ST. PETERSBURG -- Matt Moore's Tommy John surgery takes place on Tuesday, ending the 2014 season for the Rays left-hander but buying hope for a bright future.
"It's gone to the point now where, of course, the negative side is you're going to lose your guy for a year," Rays manager Joe Maddon said. "The positive side is he has a chance to come back at least as good, if not better."
Moore's operation becomes the sixth such surgery performed on a Rays Major Leaguer. Once considered radical, the surgery has evolved to where it's actually considered routine.
"With a younger pitcher, it's more tolerable I think, because there's more to go on the back end," Moore said. "The guy that's been around a while, the older pitcher, I think sometimes maybe even may try to forego and pitch through whatever they're feeling and try to strengthen it in a different way, maybe therapy-wise. There's been a lot of progress with [the surgery]. It doesn't have the same negative stigma attached to it that maybe it had in the beginning."
The first such operation took place in 1974, when orthopedic surgeon Dr. Frank Jobe performed the surgery on Dodgers left-hander Tommy John.
The purpose of the operation is to reconstruct the ulnar collateral ligament of the elbow via a graft using a tendon from elsewhere in the patient's body.
According to data from the Hardball Times website, of the 293 Tommy John surgeries performed on Major League players, five have involved Tampa Bay pitchers while with the Rays: right-hander Jason Isringhausen (June 16, 2009), right-hander Tyler Walker (2006), right-hander Seth McClung (2003) and right-hander Dave Eiland (2001 and '02).
Moore and McClung are the only homegrown Rays Major Leaguers to undergo Tommy John surgery.
Given Tampa Bay's success at avoiding pitching injuries, Rays executive vice president of baseball operations Andrew Friedman was asked if he was surprised by the recent rash of injuries incurred by the club's starters.
"No, I think if you look over the history of the game, pitcher injuries are something that in a lot of ways are inevitable," Friedman said. "It's an unnatural motion. And I think we've been more fortunate than the industry because of: A, how hard our pitchers work; and B, the tremendous training staff we have and how much they care and how deligent they are.
"... You look around the game over the last 50, 100 years, pitching injuries happen. And we do all we can to put our guys in the best position to stay as healthy as they can for as long as they can."
Inside the Rays' clubhouse, three pitchers have had Tommy John surgery: Grant Balfour, Brandon Gomes and Jake McGee. Given the fact all three currently pitch in the Major Leagues, it's safe to say their surgeries were successful.
McGee, who had his surgery in 2008, noted that it "was better than I thought it would be."
"I had a little setback around 10 or 11 months," McGee said. "After that, it was good. I was in games at 12 months. I was feeling good, fresh and bouncing back."
Gomes had the surgery in 2004 while still at Tulane University.
"I had battled elbow stuff for a while, and finally, on my third or fourth rehab program, I was coming back and blew it out on flat ground throwing a changeup," Gomes said. "As far as the surgery and rehab, I did everything at Tulane, a facility on campus -- Tulane Institute of Sports Medicine, it was right there. I was in there pretty much every day doing stuff."
In the back of probably every pitcher's mind is the idea that at some point in their career, they are going to blow out their elbow and need Tommy John surgery. Based on that mindset, Gomes was asked if he felt a sense of relief once he knew he would have the surgery. While the question of when is eliminated by having the surgery, other worries arise, according to Gomes -- worries that can add anxiety to the equation.
"I think it's still difficult knowing that you're going to miss an entire season of baseball," Gomes said. "And you have that doubt. There is that possibility that, 'I'm not going to play again.'
"There's a little bit of anxiety, obviously. Then once you start your rehab, it's much more like, 'Hey, I'm ready to get back at it.' Once you start throwing again, there's more of a sense of relief. I was fortunate, I didn't have any setbacks. I came back in 10 1/2 months. And, knock on wood, I haven't had any problems since."
McGee pointed out that the harder one works in rehab, the more that work will pay off.
"It's easier on your mind, too, knowing the percentages about how successful the surgery has been," McGee said.
Dr. James Andrews, who will perform Moore's surgery, also did McGee's.
"Dr. Andrews told me it's 75-80 percent I'd return, like I was," McGee said. "He's like, 'Five or 10 percent, you'll come back a little stronger than you were.'
"I think I'm stronger than I was before, because I'm sitting higher with my velocity. Before I had surgery, I had to really let it go and not care where it's going [to hit the mph I am now]. Now I feel like I can still be in control and get up to 97 or 98 and know where it's going."
Balfour, who also had shoulder surgery, had his elbow surgery in 2005, and he said he came back stronger, too.
"It's part of the game," Balfour said. "It happens a lot. I think the sooner you can accept it and just go get it done -- from somebody reputable, who has obviously done it -- and then from there, it's really how you rehab and stay on top of it. That's a big part of it in coming back. If you work hard, rehab, come back, a lot of times, you come back stronger than you were."
But routine? As the old saying goes, surgery is always routine -- when it's somebody else's surgery.
"It seems to be [routine], but there are guys who haven't come back," Balfour said. "So there has been a handful that are having a tough time.
"I talked to Matt a little bit about that. One of those things, it's part of the game, don't get too down about it. It's a tough time, no doubt, any time you have surgery."
Gomes pointed out what he felt was the hardest thing to deal with when having the surgery, and it had nothing to do with the elbow.
"What I found to be the toughest thing was knowing that I wouldn't be playing for a year," Gomes said.
Bill Chastain is a reporter or MLB.com.