and tear in the Japan Leagues on a weekly basis, but they certainly are making up for it in their pregames."
Matsuzaka had already thrown 1,401 2/3 innings in Japan before signing with the Red Sox in 2007, Darvish 1,268 1/3 frames before signing with the Rangers in 2012.
Tanaka had already thrown 1,315 innings over seven seasons in Japan. In 2013, he started and lost Game 6 of the Japan Series for the Eagles against the Yomiuri Giants and then came back to save Game 7 and win the title.
That's a lot of wear and tear. Less than a year later, Tanaka's elbow began to break down.
It's a hazard with all pitchers, Cashman concluded, not just the ones who come over from Japan.
"It's easy to theorize that the workload is different here than over there, but at the same time, all pitchers get hurt," Cashman said. "Obviously, this is not what I wanted out of Tanaka when I signed him, but it's also not what I wanted out of Michael Pineda when we traded for him.
"All pitchers are going down. It's very rare to have somebody that does not have health issues over time."
Barry M. Bloom is a national reporter for MLB.com and writes an MLBlog, Boomskie on Baseball. Follow @boomskie on Twitter.