"He will come back, I think, and pitch at some point next year in the second half," head trainer Mark Mann said. "But it will most likely be 2011 before you see the old Edinson Volquez."
Kremchek didn't make the decision to perform the Tommy John surgery instead of a less invasive arthroscopic procedure until he could take a look inside the elbow.
The situation was about as serious as these types of injuries can be.
"Not only was the flexor mass torn like we thought, there was also a tear in the ligament," Mann said. "It was almost completely torn."
A 17-game winner and an All-Star last season, the 26-year-old Volquez is 4-2 with a 4.35 ERA in nine starts this season. He hasn't pitched since June 1, when he threw one inning vs. the Cardinals in his first start back from a stint on the disabled list caused by back spasms.
Volquez underwent two MRIs after going on the DL, but neither showed the tears in his elbow.
"It's not the worst possible news, but it's not good news," manager Dusty Baker said on Monday afternoon. "At least we know what it is. It sure hurts your heart, though."
On Friday, Volquez had to shut down a simulated game 20 pitches into what was to be an 80-pitch session when he complained of tightness in his elbow. He had previously thrown four bullpen sessions without incident.
Pitching coach Dick Pole was distraught when he heard that Volquez needed the more serious operation.
"I thought he was coming along really good with the side [bullpen session] and he wasn't feeling any pain," Pole said. "The day he had hitters up there, he exerted himself a little more and the pain came back."
Last season, Volquez threw a career-high 196 innings for Cincinnati. He also pitched in two regular-season games plus some playoff games during the Dominican Republic winter ball season. He was pitching in the offseason to prepare himself for the World Baseball Classic, in which he worked three innings for the Dominican squad.
"I can't say that was the reason," Baker said. "Any time you do an unnatural act like throwing overhand, you risk something every time you pick up the ball."
Volquez's previous professional high in terms of innings was 178 2/3 innings, thrown in 2007 when he was with the Rangers organization.
The Reds discouraged both Volquez and Johnny Cueto from pitching in winter ball after last season, but that doesn't always convince players not to participate in their home countries.
"There's big-time pressure to play, and to perform well," Baker said.
Pole provided both Volquez and Cueto with a throwing program to follow. For Volquez's first winter start, Pole's program called for 50 pitches. Volquez threw 99.
"They were playing Cueto's team. That's how I found out about it," Pole said. "I know the guy that was taking care of Cueto and that he would do what I asked him to do.
"It's a lot of throwing. That Classic, there weren't too many guys that repeated from the first time they did it and went back and pitched the second time," Pole said. "They knew the rigors of getting ready for that thing early."
Without Volquez, the Reds will enter 2010 with a big hole in the rotation. In addition to Cueto, Aaron Harang is enduring his second consecutive rough season, and Bronson Arroyo has a 5.10 ERA this year. Micah Owings has been inconsistent. The club will have to spend the offseason either preparing another starter from the Minors or exploring the trade and free-agent market to pick up Volquez's slack.
There was a time that such elbow injuries as Volquez's would mean the end of a career, but many pitchers that have had the Tommy John procedure often come back and throw as well or better than they did before. Obviously, the Reds will be hoping for that type of outcome.
"I know Volky," Pole said. "He will work his [behind] off and get back at it. He's got a good work ethic."