A Joe Kelly return? One notable doctor makes a case for the pitcher

75756A5E-120A-4932-810C-2FD980DB785E

When news came down Saturday that the Dodgers were officially declining the $12 million 2022 option for Joe Kelly, the wheels started turning in the world of Red Sox social media.

A case can be made.

After missing the first month of the season, Kelly came back to turn in one of his best seasons. The 32-year-old posted a 2.86 ERA, striking out 50 and walking 14 in 44 regular-season innings, allowing just two of his 20 inherited runners to score.

But the moment that likely sealed his fate when it came to the Dodgers' option decision arrived when Kelly was forced from his American League Championship Series start against the Braves. After allowing just three hits over six postseason outings, the righty walked off the mound saddled with a pair of runs and a concerning arm injury.

But, now, two weeks after what has since been diagnosed as a musculocutaneous nerve impingement in his right biceps, the doctor who immediately tended to the former Red Sox is going on record to offer optimism for whatever team lands the free agent.

"He’s very effective, especially when it really counts. He’s a real gamer. If it ever worked out if it was in the cards to come back to the Dodgers, or any other team, I would tell the front office and their team doctors that I would be very optimistic that he would be ready for spring training," Dodgers team doctor Neal ElAttrache told WEEI.com by phone Saturday night.

"When you see the guy, he’s not 6-foot-4 or anything like that, but he’s in great shape, his mechanics are really, really good. He stayed at this level for a long time. He’s an example of Darwinism in baseball. Guys that are survivors, they survive. They survive longer. He knows how to pitch. There is no indication, at least from this past year, he is on the downhill slope. His performance this year, according to how he felt, was better than it had been for a while. I look forward to seeing him pitch next year. I think he is going to be great, hopefully for the Dodgers, but he is going to be great for somebody."

If ElAttrache's name sounds familiar, it should. When an orthopedic surgeon is needed to take care of high-profile athlete, he is always at the top of the list. In Boston sports circles, ElAttache can be credited with performing the surgeries on Tom Brady's knee and Chris Sale's elbow, to name a few.

In Kelly's case, according to the doctor, the prognosis for 2022 is a good one. Whoever's spring training the reliever finds himself in, it is expected Day 1 will be a full-go. But that reality is in large part because of the immediate diagnosis when the pitcher walked off the field for the final time in 2021.

ElAttrache, who performed labrum surgery on Kelly a year ago, understood immediately what they were dealing with.

"Structurally with his shoulder and elbow, I already know what is happening," the surgeon said. "I operated on his shoulder last year and that turned out just great. He got better even quicker than we expected. So I have seen what is on the side of his shoulder. His elbow is fine.

"So when he came in with these new symptoms during that game, I had seen this maybe five or six times before. But the other ones that I saw over the course of a week to 10 days develop significant atrophy of the muscles and they remained a bit numb in the forearm for several weeks. But the difference between this and those is that I didn’t get a chance to see those other cases immediately when it happened and half of those, basically, they thought they were muscles strains and just kept trying to pitch and reinsured the nerve and knocked them out much longer. The other half, as soon as the discomfort in the upper-arm went away with the diagnosis as a muscle strain, they went back and pitched and the second crush on the nerve when the nerve is not really completed recovered … That’s what happens when someone has a concussion and they have the second blow before the brain is healed, that’s what happens to nerve tissue. It’s the second insult that put it to sleep a lot longer.

"The unusual thing about this was that the symptoms could easily be confused as a muscle strain of his biceps, but that really doesn’t happen with pitchers in the muscle belly. So the symptoms were characteristic of the nerve injury, with the burning-type pain and the numbness in the forearm and then the searing pain in the biceps. I knew what we were dealing with very quickly and immediately put him on some medication to keep the nerve from swelling. His sensation recovered in just a matter of a few days and he never developed the atrophy. So preventing him from having the second crush, and treating him immediately, kept this to a very reversible, short-lived thing."

The worry regarding Kelly's arm came and went fairly quickly, with his wife, Ashley, even taking to social media to temper any fears that this was going to be a half-a-year recovery.

"The sensation came back and the pain went away very quickly," ElAttrache explained. "He has been sending me pictures to show there is no atrophy and that all the strength in his biceps is back. These are all promising things. Knowing Joe, he wanted to start throwing again. I said, ‘No, no. No matter how good you feel, Joe, you’re done for about six weeks.'" ... Just seeing how quickly he recovered, that tells me he would be ready for spring training."

As for the rest of Kelly's arm, ElAttrache is just as optimistic.

"I think the labrum procedure last year turned the clock back for him," he noted. "As he said, his shoulder hasn’t felt that good in a few years. He had been pitching with a labrum that wasn’t perfect and that had caused a cyst and some swelling in a different nerve up by his rotator cuff. By taking care of that and getting rid of the cyst around that nerve, he said he felt stronger and felt better pitching than he had in a long time. He will tell you that. And his velocity was back up over 100, which is unusual after shoulder or labrum surgery."

Where will all of it lead Kelly? Well, with 100-pitch starting pitchers trending toward extinction, Major League Baseball teams need reliable relievers more than ever ... and heading into this offseason the Red Sox are certainly no exception.