John Lackey's Elbow Under Dr. Yocum Examination

John Lackey of the Boston Red Sox reacts after allowing a two-run double to Mark Teixeira of the New York Yankees during the bottom of the first inning at Yankee Stadium in the Bronx borough of New York City. (Photo by Christopher Pasatieri/Getty Images)

[UPDATE] New General Manager Ben Cherington's first order of business was to announce that John Lackey will indeed undergo Tommy John surgery, and miss the entire 2012 season.

Assuming today isn't your first day at Over the Monster, then you've heard us discuss John Lackey and a potential elbow injury. He had a cortisone shot in his throwing elbow earlier in the 2011 season after a disastrous start, and while he wasn't great following it, he was exponentially better than he had been prior to it, as the swelling and discomfort in that joint kept him from producing at a level even remotely comparable to competent.

The further he got from that shot, though, the more difficult things became for him, something I discussed as a possibility back in late June:

...the issue is that we don't know how long it will last. His elbow must have felt fine last night, when he went 7-2/3 innings against the Phillies, allowing just two runs while striking out five and giving up one walk, but if/when the effects of the [cortisone] shot and the rest he got from going on the DL wear off, will he pitch like he did in April again? Will he need Tommy John surgery, as has been the buzz in the media the last 24 hours?

The answers to those questions are "probably" and "I'm not a doctor." The Red Sox are monitoring his elbow, making sure he stays healthy, and that's about all they can do at this point.

Fast-forward to September, and as far away from the cortisone shot as the constraints of the regular season allow, and Lackey did pitch like it was September once again. His ERA through May 11, before he was injected with cortisone and placed on the DL, was 8.01, and he was striking out 4.4 per nine while walking just one fewer batter, and had allowed 1.1 homers per nine, as well as an opponent slugging percentage of .720 -- for reference, the league-leader in slugging this season, Jose Bautista, finished at .608, and he was the only hitter over .600. In September, Lackey threw 23-2/3 innings over five starts, posting an ERA of 9.13, with 5.4 whiffs per nine and 4.6 walks per. Opponents slugged "just" .480 in that stretch, but hit .353 thanks to a .393 BABIP. If you watched the way he delicately placed the ball in the strike zone for anyone to have a shot at when he fell behind in the count, you wouldn't question where that massive BABIP spike came from.

It's clear something is amiss in his elbow. The cortisone shot existed for a reason, and, given his September and his failure to ever rise above anything resembling "average-ish" at any point in the season, we have reason to believe it was delaying the inevitable more than anything. We don't know yet if Lackey will need Tommy John surgery, as was speculated by many, including Peter Gammons, over the summer. What we do know is that this visit to Dr. Lewis Yocum is a necessary one, so we can find out once and for all if Lackey is as hurt as we've come to think he is.

Should he be injured and in need of a major elbow procedure, assuming this is from his pre-existing elbow condition, the Red Sox should be able to employ Lackey in 2015 for the league minimum rate, which would do two things, one of which Rob Bradford points out in the article linked above: cut the average annual value of his contract down from $16.5 million to $13.8 million, giving Boston a little more wiggle room under the luxury tax, and would also mean that, while Boston would lose a season of Lackey to recovery, spending $15.25 million on him in the process, they would also get him for relative pennies in 2015, when he is, in theory, in one piece once again. 

We'll speculate on all of that when we know for sure what's up with him, but if this examination is any indication, we won't have to wait very long for that.

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