WASHINGTON -- Though the Mets confirmed on Tuesday that pitchers Steven Matz and Noah Syndergaard are both suffering from bone spurs in the backs of their pitching elbows, the spurs are different enough to warrant divergent methods of management.
The Mets announced that they will push back Matz's next start from Wednesday in Washington to Thursday at Citi Field against the Cubs, giving him one extra day of rest as he deals with his issue. While Matz will eventually require surgery to remove the spur from his elbow, the Mets hope to delay that operation until after the season. In the rookie's place, Logan Verrett started Wednesday against the Nationals.
Syndergaard is nursing a much smaller spur that will not require surgery. He will continue to pitch every five games.
All told, the Mets believe neither spur is serious enough to warrant significant concern. Both are pain tolerance injuries, meaning as long as Matz and Syndergaard are able to pitch through their discomfort, the Mets will allow them to do so. Team doctors have given the Mets "absolute assurance" that pitching through the bone spurs cannot cause further damage, according to general manager Sandy Alderson.
"I think what we have a tendency to do around here is kind of manufacture anxiety," Alderson said. "But I don't think that anxiety is the proper response in Syndergaard's case. And in the case of Steven Matz, it's pretty clear-cut as well. He'll either be able to pitch and tolerate the discomfort, or he won't."
Matz, 25, first learned of his bone spur more than a month ago. After going 7-0 with a 1.13 ERA from April 17 through May 25, the left-hander has since gone 0-2 with a 5.00 ERA over his last five starts. He received a cortisone injection in early May and has recently been taking anti-inflammatory medication, but was unwilling to blame the spur for his recent struggles.
"If I'm claiming to be able to pitch, then I have no excuses," Matz said. "I expect myself to go out and pitch like I can."
Syndergaard denied the presence of his bone spur as recently as Monday night, when he flatly denied reports of it after giving up five runs to the Nationals in three innings. But the Mets confirmed his injury the following afternoon, with Alderson explaining Syndergaard's denial as an attempt to avoid making the spur an excuse. Syndergaard refused comment when approached again Tuesday about a bone formation that Alderson called "not nearly as significant" as the one in Matz's elbow.
"Ninety percent of the pitchers that are throwing in Major League Baseball" have similar spurs, Alderson said.
For both pitchers, the goal is now pain management. Dr. Bradford Parsons, an orthopedic surgeon at the Icahn School of Medicine at Mount Sinai, described bone spurs as repetitive use and impact injuries that can -- but do not always -- grow over time. There is little to no risk of bone spurs growing large enough to damage ligaments or other tissue, meaning soreness and inflammation is the most significant issue for pitchers.
"If they're prominent enough where they're blocking motion or causing pain … then that can affect their throwing motion and make it tough to pitch," Parsons said. "Generally, treatment is aimed at relieving any inflammation in the soft tissues around the spurs that may have developed over time, trying to take away pain associated with them, making sure the elbow has good flexibility and motion. And if they can manage this, they'll manage it. … It really is based on how much trouble the pitcher is having with it."