San Francisco Giants: Mysterious elbow injury may send Johnny Cueto to Dr. James Andrews

AT&T PARK — San Francisco Giants starter Johnny Cueto has had issues around his elbow before. While still with the Cincinnati Reds in 2015, Cueto missed one start with elbow tenderness. Last year, he missed one start with a flexor tendon strain.

He began to feel tenderness again after his April 22 road start against the Los Angeles Angels of Anaheim, but over the first month of the season, Cueto showed no outward signs of discomfort on the mound. The 32-year old righty went 3-0 with a 0.84 earned run average in five starts, striking out 26 in 32.0 innings of work.

Over his last two starts, though, though, that tenderness has become more and more prevalent, and on Tuesday, Cueto landed on the disabled list, upping the amount of payroll tied up on the Giants disabled list to $79.1 million.

“Pretty amazing, really, the numbers and his performance out there,” manager Bruce Bochy said. “It’s incredible what he’s been able to do. It’s been a little achey the last two starts, he could feel it. We just don’t want to take any risk at this point, so this is why we made the move. Impressive month, considering.”

Cueto will make the trip to Atlanta with the team on Wednesday evening and will get a second opinion. When asked about Cueto’s UCL, Bochy said the Giants “won’t rule out anything,” and hedged when talking about different rehab paths and how long it would take for San Francisco to get Cueto back.

“The MRI, all the docs are still looking at at all his stuff there, and he’s being evaluated at this point,” Bochy said. “It’s a matter of putting all of our heads together — our medical people — and deciding the type of rehab and what needs to be done.”

The Giants’ next road trip will take them very close to the home base of Dr. James Andrews, noted Tommy John surgeon. Bochy said before the game that “it’s a possibility,” that Cueto will see Andrews during that time. Post-game, Bochy said it’s “part of the plan” for Cueto to get a second opinion from Andrews once the team arrives in Atlanta.

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Madison Bumgarner (left pinky finger), who was cleared to start a throwing program earlier this week by Dr. Donald Sheridan in Arizona, will join the team in Atlanta and begin throwing. He will likely make four or five rehab starts once his rehab officially begins, in order to get him ready by June 1.

“I think you look at it like spring training,” Bochy said. “You’re looking at four or five, in that area, but I don’t have it in front of me, the plan, once he officially starts his rehab.”

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Second baseman Joe Panik, who underwent surgery earlier this week, will also accompany the team to Atlanta. The surgery to repair his UCL — which was completely torn off the bone on his non-throwing hand — will likely take six weeks to recover from, meaning he’ll return at roughly the same time as Bumgarner and Mark Melancon.

“I guess I’ll be hanging out with some pitchers,” he said.

Melancon, who opened the season on the disabled list with a right elbow flexor strain, will throw a bullpen in Atlanta on Saturday.

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Reliever Josh Osich, who was placed on the disabled list on April 27 (hip strain), threw a bullpen on Wednesday, but will head to Arizona once the Giants leave for the East Coast.

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The Giants activated reliever Will Smith from the disabled list, and in a corresponding move, optioned outfielder Austin Slater to Triple-A Sacramento. After a rough doubleheader last weekend against the Los Angeles Dodgers, and given the starting rotation — veterans Jeff Samardzija and Derek Holland, backed by third-year righty Chris Stratton, Ty Blach in his second full season and rookie Andrew Suarez — San Francisco is trying to keep as many relievers on the roster as possible.

Right now, the Giants have 13 active arms, and to keep that many moving forward, a position player may have to be sacrificed. In all likelihood, that will be an outfielder, though Alen Hanson and Brandon Belt could fill in should that happen.

“I would be fine [with Hanson playing the outfield],” Bochy said. “[The cut would] probably be in the outfield. That would have to be it, so that’s why it would be difficult, because they’re all doing a good job.”

Ryan Gorcey

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