Dodgers ace Walker Buehler has been on the IL since June with an arm injury, but the initial diagnosis was a grade 2 flexor strain. He then underwent surgery on the elbow to remove a bone spur that had been there for awhile. His medical team figured that while he was already going to be facing a lengthy absence it made sense to take care of the bone spur. Now he will undergo season-ending surgery, and it might be Tommy John.

Buehler’s MRI back in June indicated damage to the flexor tendon, which attaches the flexor muscles that run through the forearm to the elbow. His initial recovery time was 10-12 weeks, confirming that this was a significant strain (aka partial tear). Now his injury is serious enough to require surgery. You might think this is two separate injuries, but where the flexor tendon attaches in the elbow is very close to the UCL (ulnar collateral ligament). This is the most important stabilizing ligament in the elbow, and when there is a tear it requires Tommy John Surgery. We’ve seen many pitchers over the years begin with a flexor tendon injury but ultimately need Tommy John surgery. When one is damaged, the other often follows.

This will be Buehler’s second Tommy John surgery, which makes it more concerning that it already is. Buehler last underwent this procedure in 2015 and has had his elbow flare up multiple times since then. He is scheduled to undergo surgery on August 23, and that’s when a final decision on what type of surgery he needs will be made. Tommy John surgery would sidelined him for the entire 2023 season.

The 2022 season had been a struggled for Buehler, even before the injury. But in 2021 he had a lot of success. Buehler made his second All-Star team and finished fourth in NL Cy Young voting. This was thanks to a 2.47 ERA, 0.968 WHIP and 16-4 record while recording 212 strikeouts and 52 walks in 207.2 innings pitched.

In addition to losing Buehler, the Dodgers are also currently without Clayton Kershaw. He has been on the IL since August 4th due to a recurring back problem. This time it’s described as lower back pain. Kershaw has since been able to throw without pain, but this has sidelined him many times in recent years, so he comes with a High Risk of re-injury. Dustin May is also working his way back from Tommy John surgery and just completed his fifth rehab start. He could return to the rotation by the end of the month.