Chad Kuhl will be shut down from throwing for the next four weeks after a second opinion from Dr. David Altchek in New York confirmed the Pirates' initial diagnosis of the right-handed starting pitcher.
In the weekly update from Todd Tomczyk, the Pirates' director of sports medicine told reporters at PNC Park that Altcheck agreed "conservative management" would be best to treat the "right forearm/elbow" injury Kuhl suffered at Citi Field on June 26.
The initial plan is for Kuhl to resume throwing following those four weeks, and Tomczyk expressed optimism a procedure won't be needed to treat the injury.
"I doubt at the end of four weeks we say he needs some sort of different procedure," Tomczyk said. "At the end of four weeks, we’ll assess to throw and most likely we’ll begin a throwing program and go from there."
Kuhl felt what he described as a muscle pull after throwing a sinker to the Mets’ Jose Reyes in the fourth inning at Citi Field. Clint Hurdle and Ben Potenziano, the Pirates’ assistant athletic trainer, exited the dugout to check on Kuhl; however, he remained in the game to face two more batters. Kuhl didn’t think anything was wrong at first since his fastball velocity remained consistent, but the discomfort continued while he finished the inning.
He was removed from the game and placed on the disabled list three days later. “During the start, it just felt like I kind of had a muscle grab,” Kuhl said this past weekend. “I just knew the last pitch didn’t feel good. I came out, threw that warmup pitch and the next one was 96. I’m still thinking structurally I’m fine, but I know something is going on. It’s not feeling great. I pitched to one or two more hitters and then it kind of got more inflamed. It just felt tighter as the night went on.”
Kuhl, 26, has a 4.55 ERA and 1.43 WHIP in 16 starts this season. He made his big-league debut on June 26, 2016 and earned a spot on the opening day roster the following spring. The right-hander then started 31 games, striking out 142 batters in 157 1/3 innings in 2017. He remained inconsistent this season, as he was tagged for eight runs in two innings in his start prior to the one at Citi Field.
Kuhl had a 2.89 ERA with a .235 opponents’ batting average in eight starts from May 6 to June 15.
In addition to Kuhl, Tomczyk provided the following injury updates:
• Jung Ho Kang, placed on the Triple-A disabled list June 27 with a right hand/wrist injury, will be reassessed by Dr. Edward Birdsong of Allegheny Health Network next week.
Kang suffered the injury, which affects the outer part of his hand beneath the pinky, following a three-hit performance for Indianapolis on June 19. He returned to the lineup four days later, only to be placed on the disabled list after playing two games. The third baseman was batting .235/.308/.265 in 34 at-bats with the Indians.
• Reliever A.J. Schugel has been throwing bullpens in Bradenton and is expected to throw a sim game in seven to 10 days. Schugel pitched only once in Grapefruit League play this spring and suffered a setback during his rehab assignment in April.
• Reliever Nick Burdi, acquired by the Pirates at the Rule 5 Draft in December, will continue throwing simulated games at Pirate City, although with more intensity, including under the lights. He's been pitching to rehabbing Double-A and High-A players.
Burdi, who is on the 40-man roster, underwent Tommy John surgery last spring after suffering an elbow injury while pitching for the Twins' Double-A affiliate. He was 2-0 with one save, a 0.53 ERA, 20 strikeouts and a .161 opponents' batting average in 17 innings.
Burdi pitched only three innings in 2016 because of a bone bruise to the humerus in his pitching arm. His only full season of professional baseball was 2015, when he had a 4.52 ERA and 1.37 WHIP in 63 2/3 innings between High-A and Double-A. He'll likely require a full 30-day minor-league rehab assignment upon finishing his sim progression.
• Outfielder Daniel Nava, who underwent back surgery in late February, is still unable to work out and will be returning home to Arizona in the coming days. Nava, 35, signed a minor-league contract with the Pirates during the offseason.
"Unfortunately, it hasn't been a successful rehab for him," Tomczyk said. "He continues not to be able to do any baseball activities and we're looking to get him back to Arizona, to home, to continue his rehab there."