searchMasahiro Tanaka is scheduled to return to the mound for the Yankees on Sunday against the Blue Jays and, according to Joe Girardi, will have a 75-pitch limit. With the club essentially out of playoff contention, the purpose of this outing – and perhaps one additional start that can be squeezed in before season’s end – can only be to see if Tanaka’s elbow holds up well enough to avoid off season Tommy John surgery.

Diagnosed with a small tear of his ulnar collateral ligament, Tanaka is attempting to be one of few pitchers who return to competition after this injury but without surgery.

The 25 year-old Tanaka, in the first year of a seven-year contract, last pitched in a game on July 8th, after which he revealed the issue with his elbow. This followed four uncharacteristic performances in which his ERA was 4.35 – a huge spike up from the 1.99 he’d demonstrated in 14 starts to that point.

After consulting several medical experts in July who agreed that Tanaka had the potential to avoid surgery, the pitcher was expected to return to the mound after PRP injections and six weeks of rehab. He is only slightly behind that schedule, having progressed through a throwing program in which he gradually increased the number of pitches tossed. Only once – on August 29th – was it reported that Tanaka experienced a setback, complaining of a general soreness throughout his right arm after a practice session. However, on September 6th – after throwing just 35 pitches in the bullpen – Tanaka commented that he felt “way stronger… I think the fatigue is done.” It has been a rather quick progression back to a major league mound, particularly in light of the blip in Tanaka’s recovery.

Even if he successfully completes one or two 75-pitch-starts without complaint, there is no assurance that Tanaka will be able to avoid surgery. It is not likely that the tensile strength of his torn ligament is fully restored as of yet, and – even if he passes the first test – only repeated demands will determine the outcome. If these cumulative demands exceed the ability of the ligament to withstand the stress, it will break down once again.

Clearly, the sooner it is determined whether Tanaka needs surgery, the better. He will need a year to rebound should that be the eventual answer.

Follow Abby on Twitter @abcsims.

About the author

Abby serves as the Injury Expert for CBS New York where, since 2010, her Injury Breakdown Blog examines injuries in professional sports. She also blogs on health & fitness as well as sports injuries for Huffington Post, and Recovery Physical, where her blog earned a top ten mention for physical therapy blogs in 2012 @ In a ranking of the Top 30 Healthcare Blogs for 2012, Top Masters in Healthcare also rated Abby’s blog in the top three in Physical Therapy! Abby is the founder of Fit-Screen and she welcomes your comments and questions!