After having three elbow surgeries -- including two Tommy John elbow ligament replacement surgeries -- since he last pitched for the Phillies in 2006, Mathieson will have beaten the odds if he pitches again in Major League Baseball. And that could happen in 2010.
"He's got one of the better arms we've got," Phils assistant general manager Benny Looper said recently. "I wouldn't rule him out as having a chance to help us at some point next year. It's rare to come back from two Tommy John surgeries, and you have to give him a lot of credit.
"There's a lot of work to go through for just one of them. It's a year. It's strenuous rehab. I could see somebody wanting to give up because they wouldn't want to face another one. You have to give him a lot of credit for having the desire to want to come back and pitch.
"It's a great story. Hopefully it becomes a better story."
Mathieson felt pain in his right elbow after throwing just six pitches to one batter Sept. 2, 2006, during a start against the Braves at Citizens Bank Park. He had his first Tommy John surgery 24 days later.
He had his second on May 15, 2008.
In between, Mathieson had ulnar nerve transposition surgery Sept. 24, 2007, which the Phillies considered a minor surgery that would allow him to pitch in Spring Training last year. Mathieson did pitch in 2008, but he felt a pinching sensation almost immediately in his elbow. The righty visited specialists and tried to recover on his own before he had the second ligament replacement surgery.
Pitchers typically have an 80 to 90 percent success rate after the first Tommy John surgery. That number drops to 30 percent after a second.
Mathieson has thrown just 32 1/3 innings in the Minor Leagues since 2006, but there are reasons to be encouraged. He went 4-0 with 0.84 ERA in 22 appearances last season in the Minors. That included a 1.40 ERA in 13 appearances for Double-A Reading. He then was 0-0 with a 2.84 ERA in 11 appearances in the Arizona Fall League. In 12 2/3 innings, he allowed 10 hits, four runs, eight walks and 15 strikeouts. Opponents hit just .227 against him.
Mathieson has some things he needs to accomplish before he pitches for the Phillies, but if he remains healthy, they should come in time. The Phils want Mathieson to continue to work on his slider and improve his command. He also did not pitch back-to-back days last season and now must show he can do that.
"Come next year, we'll have to take the gloves off," Looper said. "He has a great arm. It's just a matter of keeping him healthy."
Todd Zolecki is a reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.