Andrew Painter injury: Phillies' top pitching prospect has sprained UCL, will be shut down for four weeks

Painter will attempt rehab, rather than surgery

Philadelphia Phillies right-hander Andrew Painter, one of the very best pitching prospects in the game, will be sidelined at least four weeks with a sprain in his ulnar collateral ligament, the team announced Friday. A sprain is a tear and that's the Tommy John surgery ligament, but surgery has not been recommended and Painter will attempt to rehab the injury. 

Here is the team's update:

Andrew Painter underwent an MRI-Arthrogram on March 3 which revealed a right proximal ulnar collateral ligament sprain. Painter sought a second opinion from Dr. Neal ElAttrache, who confirmed a UCL sprain. 

Both the Phillies medical staff and Dr. ElAttrache recommend Painter rest for four weeks from the date of injury and then begin a light tossing progression.

The four-week shutdown period puts Painter on track to begin throwing in mid-April. From there, a build-up period would take another few weeks. It's unlikely Painter will begin pitching in minor league games until May at the earliest. Several players have successfully rehabbed minor ligament tears and avoided Tommy John surgery, most notably Masahiro Tanaka in 2014. Seth Lugo was diagnosed with a partial UCL tear in 2017 and has continued pitching, signing with the Padres this offseason. Painter's own prospective rotation partner, Aaron Nola, has made 170 starts since he was diagnosed with a mild UCL sprain in 2016.

That said, there is a chance the rehab fails and Painter will eventually undergo the knife. If that happens, he would miss the entire 2023 season and the start of 2024, same as if he has surgery now. Surgery is always the last resort and minor tears can be rehabbed successfully. It's worth trying the rehab to avoid a major arm surgery.

Painter, 19, tossed two innings and ran his fastball into the upper-90s in his spring debut on March 1. He reported tenderness in his elbow almost immediately and went for tests. The Phillies repeated delayed announcing the diagnosis this week while seeking a second opinion. Painter was competing for the team's No. 5 rotation spot this spring.

Our R.J. Anderson ranked Painter the No. 14 prospect in baseball earlier this spring. The No. 13 pick in the 2021 draft pitched to a 1.56 ERA with 155 strikeouts in 103 2/3 minor league innings last season and reached Double-A. Painter had a chance to become the first teenager to pitch in the big leagues since Julio Urías in 2016.

The Phillies went 87-75 last season and won the National League pennant last season. Lefty Bailey Falter is now the overwhelming favorite to be the team's No. 5 starter on Opening Day.