KANSAS CITY – The Royals provided more clarity on two of their injured pitchers and made a flurry of roster moves ahead of Friday’s series opener against the Tigers at Kauffman Stadium.
Starter Cole Ragans was placed on the 15-day injured list with left elbow impingement as he deals with valgus extension overload (VEO) in his left elbow, a condition commonly called pitcher’s elbow that’s characterized by back- and middle-elbow pain related to repetition in throwing athletes.
Reliever Carlos Estévez has a right rotator cuff strain after he experienced shoulder discomfort in his first rehab appearance on Wednesday, and he will be shut down for the next three to four weeks. Estévez was returned from his rehab assignment on Friday and remains on the 15-day IL.
In corresponding moves, the Royals recalled starter Stephen Kolek and reliever Steven Cruz from Triple-A Omaha while optioning reliever Eric Cerantola.
Kolek will likely slot into the rotation in Ragans’ spot when that comes around again next week, although he could be used in an emergency bullpen situation if needed before then. Cruz offers another fresh arm in the ‘pen after the unit was taxed heavily the past two days.
Ragans exited Wednesday’s start against the Guardians after just three innings and 58 pitches, feeling tightness in his left triceps and elbow. Testing on Thursday showed the VEO, and he received an injection that acts as a lubricant to help minimize the tightness. The Royals are optimistic that his IL stint will be a minimal one – although it’ll depend on how he feels as he begins to throw again.
Ragans will be shut down for the next three or four days before a ramp-up begins. If playing catch early next week goes well, he’ll progress to bullpens and then a rehab assignment.
“It’s like any other rehab,” manager Matt Quatraro said on Friday. “You have to see how he feels that day, then the day after, and then you keep progressing. So we don’t have any particular timeline filled out, but we’re hopeful that it’s not much more than 15 [days].”
Ragans is not the first pitcher on the Royals’ injured list with VEO this season – reliever Bailey Falter has been sidelined with the same injury since April 3. Ragans and Falter aren’t in the exact same situation with different elbows and different roles, but Falter was shut down for a few days then threw a bullpen on April 8 and began a rehab assignment on April 15. Falter has been throwing consistently on the rehab assignment since then.
Ragans said Friday that he feels good physically with symptoms that haven’t lingered, although he hadn’t tried throwing since his start Wednesday.
“To say I’m not pissed off would be a lie,” said Ragans, who missed significant time last season with a left rotator cuff strain. “It’s never fun to go on the IL. But [I’m] pretty optimistic about it, pretty optimistic that I’ll bounce back pretty quick and slot back in. Did all the testing stuff, everything came back good, so pretty optimistic about it.”
Estévez is a different story. The 33-year-old reliever has been on the 15-day injured list since April 1 after he was hit on the left foot by a comebacker on March 28. In addition to the left foot contusion, Estévez has been working on getting his velocity back after seeing a significant dip during Spring Training and that first outing.
The Royals were optimistic about getting Estévez out on a rehab assignment this week to see where he’s at with his health and delivery. Three batters and two outs into his outing with Triple-A Omaha, Estévez was experiencing shoulder discomfort and leaving the mound with a trainer.
Rotator cuff strains have varying levels of severity, leading to different timelines. Estévez will be re-evaluated, including getting updated imaging of his shoulder, after three to four weeks of not throwing to determine the next steps in his recovery.
“He takes it in stride,” Quatraro said Friday. “He’s a pro. But it’s disappointing, for sure. He was really looking forward to getting on the mound in Triple-A and getting ramped up and back here quickly, and obviously that’s not going to happen. So he’s disappointed, but if anybody can handle it, he can.”