On August 13, C. Trent Rosecrans broke the news that Homer Bailey was bound for the disabled list. An MRI earlier that day had shown that Bailey had suffered a strained right flexor muscle.

Flexor Mass Injuries

The muscles that bend or flex our fingers are called flexor muscles. The Flexor Pronator Mass is in your forearm by your elbow. The flexor muscles move our fingers through cord-like extensions called tendons, which connect our arm muscles to our finger bones. The tendons stretch from the elbow to the fingers. This group of muscles and tendons is what allows a pitcher to grip or throw a ball. Muscle and tendon strains are actually tears.

Because pitchers use these muscles and tendons with great frequency, they are subject to overuse inflammation and injury. For the rest of us, this condition is commonly referred to as golfer’s elbow or tennis elbow. The site of the pain is the elbow, because that’s where the tendons of the forearm become degenerative at their attachment site. Inflammation, pain and swelling is caused by small tears in the tendon. It can lead to a sharp, stabbing pain if you flex your wrist or apply pressure with your hand.

The Inflammation and degeneration can reach various degrees of severity. A mild case might result in tendonitis with soreness and inflammation. More chronic cases can lead to a partial tear. Most seriously, and rarely, the tendon tears completely. With mild cases, the flexor muscle irritation usually responds to rest and time. Mat Latos suffered from such a condition in April and was held out until June. He did not undergo surgery.

In more serious cases, surgery is required to remove the degenerated tissue and repair the remaining tendon. Degenerative scar tissue accumulates where the tendon has partially torn and has to be removed. This is an entirely different condition and procedure than what is referred to as Tommy John surgery on the ulnar collateral ligament. Actual pictures of the surgical repair are available at Dr. David Lintner’s site, where he also talks through the stages of the surgery. Dr. Lintner says the results of this surgery are good and the recovery time is much faster than after UCL reconstruction.

After flexor mass surgery, the pitcher usually resumes throwing within three months of the operation.

Bailey’s Treatment

Homer Bailey’s final appearance in 2014 took place at Great American Ball Park on August 7 against Cleveland. After that start, Bailey noticed his elbow hadn’t recovered as usual.

“In the third or fourth inning of the Cleveland game, my elbow locked up on me,” said Bailey. “I don’t personally think it was from throwing. I think I did it whenever I got a hit. I don’t know. It could have been throwing because that’s what we do. It could have been from hitting. The next day it didn’t recover like it should have.” (Rosecrans) [Bailey had singled in the bottom of the second inning. Thanks stupid National League rules. You may remember that Bailey then scored from first on Billy Hamilton’s triple. Hamilton was thrown out at the plate trying to score on the same play.]

Early reports indicated surgery for Bailey might not be necessary. The Reds initially tried a standard conservative course of treatment. They had Bailey go a week without throwing. After that period of rest didn’t result in noticeable improvement, the club had Bailey take the MRI and found the flexor strain.

The blood supply to that area of the elbow is poor, so healing is slow and limited. Just as the medical staff attempted with Joey Votto’s quad tendon, the Reds ordered a Platelet Rich Plasma treatment for Bailey to see if that would help heal the strain. PRP is a common approach to mild flexor strains as a strategy to avoid surgery. When Bailey subsequently noticed no improvement, the Reds scheduled his surgery.

Dr. Tim Kremcheck performed Bailey’s surgery on Friday, September 5. The training staff estimates Bailey will start throwing in December. Last fall, Jonathan Broxton underwent the same surgery in August and ultimately missed the first ten days of the season. Kremcheck said Bailey’s tear was pretty small in comparison to Broxton. Trainer Paul Lessard described Bailey’s injury as not as extensive but similar (Sheldon). Pitchers are typically back on the mound in 5-6 months. Reports say Bailey will be ready to pitch in time for spring training or just after the start of it.

The Texan will wear a long arm split for six weeks, potentially providing African lions a bit of a reprieve this fall.

Bailey’s Season

2014 proved to be a frustrating season for Homer Bailey. He was plagued by minor injuries throughout, dating back to a strained groin muscle (strains are tears) in spring training.

“I’ve kind of been fighting stuff most of the year,” said Bailey. “It’s been a really, really tough year for me – a pulled groin, a herniated disc in the back, elbow, I took a ball off the jaw, took a ball of my biceps. It’s just been one of those years.” (Rosecrans)

Bailey saw his K/BB fall for the first time in his career. He ended the season with 23 starts, a 9-5 record, a 3.71 ERA and a 3.61 SIERA. Bailey threw seven shutout innings in the 4-0 win over Cleveland in his final start. His ERA in his last seven games was 1.62. In that stretch he gave up only one run three times without earning a win. On the positive side, his ground ball rate was up significantly (to 50.6% from 46.1% in 2013 and 39.5% in 2011). Bailey’s swinging-strike rate was the highest of his career as was his fastball velocity. Bailey’s average FBv of 94.3 mph was the ninth highest for a starter in the major leagues.

Bailey spent time in 2010 and 2011 on the DL missing a combined 25 starts with shoulder concerns.

“I think getting such a bad start early put a damper on things,” said Bailey. “I’ve always been a second-half performer. I heard someone say your second half is a direct reflection of your offseason. I don’t think anyone works as hard as I do I the offseason. I just try to, especially when it comes down to crunch time, to have the same mentality that everybody does who takes that ball on the mound. We want it. We want to win games. If you’ve got to take them off the jaw, you take them off the jaw. Just give me the ball back and let’s keep going after it.” (Kevin Goheen, Fox)