ST. LOUIS -- Whether Michael Wacha, who was placed on the disabled list with a right shoulder injury on Tuesday, returns to throw another meaningful pitch for the Cardinals likely won't be known for a few weeks. But as the 25-year-old begins rehabbing an injury that can now be defined as recurring, he'll do so with as much focus on the long term as the immediate.
Wacha missed 2 1/2 months of the 2014 season due to a stress reaction in his right shoulder, and now that injury is back. The righty had endured soreness after his last several starts but felt especially compromised during Monday's five-inning outing. Manager Mike Matheny noticed a dip in velocity and uncomfortable mechanics, and Wacha confirmed that he wasn't feeling right.
An MRI taken on Tuesday morning then confirmed damage to his scapula.
"I just have to try and find different ways to prevent it and keep it from coming back up," said Wacha, who has a 7-7 record and a 4.45 ERA. "I'm keeping it positive. Take a little break from throwing and hopefully that irritation goes away and I can get back on the mound and start throwing again without that irritation in there."
The injury is rare in baseball, with Brandon McCarthy being the most prominent documented case. The fact that the injury has been recurring throughout McCarthy's career has heightened the concern around Wacha. From 2007-13, McCarthy was on the DL five times due to shoulder issues. It's an injury that cannot be addressed by surgery.
"We know what. We don't know exactly why," general manager John Mozeliak said. "Ultimately, that's what we have to work on between now and next season. … I think when you're looking at really trying to solve the problem, we're going to have to roll up our sleeves and figure it out."
That will include determining whether Wacha can handle the workload demands of a starter, and whether he'll need to change his mechanics (as McCarthy did) to better protect his shoulder. Mozeliak acknowledged that trying to get 200 innings a season out of a pitcher with this injury is something that "I don't think we're comfortable making that bet long term at this point."
Wacha considered changes to his high arm angle after the injury first presented itself in 2014, but never did make a switch.
"I pitched all last year and it felt great with the same mechanics," Wacha said. "I worked my tail off. I didn't want to leave any doubt for that thing to come back. It's not a very good feeling right now knowing it's come back. I have to attack it a different way, I guess, and continue to get better."
He'll visit a specialist in Chicago later this week to get a second opinion.
Jenifer Langosch has covered the Cardinals for MLB.com since 2012, and previously covered the Pirates from 2007-11. Read her blog, follow her on Twitter, like her Facebook page and listen to her podcast. This story was not subject to the approval of Major League Baseball or its clubs.