BUFFALO—The recovery from Tommy John surgery has become so routine that pitchers are expected to simply go through the rehab process step by step, checking each box as they go until they’re back in the big leagues healthy, strong and ready to go.Â
The truth is that it’s very much not a linear process. There are good days and bad days all along the way and Wednesday afternoon, in his first rehab start at Triple-A, Alek Manoah had a bad day.
“Just one of those days where kind of everything felt out of sync, and I’ve had those days along the rehab,” the Blue Jays right-hander said after a start in which he lasted just an inning and two-thirds. “There are some days where you come out throwing 95 (m.p.h.), you don’t have to think about it, and there are some days where you come out with a little less velocity and you’re like: Oh, what’s a little off?”
Because of the rules of the rehab, Manoah was lifted after throwing 27 pitches in the second inning having only recorded two outs. Teams can’t risk having pitch counts get to 30 in a single inning. His fastball topped out at 92.1 miles per hour.
“I reached (27) pitches for the inning, so it was time for me to be done,” said Manoah, who had reconstructive elbow surgery in June 2024. “Just got to keep having patience with that and understanding there’s going to be days like that. The good thing is that everything feels good.”
Manoah’s outing didn’t start all that well, either. He walked two Lehigh Valley IronPigs in a 22-pitch first that included a 55-foot slider, but no runs allowed. In the second, there was an infield single that snuck under his own dive, a hit batter (on another bounced slider) and a walk to load the bases for Justin Crawford.
You might recognize the name. His father Carl was a huge thorn in the Blue Jays’ side as an outfielder in his Tampa Bay Rays days.Â
Crawford, the Phillies’ No. 3 prospect according to MLB Pipeline, ripped a two-run double toward the right-field corner — the only well-hit ball off Manoah over his short afternoon’s work.
The next batter, rehabbing big-leaguer Alec Bohm, grounded out to third and Manoah was done.
“I thought I made some good pitches to (Bohm),” Manoah said in a conversation that can be heard on Thursday’s episode of “Deep Left Field,” the Star’s baseball podcast. “In his first at-bat (a walk), a couple of pitches got away from me ... in that second, I just went right at him.”
Shane Bieber, acquired at the trade deadline from the Cleveland Guardians, is two months ahead of Manoah on the surgical recovery calendar and has looked very much like himself in two rehab starts for the Bisons. He’ll have one more Friday, and will almost certainly be back in the majors for his next one. Manoah did not look like himself on Wednesday, but again he’s only 14 months post-surgery.
“Sometimes when you have some frustrating days where you don’t reach your pitch count or whatever the case may be,” said the six-foot-six right-hander, “it’s still (a pretty big accomplishment) just to see the work that it’s taken to get here, from literally laying on a table and having my arm cut open to being here and throwing a baseball at a high competitive level.”
He sees a positive in Wednesday’s rough day, in which he gave up three runs on two hits, while walking three, hitting another and striking out one: Crawford leading off the game.
“It’s kind of a good problem for my problem to be either mechanical or competitive or synced up,” said the 27-year-old Manoah, who finished third in Cy Young balloting in 2022. “At the end of the day, you still have to remember that the arm feeling good ... the elbow bouncing back good is priority number one.”
Manoah can take his time getting things right. With the Jays rotation healthy and Bieber about to come back, there’s no room in the rotation and no desperation for a team with the American League’s best record. While most injury rehab assignments are limited to 30 days, pitchers returning from Tommy John surgery are allowed up to 60 days, so the Jays don’t need to make a decision on whether to activate Manoah or option him to the minors until mid-September.
He has no expectations — that’s beyond his control — but he made it clear that he’s happy to help the big club in any role, starting or relief, if he’s healthy and ready to go.
”(General manager Ross Atkins) makes those decisions,” Manoah said when asked if he sees himself in ÎÚÑ»´«Ã½ this year.
“They know what I’ve got. They know that I pitch with my heart, I pitch with my mind and I pitch with my nuts. I’m going to go out and do that no matter what.”
It’s just a matter of getting everything in sync. Wednesday, it definitely was not.
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