The soreness in his surgically repaired left elbow surfaced in the early days of March. The discomfort lingered for weeks. Tim Collins hoped it was natural, the usual progression in a year-long rehab following Tommy John surgery last March. His instincts told him it might be something else.
On Wednesday, Collins’ worst fears were confirmed. An MRI detected that the tendon graft in his left elbow had failed. The damaged condition of his elbow will require a second Tommy John surgery. Collins, a 26-year-old relief pitcher, is facing another 18 months of rehab.
“It’s not the news I wanted to hear,” Collins said quietly, standing inside the Royals’ locker room on Thursday morning. “But that’s life, I guess.”
The news cast a pall over Royals camp on Thursday morning. Just days earlier, Collins had boarded a flight and traveled home to witness the birth of his second child, a daughter, on March 18. When he returned, he underwent an MRI to get to the root of the ongoing soreness. The results offered a devastating diagnosis.
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Collins, 26, was in the final months of rehab after his first Tommy John surgery, a procedure in which a healthy tendon is extracted from the body and replaces a damaged ulnar collateral ligament in the elbow. He was set to return in May. The latest setback could put his career in jeopardy and his future with the Royals in peril.
“It just shocked all of us,” Royals manager Ned Yost said.
Collins, a 5-foot-7 southpaw, forged an improbable career by beating the odds. Now he will have to do it again.
“Back to square one,” he said.
Collins suffered his original elbow injury last March. He watched the Royals from the sideline in 2015, working through his rehab as the club won its first World Series in 30 years. The sight, he said, offered motivation as he grinded through tedium of workouts and arm exercises.
When the season was over, the Royals could have let Collins walk into free agency. Instead they tendered him a $1.475 million contract for 2016, a move designed to bolster bullpen depth. As spring training began, Collins set a goal of making a roster out of camp. He was fully aware that he would likely be rehabbing until May. The wait will now stretch until 2017.
“It’s frustrating,” Collins said. “Obviously, you don’t want to have to go through it twice. (But) I can’t change anything. I just got to go at it the same way I did the first time. I’m not going to change anything that I did in the first one.”
Standing inside the Royals’ clubhouse on Thursday, Collins said he first began to sense something was amiss as he worked through his throwing program here in Arizona. He felt continual soreness in his left elbow. The sensation caused alarm. Yet the soreness was considered standard for a pitcher returning to the mound. Collins consulted with other Royals pitchers who have undergone Tommy John surgery. All said they had suffered from similar fatigue. Collins opted to keep pushing forward — until he couldn’t any longer.
“The confusion was a lot of the normal stuff I was feeling could also be stuff that’s not good,” Collins said. “It’s kind of hard to differentiate that. I was at a point where I didn’t want to keep trying to push through it.”
In mid March, as the soreness reached a head, Collins returned home for a week to be with his wife as his second child was born. The time off, Collins said, allowed for the inflammation in his elbow to subside. When he returned to Arizona, the Royals’ medical staff sent Collins to have an MRI.
“He was feeling some soreness in there,” Yost said. “And he thought it was natural soreness. But it was just sore. We just thought, ‘Let’s just get him an MRI, and we’ll ease his pain, show him everything is normal.’ But when it came back, the tendon was torn again.”
Collins’ first Tommy John operation was conducted by orthopedic surgeon James Andrews in Birmingham, Ala. The Royals said Thursday that there is no set date or doctor for the second surgery.
For Collins, the 2016 season was supposed to offer a platform to rebuild his once-promising career. He had come to the Royals in 2010, in a deal that sent Rick Ankiel and Kyle Farnsworth to the Atlanta Braves before the trade deadline. The deal also brought Jesse Chavez and Gregor Blanco to Kansas City. Collins was the most intriguing prospect.
At 5 feet 7, he had gone undrafted out of Worcester, Mass. He never played an inning of college baseball. His path to the big leagues was most unusual.
Collins signed with the Toronto Blue Jays in 2007, a diminutive left-hander with an insatiable work ethic and solid athleticism. He grew into a revelation in the minor leagues. His fastball eventually reached the mid 90s. He supplemented the gas with an effective curveball. The arsenal helped him become a mainstay in the Royals’ bullpen from 2011 to 2013.
In 228 career appearances, Collins has recorded a 3.54 ERA. He is still five months shy of his 27th birthday.
“I’m still young,” Collins said Thursday, answering a question about his future. “I’m 26. Obviously, you don’t want to miss two consecutive years of baseball. A lot can happen in those two years.”
For now, the Royals’ have the bullpen depth to cover Collins’ absence. The prognosis for Collins is more uncertain. The research suggests that pitchers who undergo a second Tommy John surgery have slimmer chances of returning to the big leagues. According to a 2015 study, published in the Journal of the American College of Sports Medicine, just 65.5 percent of pitchers who have a second Tommy John surgery have returned to the big leagues. The success rate after a first Tommy John surgery is closer to 90 percent.
The sample size is small, of course. The study looked at just 33 pitchers, and the Royals’ clubhouse features two pitchers — Kris Medlen and Joakim Soria — who have overcome two Tommy John surgeries. As Collins prepares for another operation, he is hoping to join that group. He is hopeful he can beat the odds again.
“I’m just going to take my rehab one day at a time,” Collins said, “and go from there.”