CLEVELAND -- Vinnie Pestano sat quietly in the doctor's office, just he and a surgeon. It was the last place Pestano wanted to find himself, especially only a month before the 2006 First-Year Player Draft.
But here he was, ready to forget about how the devastating elbow injury had happened and ready to focus on his options for fixing it.
The surgeon spoke and Pestano listened, but he didn't particularly like what he heard. The surgeon told Pestano he could live a perfectly normal life without having surgery. He could do anything, really. But the one thing Pestano wouldn't be able to do without surgery -- the thing he'd never be able to do again without it -- was throw a baseball.
"I could play golf, I could lift weights," Pestano said. "I could do everything, but the only thing that hurt to do was throw a baseball.
"So he asked me a question. He was like, 'Is this what you want to do? Because you cannot have the surgery and go and and do whatever you want.'"
The surgeon's question was a legitimate one. It kind of made sense for Pestano to give up baseball and do something else. He'd avoid surgery, and the long recovery period that followed. Plus, with the injury taking place so close to the Draft, Pestano figured to drop significantly on many teams' boards.
But he wasn't ready to quit.
"I was like, 'No, this is what I do. This is what I've worked my whole life for.'"
Pestano, now in his third season in the big leagues, has become one of the best setup guys in the Majors seemingly overnight. For Pestano ,however, it has happened anything but fast. He had to deal with the long road back to the mound after his surgery and the lengthy journey back to the path of success.
It all started the day of the injury.
"It was pretty devastating"
When Pestano felt his elbow pop, while throwing a pitch during his junior season at Cal State Fullerton in 2006, he immediately knew it was bad. He didn't want to believe it. He'd never had any elbow problems in the past. It couldn't be as bad as it felt.
"I tried shaking it off and throwing another pitch," he said.
Pestano's elbow continued to throb with pain and he called for the medical staff. His season was over.
"It was pretty devastating," Pestano said. "It was just one pitch. It happened. It was just really bad timing. It was a month before the Draft. I was having a good year, so I was looking to go pretty high and then the bottom fell out of that whole situation."
After having Tommy John surgery, Pestano was drafted in the 20th round by the Indians. He was solid out of the bullpen at nearly every level in the Minors, but his elbow flared up again in 2009. Pestano was an Eastern League MidSeason All-Star for Double-A Akron before his season ended in mid-July due to an elbow strain.
Pestano knew he needed to make a change. He had been putting too much pressure on his surgically-repaired elbow and it caught up with him.
"He looked at some video on his own, and he thought by raising his arm slot that it would help him out, relieve some of the pressure off his elbow and it did," said Indians bullpen coach Dave Miller, who was the organization's Minor League pitching coordinator during Pestano's transition. "He's been able to go out and throw three days in a row and the third day being just as good as the first day."
Becoming a strikeout pitcher
In addition to taking pressure off his elbow Pestano's new arm angle had an unexpected effect -- it turned him into a strikeout pitcher.
"It improved his slider a little bit," Miller said, "and also allowed him to four-seam the ball a little more, ride the ball up in the strike zone."
In 2009 Pestano notched a very respectable 31 strikeouts in 34 2/3 innings for Akron. In 2010 his numbers jumped to 77 punch-outs in 59 2/3 innings for Akron and Triple-A Columbus. Pestano carried his strikeout mentality to the Majors and he's continued to have success.
He had 84 K's in 62 innings for the Indians in 2011 and, earlier this season, he set a record for Cleveland relievers when he struck out at least one batter in 22 consecutive appearances. Pestano had 51 strikeouts in 40 1/3 innings (42 appearances) entering Monday's game against the Orioles. He has boasted a minuscule 1.56 ERA.
Pestano's elbow strain may have just been a blessing in disguise.
"I've always had the come-at-you attitude," Pestano said. "But after the arm-angle change, the velocity picked up and I added a little deception. Guys weren't picking me up as well, so I started striking guys out. I would just run it up in on guys. I still had the same attitude of coming at you, but now that I've got my strikeout-capable stuff, that's kind of what my mentality has become."
Closer in the making?
It has been a long journey back for Pestano, but he knows it is far from over. The same injury that once threatened his career has now helped him transform it. While he's had great success in the setup role for the Indians, it's only a matter of time before people start whispering about Pestano as a closer.
"I think he has the stuff," said Chris Perez, the Indians' All-Star closer. "I don't want him to be it on this team, obviously, for my reasons, but I think he could do it for sure. Nothing's fazed him. He's stayed the same. He gets big outs for us. He's a bulldog out there."
Closers are known for being a little bit crazy. They get all the attention while the rest of the bullpen is only talked about when it does something wrong.
Considering those things, perhaps Pestano wouldn't fit so well in a new role. He's always done his job, but he's rarely ever been noticed.
"I've kind of been overlooked my whole life," Pestano said.
If he keeps pitching the way he has in his big league career thus far, it won't be long before that changes.
Justin Albers is an associate reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.