The tentative date for the operation is April 4 in Cincinnati with team medical director Dr. Tim Kremchek performing the procedure. Madson returned to Arizona to close up his living arrangements and visit with teammates. He spoke to relievers Sean Marshall and Bill Bray, among others, at the team complex.
Madson, 31, was signed to a one-year, $8.5 million contract by Cincinnati to replace Francisco Cordero as the closer. His presence in the bullpen was considered a key cog to the Reds' hopes of contending for the National League Central title and a playoff berth.
While the Reds will move on without him, Madson feels worse for his team than he does about his elbow being hurt.
"It will get taken care of," Madson said of his elbow. "I'm very confident that Kremchek and the [staff] here will get me back 100 percent, if not better. The main thing is my role on the team this year. It was to be a leader in the bullpen and take care of the heavy stuff, and now I can't do that. I'm very disappointed in myself and that I let my teammates down. It feels horrible."
In a big league career that began in 2003 with the Phillies, an elbow injury has never put Madson on the disabled list. In late February, he was shut down from throwing temporarily by the Reds after he reported irritation in his right elbow. The injury was not considered serious, and Madson claimed it was something he had previous experienced in past Phillies camps.
Madson resumed throwing after a few days off, and after a few successful bullpen sessions, threw a 20-pitch simulated game against Reds hitters on Tuesday.
At some point along the way, his elbow blew out. The how and when it happened remains a mystery.
"That's a question I can't answer," Madson said. "I think it happened over time here at Spring Training, and coming back from the little injury to the back of my elbow. I think throwing through that kind of aggravated it. I never felt any one moment where it happened. That's why I was so shocked at the result.
"When I threw last to the hitters, I felt great. Just there at the end, there were a couple of pitches where it was tight. I just thought it was normal tightness that we feel. We throw through a lot of pain and tightness and all that our whole career. I thought it was just more of that."
The Reds got Madson at a relative bargain in late January, after he fell through the cracks of the free-agent market. Early in the offseason, he appeared to have a reported four-year, $40 million deal to return to Philadelphia. At some point, Madson believed, the offer was pulled off the table by the Phillies after the agreement was struck.
"There was never a point where I turned anything down from the Phillies," Madson said.
Madson found a landing spot with the Reds after having saved 32 of 34 games while posting a 2.37 ERA in 62 games in 2011 for the Phillies. What he didn't get was long-term security. That meant personal risk if something like an elbow injury happened. Still, the right-hander didn't view the injury as part of a run of bad luck from his offseason contract issues.
"You can't control any of this stuff," Madson said. "You can't plan anything. I just have to put it in God's hands and let him take care of it. Everything will be fine. I trust that, and I will do what the trainers say. Bad luck? I don't know if you can call it that. Many guys have had this surgery and come back stronger. It's kind of a rite of passage. Hopefully, that's all it is."
There is an $11 million mutual option included in Madson's contract for next season, with a $2.5 million buyout. It'd be hard to fathom it being picked up by the club, but Madson did not close the door on returning to the Reds in 2013.
"There's definitely interest there, and now I want to prove to them that if I can get through this, I can pretty much get through anything," Madson said. "Once I prove to them that is the case, I'm sure they will be more than interested."