In hopes of contending this year, the St. Louis Cardinals prioritized adding pitching this winter. Unfortunately, the team’s lone reliever free-agent addition has yet to make his season debut, and it doesn’t look like it will come any time soon. According to Cardinals manager Oli Marmol, right-hander Keynan Middleton suffered a setback in his rehab and will receive an MRI on his right elbow and forearm on Friday. A procedure to address his ulnar collateral ligament appears likely.
#STLCards RHP Keynan Middleton is headed for further testing on his forearm. UCL replacement or repair surgery could be coming for the free-agent signee expected to be an integral piece of the STL bullpen. Middleton has yet to pitch in the 2024 season because of persistent pain.
— John Denton (@JohnDenton555) May 29, 2024
Middleton initially suffered a forearm strain during Spring Training and started the season on the injured list. He missed several weeks, but looked like he was nearing a return to the majors. The 30-year-old appeared in five minor league rehab games in mid-May, but was shut down after experiencing discomfort.
The outlook on Middleton’s setback does not appear great, and imaging should reveal what type of procedure is needed.
Keynan Middleton Suffers Setback, To Undergo MRI
The Cardinals signed Middleton to a one-year, $6 million deal after he broke out in 2023. Split between the Chicago White Sox and the New York Yankees, the righty posted a 3.38 ERA (132 ERA+) in 50 2/3 innings. Middleton struck out a career-high 30.2 percent of opposing batters and excelled at inducing weak contact and ground balls.
His breakout performance led the White Sox to trade him to the Yankees at the deadline. He pitched well in the Bronx, but missed most of September with shoulder inflammation. While it’s unclear if the shoulder inflammation and this current arm issue are related, Middleton returned on September 29 and passed a physical when signing with St. Louis.
Keynan Middleton is another nice bullpen depth pickup by the FO
2023 with CHW and NYY:
-50.2 IP
-30.2 K%
-10.8 BB%
-3.38 ERAHis fastball sits 95-96 and also features a plus slider (.208 wOBA against)
He'll generate whiffs for a team desperately in need of K's#STLCards pic.twitter.com/JO9eiQel1H
— Adam Akbani (@AdamAkbani) February 2, 2024
Furthermore, Middleton is no stranger to injuries. He looked like a piece to build a bullpen around during his 2017 rookie season with the Los Angeles Angels. In 64 games, Middleton tossed 58 1/3 innings, posted a 3.86 ERA (111 ERA+) and finished 17 games.
Unfortunately, he underwent Tommy John surgery in 2018 and did not experience a smooth rehab. He eventually came back late in 2019 and dealt with struggles and more injuries throughout the rest of his Angels tenure.
Los Angeles let him go after 2020, and Middleton tossed just 60 innings in the majors over the next two season with the Seattle Mariners and Arizona Diamondbacks. He re-established himself as a high-leverage reliever in 2023, but it seems an UCL surgery will stunt his career once again.