Phillies place reliever José Alvarado 15-day injured list with elbow inflammation

When reliever José Alvarado reported tightness in his left wrist and the Phillies held him out of Tuesday night’s game, the hard-throwing left-hander laughed off concern that he would miss additional time.

It may have been wishful thinking.

Alvarado won’t pitch for at least two weeks — and likely longer — after being placed on the 15-day injured list Wednesday. An MRI exam showed inflammation in the left elbow, a diagnosis that was confirmed after the Phillies sent Alvarado to see a team doctor for a more complete picture.

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That’s a best-case scenario, believe it or not, considering manager Rob Thomson’s concession before Alvarado returned from the doctor that he was “a little concerned, for sure,” about the status of the Phillies’ best reliever.

“Just a couple days’ rest, that’s it,” Alvarado said after the Phillies’ 2-1, 10-inning victory over the Blue Jays.

Still, the Phillies intend to take their time. Alvarado is eligible to be reinstated from the injured list before a May 23 game. It would be mildly surprising if he’s activated that night.

“We’ll really take good care of this guy,” Thomson said. “We’re not going to rush him back at all.”

Because Alvarado has been arguably the most dominant reliever in baseball since the middle of last season. In 14 appearances this year, he has a 1.88 ERA and has struck out 24 of 52 batters — without allowing a walk. Since returning last June from a brief stint in triple A, he has a 1.72 ERA and a 43.8% strikeout rate.

So, Alvarado’s absence, however brief, will have a trickle-down effect on the other lefties in the bullpen.

Thomson doesn’t designate a closer, but there will be higher-leverage spots now for Gregory Soto, which means more sixth- and seventh-inning chances for Matt Strahm, who only recently returned to the bullpen after beginning the season in the starting rotation. For now, Thomson won’t use him on back-to-back days.

“I feel very confident in my teammates,” Alvarado said.

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Alvarado tends to go through periods of “general body soreness” during a season, according to Thomson, a byproduct of throwing a fastball that often registers triple digits. He made the team aware of the wrist soreness after playing catch in the outfield Tuesday.

But the MRI revealed inflammation in the elbow, which often leads to more ominous problems.

“I’m not surprised,” Alvarado said. “Because if I say something to the trainer, I feel something. I think I pitched a lot last year, like in the World Series.”

Reliever Andrew Bellatti returned from the injured list to take Alvarado’s seat in the bullpen. Bellatti, who has a 6.23 ERA in 10 appearances, was sidelined since April 21 with right triceps tendinitis.

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Meanwhile, the Phillies will continue to hold their breath on Alvarado, who accompanied the team on a six-game road trip that begins Friday night in Colorado. It’s likely that he will attempt to throw by the end of the weekend.

“He’s a big part of the bullpen,” Thomson said. “He’s one of the best relievers in baseball, if not the best.”