The Giants could be without young right-handed pitcher Tristan Beck for a while.
Beck was on track to earn a spot in San Francisco's starting lineup this season, but earlier this week he was diagnosed with an aneurysm in his upper right arm and told reporters on Friday that he would undergo surgery on Monday after seeing a vascular specialist in San Francisco to address the problem.
What exactly is an arm aneurysm and how long could Beck be out? Michael T. Freehill, associate professor of orthopedic surgery at Stanford Medicine, answered those questions in an interview with NBC Sports Bay Area on Friday.
“Especially elite-level and professional throwers, they throw with such force and speed that it can put a lot of stress on the blood vessels in the arm,” Freehill explained. “And while it’s relatively rare for pitchers at higher levels, we definitely see it. And what happens is that there can be a tear in the intima or a tear in the blood vessel wall, and as that gets thinner it starts to bloat out something, hence what we call an “aneurysm.”
“You don't think of a rupture like you would with an aneurysm in the head, but what happens when the balloon forms is that the body tries to heal it by depositing a so-called thrombus that clumps together in that area, “so that the body can heal.” And that's usually a good thing, but with throwers, the constant, repetitive forces and tensions can cause some of the thrombus to flow from the injured area into the larger arteries that are on the End running down the arm and it can get stuck and this can lead to this variety of symptoms.
Freehill wears many hats, including the role of head team physician for the Stanford baseball team, assistant orthopedic surgeon for the Oakland Athletics, and teaches in the Department of Orthopedic Surgery at Stanford University School of Medicine.
While the Giants have not released official details about Beck's upcoming surgery and his timetable for a return to the mound, Freehill estimates the 27-year-old could miss some time this season.
“If it’s an aneurysm, where is it located? Once identified, a blood vessel needs to be repaired,” Freehill said. “That will probably take up to four weeks to heal. You're probably going to do at least four weeks of physical therapy, if you will, after those first four weeks, and then start to build the movement back up.” When you introduce strength, you're probably already two months old before you start, what we would call an interval throwing program.
“And then it would drag on, and it could take more than two and a half to three months. So generally speaking, you can probably expect something like this to happen up to five months before you're competitive in a game.”
If Beck is sidelined for up to five months, his potential return to the mound could be tied to injured veteran pitchers Alex Cobb and Robbie Ray, who are expected to miss most of the first half of the season due to their respective injuries.
Aside from relief pitcher and current starter Jordan Hicks, the Giants haven't added a healthy arm to their rotation this offseason. If Beck, Cobb and Ray all three miss most of the first half, San Francisco's rotation could be pretty thin heading into the 2024 MLB season.
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