The Angels’ Garrett Richards chose injection treatments, not surgery, and now he’s back

Last May, Angels pitchers Andrew Heaney and Garrett Richards each received stem-cell injections, hoping to regenerate the ligaments in their elbows that had ripped and prevented them from pitching.

Heaney went first, and he gave Richards a rundown of what to expect, including one important piece of information.

“Make sure you bring your credit card,” he told Richards. “You gotta pay for it.”

Until then, Richards had not thought about the cost of the procedure. He assumed it’d be covered by the team that employed him, like every other operation he’d had in his seven years as a professional ballplayer.

“You’d think so, right?” Richards said. “But in the big scheme of things, I looked at it like, ‘OK, this is totally worth it possibly working.’ To me, it was invaluable. If it could work, I probably would’ve paid twice, maybe three times as much, as I already did.”

He remembers it cost about $3,000. He then received a supplementary platelet-rich plasma injection in October, which the club covered. Stem-cell injections requiring out-of-pocket payment are a quirk of Major League Baseball. Angels physician Steve Yoon, who performed the injections on Heaney and Richards, said NFL, NHL and NBA teams all cover the cost of the procedure.

For Heaney, it did not take, and he underwent elbow reconstruction surgery in July. But Richards will make his first start of 2017 on Wednesday against Oakland. Yoon has pronounced him fully recovered and healthy.

“The changes are dramatic under imaging,” Yoon said in a phone interview.

Considering those changes and the severity of the initial tear, Yoon said he was convinced that the stem cells played a part in the recovery, not merely rest, as has been suggested.

“At the time we were performing the procedure, we knew what the stakes were, and the possibilities with regards to actually healing the ligament and having him return back to baseball,” Yoon said. “There were prominent surgeons out there that told him you need to reconstruct your ligament. To have him return the way he did shows some of the potential in sports medicine.”

Richards does not view himself as a heroic figure. Some doctors suggested surgery, yes, but others recommended he try the procedure. So he heeded their advice.

“How many people are gonna hear that, sit in the chair and be like, ‘Let’s just have surgery’?” he said.

But, as one of the first known pitchers to complete a stem-cell comeback, he understands the attention he will receive if his return continues unfettered.

“Obviously, I’m here because I enjoy playing baseball, and I like being a role model or an example for the next generation — or even the guys in this room,” Richards said. “If I could leave a thumbprint like that on the game of baseball outside of the actual game, there’s not a whole lot of guys who’ve been able to do that.

“For whatever reason, it worked for me, and I’m in this research experiment.”

He also understands the randomness with which his advocacy has swung.

“Let’s say it didn’t work, and I had to get surgery in September,” Richards said. “I probably would’ve been sitting here saying, ‘Man, I wish I would’ve just gotten the surgery in May.’”

Richards recognizes that other pitchers have had the same procedure and come back fine. He might even have talked to a few of them, who want to retain their privacy. It is just the circumstances around his injection that make him the potential poster boy.

“I feel like in the sports world, not just baseball, the medical side of it is very private, because the less other people know, the better, when it comes to contract time, when it comes to everything,” Richards said. “Leaked information can totally derail somebody’s career. To be honest with you, if I didn’t have to come out and say anything about it, I probably wouldn’t have. I probably would’ve just quietly disappeared for the whole year.”

Yoon estimated he has performed the procedure on 15 to 20 professional pitchers. Physician-patient confidentiality agreements prohibit him from naming them, but only a few of those injections have been publicized.

“There’s a number of high-level athletes that you see on ‘SportsCenter’ every day who have had this treatment,” Yoon said.

Think about it from a player’s perspective, Richards said.

“If I didn’t have to come out in public and tell everybody that I was hurt and that I was going down this path, do you think I would have?” he asked. “Definitely not. But it wasn’t like it was the end of the season and I just went home and had this done on my arm, which is probably when it’s happened for other people.

“Then you take three months off, and it’s the ideal time. Funny enough, right?”

pedro.moura@latimes.com

Twitter: @pedromoura