NEW YORK -- Understanding the risk involved, Matt Harvey is gambling on his future. Rather than immediately undergo Tommy John surgery to replace the partially-torn ulner collateral ligament in his right elbow, which would sideline him until 2015, Harvey will attempt to rehab his elbow non-surgically.
On the advice of renowned orthopedist Dr. James Andrews, who evaluated him Monday, Harvey will participate in a structured throwing program over the next six to eight weeks. In a statement, the Mets said that "during or following this throwing regimen, a final decision will be made on the near term need for surgery."
"There's always a risk to having surgery, and there's obviously going to be a risk not to have surgery," Harvey said. "I'd rather bet on myself doing the work to stay out of getting surgery than having to go through it."
Harvey, who was 9-5 with a 2.27 ERA and 191 strikeouts in 26 starts prior to his injury, will soon begin what general manager Sandy Alderson called a "typical progression" for Andrews' rehab patients: strengthen the area around his elbow, throw off flat ground, and finally climb back atop a mound.
If at any point along the way Harvey experiences a "red flag," in his words, he will shut down his throwing program and undergo surgery.
"Any pitcher can throw any pitch at any time and have an issue," Harvey said. "There's no way to know how long a particular ligament is going to last, healthy or not. I know one thing: I'll put all the rehab and time in to making sure it doesn't happen. If we cross that line through the process or later down the road, then at that time things need to be [reevaluated]."
Considering the lengthy history of pitchers who have attempted to rehab from partially torn elbow ligaments only to undergo surgery in the end, it is an unorthodox plan. But Harvey believes it is far from a delusion. Several prominent pitchers, including Ervin Santana and Adam Wainwright, have successfully rehabbed UCL injuries, though Wainwright completely tore his ligament seven years later.
At his office in Gulf Breeze, Fla., on Monday, Andrews determined that Harvey's UCL is strong enough to withstand a rehab program, which Harvey suspected given the lack of acute pain in his elbow. Alderson said that while Andrews confirmed Mets doctors' initial diagnosis of a partial tear, he never told the Mets what percent of Harvey's ligament is torn.
The difference in evaluations was that Mets doctors "determined that a surgical repair would likely be necessarily," according to the team's statement, "unless Matt could complete a throwing program free of elbow-related symptoms." Dr. Andrews, conversely, specifically recommended the throwing program."
"There could be a decision made at any time," Alderson said, stressing that surgery remains a distinct possibility. "But the one thing that's important to keep in mind is that we don't believe, even with two months invested in this program, that it will affect 2015 if surgery is ultimately necessary."
What Harvey's situation could affect is Alderson's winter plans, considering his recent statement that he would pursue free-agent starting pitching with Harvey sidelined. Tuesday, Alderson dismissed that as "speculation," citing the organization's trove of young pitchers as reason to avoid a heavy free-agent investment.
That said, a six- to eight-week throwing program would not even last through November, giving the Mets plenty of time to pursue outside help should Harvey undergo surgery.
"Hopefully, Matt is part of our starting rotation next year," Alderson said. "But if he's not, I don't foresee us working hard to fill his spot from outside the organization."
Until the Mets know for sure, they will continue doing the same thing they have done since Harvey first learned of his injury more than three weeks ago: wait and see. At this point, they have still not committed to anything, despite Harvey's optimism for the future.
"The last three weeks have been pretty tough," Harvey said. "I want to be on the field. I want to be pitching. Being in that area of not knowing what's going on is a tough process. But everything feels completely normal. I know there were some symptoms of forearm tightness, this and that. But I never had sharp elbow pain or numbness or anything like that. We'll see, definitely, how the rehab process goes, and the throwing, and see how it goes from there."