JUPITER, Fla. — A year after he was the opening day starter for the Cardinals, Miles Mikolas will start the regular season on the injured list and could have his season debut delayed by as much as a month.
Mikolas received a platelet-rich plasma injection Tuesday morning into his right arm and around the ailing flexor tendon. He has been prescribed rest for the next three to four weeks. He will be able to participate during the non-throwing drills of spring training. He will be evaluated in mid-March to determine if he can begin a throwing program and use the minor-league spring training to ramp up to be ready to join the rotation at some point, possibly in late April.
"Just realized it was necessary," manager Mike Shildt said as he confirmed the treatment plan. "Gives us a better chance to get him off to a healthy start and get what he's dealing with behind him. That's where we are."
Mikolas received a PRP injection at the end of this past season and was also prescribed rest at that time. He felt a return of the discomfort as he threw with greater intensity with the official start of spring training.
The Cardinals' concern was not just the recurrence of the pain in his flexor tendon, but the fact that it could indicate a weakness or injury elsewhere. Mikolas had an MRI this past week to check the stability of his elbow and the status of his ligaments, and the Cardinals were encouraged when they compared that picture to pictures taken last season and last fall.
Shildt reiterated that the team is confident in the condition of Mikolas' ligament. Treatment for the flexor tendon is part of the preventative measures taken to assure the ligament isn't at risk, because a ligament injury could require Tommy John surgery and a longer recovery.
The Cardinals already had Carlos Martinez and Kwang-Hyun Kim vying for the one opening in the rotation.
That group of starter candidates now expands to embrace John Gant, Ryan Helsley, and Genesis Cabrera -- any of whom could serve as a short-term starter and then a long-term reliever. Daniel Ponce de Leon and Austin Gomber are also being prepped as starters, whether they win a spot in the major-league rotation or position themselves as the first-starter-up from Class AAA Memphis.
Shildt mentioned that Alex Reyes will also be in the mix because he's on a starter's schedule. The Cardinals are hesitant to stack a starter's workload on Reyes this season after missing three years due to injury. However, the short-term assignment as a starter has an appeal for the Cardinals as they then would manage his innings in a relief assignment later.
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