Thoracic Outlet Syndrome is a condition that causes symptoms such as numbness in extremities, as well as shoulder and neck pain. The cause is from nerves or blood vessels being strained in a person's chest, and the remedy involves a surgery the removes a rib from the body. In baseball, it's a surgery that has become more prevalent, but one that has had mixed results, and leads to a good deal of uncertainty.
For much of 2016, Phil Hughes seemed to be laboring, and at times was even called into question as to why he was pitching at all. There were conflicting reports, and eventually he found himself shelved. His season ended after suffering a left knee fracture endured on a comebacker from J.T. Realmuto. This also served as a time in which he could undergo the TOS surgery, and rehab both injuries to get ready for 2017.
At points throughout 2016, Hughes had his velocity questioned, and the results showed there was cause for concern. For a pitcher that hasn't sniffed a double digit strikeout rate since being used as a reliever with the Yankees during 2009, the room for error has always been relatively small. In Hughes' corner, is the reality that with the Twins, he's issued very few free passes (setting an MLB all time record in K/BB during 2013). As things stand now however, hitters seem to be teeing off on what Hughes puts over, and they're having a good amount of success.
Starting with velocity, Hughes sees his biggest red flag. When at his best with Minnesota in 2013, he posted an average of 92 mph on his fastball. This season, through three starts, he's averaging under 90 mph on his fastball, with each of his other pitches following suit (in fact, he's lost 3 mph on his changeup). The combined result has equated to Hughes giving up hard hit contact 51.9% of the time (up from 37.7% in 2016, and 30.2% in his career).
Over the entirety of his career, Hughes has always been prone to the long fly. In 2015, his 29 homers surrendered led the league, and giving up 11 in 12 games prior to shutting down last season wasn't a great path either. The trend has continued in 2017, as he's allowed three longballs in three starts. What's worse is that along with the lack of velocity, or trust in his offerings, is that Hughes' location hasn't been ideal either. He's given up homers on absolute cookies.
What it all boils down to is uncertain at this point, but there's some pretty concerning trends here. The lack of velocity is a real issue, and one that won't correct itself over time. Whether he moves to the pen or not, Hughes' effectiveness is going to be sapped by his declining pitch speed. On top of that, he seems to be guessing as to which pitch he trusts most, and that could leave him in a spot with nothing to rely on.
When the dust settles, Phil Hughes is in a place where a guy that doesn't strike many out doesn't want to be. The Twins hurler is giving up a ton of hard contact, keeping lots of balls in the zone, and doesn't have a way to get a pitch by an opposing hitter. With two years and over $26 million left on his contract, the Twins need some sort of revolution from Phil, and it's a serious predicament as to whether or not it will happen.