While the Orioles enjoy the first of two off-days this week, any break providing relief after losing 11 of the last 12 games and 15 of 18, pitcher Alex Cobb remains in Nashville, Tenn., while thrust into the early stages of a rehabilitation program following hip surgery.
Cobb is staying close to orthopedic surgeon Dr. J.W. Thomas Byrd, who repaired a tear in the labrum that ended the veteran's season after only three starts and another round of discomfort and disappointment.
And Cobb isn't done.
He's scheduled to undergo a procedure on his knee later in the summer, another issue that came to light during the latest MRI.
"I'm planning on doing that in maybe four or five weeks," Cobb told MASNsports.com. "They weren't able to do both at the same time, obviously, just for rehab purposes. I just don't think that's commonplace.
"Nothing concerning. It's just a partial meniscus that they go in and clean up and I think you're good to go a week later."
The first surgery is more of a long-term project that should correct the pain Cobb was experiencing in his groin and back. It's all tied to the lumbar strain that twice put him on the injured list during the regular season.
Cobb missed his assigned opening day start, the first of his career, due to a groin injury that he tried to fight through in order to begin the season with the rest of his teammates. Something he couldn't do last year after signing late.
Dr. Byrd planted six anchors in the hip.
"I think they classified it as a Grade 3 out of 4 tear, so everything sounded like it went terrific," Cobb said. "Everybody I talked to afterward, whether it was the physical therapist or the report the surgeon gave the team. They all said it was something where I'd have full ability to come back from it.
"It's possibly something I had been dealing with for a little while without even knowing. There was a lot of scar tissue and stuff that was built up in there. It was nice to get out and have a positive report on how the surgery went."
Cobb and the Orioles tried to avoid it with rest and rehabbing. With injections and exercises. But Cobb didn't make it back into a game after an April 26 start in Minnesota, where he allowed four earned runs and five total in four innings to leave him with a 10.95 ERA and 1.865 WHIP with nine home runs surrendered in 12 1/3 innings.
Surgery became the only option for Cobb, who will return next spring with two years remaining on the four-year, $57 million deal he signed on March 21, 2018 that included deferred money in each season.
"I think, at that time, I kind of coped with the fact that this season was over for me, but going into this whole process, obviously it's devastating," he said. "You do so much to try to prepare and get ready for a season, even dating back to the previous year where I had struggles and felt like I finally started to get in a little bit of a groove. And then had an offseason to really settle down and get strong and kind of clear the slate and have an impactful season this year.
"You're training five days a week for hours on end to stay healthy and strong throughout the course of a season and then you realize you've got to get through spring training and toward the end, my last start, I started having a little bit of pain and it started to prevent me from doing what I needed to do and then other issues are going along with it. Then you get the diagnosis and there's a little bit of hope that you're able to power through it, rehab it, be able to come back and have enough strength, enough ability to do what you need to do on a major league mound, so you keep that hope and you fight through it all and then there's just a moment when you realize this just isn't going to work.
"You take the counsel from what other doctors are saying and second opinions. You listen to your body and how it's responding on a day-to-day basis and you realize you just can't do it. You also have to keep the perspective of the timeline and realize that, OK, do I just take the plunge and go ahead and do it right now and make sure I'm 100 percent ready for next year or do I keep fighting this, maybe come back in August and September, not fully ready to go, but able and then dealing with this whole situation again next season? So you do a lot of different things that you take into account when you're dealing with it, but ultimately just not being able to continue to do it, you realize that there's no other path that you can take."
It took a while to figure out that the back and groin were connected to the tear in his hip.
The labrum is a rim of soft tissue or fibrocartilage that surrounds the hip socket and adds to the stability of the hip by deepening the socket and protecting the joint surface.
"I, like you, probably didn't know anything about the complexities of the hip," Cobb said. "I just kind of figured my hip was on the outer thigh region and you would know when your hip is actually hurting, but going into it and hearing what all the doctors are saying and hearing other people's experiences with it, it can mimic a groin strain. It can totally make your back go out. There's a lot of different symptoms that it can cause.
"What was going on with me was anytime I got in competition, my groin would start to hurt. That started the last start of spring training and that day I thought I pulled my groin and the next day I remember talking to you guys that I was hopeful of being able to pitch still on opening day because it really wasn't that bad after it all settle down. And then sure enough, I was. I ended up pitching Friday in a rehab start instead of that Thursday opener in New York. And then came back to the big leagues and I pitched against New York in the home opener and I started to feel my groin tighten up a little bit toward the end.
"It wasn't a big deal. I thought it was just some minor aching going on in the muscle there and didn't think much of it and then after the game was just hanging around, went in the weight room. I think I was just taking my shoes off or something and my back just totally locked up on me and I'm sitting here thinking, 'Man, what in the world is going on?'"
Cobb couldn't blame it on his age, though that's a common reaction to new aches and pains.
"I know at 31, people say your body starts to give out on you a little bit, but I know what I was experiencing was a little bit extreme for that," he said. "I was incapable of walking, incapable of putting my socks on. So I started probably thinking what's going on at that point. And then the back was the reason I was unable to continue to pitch and I did everything we could to treat the back. All different types of anti-inflammatories, core exercises and time and rest, all those sorts of things and the back was just never getting better.
"It got to a point where I was at least able to go out there and throw the ball. At that time, I was willing to go out there and pitch and obviously it wasn't the best decision, looking back on it. How poorly my performances were. I just wasn't able to do anything that you need to do on a big league mound. My back was going on and my leg, I just kept telling everybody it felt dead. So we ended up doing MRIs and sat in the tube for hours and did every body part and found the knee issue.
"Found nothing in the groin, to where there would be signaling if you pulled the groin at any point and there wasn't any, so we found the tear in the hip labrum and went and saw a specialist for it and they did some tests. They suggested trying to rehab it and coming back, but it didn't work out."
A dose of good news came to Cobb, a man in desperate need of it. He's supposed to be ready for spring training when pitchers and catchers report in February to the complex in Sarasota.
"One hundred percent, yeah," he said. "I'm very fortunate that it is a procedure that is a fix. It's not a surgery that ... I think Tommy John, I think shoulder injury, those are big question marks on whether you come back from it. If you're a different type of person, a pitcher, your abilities are different, but this is something that's just going to relieve a lot of pain for me and maybe strengthen up that leg a lot more than I've had in the past.
"I'm excited to see how the rehab is and how I feel post-rehab and going into spring training."
Cobb won't head down to Sarasota to continue his rehab until cleared to do so at the National Hip Institute in Tennessee. And until he undergoes the cleanup procedure on his knee.
"It's him and one other guy who are very good at this specific surgery and obviously the rehab that goes along with it," Cobb said, "so I'm going to do that and get the knee surgery while I'm up here at some point and then I'm not sure what's going to take place after that."
Any trade talks involving Cobb have been silenced. He's no longer a chip for a rebuilding club. He's got to prove that he's healthy, get people out and begin enticing other teams again.
Cobb is more focused on giving something back to the Orioles after they handed out the richest contract for a pitcher in franchise history. With the cash comes guilt at not being able to live up to his end of the deal.
"I feel awful the way everything's kind of transpired and my career so far in Baltimore," Cobb said. "I am working hard to make the future the best that I can. I can't undo what's happened already, but I'm going to work hard to make things right going forward."
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