CINCINNATI -- A second opinion on reliever Keith Butler's right elbow confirmed a tear to the ulnar collateral ligament and leaves Butler expected to have season-ending Tommy John surgery on his elbow.
Butler, who is on the Cardinals' 40-man roster and was a member of the Opening Day bullpen, went on the Triple-A disabled list on May 14 due to elbow discomfort. He had his elbow examined by the Cardinals' medical staff, and then sought out another opinion from former team orthopedist George Paletta.
General manager John Mozeliak said that Paletta is expected to perform the procedure. The recovery time for Tommy John surgery is typically 12-18 months.
Butler may be the first Cardinals pitcher headed for Tommy John surgery this season, but he is the latest in a growing number of Major League pitchers who are losing a season's worth of time due to a compromised elbow ligament. The high number of players needing Tommy John surgery has caught the attention of the baseball community and has generated many a theory as to why elbow injuries have become increasingly common.
On Saturday, Mozeliak offered his thoughts on the epidemic.
"In the end, I do think there is sort of a usage issue going on, but I'm talking about way before we get them, maybe at the ages of 8 to 12," he said. "Then I also think there's a slight correlation, too, on sort of the strength. Guys are getting stronger and more physical. It's not country strong, it's more weight-room strong. The body clearly can't handle that torque on the elbow.
"I think as our industry tries to get a better grasp on this, we have to look at everything, question everything from usage to strength training to preparation. I do think that when we start to drill on this it has to be a concerted effort and more a group-think approach, because if any one team thinks they're going to find this answer, it's going to be very hard. There's not a lot of data to drive this."
The Cardinals have their own internal system that they use to identify risk factors and injury probabilities. Of that, Mozeliak said: "I'm not going to get into specifics on how we do that, because I do think we have a little bit of an edge there with how we think about things."
Forearm strain lands Siegrist on 15-day DL
CINCINNATI -- Cardinals reliever Kevin Siegrist, who has been dealing with persistent discomfort in his left forearm for much of the past week, was placed on the 15-day disabled list Saturday, shortly after Siegrist had his pitching arm examined by team orthopedist Timothy Farley back in St. Louis.
Cardinals general manager John Mozeliak said that Saturday's exam did not reveal the injury to be elbow-related and described the area of tightness as more between the forearm and wrist than near the elbow. Siegrist has been prescribed a period of therapy and rest. He's expected to be reevaluated in about a week.
Siegrist retired all four batters he faced on Friday, but notified the training staff afterward that he could not get loose during the 11-pitch appearance.
"It got to the point last night where he felt like it was not improving," Mozeliak said. "It's not acute. It's just something where he feels like he just can't get loose. And so when he's throwing, it's not that he can't throw or is in extreme pain. It's just sort of a mild discomfort."
Before Friday, Siegrist had pitched just once in an eight-day period. On several of those days, he was designated as available only in an emergency situation. The Cardinals had hoped that rest would alleviate this issue. Manager Mike Matheny said that Siegrist passed several tests and was cleared for usage on Friday, which is why he was deployed in the seventh inning.
Siegrist had been one of the most heavily used relievers in the Cardinals' bullpen before this recent layoff. He appeared in half of the team's first 44 games, logging 18 2/3 innings during that stretch. Mozeliak downplayed the possibility that this injury could be related to that workload.
"Certainly, when he's feeling better again, we'll have to watch his usage moving forward," Mozeliak said. "But I don't feel like you could conclude there was a usage factor."
Left-hander Sam Freeman was recalled from Memphis to take Siegrist's place in the bullpen. He was expected to arrive at Great American Ball Park around game time Saturday.
Freeman was optioned to Triple-A only a week ago when the Cardinals made room for Jason Motte. Freeman made one scoreless appearance for the Cardinals. Typically players have to remain in the Minors for at least 10 days after a demotion, though that is waived in cases where a team makes a DL move.
Matheny again rests Adams vs. lefty starter
CINCINNATI -- For the second time in three days, manager Mike Matheny sat first baseman Matt Adams against a lefty and worked outfielder Shane Robinson into the lineup in Adams' place.
Matheny described Saturday's lineup decision as not so much a reflection of Adams' overall troubles versus southpaws this season, but rather about the difficulties of the particular matchup against Reds lefty Tony Cingrani. Matheny also expressed a desire to give Robinson another starting opportunity following Robinson's three-hit game on Thursday.
"That was part of Matt's goals, I know he wanted to have us and himself know that he can go up against any lefty," Matheny said. "Once again, I think he has proven that, and over time, he'll even see better results. … Every once and a while, you have the tough lefty that he doesn't necessarily have good numbers against -- you could say that's the case tonight."
Adams was 0-for-6 against Cingrani with a walk and four strikeouts. His season numbers against lefties aren't all that impressive either, as Adams has totaled five hits and 12 strikeouts in 38 at-bats. His only extra-base hits are doubles, and Adams has driven in just one run when facing a lefty pitcher.
The Cardinals had been consistent in keeping Adams a part of the lineup regardless of the starting pitcher until this recent stretch. Part of their evaluation about Adams' long-term viability as a starter was to see how he could produce against left-handed pitching.
Cards to honor '64 champs, Jeter on Monday
CINCINNATI -- More than a dozen members of the Cardinals' 1964 World Series championship club are expected to be present for a 50th anniversary celebration at Busch Stadium on Monday.
Fittingly, the Cardinals will be hosting the New York Yankees in an Interleague series next week, as it was the Yankees whom the Cardinals defeated in seven games to capture the franchise's seventh championship. That was the last time the two storied franchises met in a Fall Classic.
Monday's pregame ceremony will be streamed live on MLB.TV and will include a parade of the players around the warning track.
The Cardinals also have scheduled a gift presentation for Yankees shortstop Derek Jeter as part of the pregame festivities on Monday. Jeter, who has announced that he will retire at the end of the season, will be joined on the field by several Cardinals front office members, Hall of Fame shortstop Ozzie Smith, and Hall of Famer Red Schoendienst, whose No. 2 has been retired by the organization.
• Peter Bourjos was scratched from Saturday's lineup shortly before first pitch due to a stomach virus. Jon Jay took Bourjos' place in center, while right fielder Shane Robinson was moved up to the second spot in the order.
• Sunday's night game against Cincinnati will wrap up a four-week stretch in which the Cardinals will have been featured on ESPN's Sunday night broadcast three times. The Cardinals' next Sunday night appearance is scheduled for July 20, a home game against the Dodgers.
• Top prospect Oscar Taveras had his fourth consecutive multihit game on Friday. Taveras doubled, homered, drove in three and scored two times in Memphis' 12-10 loss. He now has seven homers this season.
Jenifer Langosch is a reporter for MLB.com. Read her blog, By Gosh, It's Langosch, and follow her on Twitter @LangoschMLB. This story was not subject to the approval of Major League Baseball or its clubs.