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Bryce Harper? Elbow. Ranger Suárez? Elbow. Andrew Painter? Elbow. An orthopedic surgeon explains what’s up.

Baseball is an especially unforgiving sport to players' elbow. The Phillies are no exception on this opening day.

As Phillies Bryce Harper tosses a baseball during spring training, his scar from Tommy John elbow surgery is visible.
As Phillies Bryce Harper tosses a baseball during spring training, his scar from Tommy John elbow surgery is visible.Read moreYong Kim / Staff Photographer

The National League champions are back in action, but three Phillies won’t make it on the field in Texas for their season opener against the Rangers because of pesky elbow injuries.

  1. Andrew Painter had a shot at becoming the first 19-year-old to pitch for the Phillies in over 40 years, but that may not happen after he sprained his right elbow. (His birthday is April 10.)

  2. Ranger Suárez, a starting pitcher, is still healing from an inflamed elbow.

  3. All-Star slugger Bryce Harper is recovering from Tommy John elbow surgery.

» READ MORE: Meet the 2023 Phillies: Predictions, season projections for every player

To learn more about the injuries that Phillies are coping with at the start of the season, The Inquirer spoke with Leslie Barnes, an orthopedic surgeon at Temple University Hospital who specializes in elbow and shoulder injuries.

Barnes did not treat the injured Phillies players, but it’s her opinion as a medical expert (and a fan) that the team is going to have a great season.

“Listen, those guys are so strong, I have no concern about the team,” she said. “They’re gonna do awesome.”

Are elbow injuries common outside baseball?

It depends on the injury.

Baseball fans will be familiar with news related to the ulnar collateral ligament, or UCL. The three bands connect at the pinky’s side of the humerus (upper arm bone) to the ulna (one of the two bones in the forearm).

Barring significant trauma, injuries to the UCL are relatively rare among those of us who can’t pitch at 90 mph, Barnes said.

“It’s all on that one arm and you’re doing it with such force, velocity, precision and over and over again,” she said.

» READ MORE: Will Rhys Hoskins be out for the season after tearing his ACL? Here’s what to know about recovering from the injury

Other athletes in sports that involved throwing — such as javelin throwers — are also susceptible to overuse injury of the UCL.

Elbow injuries among non-athletes, such as when someone attempts to stop a fall with their arms, more often involve the ligament on the other side of the elbow, Barnes said.

What is a UCL sprain?

A sprain is an injury to the ligament.

Nearly a month ago, an MRI revealed that Painter suffered a proximal UCL sprain, which is a sprain to the part of the ligament that connects to the upper arm.

» READ MORE: Phillies pitcher Andrew Painter’s MRI reveals a UCL sprain. He will rest for four weeks, team says.

The location of the sprain means that “there is a good chance it will heal on its own without surgery,” Barnes said.

When will Painter pitch?

A lot of Phillies fans want to know.

After four weeks of rest, the 99-mph phenom should start playing light catch any day now, The Inquirer reported. He will increase distance slowly if all goes well and could start a game in May. Unfortunately, he might not make it back on the field before he turns 20 on April 10.

What is Tommy John surgery?

The procedure to repair or reconstruct a torn UCL.

In November, Harper underwent “successful” Tommy John surgery in Los Angeles. Harper’s surgeon initially thought that he would require a partial repair, but he ended up undergoing a full repair that also moved a nerve.

» READ MORE: How Bryce Harper planted the flag in Philly and got his friends to follow: ‘Cool to see guys picking the Phillies again’

The 60-to-90-minute procedure, named after the baseball pitcher it was first performed on in 1974, involves stitching back together the damaged part of the UCL. In some cases, the ligament may be replaced with tissue from the athlete or from a donor, Barnes said.

When will Bryce Harper return?

It can take time.

After his surgery in November, the Phillies released a statement saying Harper will be back “by the All-Star break of 2023.” That’s mid-July, or about half a season.

It’s hard to estimate how long Harper will be out because few outfielders have gone through the procedure. Data suggest that outfielders take about half the time that pitchers need to heal, which can be 12 to 18 months. When Shohei Ohtani underwent Tommy John surgery in 2018, he returned as a designated hitter for the Angels within 218 days.

» READ MORE: When will Bryce Harper play again for the Phillies? These two cases offer some clues.

What causes elbow inflammation?

Many things, including overuse of the elbow or form.

The treatment is usually allowing the elbow to rest. Players may also reduce pitch count, diversify the types of throws, and work on overall strength, Barnes said. All of those factors contribute to the stability of the elbow.

Last week, Suárez was scratched from a bullpen session because of inflammation in his left elbow after not pitching in a single spring game. He has played catch since but is still recovering. Today he threw from 120 and reported feeling good.

When will Ranger Suárez return?

Hopefully in a few weeks.

“He’ll miss the first two weeks, for sure,” Phillies president of baseball operations Dave Dombrowski said in the last morning of spring training.