Home remedy: Rays medical staff helps Moore return

After his April 2014 Tommy John surgery, Matt Moore spent 42 of the following 45 weeks leading into Spring Training rehabbing a minimum of five days a week at Tropicana Field under the direction of Rays head athletic trainer Ron Porterfield and his staff.

April 7, 2014. Matt Moore knew it was going to take a special effort to win his second start of the season. He was sick, requiring a dose of Dayquil earlier and a teaspoon every other inning to help him through his outing on that windswept night in Kansas City. But as the game entered the fifth inning, it wasn't a chest cold that ended his outing.

According to Hardball Times, 351 major league players and hundreds more Minor Leaguers have undergone ulnar collateral ligament (UCL) reconstruction, more commonly referred to as Tommy John surgery, since Dr. Frank Jobe performed the first procedure on the Los Angeles Dodgers lefthander in 1974.

On that cool night inside Kauffman Stadium, Moore felt something wrong in his throwing elbow. Two weeks later, he joined that group.

Moore admits he wanted to find a way to finish last season in the bullpen, but he needed to recover to rejoin the rotation in 2015. "We had our heads held high going into the season with the squad we had, and I wanted to be a part of it," he says. "I didn't want to leave for a year and say, 'See you guys.'"

Instead of going home to New Mexico for rehabilitation, Moore remained with the team, which has made all the difference in getting back on the mound. His return will have been the result of 14 consecutive months of rehab supervised by head athletic trainer Ron Porterfield and assistants Paul Harker and Mark Vinson.

Porterfield prefers to conduct player rehabilitation in-house. By his own estimation, he's helped about 100 players return from Tommy John surgery at the major and minor league levels with the Rays and Astros organizations.

"It's ideal because it's the same people working with him, and we're after a common goal," he explains. "If he goes out to a physical therapist, they do a protocol rehab and don't have to answer for him during the season."

For the first six weeks, Moore's arm was confined to a hard brace that the staff used to increase his range of motion by 10 degrees per week.

"That was the most discomforting," Moore remembers. "I felt like I had this urge to extend my arm and get out of it."

In those months, he learned the mental component to his rehabilitation would be just as crucial as the physical one. It was slow work. Moore knew he was only as good as his elbow was on any given day. He squeezed a ball to strengthen his fingers, did shoulder exercises, and eventually graduated to light weights for his forearms.

"The thought process is what I hated the most. It's not one exercise, one day of rehab that I dreaded," Moore says. "I got to the point where it's normal for me to know that I didn't want to do it, but wanted to see how fast I could get out of it. I took on the mindset, 'Don't let today be a waste,' and to focus on getting as much as I could out of each rep."

He had positive reminders along the way that he would get better. Moore spent time with Wounded Warriors, whose stories gave him hope. "They're dealing with stuff for the rest of their lives, and I'm dealing with a process in which it's going to feel pretty good on the other side. I have an elbow, I have a contract and a team with open arms trying to get me back to where I need to be. I had to look pretty hard to find negative things to dwell on."

At 4 1/2 months, he began doing "sock throws," going through the motion of releasing a baseball inside a long sock taped around his wrist, accompanied by plyometrics, both of which served as prerequisites before being cleared to play catch. Moore cleared that milestone in September, tossing from 45 feet initially and building up to 150 feet, but parts of the throwing program moved "at the rate of molasses," he recalls.

"There were times when I was like, 'Holy cow, I'm still playing catch at 75 feet three times a week,' when I think I'm ready to throw [from a longer distance.]"

In those instances, the training staff held him in check.

"You can't always be their buddy," Porterfield says. "I have a kid. I know how I want him to be treated. Not every day is going to be good. We try to pick up the good things and really emphasize those, and don't dwell on the bad things. There's tough love, but I'm still going to love him."

"Ronnie takes that route with a lot of guys because he knows we're not just machine baseball players," Moore says. "He pays attention to the facial expressions. After all his years of doing this, he gets what it means if a guy says one thing and his face is showing something different."

Following the season, the staff rotated on a two-week schedule to see Moore's rehab through the winter months at Tropicana Field. He came in five days per week for sessions lasting 2-3 hours, depending on the workload.

"I can't say enough about the sacrifice these guys made in being away from their families," Moore says. "I know we're all here and it's a team effort, but it's asking a lot for someone to take out four months of their down time to be hands on with players. I'm grateful because I didn't have to go from being with them to being away, having my rehab translated to a third party and then reporting back here. There's the rapport, the system and loyalty, and Ron, Mark and Paul had smiles on their faces every time I came in."

"He wasn't someone we could just stop and send home," Porterfield says. "Cycling in and out gave us a little break and allowed us to keep working with the same goal in mind."

They gave Moore a three-week break in December, too.

"His preparation for the 2014 season started in November of 2013, so he'd been working nonstop for a year and a half almost," Porterfield notes. "We had to be able to give him some time off, to prevent him from burning out and keep him fresh for August and September."

By the end of January, Moore was throwing off the mound and in February began a three-month bullpen program, with Porterfield suiting up to catch him on occasion.

"I love to do that because I can see the movement on pitches, if they're getting their arm through the ball, what the rotation is," Porterfield says. "And then I can relate to what they say. If they tell me it's great, and they're not throwing the ball well, we're not where we need to be."

Over the past few months, the hardest days have been when the team played on the road. Those days Moore would plan around making dinner and watching the game in the evening. Moore reported to the ballpark, followed his regimen, golfed or fished until dinnertime.

He hasn't felt the need to rush back to action, impressed by fellow starters Chris Archer and Jake Odorizzi.

"They're strutting right now. It's helped me feel like I don't have extra pressure to push this to be somewhere before I'm ready."

After 14 months, he is.

"This year, I've felt more pumped up about the season. Last year it wasn't in the realm of possibility to play again, so I wouldn't dwell on anything, where here I've been wondering, 'What day, what series, what team?'