TEMPE, Ariz. (AP) Tommy John surgery might not need to be the answer for pitchers who blow out their elbows. That's what Garrett Richards is hoping.
The righty who might be the Los Angeles Angels' top starter made his first start this spring on Sunday, earning high-fives from his teammates after sailing through a scoreless first inning against Cincinnati. The Reds touched him up for four singles and three runs in the second.
''I felt totally fine,'' Richards said.
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Richards may be the most prominent pitcher to opt against Tommy John surgery, where a tendon from another part of the body is transplanted to reconstruct the pitcher's elbow. Pitchers usually miss 12 to 18 months.
Instead, Richards used a combination of stem-cell therapy and platelet-rich plasma injections after he suffered a partial ligament tear in his elbow last May.
Because he figured he would miss the rest of 2016 and all the 2017 season, he had time to explore other options. So, stem cells from the marrow in Richards' pelvic bone were injected into his elbow.
After 10 days of rest, Richards said his elbow felt ''100 percent normal.'' He didn't try a comeback late last season, though, because the Angels were going through a down season.
As far as he's concerned, the mental hurdles were cleared last fall when he pitched for the Angels' instructional league team.
''The ball was coming out of my hand the best it's ever come out of my hand,'' he said.
''I went down an unorthodox avenue. I'm still kind of figuring it out. But everything feels normal. I've already been checked out by the doctor. It's perfectly fine. I'm just excited to be back out there,'' he said.
Richards said he hopes his story can give other pitchers with elbow damage ''another avenue to go down. Any time you can save yourself from getting cut on, I feel that's huge,'' he said.
The type of injury and the timing during a season are major factors, he said. But in any case, ''It worked for me.''
Other paths to Tommy John could become more commonplace, Angels manager Mike Scioscia said.
''There's no doubt the research is going in that direction, to where there are some alternatives,'' he said.
''There's been a huge advance in the last five years . (with) very encouraging'' results, Scioscia said. ''Although the player most likely will miss time, hopefully it's not going to be as devastating as having to have the transplant.''
Richards has had a normal spring with no limitations, he said. ''He's been full go.''
But this alternative to Tommy John surgery doesn't work for everyone.
Standing a few feet from Richards' locker Sunday morning was Andrew Heaney, an Angels' starting pitcher who also tried the stem-cell therapy.
''It just didn't work,'' Heaney said. ''Nothing happened.''
Tests, including MRIs and ultrasounds, showed no visible differences after the treatment, he said.
Heaney underwent Tommy John surgery and is likely to return in 2018.
''Medicine is always moving forward,'' Heaney said. ''It would be great, obviously, any time you can get guys back faster and not have to throw away a season or season-and-a-half. It would be huge.''
Then there's Tyler Skaggs, whose locker stands between Richards' and Heaney's.
''It would be great'' if stem-cell therapy could replace Tommy John surgery, Skaggs said. ''Everybody's elbow is different, though.''
Skaggs underwent the Tommy John elbow reconstruction in 2014. He returned in 2016, going 3-4 with a 4.17 ERA in 10 starts.
Skaggs said he is healthy and ready for the upcoming season.
''I'm excited. It's going to be a good year,'' he said.