Bradish undergoes Tommy John surgery, Coulombe has bone chips removed from elbow (updated)

NEW YORK – The list of injured Orioles pitchers keeps growing, along with the worries over how the team will move forward and stay upright.

Kyle Bradish underwent Tommy John surgery this morning in Arlington, Texas, with an internal brace part of the reconstructive procedure. And high-leverage reliever Danny Coulombe had bone chips removed from his left elbow yesterday in Los Angeles, with an optimistic return date of September.

Executive vice president/general manager Mike Elias met with media at Yankee Stadium earlier today to provide the updates.

Dr. Keith Meister handled Bradish’s procedure, which is a little more complex than his work with John Means and Tyler Wells. It’s reconstructive rather than a repair, which likely leads to the usual 12-to-18 month recovery, but the brace brings additional support and makes in a hybrid.

Bradish was diagnosed in January with a sprained ulnar collateral ligament in his right elbow and received a platelet-rich plasma injection. He made eight starts after his reinstatement from the injured list and posted a 2.75 ERA and 1.068 WHIP with 53 strikeouts in 39 1/3 innings.

"We're all familiar with Tommy John surgery right now and what that looks like in terms of recovery and obviously he's out for the rest of 2024. We'll take it from there otherwise," Elias said.

"I do want to say Kyle, enormous talent, enormous part of the team. This is a huge blow. This guy is really a tough hombre and he pitched through an injury. We were marveling at how well he was pitching with it, and he gave us everything he had and we're going to miss him, and we're going to take really good care of him and get him back to full strength with everything in our power. And can't wait for that and to have this behind him. He's an enormous part of this team and organization and it's a tough blow, but it's going to be temporary."

The possibility of an unhappy ending in 2024 always existed for Bradish following his January diagnosis. He outlasted others in the rotation but eventually could not sustain the momentum or results.

Elias disagreed that the surgery was "inevitable," saying it's "a strong word."

"As you saw, he had damage to his UCL, we got it treated with a PRP and rest and rehab, and he did great for a while and he was pitching amazingly," Elias said. "It was really impressive. It's not an easy thing to do. And definitely not a shortcoming of his. It just came to an end. This guy, I think he would have kept pitching until his arm fell off if people let him. He did a hell of a job. He helped us win games, and we're going to pick up the slack for him and we're going to get him back."

No conversation about UCL damage is going to exclude the chances of a surgical procedure, but Elias said it wasn't a serious consideration leading into spring training based on how the elbow responded and the particulars of the case. And Bradish wanted to avoid the procedure if possible.

Bradish mentioned the discomfort after the fifth inning of his last start against the Phillies, and he was removed at 74 pitches. Alarms immediately sounded, making today's news less of a shock.

"It's challenging to pitch with a partially torn UCL," Elias said. "It's not necessarily pain. It's just not easy to do. You have to build your arm back up a certain way and he did all that because this guy wanted to pitch and he wanted to win baseball games for this team. And he did that as long as he could. He's a tough guy and a great player."

Bradish was the undisputed staff ace, starting Game 1 of the Division Series and finishing fourth in American League Cy Young Award voting, until Elias traded for Corbin Burnes. They formed an imposing one-two punch.

"Huge loss for us," said manager Brandon Hyde. "He's a top-of-the-rotation type of guy. I feel confident that he'll be like that when he comes back but it's going to be a while. We're losing a top-of-the-rotation arm that's been unbelievable for us for the last year-plus, two years. We were hopeful that it wasn't going to come to this, but unfortunately it has and we're going to miss him.

"Kyle Bradish is an absolute warrior. Probably didn't let on what he was pitching through because he loves to compete, he wants the ball, he doesn't want to come out of the game. He's just a fierce, fierce competitor. The makeup, he's as tough as any player that I've had. So it sucks to lose him, because of what he brings in so many ways. He was really disappointed that night, that he had to come out of that game. It's going to be a long road back and we're going to be keeping in constant contact with him. I feel for him. He's a huge part of our team.

"Just because he's hurt doesn't mean he's not, but we need to step up in his place. We need guys to step up. But it's a huge loss because it's a lot of fun to play behind him and a lot of fun to watch him pitch."

Dr. Neal ElAttrache performed the surgery on Coulombe's elbow and Elias said "it went well."

"It's an injury that there's quite a bit of history with it with baseball pitchers, and when you look at the history of recoveries with guys that have had this type of bone chip removal procedure, we're very hopeful that we'll get him back in the regular season here this year," Elias said. "So that's our hope there and we can't wait to have him back and have him back hopefully at full strength, having this injury behind him."

Coulombe ranked among the most valuable Orioles last season, acquired from the Twins at the end of spring training and enjoying a career year with a 2.81 ERA and 1.110 WHIP in 61 appearances. He surrendered only four home runs and struck out 58 batters in 51 1/3 innings.

There are no signs of regression in 2024. Quite the opposite.

Coulombe had made 29 appearances and registered a 2.42 ERA and 0.615 WHIP with only three walks and 28 strikeouts over 26 innings. Left-handers hit .171 with a .400 OPS against him and right-handers hit .130 with a .490 OPS. A manager’s dream under the three-batter minimum rule.

There also were no signs that Coulombe was injured as he retired all six batters faced June 8 at Tropicana Field and struck out three.

"Injuries come in all different sorts of fashions," Hyde said. "When he came out of the game, the next day he played catch. I wasn't expecting Danny Coulombe to be on the injury report, but these things happen. ... You just don't know what the rotation's going to look like, what the bullpen's going to look like, because things like this come out of nowhere a little bit.

"We feel good that he's probably going to be back with us at some point during the last part of the season. He's been a huge piece of our bullpen and we're going to miss him the time that he's gone, also."

This is another huge setback for a team with championship aspirations, but the Orioles will keep trusting the next man up and perhaps get busier at the trade deadline.

Means and Wells are out for the season after undergoing elbow surgery – the former a second Tommy John and the latter the internal brace procedure. Bradish makes three starters with UCL repairs this month.

"Injuries are a part of the game," Hyde said. "We're very aware, players are aware. They're just going out and playing. Obviously we feel terrible for the guys that have gotten hurt and they're friends, they're teammates. We know their families. The whole thing. It's a very, very hard thing, but the game doesn't stop for you and you keep playing, and we've done that.

"Our guys have known for a little while now that these guys would probably be out for an extended period of time and played really well against the Phillies. Last night didn't go our way. We feel terrible for the guys that are hurt, but we've got to keep moving on."

Elias will keep the phone lines open with other executives, of course. He wasn't going to stand pat before the surgeries and he certainly won't do it now.

"I've got a sense of urgency to win baseball games and part of that is just taking care of the whole organization," Elias said. "The deadline's the deadline, even before we have injuries. I think it would have been pretty naive to think that the injury number would be zero, especially with some of these guys coming into camp banged up, so this isn't coming out of left field because of that. We're looking at the whole picture when it comes to this trade deadline – where our team's at, what our health looks like, where we can upgrade, what the market looks like, which teams are selling, what are they asking for.

"It's so complicated, it's just hard for me to make sweeping statements and opine about it, and especially in June. But we have what I think is a really good, hard-working front office and we're going to do our job."

Dean Kremer made an injury rehab start Sunday at Triple-A Norfolk and will start again for the Tides on Saturday in Lehigh Valley, with the hope that he can complete five innings and reach about 75 pitches. He’s recovered from a strained right triceps, and his importance to the team grows with every medical update on his teammates.

"We will take it from there after that," Elias said. "That's the extent of the certainty of our plan with him."

Jordan Westburg left last night’s game with soreness in his left hip after a collision with Juan Soto in the bottom of the first inning. Westburg was fielding a grounder from Giancarlo Stanton and Soto’s knee struck Westburg in the hip, leading to an interference call and the removal of one of the club’s best players.

"It's still really sore," Hyde said. "He got hit in a really tough spot in the hip, but moving around a little better today than he was last night. It was really, really sore last night. He got treatment most of the day and he's still getting treatment right now, but he's trending better."

Though Westburg is out of tonight’s lineup, Elias expressed confidence that the injured list wouldn’t be necessary. He probably won't play tonight.

"He's feeling better," Elias said.

Westburg is batting .277/.331/.502 with 14 doubles, a team-leading five triples, 11 home runs and 42 RBIs in 67 games. He has a 2.6 bWAR that’s second on the club behind Gunnar Henderson’s 5.0.

Jackson Holliday remains on Triple-A Norfolk's injured list with elbow inflammation.

"I don't have a huge update there, but several days now since that happened," Elias said. "Things have been moving in the right direction. He's feeling better, and I maintain my early hope and optimism that this is a minor injury that's measured in weeks."