TOWER GROVE — Back in 2008, during St. Louis Cardinals team physician George Paletta’s talk with the media about what’s become the most famous injured elbow in baseball, the doctor described the network of scar tissue and these bone spurs in Albert Pujols’ joint as a support structure, one that maybe was helping his arm operate with a torn ligament.

That was one of the reasons why none of it was disturbed and the ligament wasn’t repaired when Paletta went into the elbow about a year ago for what was described then as “relatively minor” surgery.

This morning, the Cardinals first baseman and presumptive National League MVP will have a procedure in Birmingham, Ala., to address ongoing discomfort in the elbow related to the torn ligament. This surgery, by description, will be more invasive than last year’s ^[1]. The plan is to remove the bone spurs Paletta mentioned back in spring training 2008. If Dr. James Andrews, et. al., go in and do as hoped, it will be another offseason that Pujols avoids the fully monty of Tommy John surgery.

This is how Post-Dispatch staff writer Joe Strauss described the nerve-transposition surgery that Pujols had a year ago out in West County to address late-season discomfort in the elbow:

The procedure transferred the ulnar nerve from a groove running along the inside of Pujols’ elbow to in front of the joint’s bony prominence. Paletta called the nerve “clearly irritated and inflamed.” Before surgery, the nerve popped from its groove whenever Pujols tried to straighten the elbow, according to Paletta. The condition caused tingling and numbness in Pujols’ right pinky and ring finger.

After doing that surgery, Paletta said the ligament did not require “reconstruction at this time.” His stance was at that time that Pujols could continue to his career with the tear if he continued with treatment and maintenance. That was the introduction to The User’s Guide to Albert Pujols’ Elbow that we put together back in 2008 for just these kind of days. Below is a link to the blog entry that takes you through the time line of Pujols’ injury, the various treatments attempted, what exactly the injury is, and why he’d be years removed from Tommy John surgery if he were a pitcher …

“A User’s Guide to Pujols’ Elbow” ^[2]

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