Under The Knife 5/18/26
Suze and Cocchi
BLAKE SNELL, SP LAD (inflamed elbow)
“Snell needs surgery for loose bodies in elbow; return this year in play” is the headline on MLB.com. I will note that writers don’t normally write their own “heds” and going for SEO, even on a speciality, in-house site like MLB.com, is the norm. Still, you’d think people on a baseball site might have noticed the big story of last week about one of the best pitchers in the game, or that Blake Snell didn’t need a nano-needle to come back in-season seven years ago when the condition reared it’s head in July, not May. The reality is that needle or not, Snell as well as Hunter Greene and Edwin Diaz are likely to return this season.
What changes now is not necessarily the prognosis, but the conversation around how these procedures are viewed. Before Tarik Skubal’s nanoscopic cleanup became public, most fans mentally sorted “elbow surgery” into two buckets: Tommy John or “something minor.” Baseball medicine has moved far beyond that simplistic split. Loose bodies, posterior impingement, synovitis, cartilage irritation - all of these can create symptoms significant enough to shut a pitcher down without meaning the ligament itself is compromised.
Snell’s history actually makes this easier to understand if you know where to look. In 2019, he underwent arthroscopic removal of loose bodies and returned in less than two months. The velocity came back. The stuff played. The world kept spinning. That precedent matters because elbows tend to behave consistently over time unless the underlying mechanics or tissue quality deteriorate substantially. With this, his elbow created loose bodies and it’s not surprising it’s done so again and the seven year gap doesn’t mean it happens quickly.
The interesting thing is whether the Dodgers decide this is another opportunity to push forward procedurally the way they just did with Skubal. Dr. Neal ElAttrache has already shown he’s willing to use nanoscopic techniques aggressively in the right patient profile. Snell arguably fits it: experienced rehabber, relatively clean ligament status, flexible body type, and an organization that treats medical innovation almost as a competitive advantage.
What to watch isn’t the surgery itself, scheduled for Thursday. That’s the easy part now. Watch how quickly the Dodgers let Snell resume throwing, how the elbow responds after workload spikes, and whether the club starts speaking confidently or carefully. Teams always tell you more through pacing than press releases. The Dodgers, meanwhile, will adapt because this is what they do. Their entire roster construction model assumes attrition. They stockpile arms, stretch bullpen roles, manipulate workloads, and quietly prepare for October while everyone else is still reacting emotionally to May headlines.
A reminder that a subscription is only five bucks a month and that Dr. Neal ElAttrache is scheduled to be a guest on Injury Territory this week. The two are not unrelated. More subscribers gets me more visibility and that means better guests.