Tuesday night, Kuo told trainer Stan Conte that he could no longer pitch. He met with manager Don Mattingly and pitching coaches Rick Honeycutt and Ken Howell, Mattingly saying he was not surprised with Kuo's decision because he had been discussing it for a while. Kuo left Pittsburgh for Los Angeles before the game and was placed on the disabled list indefinitely.
It is not unlike what happened to Kuo in 2009, when he spent three months rehabbing in Arizona before overcoming the yips and returning to help the Dodgers reach the playoffs. The difference is, that time he was on the shelf with what was officially termed left elbow irritation.
Teammate Hiroki Kuroda, after pitching the Dodgers to victory Wednesday night, revealed that he had the yips in high school and college and had been talking frequently to Kuo.
"I'm very concerned. I talked to him a lot in the past week," said Kuroda. "There are so many things only he can understand. I, myself, went through something similar in the past. The degree seems to depend on the player. I can't give you an easy solution for Kuo."
Kuroda said he didn't throw in a game during his wild spell in high school and didn't pitch in a game during his freshman year of college.
"I threw batting practice and so many times the hitters didn't attempt to swing at a pitch," he said.
An emotional Mattingly had trouble explaining what happened to Kuo or what will happen. There is no timetable for a return, other than to give Kuo time to decompress and, likely, seek counseling. Some teammates believe Kuo wants to retire.
"The main thing, I think, as much as anything, he didn't feel like he could do it," said Mattingly. "Kuo has had some issues before. It's hard for me to understand it and hard to talk about it. I've seen it with Knoblauch in New York a little bit.
"I didn't know what to tell him. There is so much respect for him, he's such a competitor and everything he's been through with the surgeries. He's got so much respect in the clubhouse for what he's done. I don't know where it goes from here; it's a medical decision."
Kuo's most recent outing was Monday night, when he allowed RBI doubles to the only two batters he faced. It was his third appearance in four days, which included a game-losing throwing error Kuo committed on a routine bunt. On Tuesday, Kuo said: "I've got to be better, that's all. I feel all right."
This came at a time when Mattingly said Kuo had convinced the club to treat him like a normal pitcher, instead of using the kid gloves that had been the norm since he finally reached the Major Leagues after battling chronic elbow problems that led to four operations, two of them Tommy John reconstructions.
Through nine games this year, Kuo had an 11.57 ERA. He was activated May 1 after missing 16 games on the DL with what officially was listed as a sore lower back, but also was prompted by another case of the yips.
Last year, it appeared Kuo had finally overcome his demons, making the All-Star team and setting a franchise record for the lowest ERA at 1.20. He also led all relievers with a .139 opponent batting average, with left-handers going a paltry 6-for-63 (.095), and he inherited the Dodgers' closer role when Jonathan Broxton struggled.
"The demons he's had to fight off -- I don't know how he's done it," former teammate Randy Wolf said in 2009. "It's amazing, because the scariest things are the ones we create in our head and with him it snowballed into that. You see guys with the yips that never recover from it. For some reason, that's a problem that can stick with you. For Kuo, he battled back and conquered it. We are all so happy for him. Hong-Chih doesn't have quit in him."
Kuo has been in the organization longer than anyone on the roster. Signed in 1999 out of Taiwan at age 17, he has played for five Dodgers managers, five general managers and two owners.
To replace Kuo on the roster, the Dodgers recalled Scott Elbert, who coincidentally missed half of the 2010 season dealing with emotional issues.
Elbert, a former No. 1 Draft pick, has 13 appearances for Albuquerque with a 2-0 mark and 5.02 ERA, apparently is still plagued by wildness. In 14 1/3 innings, Elbert has issued nine walks with 16 strikeouts. Seven of his eight earned runs allowed have come in two appearances.