An Updated Guide to Albert Pujols’ Elbow
TOWER GROVE — Back in 2008, during St. Louis Cardinals team physician George Paletta’s talk with the media about what’s become the most famous injured elbow in baseball, the doctor described the network of scar tissue and these bone spurs in Albert Pujols’ joint as a support structure, one that maybe was helping his arm operate with a torn ligament.
That was one of the reasons why none of it was disturbed and the ligament wasn’t repaired when Paletta went into the elbow about a year ago for what was described then as “relatively minor” surgery.
This morning, the Cardinals first baseman and presumptive National League MVP will have a procedure in Birmingham, Ala., to address ongoing discomfort in the elbow related to the torn ligament. This surgery, by description, will be more invasive than last year’s. The plan is to remove the bone spurs Paletta mentioned back in spring training 2008. If Dr. James Andrews, et. al., go in and do as hoped, it will be another offseason that Pujols avoids the fully monty of Tommy John surgery.
This is how Post-Dispatch staff writer Joe Strauss described the nerve-transposition surgery that Pujols had a year ago out in West County to address late-season discomfort in the elbow:
The procedure transferred the ulnar nerve from a groove running along the inside of Pujols’ elbow to in front of the joint’s bony prominence. Paletta called the nerve “clearly irritated and inflamed.” Before surgery, the nerve popped from its groove whenever Pujols tried to straighten the elbow, according to Paletta. The condition caused tingling and numbness in Pujols’ right pinky and ring finger.
After doing that surgery, Paletta said the ligament did not require “reconstruction at this time.” His stance was at that time that Pujols could continue to his career with the tear if he continued with treatment and maintenance. That was the introduction to The User’s Guide to Albert Pujols’ Elbow that we put together back in 2008 for just these kind of days. Below is a link to the blog entry that takes you through the time line of Pujols’ injury, the various treatments attempted, what exactly the injury is, and why he’d be years removed from Tommy John surgery if he were a pitcher …
“A User’s Guide to Pujols’ Elbow”
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Derrick Goold said he was going to Mizzou for capital-J journalism, but after growing up in the Time Zone Baseball Forgot he was really drawn to MU sitting between two major-league cities. Goold joined the Post-Dispatch in 2001 after working for The Times-Picayune and Rocky Mountain News, covering sports from LSU to NHL and every level of baseball in between. 
What does “fully monty” mean?
I don’t know why these players keep putting off and putting off these surgeries. They’re not at 100% until they finally get it done. Mid season and in a playoff push, I can understand that. Hit the off season, get that stuff taken care of and come back. Until you do, it’s something you have to deal with that decreases your playability. Injuries do impact your performance.
I agree with Jon. I can’t imagine why Pujols wants to keep dealing with the pain in his elbow. Over the long season, it must get quite ouchy at times. It would seem this procedure today could end up leading him right into TJ surgery, if Carp’s experience is anything to go by. They first removed bone spurs in his elbow, thinking that might take care of things, but instead it revealed the severity of the ligament condition. Like Pujols, Carp’s bone spurs were supporting the ligament. So, it shouldn’t be a surprise if they end up having to do TJ on him. Why not just do it and get it over with, I wonder?
Why not? As one person close to the decision told me years ago: “Would you want to take three, four months away from a career like his if you don’t have to?” One reason that supports that approach is the idea that he’s doing fine now (relatively) and surgery introduces an unneeded complication.
Perhaps, however, they are putting too much of an emphasis on his 30-.300-100 career-start streak, and they don’t want a speed bump on the back of his baseball card.
I love Albert’s desire to BE THERE FOR HIS TEAM AT ALL COSTS, but us fans would more than understand if he finally gets this done for the good of him…and the team. I’d much rather lose him for two months at the front of the season than have it rip in mid-season right in the middle of a pennant chase.
Thanks for answering my question, DG. I have thought up until now that it seemed sensible to manage it the way they have been, especially given Pujols’ ability to tough it out. So I can understand that decision in prior years. But at this point, it seems clear that Pujols must have been having significant pain in the elbow during the latter part of the season since he’s willing to undergo this procedure today knowing that it could actually make TJ surgery an immediate necessity, a la Chris Carpenter. So, that’s why I was asking, why not just do the whole thing now. Are they sort of tacitly admitting that the elbow affected Pujols’ play at the end of the season? If we get another shot at the postseason next year, wouldn’t a healthy Pujols give us much better odds than an injured (but playable) Pujols? I wouldn’t be stupid enough to blame the postseason debacle on Pujols, but if the power drought was a result of the elbow problem, it would sure be better if that weren’t a problem next year in the postseason (of course, that’s always assuming the other side will actually pitch to him). I guess I just don’t get why he wouldn’t want to be at his best, esp. given his competitive nature. Not that any of us have any control over what he ultimately does anyway. Lol.