It ended up being loose bodies, prompting the invasive-yet-less-daunting procedure to remove bone chips. Alvarez missed the final four months of the Minor League season, but he got some work in extended spring, spent the offseason dominating in Venezuela and showed up to Spring Training with a little bit more velocity on his fastball.
The Angels had acquired a lot of starting-pitching depth over the last 12 months, and sometime around the middle of March, they decided Alvarez, a starting pitcher each of his nine prior years in professional baseball, could help them as a long reliever and occasional lefty specialist.
Seven weeks in, the 26-year-old Alvarez has a 2.84 ERA, a 0.79 WHIP and 18 strikeouts in 19 innings.
On Friday night at Fenway Park, he entered in the bottom of the seventh with the bases loaded and none out, struck out David Ortiz and got Daniel Nava to bounce into an inning-ending double play to maintain a six-run lead.
Alvarez, acquired from the Tigers for utility infielder Andrew Romine on March 21, 2014, looks awfully different from the guy the Angels saw last year.
"It's tough, because when he was starting in Triple-A and came up a little bit last year, his elbow wasn't [healthy]," Angels manager Mike Scioscia said. "He wasn't finishing his pitches, his velocity was probably 88 [mph]. Now it's 90, which also helps his slider, his cutter, his curveball and his changeup. He's throwing the ball a little crisper with an easy delivery, just because his arm feels good."
Alvarez only pitched 32 1/3 innings for the Angels last year -- two-thirds of them in the Major Leagues -- but he got off the mound again in late August, then went to pitch for the Caribes de Anzoategui, the Venezuelan winter ball team that plays a couple blocks from his house.
"I wanted to throw innings out there," Alvarez said in Spanish. "I was coming off an injury, and I wanted to show them that I'm fine."
Alvarez did more than that. He went 6-1 with a 1.91 ERA in 56 2/3 innings, won the award for best pitcher in Venezuela, arrived to Spring Training eyeing his first Opening Day roster and got there by quickly adapting to a reliever lifestyle.
Alvarez prefers being a starting pitcher, but he will gladly accept the role in front of him.
"It's an opportunity, and I welcome that," Alvarez said. "I'm on the team. To me, that's the most important thing."