August 26, 2025
Kyle Ross/Imagn Images
Zack Wheeler will have an unusual surgery to fix an unusual injury.
Zack Wheeler was in the thick of the NL Cy Young race, and was the best Phillies pitcher on a staff full of aces. Then it all suddenly stopped.
He didn't break a bone, or tear a ligament. He developed a blood clot. The Phillies rightly shut him down, had the clot in his shoulder removed and put him on the shelf for the season. It was then revealed he needed thoracic outlet decompression surgery to alleviate venous thoracic outlet syndrome.
This is a rare surgery, but it's not unheard of.
Dr. Dinesh Dhanaraj, the Attending Orthopedic Surgeon at St. Mary Medical Center in Langhorne, weighed in on some of the specifics of Wheeler's injury, to help us understand what might happen to him career-wise if/when he returns next year.
(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 MLB team or a team's athletic physicians.)
"It's a serious health issue," Dhanaraj said. "The fact that he had a blood clot removed is the beginning of this problem, a life-threatening problem. A blood clot can travel all the way to your lungs and cause a pulmonary embolism and be fatal, the good news is he is out of the woods, he had that prevented."
His health is the most important thing. Wheeler is a family man, and at 35 entering the last few years of his career anyway. It was recently reported that the hurler planned to retire after his monster three-year, $126 million deal wraps up after the 2027 season.
So what is his baseball outlook?
"It's not like a sports injury... it's an anatomic variant in people, they have an extra cervical rib, instead of where the normal ribs come off they have an extra rib, it actually presses on the soft tissue," the doctor said. "It pushes on it and causes compression. They'll remove the rib to release the pressure."
There won't be a ton of rehab when he's post surgery. It'll just be healing.
"It's removing an area of compression so it's mostly pain," Dhanaraj said. "It's not structurally where you need ligament to heal or a bone to heal or tendon, it's mostly pain threshold, but it's not like they'd be having him throw fastballs for a couple months."
There is some precedent with this injury when it comes to top-of-the-line starting pitchers. Here's how things panned out for a handful of pitchers who had surgery for thoracic outlet syndrome:
| Pitcher | Time missed | Performance after |
| Merril Kelly | 6 months | 130 starts, 3.60 ERA since |
| Josh Beckett | 9 months | Pitched one more year, 2.80 ERA Threw a no-hitter in 2014 |
| Chris Carpenter | 2.5 months | Returned briefly to toss 40 innings, did not pitch again after 2012 postseason |
| Tyler Thornburg | 12 months | 62 starts, 5.37 ERA since |
| Stephen Strasburg | 11 months | Pitched 4.2 innings, then retired (complications) |
| Matt Harvey | 9 months | Pitched 98 games, 6.15 ERA since |
The track record is varied. Kelly had a fruitful career. Beckett, Carpenter and Strasburg tried to return with various — and brief — results. Thornburg actually pitched for a few years after his TOS surgery but his ERA and performance were noticeably worse.
Wheeler has been one of the better pitchers in baseball for the last half decade. He recovered and was even stronger after Tommy John surgery 10 years ago. If anyone can do it, it's Wheeler.
But there isn't much of a roadmap for him to follow. The flame-throwing pitcher will need to chart his own course, and the Phillies certainly hope it means two more years of dominating in Citizens Bank Park.
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