MLB's new most common pitching injury has been SOLVED and its awesome

Added: 2026-05-21

[00:00:00]There is a new surgery that is changing the lives of some of baseball's best pitchers. So, what is this miracle surgery and what the hell are loose bodies? I'm going to get into it all right now on another edition of Mayplaining. Repoto and Hawkeye all tell you this information. Paul Skins has added two pitches to his arsenal going into 2025.

[00:00:22]No, don't do it. Don't buckle up. It's time for some mazeplaining.

[00:00:31]But first, don't forget to like and subscribe so you don't miss any of these videos in the future. And also go check out some note merch over at maydaywear.shop so you can be be cool like me.

[00:00:45]Pitchers, especially in the major leagues, have a fairly narrow set of injuries that happen to them most often.

[00:00:52]You've heard of Tommy John of like labroom surgery or the increasingly common thoracic outlet syndrome. These are all talked about the most because of the long downtime associated with recovery. Most of the time it's the downtime, not the injury itself, that is the biggest reason news of these impending surgeries can feel so catastrophic when you hear about them.

[00:01:17]However, there is another possibly even more common injury that is popping up more and more these days and you may not be super familiar with it. They're called bone chips or the provocative loose bodies. So, what are these loose bodies and what do they mean? Well, we just so happened to know someone who knows a lot about it. Producer David reached out to his father, interventional radiologist. Yeah, try saying that five times fast. Dr. William Korn, who broke down exactly what loose bodies are. He said, quote, "In general, loose bodies are small bits of cartilage or bone that come off the surface of one of the adjacent bones and are floating around in the joint space. This usually causes pain and like locking, but they can be removed. So, this is an elbow.

[00:02:12]That is a loose body. It can be on the inside. Sometimes they're on the outside, in the inside, whatever. It's just little pieces around the joint that get come loose or maybe even shear off of the the main body and they become loose. Dr. K also described the sensation as having a pebble in your shoe that you can't get out. Now, if there was ever a metaphor that made my skin crawl, it was that one. Now, as you can imagine, these are pretty common for pitchers, especially in the elbow area, because the active pitching basically makes you bend your elbow and then lock it out over and over and over again. As that happens, the structures that hold that elbow together get wear and tear on them. So more so than Tommy John or even the labreum surgery in the shoulder, this is less of something giving out than that you need to be kind of the seat belt of the joint and more of a wear and tear type of uh injury like uh like the treads on your tires going out or something like that. It it is pretty impressive that a pitcher can throw a certain amount of time without actually having any of this. And it usually happens to a certain type of guy, but most guys have this sensation at one point or another in their career. Now, that pebble in the shoe sensation is what TKO has been dealing with and was dealing with for the month or so leading up to his IO placement on May 4th.

[00:03:42]Shortly after, it was announced that he was going to be having surgery to remedy the problem. Now, understandably, most fans and other baseball people, myself included, assume that this meant a longer recovery, potentially the rest of the season. Hearing a pitcher need surgery at any point in the season likely means that more so than a position player, because of the amount of time you need to build back up your endurance in your arm and then also get sharp till you can be effective against big league hitters. It it takes a while even when you're healthy. So like factor in the 6 weeks to do that with the actual surgery time the assumption makes a lot of sense you know after all how often do you hear this and then they just you just don't see them for this year you know all the time this happens all the time but there is good news fortunately for Scooble and baseball as a whole there's a new procedure that drastically reduces that timeline especially when it comes to loose bodies is what is what school has and Scubble volunteered to be the First, it's called a nanoscope. According to this attractive individual, Dr. Neil Elatro, who is the team physician for the LA Dodgers and the Rams, he described it like this in an interview uh with the Athletic. He said, quote, "There's a smaller incision, almost like a poke for an IV, where a larger arthroscope has you push through layers of tissue, sometimes causing more bleeding, scarring, and inflammation. The nano needle, which is what uh is being used in this new procedure, could more easily glide to the location. The surgery requires pumping an estimated 65% less fluid into the elbow. Now, I probably should have said trigger warning before that, so if you had to listen to something you didn't want to listen to right there, I am very sorry. But detailed explanation aside, it sounds like it is a less invasive uh uh situation that because of the nature of it and the sensitivity of the area it goes into that a lot of the recovery is not from the actual procedure but uh all of the steps you need to take to to get the job done. Now this is a nanoscope and this is a traditional arthoscope. So you might have heard arthroscopic surgery before or someone getting their elbow scoped. This is traditionally what it meant. It means just cleaning up the area. Uh this is a very common procedure to be done in all kinds of different areas when you have some irritation happening. Okay, this is more common than you think. A lot of people have these at some point in their life. Now, this tool, the nano needle, is a lot different, as you can tell, because it is over 50% smaller, which, as you can imagine, causes less damage on the way in and way out, as Dr. Ollet mentioned.

[00:06:32]Basically, it's more akin to getting a shot than an actual surgical procedure.

[00:06:36]A trade-off that I'm sure most of us would take. Now, here's what TKO had to say about the new surgery via The Athletics Cody Stavenhagen. I didn't realize how much it was impacting me dayto-day until taking that thing out of there. I feel great. It's different stuff, too. Stuff that's not even pitching related. These symptoms would come up at home, too, sometimes. To not have that has been a huge blessing. Scoo also described the marks from the surgery as small dots instead of a larger scar, one that he already has cuz he's had Tommy John surgery. Now, this new surgery hasn't only helped baseball players. The NHL's Winnipeg Jets team physician Peter McDonald used an anonyle on goalie Connor Helak. Sorry, tell me in the comments how to say that. I have no idea. He was a starting goalie for Team USA in this year's Olympics. And they used the same scope to repair a torn meniscus and uh removing a Baker cyst from Connor's knee. He was initially expected to miss 4 to 6 weeks.

[00:07:35]He was full strength at closer to three.

[00:07:38]Additionally, there is no risk to the new surgery. If for some reason the nano needle can't do the job, elatros would simply switch to the traditional arthoscope and the patient would be no worse off than before and have a traditional recovery timeline. So, as you probably can pick up on, the the biggest benefit of this new strategy is the reduced timeline. Traditionally, removing bone chips from an elbow or even repairing a meniscus would take four to 6 months of recovery. Sometimes depending on the size of the loose body or how long it's been there or what kind of damage it's causing, it could be 2 or 3 months, but like it's usually in the months. Now, we add the 6 weeks onto the 3mon recovery for that I mentioned before, that's 4 and 1/2 months. That's almost the entire season. But now we can move that timeline up. And that we're already seeing evidence of that with Trick Scooble. After playing catch just two weeks after he had surgery to remove the bone chip in his elbow last week, Scubble threw a full bullpen session on Monday, using all of his pitches and resuming a typical five-day routine.

[00:08:43]Again, less than 3 weeks after, he's already back on the mound throwing. I cannot explain to you how rare that is for a pitcher. It's like hiring a contractor to do work on your house. They might say it's four weeks. You better bet it's going to be at least eight. The session marked the second time Scooble has thrown off the mound since surgery to remove a loose body from his left elbow.

[00:09:08]Only 12 days before Monday. So 2 weeks he's back on the mound. And boy, that must be exciting for Tigers fans cuz I'm not even a Tigers fan and I'm excited.

[00:09:20]Scubble said on Monday everything was very normal. I think that's what the goal is to get back to normal as fast as possible and get in a 5-day rotation and get your body back in shape to be back in the big leagues. I think that's the hardest part right now. I feel really good and I want to let it go, but I've been instructed not to. Been there, my guy. So, let's take the 2 to 3 month timeline that I mentioned before and look at it now. There's a legitimate chance he will be back at pitching as soon as a month later, which is awesome.

[00:09:52]It's just awesome. School is believed to be the first major league pitcher to have this kind of surgery with the nanoscope which is designed to reduce the invasive nature of the procedure.

[00:10:01]And it was also performed by Dr. Elatro, who I mentioned before, who usually does Tommy John's and labroom surgeries. He's the same guy that handles pretty much all the other normal injuries pitchers have. So, you know, he knows what he's doing, too. So, give a guy a tool like that. The outcomes of this are are very likely going to be very good consistently. and wouldn't be a uh story about a very good pitcher without mentioning this guy Scott Boris uh and where he coined the operation the Scooble Scope because you know he was the first one to do it. Now the timing of this is significant for both Scoo and the Tigers. Scooble is set to enter free agency after this season and if he is able to return to the Tigers by early June, this gives the Tigers more leverage in a potential trade. I know that Tigers fans might have been happy about this story up until maybe this point, and I hope he doesn't get traded, but I think we all know uh how this thing goes. Producer David also wrote recently about a potential Terubble trade in his recent Substack article, which you should go check out. That is mayday.show. If you haven't become a subscriber, you should. And said that the Padres's could be an ideal trade partner if the Tigers make him available. I tend to agree with that.

[00:11:11]Even though the Padres's do have a pretty strong starting staff right now, I think anybody could use this guy and maybe they have the pieces to get it done. But then there's the other left-handed twotime Sai Young award winner that seems to be next in line to get the same surgery. Enter Blake Snell.

[00:11:29]Blake Snell is set to undergo surgery to remove, you guessed it, loose bodies from his elbow and will have the same new nanoscope surgery as Scooble.

[00:11:37]Dodgers general manager Brandon Gomes confirmed as confirmed by Dodgers general manager Brandon Gomes on Monday.

[00:11:44]Also, Neil Elatro is Blake Snell's team doctor. So, there's a good chance that he's going to be the one doing the surgery and he just had a pretty successful one with Scoo. Now, here's what Gomes said according to the athletics Katie Woo. Hopefully, it's the shorter timeline. That's the hope and expectation right now. Obviously, we won't know 100% until they're in there, but that's what we're expecting. Snell had the more traditional loose body removal to address the same elbow problem in 2019 while he was a member of the Tampa Bay Rays. That year, he missed two months before returning to the mound. Still a pretty quick turnaround, but if they can make that half as long, all the better. According to the California Post, Jack Harris Snell was a candidate for the new surgery specifically because of where the loose bodies in his elbow are located. Now, like I said, they can be anywhere in this joint capsule, and everyone is different. Depends on the size, depends on how it'll be removed or what needs to actually be done to it. So Snell had missed more than a month to begin the 2026 campaign while recovering from offseason shoulder fatigue which stemmed from a shoulder injury that cost him 4 months during his debut campaign with the Dodgers in 2025. With any luck, the Nanoscope will get him back on the field by the All-Star break. Now, it's not every year that we get a breakthrough like this that improves outcomes this drastically this fast. And that's awesome, especially considering how much more common bone chips seem to be getting in the league. Like every other day, it feels like we hear somebody is getting a a cleanup in their elbow or especially going into the off season, the the the old like we're going to have a normal procedure done and they'll be ready for spring training and then they're usually show start a little late for spring training. But that was usually bone chips and it's usually in the elbow situation. Sometimes there's some knee related stuff or or whatever, but for pitchers almost always in the elbow. So why is that? Why are elbows chipping at all? Like why why is this a thing? Why does this thing seem like it's a bigger deal now? Well, my theory lays the blame on injury prevention in general because Tommy John's become so common and labrum surgeries are so terrifying because of the not so great outcomes when trying to come back. I think that arm care has shifted with a hyperfocus on to strengthening those areas namely in the ligaments and the muscles involved in doing the movements.

[00:14:25]So as those areas become stronger and and better able to move uh force management like through the area, they must also have the actual physical stability, the scaffolding if you will to facilitate that force. That structure is made up of bones and we don't yet have a great way to like make your bones stronger. Now, there are things called like bone stimulators, which I've had to do on my own arm when I had a stress reaction in my humorris up here. Jake Deg GR had the same thing. So, it's interesting that now that guys are throwing super hard or much harder than they were in the past. And the injuries that are coming out of that seem to start being bone related because we're getting even better at building all of the other uh muscles and ligaments up around it. Now, that's the next step, I think, in in learning about how to strengthen the bones to handle this type of force. But that said, if the tradeoff were between a 6 week, you know, bone chip situation, especially with the nanoscope, or 16 months of downtime for Tommy John, I know what I'm choosing at least nine out of 10 times. So, will Scoo return better than ever? Will we see Blake Snell before the All-Star break? Let me know down in the comments.

[00:15:44]And as always, drink your water, enjoy your baseball, and I'll see you next time on the future Emmy award-winning baseball show, Mayday.

[00:15:57]See you.