Toronto Blue Jays starter Alek Manoah was placed on the 15-day injured list Friday due to a right elbow sprain and was scheduled for an in-person evaluation with orthopedic surgeon Dr. Keith Meister next week.
The 26-year-old right-hander, who missed the first five weeks of the season due to right shoulder inflammation, was removed in the second inning of Wednesday's 3-1 win in Chicago after experiencing discomfort in his throwing arm.
"Alek's MRI revealed a right UCL (ulnar collateral ligament) sprain. That's all we know now," Toronto manager John Schneider said before the Blue Jays' night game against Pittsburgh.
Manoah was 1-2 with a 3.70 earned-run average over five starts. The move to the IL was retroactive to Thursday.
Schneider said Manoah received treatment after his May 24 start against Detroit and "looked and felt good" after throwing a side session in Chicago. However, his velocity dipped in the second inning against the White Sox and he was pulled after recording two outs in the frame.
Meister, who's based in the Dallas area, is considered one of the leading orthopedic surgeons in the sport. Schneider said it was too early to speculate on how long Manoah will be out of action.
"I think again, an in-person meeting with Dr. Meister (on Thursday) will give us more information on that and a plan going forward," he said.
Manoah was an American League Cy Young Award finalist in 2022 but struggled last year and was demoted on two occasions. The six-foot-six 285-pound native of Homestead, Fla., was shut down in mid-September after receiving multiple injections in his pitching arm.
Manoah was roughed up in his first start on May 5 but showed flashes of his previous all-star form later in the month.
"He's got strong faith," Schneider said. "He's been through a lot in the last year. I think he's met everything head-on in the last year and that's where he's at right now."
The news was a blow for a starting rotation that has found its footing over the last couple weeks after a middling start to the season.
Bowden Francis is one option as a potential replacement as he nears a return from an IL stint due to right forearm extensor tendinitis. Yariel Rodriguez, who's on the IL with thoracic spine inflammation, was scheduled to make a 50-pitch appearance for triple-A Buffalo on Friday night.
Schneider could also use a bullpen day to cover a start or two if needed.
"I think right now we're just focused on the next turn through (the rotation) and (then we'll) go from there," he said.
Also Friday, the Blue Jays acquired right-handed reliever Ryan Burr from the Philadelphia Phillies in exchange for cash considerations and designated right-hander Joel Kuhnel for assignment.
Burr was 2-1 with a 2.16 ERA, five walks and 29 strikeouts over 15 Triple-A appearances this season. He was active for the Blue Jays' interleague series opener against the Pirates.
"I think what we liked are the strikeouts for one, and just maybe adjusting some of the pitch mix arsenal — not a lot — because he's getting good results right now," Schneider said. "But I think there's a lot of upside in him too in terms of what he can offer out of the bullpen with the fastball-slider combo."
Top prospect Ricky Tiedemann, who's on the minor-league seven-day IL with left ulnar nerve inflammation, is continuing to build up in Florida. Schneider said the left-hander threw a 20-pitch live bullpen session on Friday and the next step would likely be a rehab outing.
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