Giants pitcher Blade Tidwell appears to be headed toward elbow surgery

The relentless wave of San Francisco Giants injuries has claimed another young starting pitcher. 

Since March, the team has lost three promising starters, Hayden Birdsong, Trevor McDonald and Carson Whisenhunt to Tommy John surgery, and it appears Blade Tidwell is heading the same way after an MRI on Tuesday revealed he has a “high grade” UCL sprain. 

Tidwell, who left in the fourth inning Monday night after feeling discomfort on a pitch, was scheduled to meet with team orthopedist Dr. Kenneth Akizuki on Tuesday night to go over his options, but the right-hander knows that surgery is a strong possibility.

“It’s pretty concerning,” Tidwell said. “It’s not something that I want, but it happens to most pitchers in today’s game, so I know I can get through it.

“It’s wild all four of us, especially younger guys, doing it in the same year. It’s just unfortunate.”

As many as 40% of professional pitchers have had Tommy John surgery; it’s the most common surgical procedure in the game and there are numerous theories about why, including the emphasis on velocity and year-round baseball and travel ball at the youth level. Losing four starters all the same age – 25 – does make one wonder, but Tidwell came from the Mets system, and the Giants, like most teams, are careful with minor-league starters, and as manager Tony Vitello noted, these pitchers aren’t known for high velocity. 

“I mean, it’s worth a conversation or looking at,” Vitello said, adding that Tidwell “has had a long year and he’s done a little bit of both: relief, start. I don’t know how much any of that plays into that. … A little bit of a surprise, I guess.”

When the Chronicle asked president of baseball operations Buster Posey earlier this month about the numerous UCL tears, he said, “I think you have to look at it. I will say I’ve known Dave Groeschner’s medical staff for going on close to 20 years and I think they’re some of the best in the game. 

“I’m not going to pretend to share medical advice because I don’t know it. I think some of this, I hope some of this, is just a little bit of ‘it all happens at once.’ We’ll have to look and see if there’s anything we need to adjust, but I have the utmost trust in our medical group.” 

Occasionally, elbow sprains are treated with extensive rest and platelet-rich plasma, but even many of those pitchers go on to need ulnar collateral ligament replacements within the next year. Some do recover well – All-Star reliever Mason Miller among them – but most UCL sprains mean surgery. 

With Tidwell out, the Giants have an astonishing 24 players on the injured list, including 16 on the 60-day IL, and they’ve used a franchise-record 70 players – the second-most ever behind the Braves’ 71 last year. The 2025 Orioles and 2024 Marlins also used 70 players. 

With Tidwell joining the IL, right-hander Braxton Roxby was recalled from Triple-A Sacramento. He had a 1.23 ERA with seven strikeouts and no walks in four appearances with the River Cats after being sent back down Sept. 7. 

In a related note, Landen Roupp, the team’s No. 2 starter, was shut down and won’t make his final start of the season, joining top starter Logan Webb on the sidelines after a long season and heavy workload. Roupp has thrown a career-high 155 innings after 106⅔ innings last year. 

“Just being cautious. I definitely could have thrown, but it was just smarter to shut it down,” said Roupp, who was not placed on the IL. 

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This article originally published at Giants pitcher Blade Tidwell appears to be headed toward elbow surgery.