With Keynan Middleton out for season, how will Cardinals navigate late innings?

HOUSTON — The St. Louis Cardinals bullpen, arguably the team’s strongest unit, took a significant hit Tuesday afternoon.

Keynan Middleton will undergo season-ending flexor repair surgery next week, manager Oli Marmol said, ending the 30-year-old’s season before he could throw a pitch. Undergoing surgery now will give Middleton, who signed a one-year, $6 million contract with a team option for next season, the best chance of being ready in 2025.

“This news has me sick to my stomach,” Middleton wrote on an Instagram story. “I don’t think I’ve ever looked forward to a season like I did this one. I’m sorry to let the city, my fans and my brothers down… I can promise you this in ‘25 … I’ll be back and hungrier and better than ever.”

Though Middleton has been injured since March, when a forearm strain sidelined him during spring training, the announcement of his surgery feels especially unfortunate because of how close he was to returning. Middleton began a rehab assignment on May 14 with Double-A Springfield and after four appearances was encouraged by the progress he had made. But in what was scheduled to be his final rehab game on May 23, Middleton was permitted to throw 33 pitches — a perplexing decision made even more puzzling considering he was pitching in back-to-back games.

Middleton woke up sore the following morning and reported back to St. Louis. Now he’s out for the season, leaving the Cardinals limited in how they can approach late-inning, high-leverage situations.

“When you go into the offseason and you look at what last year looked like and how you wanted to address what went on, you get (Andrew) Kittredge, (Ryan) Fernandez and Middleton in order to have some right-handed options that are interchangeable in leverage,” Marmol said. “We’ve missed Middleton all year due to injury, but we’ve been able to piece it together. But when you look at the remaining part of this year, you‘re going to have to figure out ways to not overuse Kittredge, but still trust somebody when the score dictates it.”

Right now, the Cardinals don’t have a true answer as to who can fill that role. Take Monday night’s loss as an example. Clinging to a 4-3 lead, Marmol kept left-hander JoJo Romero in for the eighth inning, despite a slew of right-handed hitters due up for Houston. Romero doesn’t post heavy splits (entering play Monday, the left-hander had limited opposing left-handed hitters to a .167/.211/.167 line, with right-handed hitters registering .200/.243/.308). Still, it wasn’t an optimal lane for the usually dominant Romero. He served up a game-tying home run to Alex Bregman to lead off the bottom of the eighth, and a go-ahead two-run shot to Yanier Diaz later in the frame. The Astros went on to win 7-4.

Marmol’s reasoning for leaving Romero in the game was simple. The Cardinals had already used Andrew Kittredge in the bottom of the sixth inning to escape a bases-loaded jam. Ryan Fernandez was unavailable, as he had been used in the prior two games. That left two right-handed options: Kyle Leahy (15 innings of major-league experience) and Ryan Loutos (who had made his major-league debut on Saturday).

“I’m going JoJo there with the experience,” Marmol said.

The Cardinals do have internal options at least, but none pack the same high upside as Middleton. Fernandez should see an uptick in usage for now. Giovanny Gallegos, the team’s most-used reliever over the last four seasons, is currently on a rehab assignment (shoulder impingement) with Triple-A Memphis and could return by the middle of June. However, given his brutal start to the season (12 earned runs over nine innings), Gallegos will have to build up trust, both with the coaching staff and with himself, to be successful once more in a high-leverage role. Riley O’Brien, who has been out since early April with a forearm strain, has progressed to throwing bullpen sessions and could begin a rehab assignment within the next couple of weeks. But he still remains weeks away from the majors.

This ups the ante for Kittredge, who remains the lone right-handed set-up man when the Cardinals are leading. St. Louis prefers not to use closer Ryan Helsley in non-traditional save situations this year, as he’s been one of the National League’s best closers. But Marmol must now balance using Kittredge enough to win ball games, but not overexerting him to the point where he’s less effective.

“When you play as many close ball games as we’ve played, you’re constantly making sure that you keep 162 (games) in mind,” Marmol said. “Trust me, you want to win every single game, but at the same time, you want to make sure you’re doing it with these guys all the way through, and that you respect their health and career as well.”

That responsibility just became tougher for Marmol and the Cardinals. After coming within days of gaining one of their top offseason acquisitions, St. Louis now finds itself in a position it’s grown quite familiar with this year — patching up an area of the roster with no immediate solution.

(Photo of Middleton: Jim Rassol / USA Today)

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