Liam Hendriks goes on 15-day IL with elbow inflammation

White Sox closer Liam Hendriks went on the 15-day injured list Sunday morning with right elbow inflammation. Hendriks pitched most recently in Friday night’s 2-1 win over the Marlins, earning the win in the ninth inning.

But after that game, Hendriks began to feel discomfort in his right elbow close to his forearm. Then following examination on Saturday, the decision was made to put him in the injured list, retroactive to June 10. According to general manager Rick Hahn, this injury is not unlike the right flexor strain that sidelined Hendriks for close to a month in 2022. At least based on the initial examination.

“Symptomatically it’s presenting similar to what we dealt with last year,” Hahn said.

Hendriks went on the injured list with that injury on June 14 and was able to return by July 4. But at this stage, it is too early to tell if following something close to last year’s recovery protocol is going to be possible.

“At this point we do not know if that’s going to be a similar path for this year. He’s undergoing additional examinations at this point,” Hahn said.

According to Hahn, the next update on Hendriks likely won’t come until Tuesday when the team is in Los Angeles.

Hendriks returned from the injured list on May 29 after winning his fight against non-Hodgkin’s lymphoma. He has made five appearances and earned his first save of the season on June 6 against the Yankees. Given what he went through in his cancer treatment and then the atypical nature of his ramp-up to return to play, it might be fair to wonder if Hendriks’ elbow inflammation is a byproduct of the last six months. 

But Hahn does not believe that is the case. The team was especially cautious about Hendriks’ return to the mound.

“Based upon the fact that the number of medical professionals involved ranging from our orthopedic people to his oncologist, to rehabilitation specialist, to the number of check-ins with where he was at physically along the way, this is perhaps the most thoroughly vetted return to play of any player in certainly my recent memory,” he said. 

There’s never a good time for an injury, but the Sox have been playing their best baseball lately, so the timing of this injury will probably present another hurdle for the team to jump on their way back from an incredibly bad start in April. They are 21-17 since May 1 and 6-3 so far in June. Even after Sunday’s 6-5 loss, the Sox are in third place and only 4.5 games back in the AL Central.

“Obviously he’s a big part of our team, big part of our bullpen,” manager Pedro Grifol said. “It’s unfortunate, especially how he got through what he got through. It impacts us as a club emotionally, it impacts our roster. We gotta continue to move forward and hopefully he can recover from this. That’s all we can do at this point.”

Losing Hendriks now means that bullpen arms like Kendall Graveman, Joe Kelly, Keynan Middleton and Reynaldo López will have to resume picking up innings that might have been spots slated for Hendriks otherwise. That’s a job they have handled nicely; since May 1, the Sox bullpen has the fifth-lowest ERA (2.86) in the league. Graveman and López lead the team in saves with 6 and 4, respectively, and both will likely be called upon to pick up more in the weeks to come. They pitched for two months without Hendriks in the bullpen in the beginning of the season and had him back for two weeks. And even then, not as the officially designated closer yet. So for Grifol’s relievers, moving forward from this setback will be familiar territory.

“These guys are going to fall right back into where they were prior to Liam being here,” Grifol said. “They know what their roles are, we communicate them daily, and they’re going to continue to be great.”

Guys like Graveman and Kelly are openly flexible about their role out of the bullpen. Graveman said the job is simple: “Whenever your name is called, you go get three outs, and that’s kind of what we’ve told [Grifol] from the start of the season.”

And Kelly isn’t one to overcomplicate things either.

“It’s different every day, so nothing affects me,” he told CHGO on May 20. “I don’t give a shit. It’s one of those things, just get the ball and ‘alright.’”

The Sox lost to the Marlins Saturday when Kelly couldn’t hold a 1-0 lead in the ninth inning, and again in Sunday’s 6-5 loss when Graveman came in to secure a save with the Sox up two runs. After Lucas Giolito turned in a sparkling seven innings — allowing just one run via Jorge Soler’s solo shot in the fifth — Middleton took the eighth with the Sox up 5-1 and gave up solo homers to Solo and Garrett Cooper. Up 5-3 in the ninth, Graveman took ball and gave up the lead on Jean Segura’s home run, a walk to Soler, and Bryan De La Cruz’ double down the left field line.

“I thought I had the right pitch selection, Seby [Zavala] and I did, I just think I didn’t get to the right location,” Graveman said. “So, thought we had a good gameplan and I didn’t locate as well today. Got me behind in the counts. Didn’t finish guys when I was ahead in the counts.”

Before Sunday, Middleton had not given up a run since April 29 against the Rays. Graveman not since April 30, and he had given up a total of three hits since the start of May.

The bullpen has the added help of Garrett Crochet now as well, who returned from Tommy John surgery recovery on May 16. Crochet last pitched in 2021, and he has a 4.50 ERA in eight appearances since returning this season.

“He himself having gone through an extended rehabilitation, it does take a little bit to get those sea legs under you […] and get back to your previous level of performance,” Hahn said. “But I think you guys have all seen, we’ve all seen over the course of his early outings here, the stuff has returned back to the preexisting level and now it’s just a matter of getting him as consistent as he’s been in the past.”

The best-case scenario is that Hendriks’ injury is something akin to what happened last season. Because if it is, he could return around the time of the All-Star break. That is, assuming his path back to the mound is about the same as last year. 

But of course, any time a pitcher has elbow and/or forearm discomfort, the fear is that it is worse than something like a flexor strain. Needing Tommy John surgery could mean Hendriks isn’t back until late 2024, maybe not even until 2025. He will be under contract next year if the Sox decide to activate their club option and avoid a $15 million buyout that would be paid out in $1.5 million increments over the next ten years.

For now, the White Sox must wait and see how things look over the next few days.

“It’s just a matter of how does it present, how do you treat it and how do you get him back if we look at all the different treatment options and figure out what’s best,” Hahn said. “Again, the symptoms are very similar to what we had last year, but [we’re] not ready to say it’s a flexor strain until we can read a MRI.”