January 26, 2026
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All medical reports on Phillies ace Zack Wheeler are encouraging as pitchers and catchers get ready to report next month.
With pitchers and catchers reporting to spring training in less than three weeks, there's genuine concern about a Phillies starting rotation that brings back its top four from a group that last year was among the best in the sport.
That's because Aaron Nola, signed through 2030, was the one starter who bottomed out last year, first missing time from an ankle injury that also led him to missing his locations as his ERA ballooned to more than 6.00, and then missing about three more months from a stress fracture in his right rib.
And also because Zack Wheeler, who was well on his way to a Cy Young season, had another sparkling campaign cut short in August from a sudden blood clot in his lung that required a procedure, along with a surgical decompression to treat venous thoracic outlet syndrome.
That's half of the top four of a rotatation that will once again be asked to carry a heavy workload given the well chronicled deficiences of the Phillies' offense.
But at least there's optimism surrounding Wheeler as the team gets ready to head to Clearwater next month. The team said recently that Wheeler is already long-tossing from 90 feet and that Wheeler has been doing "very well" in his rehab.
Throughout the offseason, Phillies President of Basbeall Operations Dave Dombrowski has said the medical feedback he's received about Wheeler's surgery has been encouraging, an optimistic outlook that the 35-year-old righthander should have no residual impact from undergoing the surgery.
Although pitchers commonly struggle to get back to inital form immediately following a surgical procedure, especially those who undergo thoracic outlet surgery, Dombrowski has maintained that he expects Wheeler to appear in a regular season game by May, with no limitations.
Why would there be less concern about Wheeler's impact coming off thoracic outlet decompression surgery than other pitchers, who have struggled after TOS and, for some, bottomed out?
We asked Dr. Dinesh Dhanaraj, the Attending Orthopedic Surgeon at St. Mary Medical Center in Langhorne, to provide a better understanding of that question.
Before getting started, though, an important note: The views and opinions expressed in this article are those of the author and guest authors and do not reflect any official policy or position of any NFL team or a team's athletic physicians.
Dr. Dhanaraj explained that Wheeler's procedure was to treat a "venous" compression around his collarbone, as opposed to an arterial compression, meaning the vein is impacted, not the artery. This, he said, makes the procedure less stressful on the body.
"It pinches between the collarbone and the rib up in your chest ... and your veins, artery and your nerve come through there and you can pinch the artery, which is worse ...or you can pinch the vein," he said.
Dhanaraj said Wheeler already throwing from 90 feet represents a "good sign that he's going to come back early." He described the procedure as "more of a pain-relieving operation" than a a ligament issue or a joint problem.
"It's more compression causing pain in that arm," he added. "Once you relieve that pressure, hypothetically you can get back, your pain tolerance is what's going to determine getting back. There's no ligament healing."
He pointed to former Mets second baseman Jeff McNeil, who in November reportedly underwent a simpler TOS procedure and is expected to be ready by spring training for his new team, the A's.
"Everything around that area has to heal. But [Wheeler] has no real structural limitations," Dhanaraj said, adding that Wheeler's surgery is nothing like Tommy John surgery or even a labrum or rotator cuff surgery that can impact force generation in the arm.
Wheeler has already come back from Tommy John surgery in 2015 that caused him to miss that entire season and all of 2016 before he returned in 2017, pitching to a 5.21 ERA in 17 starts. He signed with the Phillies in 2020 and has since emerged into one of the sport's true aces.
With the Phillies, Wheeler is 69-37 with a 2.91 ERA and 1.137 WHIP. His WAR last year before getting hurt was 5.0 and in 2024 his WAR reached 6.1, the second-highest WAR of his Phillies career.
The Phillies are built around their pitching, and made additions this offseason to a bullpen that last year blew 27 saves, seventh-most in the majors, hurting a starting rotation that ranked third in wins by starting pitching, first in quality start percentage, and led the NL in starting pitching ERA.
With a healthy, dominant Wheeler, the Phillies should again have one of the sport's best rotations. If Nola can bounce back, the Phils could lay claim to having MLB's best overall rotation.
To have encouraging news on Wheeler this early is already a sigh of relief.
I'm optimistic that [Wheeler] could be back," Dhanaraj said. "He's a tougher guy, too. Resilience is a bigger factor."
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