Should St. Louis Cardinals fans be worried about Adam Wainwright?

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Prior to the start of the 2013 regular season, the St. Louis Cardinals agreed to a contract extension with starter Adam Wainwright that was five years in length and worth $97.5 million. The Cardinals already had Wainwright under contract for 2013 at a salary of $12 million so the extension spans 2014 through 2019. The extension locked in the club's workhorse ace and rotation leader through the twilight of his career.

In 2013, after Wainwright signed the extension and a full season before it began, the right-hander led the league in regular-season innings pitched with 241 2/3 innings pitched in his second year removed from Tommy John surgery. Add to that the 35 postseason innings Wainwright hurled during the Cardinals' World Series run, and the righty notched 276 2/3 innings. And in this, the first year of the guaranteed five-year deal, Wainwright has experienced some health and performance issues that may not have fully resolved themselves as the NLCS looms on the near horizon.

In his shutout against the Rays in Tampa, Wainwright didn't look like himself due to decreased velocity and a lack of whiffs induced. Shortly thereafter, the Cardinals announced that Wainwright had forearm tendinitis and would receive a cortisone injection to help with inflammation. Wainwright would go on to miss one start due to the issue, but that was all. He rejoined the rotation the next turn through and continued to make his starts. Manager Mike Matheny even chose Wainwright to start the All-Star Game for the National League squad over Clayton Kershaw.

But Wainwright's post-injection starts weren't very wagonmaker-esque. And a general dullness to his outings devolved to performances that were flat-out bad. In August, Wainwright posted a 5.17 ERA and 3.71 FIP as opponents posted a .282/.341/.395 (325 wOBA) that was fed by a .328 BABIP which was fueled by a 30.1 LD%. Wainwright proclaimed during the end of August that he had been suffering from a bout of the dead arm but felt that his arm was nearly resurrected. In September, Wainwright posted a 1.38 ERA and 3.03 FIP, seemingly putting to rest any concerns about his arm's health.

Wainwright was slated to start the Cardinals' regular season finale in Arizona. Matheny maintained that his ace would take the ball whether the Pirates won or lost (that is, whether the Cards' game that Sunday had meaning or not). The Pirates lost to the Reds, rendering the Cardinals-Diamondbacks game meaningless for St. Louis. Wainwright didn't start even though doing so would've kept him on the every-fifth-day routine that starting pitchers organize their lives around.

Then NLDS Game 1 happened. Wainwright started on what was effectively nine days' rest and looked anything but sharp. Throughout most of the game, he was unable to command his fastballs (fourseamer, sinker, or cutter). Often his control faltered badly, with Wainwright uncharacteristically missing not just his target but the entire strike zone, sometimes by over a foot. Wainwright just didn't look right and his line reflected this: 4 1/3 IP, 11 H, 6 R, 6 ER, 5 SO, 1 BB.

So it was concerning when Matheny revealed to the media before Tuesday's NLDS Game 4 that Lance Lynn might start Game 5 over Wainwright, if such a contest proved necessary.

Matheny says Wainwright "moving in that direction" to start G5, but says "we also have flexibility of using Lynn with regular rest."

— Chris Hrabe (@chrabe) October 7, 2014

Upon reading this tweet from KMOX's Chris Hrabe, there was a part of me that rolled my eyes. This felt like something out of Tony La Russa's playbook: Avoid announcing a starter until as late as possible. But given Wainwright's in-season health tribulations and Game 1 struggles, I did a double-take. Perhaps the forearm tendinitis, dead arm, or some other ailment was plaguing the Cardinals' ace starter?

Then the headline of Derrick Goold's St. Louis Post-Dispatch article on the subject popped up in my Twitter feed: "Lynn prepared to start next game if Waino cannot." It took me back to the fifth grade when my teacher would respond to the request "Can I use the bathroom?" with "I don't know, can you?" because can means 'to be able to." And this made me worry all the more. Is it possible that Wainwright won't be able to start Game 5?

Reading the Goold piece at once made me feel better and worse.

Wainwright is the planned starter, but the club wants to make sure it has an alternative if the soreness or stiffness that has complicated the second half intrudes on his availability.

"Just making sure that Waino feels right," Matheny explained later. "We’ve got two guys on regular rest; it wouldn’t be a stretch to have either one of them go.

"There’s no question that Waino has been fighting it. I haven’t made that a secret, and neither has he. It’s all going to come down to how he feels. The likelihood of him saying, ‘I can’t go’ is very slim. But it is a possibility that something might not feel right."

Cardinals general manager John Mozeliak added to that comment, saying: "As of right now, Wainwright is our starter for the next game."

He acknowledged that the team was prepared for many scenarios.

No new concerns had arisen that would render Wainwright unable to start Game 5. Nonetheless, Matheny felt compelled to word his Game 5 starter choice in such equivocal language because Wainwright's 2014 season has been such a battle physically for the veteran workhorse. Ugh.

On Tuesday night, after the Cards clinched an NLDS series win, Wainwright addressed the questions about his healthy that were stirred up by Matheny's pregame statement. From Brian Stull at STL Baseball Weekly (including audio embed):

No question at all. No question all. Yeah, I was definitely suiting up for that one. But luckily we don't have to worry about that. We'll go on and get ready for our next series.

After the Cardinals advanced to the NLCS, Matheny revealed that in fact St. Louis had held Wainwright back from the season finale against Arizona because of health concerns, per Derrick Goold in the St. Louis Post-Dispatch, but made clear that the club was planning on Wainwright starting NLCS Game 1:

The Cardinals’ concern for Wainwright is not new to October. When Pittsburgh lost on the last day of the regular season, clinching the division for the Cardinals, they pulled him from his scheduled start at Arizona. The club wanted to get its standard-bearer extra rest for October ahead of a 21st win or innings to remain sharp.

"You guys could tell when we were quick to pull him out of Arizona," Matheny said. "He’s just been grinding. There are days when you’re grinding when you just can’t get it right. He was having trouble with that in Game 1. He’s thrown a lot of innings. He’s had a lot of work. That’s what your ace does."

The ace also starts when scheduled, Wainwright has said.

In Matheny's eyes, aces are aces just as closers are closers. A heavy workload is in the job description. It's a view that Wainwright shares.

But despite Wainwright's awe-shucks declaration that he'd have started Game 5 had it proven necessary and Matheny's abiding optimism that physical troubles due workload are just a part of being an ace, there's reason for concern. The Cardinals' $100-milion arm is less than 100% and he's slated to open the NLCS on Saturday as the St. Louis starter. The Cardinals' October hopes and dreams rest on the right shoulder and arm of Wainwright, the club's workhorse ace. Hopefully a bit of extra rest has Wainwright feeling good come NLCS Game 1.

Manager's Note: This post is sponsored by Disney's Million Dollar Arm, a feature film coming out on DVD and Blu Ray that stars Jon Hamm, who is a Cardinaldom treasure. Here's video of him defending the honor of Imo's Pizza against the attacks of Jimmy Kimmel (it starts at the 1:45 mark):