With team physician Christopher Ahmad in Seattle for a conference of the nation's top orthopedic surgeons, the Yankees are taking the unusual step of sending Tanaka across the country for an in-person evaluation. Tanaka could board another flight as soon as Thursday.
"Any time you lose a starting pitcher, they're hard to replace," Yankees manager Joe Girardi said. "What he's done for us, the innings, the wins and the quality of starts, it's hard to replace."
The Yankees called up outfielder Zoilo Almonte from Triple-A Scranton/Wilkes-Barre to replace Tanaka on the active roster. Tanaka was scheduled to make his last start before the All-Star break on Sunday; Girardi said that day's starter will be announced at a later date, but suggested the nod could go to Chase Whitley.
Tanaka, 25, has posted a 12-4 record and a 2.51 ERA in his first 18 starts, earning selection as an American League All-Star. He was replaced on the AL's roster by Red Sox closer Koji Uehara, but Tanaka can still attend the July 15 All-Star Game at Target Field.
The right-hander experienced his worst outing as a big leaguer on Tuesday, surrendering five earned runs on 10 hits -- both season highs -- over 6 2/3 innings in a 5-3 loss to the Indians at Progressive Field.
"It goes without saying how important he's been," Yankees captain Derek Jeter said. "He's been as good as anyone, probably, in our league that we've seen. He's been our go-to guy."
Girardi said that Tanaka told the training staff about the discomfort in his elbow after the outing, and the decision was made late on Tuesday evening to send Tanaka to New York for further evaluation. There were no signs in the start that suggested an injury, Girardi said.
"His velocity was normal. We saw some really good splits and some good sliders," Girardi said. "There wasn't anything that led us to believe there was anything wrong."
Yankees catcher Brian McCann didn't see any signs of an injury during Tanaka's start against the Indians; McCann thought that the ball was coming out of Tanaka's hand fine, but several of his pitches were up in the zone, which was unusual.
"The only thing from yesterday was that his pitches didn't have the sharp action they they've had in the past," McCann said. "He still pitched good. He didn't pitch bad. I didn't notice anything. It was a surprise when I came in today."
Tanaka is in his first season in the big leagues after signing a seven-year contract worth $155 million with the Yanks in January. After beginning the year 11-1 with a 1.99 ERA, Tanaka is 1-3 with a 4.25 ERA in his last four outings.
"You just hope and pray that we get good news, that it's something minor," outfielder Brett Gardner said. "You worry about anybody, but he's pretty special, what he's been able to do the first half of the season.
"I think anyone could tell watching him last night; I don't know when his arm was bothering him or how long it's been bothering him, but he obviously wasn't himself. Hopefully we get good news."
The Yankees have now lost four members of their Opening Day rotation to the disabled list, with only Hiroki Kuroda remaining. CC Sabathia could be lost for the year with a knee injury, Ivan Nova had season-ending Tommy John surgery and Michael Pineda is rehabbing a shoulder injury in Florida.
"It's not how you draw it up, I can tell you that," Girardi said. "Injuries are part of the game and you've got to deal with them."