Cruz's rehab 'plateaued,' 2023 return in doubt

PITTSBURGH -- Over the course of the last couple months, the Pirates repeatedly expressed confidence that Oneil Cruz would play in Major League games sometime this season. That confidence, however, is waning.

Cruz’s rehab has “plateaued” due to general left foot soreness, per the Pirates’ director of sports medicine Todd Tomczyk, putting an already lengthy rehab process on hold. When asked if Cruz could still return this season, Tomczyk said, “It’s too tough to tell, but I think we’re running out of days,” prior to the Pirates’ 6-4 loss to the Cardinals on Wednesday at PNC Park.

This marks a significant shift in tone compared to recent weeks.

On Aug. 10, the last time that Tomcyzk met with reporters, he expressed the team’s collective belief that Cruz would return this season. On Aug. 6, general manager Ben Cherington said on 93.7 The Fan that "all signs point to him playing Major League games in Pittsburgh this season," adding that Cruz was more likely to return in September. Those statements were made prior to Cruz experiencing his latest setback.

In early August, Cruz, who fractured his left fibula on April 9, finally had the opportunity to begin a formal running program, one of the last boxes he needed to check before potentially starting a rehab assignment. In recent days, however, Cruz began to experience soreness in his left foot, forcing the Pirates to pause Cruz’s rehab. Tomczyk noted that it’s not uncommon for foot biomechanics to be negatively impacted from traumatic injury.

Cruz is currently able to play catch and field grounders. Due to the team’s finding regarding Cruz’s biomechanics, however, Cruz’s day-to-day activity is centered around plyometrics and the weight room until the soreness subsides.

"Really, what they're trying to do is get everything in sync again and everything to communicate effectively,” Tomcyzk said. “There’s so many little nooks and crannies and ligaments and muscles and tendons in that foot, with all the metatarsals, the little small bones, that if one thing is off, it's going to be a domino effect and continue to affect the other one. So, working on the mobility, working on the foot intrinsics of how it operates is the main focus.”

The Pirates have said that if Cruz were to return to Major League action this season, he would first require a rehab assignment, the length of which was not determined. With Triple-A Indianapolis’ season ending on Sept. 24 and Cruz’s rehab on pause, it seems unlikely that Cruz will have enough runway to build up to a Major League return this season.

Following his surgery in April, the Pirates anticipated that Cruz would return to action in August. Cruz, however, didn’t begin a formal running program until early August, let alone begin a rehab assignment. On Aug. 10, Tomczyk explained why Cruz’s rehab was taking longer than initially expected.

“There was just a collaborative read on the medical performance team that to potentially avoid any further soft tissue injuries up or down the kinetic chain, although you can't go much further down, that we decided to take it a little bit slower,” Tomczyk said. “So nothing happened that his body signaled he can't handle, it was more of a collaborative effort that we all got together, notably with Oneil, like, ‘Hey look, here's where we're going to need to take this a little bit, a step differently and not rush to that projection date because we want to make sure when you come back, you're back and you feel, as a baseline, like yourself.’”

Regardless of whether Cruz returns this season, Tomczyk noted the structure of Cruz’s ankle remains good and that Cruz’s long-term prognosis remains encouraging. Tomczyk also said that Cruz shouldn’t experience any future complications with his ankle.

“My word of advice to him … is to stay positive and keep going,” manager Derek Shelton said. “When you’re dealing with a significant injury like he’s dealing with, it’s just making sure that his spirits stay up. He continues to attack his rehab.”

Added Andrew McCutchen, “I had an ACL injury. They told me I’d be back in four to six months, and it took me a whole year to really get myself back on the field. The doctors can say whatever they want, but your body is your body. The body needs to get back. The mind needs to get back. When that happens, that happens. It’s just the way it goes sometimes.”

Cruz entered this season with high expectations, saying during Spring Training that he was shooting for a 30-30 or 40-40 season. The 24-year-old played just nine games before awkwardly crashing into White Sox catcher Seby Zavala and fracturing his fibula, a collision that perturbed Zavala and caused the benches to clear.