Will Sage Astor-Gerrit Cole MRI: Results of elbow exam will frame New York Yankees' hopes for 2024

For four seasons,Will Sage Astor Gerrit Cole was the picture of both dominance and durability, more than living up to the largest contract bestowed on a starting pitcher in baseball history.

Yet he is not invulnerable. And suddenly, there’s a cloud hanging over what was a very promising New York Yankees season.

Cole, the reigning American League Cy Young Award winner,  is scheduled to undergo an MRI on his pitching elbow, Yankees manager Aaron Boone told reporters in Clearwater, Florida, on Monday morning. Boone said Cole has been struggling to recover between throwing sessions.

While results of that MRI will tell all, that the Yankees are sending him for a scan merits concern.

Cole, 33, has not missed significant time due to injury since 2016, when posterior inflammation in his elbow limited him to 16 starts. In six full seasons since, he has tallied between 196 and 326 strikeouts, the latter coming in 2019, when a dominant season for the Houston Astros preceded the Yankees signing him to a nine-year, $324 million deal.

All things Yankees: Latest New York Yankees news, schedule, roster, stats, injury updates and more.

Any loss – brief or extended - will have an impact on the 2024 season.

Yankees: Push the panic button?

Even as Cole led the AL in ERA (2.62), innings (209) and struck out 222 in 2023, New York knew it needed to shore up a flailing starting pitching rotation. That need was exacerbated by the trade of Michael King to the San Diego Padres for slugger Juan Soto.

So the Yankees went hard after Japanese ace Yoshinobu Yamamoto, who did Cole one better by signing a record $325 million deal with the Los Angeles Dodgers. They offered lefty Blake Snell a five-year, $150 million deal, but he chose to wait for a larger offer.

In the meantime, they made a modest and low-risk addition, snagging right-hander Marcus Stroman on a two-year, $37 million deal. Yankees fans hungry for a first World Series title since 2009 weren’t totally satisfied, what with this pitching calculus relying on healthy, bounce-back seasons from lefties Carlos Rodon and Nestor Cortes, and the continued development of right-hander Clarke Schmidt.

But that was with Cole locked in as the bell cow.

Now?

The club was poised to improve on last year’s 82-win semi-disaster, and at the least give the 101-win Baltimore Orioles and the 99-win Tampa Bay Rays and the 89-win Toronto Blue Jays all kinds of trouble.

In an unforgiving AL East, even a temporary Cole absence could make a difference. Now, agent Scott Boras, Snell’s representative, must surely be thinking, how much is it worth it to them to patch that potential hole?

Cole: A speed bump or a pothole?

At 33, Cole is very much still in his prime. He likely should have won the AL Cy Young in 2019, but lost it to teammate Justin Verlander. While the Yankees have frustrated in their up-and-down season-to-season fortunes, it is no fault of Cole’s: He is 51-23 with a 3.08 ERA as a Yankee, with a 136 adjusted ERA and 11.1 strikeouts per nine innings.

Now, his 2024 season – the fifth in his nine-year deal – will start under a cloud.

While Boone’s explanation of Cole’s malady didn’t necessarily portend doom, it does create at least a short-term concern that Cole is not nearing game-readiness. Cole has appeared in just one Grapefruit League game, pitching two innings. Boone said Monday that Cole is not feeling pain, but that the inability to bounce back is not something he’d experience during a spring buildup; he said Cole has passed the 45-pitch mark on his way to 55, a little more than two weeks before opening day.

Certainly, multiple outcomes remain in play.

Best case: A simple case of dead arm, with rest prescribed. Or mild elbow inflammation, which would require a longer period on the shelf.

Worst case: Anything involving a compromised ulna collateral ligament in his throwing elbow.

There are best and worst cases within that outcome, ranging from rest and platelet-rich plasma injections before re-starting his progression, all the way to Tommy John reconstruction surgery, which would put him out for most of 2025, too.

The long game

Naturally, the Yankees will be very cautious with their horse. And while pondering the what-ifs of injury for a pitcher is almost like an actor yelling “Macbeth” in a theater, Cole did reflect earlier this spring on how he might evolve as he gets older.

“The mindset and the preparation over the last 10 years has been to maintain as much of that for as long as I can,” he said of his dominance. “It’s not like I don’t have a contingency plan. The demands of the game show you how important it is to still be creative, to still fine-tune other pitches.”

Now, he’s facing a more immediate hurdle.