Blue Jays starting pitcher to undergo UCL surgery

Alek Manoah will undergo surgery to repair the UCL in his throwing elbow on June 17, Blue Jays manager John Schneider told reporters (X link via Shi Davidi of Sportsnet). Doctors won’t know whether he’ll need to undergo a full Tommy John or the slightly less invasive internal brace procedure, but either surgery will end his 2024 season and sideline him well into next year.

Manoah left his start against the White Sox on May 29 with elbow soreness. His velocity was down early in that appearance and he winced on his final pitch of the evening. TSN’s Scott Mitchell reported shortly thereafter that Manoah was headed for a second opinion — typically an ominous sign that initial evaluation suggested surgery could be necessary.

That’ll unfortunately come to pass, likely costing the former All-Star more than a year of game reps. A former first-round pick and top prospect, Manoah looked the part of a budding ace between 2021-22. Over his first season and a half in the majors, he turned in a 2.60 ERA while punching out almost a quarter of batters faced over 51 starts. Manoah finished third in AL Cy Young balloting during his sophomore campaign thanks to a sterling 2.24 mark in 196 2/3 innings.

The last two seasons have been far more challenging. Manoah couldn’t find his form in 2023. He was tagged for nearly six earned runs per nine over 19 starts, leading the Jays to option him to the minors on two separate occasions. While he’d been searching for a rebound in 2024, health intervened. Manoah was delayed by shoulder soreness in Spring Training and began the season on the injured list. He made his season debut on May 5 and was out to a decent start. In five outings, he worked to a 3.70 ERA with a 25.2% strikeout rate across 24 1/3 innings.

Manoah has between two and three years of major league service. He’ll be eligible for arbitration for the first time next offseason and is under team control through 2027. The internal brace surgery typically involves a roughly year-long rehab process. Tommy John procedures usually last 14-16 months. If he requires the latter operation, his 2025 season could be in jeopardy.

Toronto will need to figure out a solution for the fifth rotation spot. They’re fairly well set in the top four with Kevin Gausman, Yusei Kikuchi, José Berríos and Chris Bassitt. Righty Bowden Francis occupied the fifth starter role during Manoah’s season-opening IL stint. He was rocked in two starts and quickly moved back to the bullpen. Francis spent around six weeks on the injured list before returning this week. He tossed 3 1/3 innings of four-run ball behind Trevor Richards in a bullpen game.

The Jays used a few Richards-led bullpen games late last summer while Manoah was trying to work through mechanical issues. That doesn’t feel like a sustainable solution for a couple of months. Offseason pickup Yariel Rodríguez could step back into the starting five. The Cuban right-hander has been on the IL since April 30 with thoracic spine inflammation. He’s on a rehab stint at Triple-A Buffalo, where he tossed three innings on Wednesday. Rodríguez has started four games in his first season in Canada but has yet to throw more than four innings or surpass 20 batters faced.

Toronto, which sits three games back in the AL wild card mix at 30-32, could find itself in the market for starting pitching at the deadline. They’d be joined by upwards of a dozen teams in that regard. If the Jays fall out of the playoff picture, they’d be in a position to market one of the top rental arms (Kikuchi). They’re one of the more interesting borderline contenders to follow over the next six weeks.