"Sproing" is the sound an elbow makes when it goes from a ready state to something that helps pay off an orthopedic surgeon's student loans, and the terror of Cardinals camp is that its echo may bring everything in this year's bid to re-win the NL Central to a dead stop. The diagnosis of a potentially devastating injury hangs over the Cardinals' hopes for 2011, and no, we're not talking Nick Punto's sports hernia. Adam Wainwright has flown back to St. Louis to see if the pain in his elbow is bad news or the worst news, and more than his two-year, $21 million nested options for 2012-13 hang in the balance.

There's no way to minimize the implication. PECOTA projected Wainwright to be the seventh-best pitcher in the league via WARP, and at this time of year nobody close to that is available or about to be made available via trade. The Cardinals may look to deal, but that's because the best internal options are far from sure things. The Cards were already in a situation where they already have Kyle Lohse to regret. Jake Westbrook was supposed to fix this problem, converting Lohse into baseball's most expensive fifth starter.

Turning to internal non-roster options like Brian Tallet or Miguel Batista and simultaneously maintaining postseason pretensions basically requires that the offense crank out runs at a clip it hasn't mastered since Jim Edmonds' heyday in the early Aughties; this team doesn't have 800 runs in it. It could ill afford Lohse limping along before, but now it needs a restoration spell the likes of which Dave Duncan hasn't had to cast since… Dave Stewart? Batista hasn't been a successful major-league starter since 2007; if he gets the 10 starts initially guessed at in our Depth Charts, in his age-40 campaign, you may as well fold up the season and devote the summer to figuring out what's the best offer to give to Albert Pujols during the post-season negotiating window. Brian Tallet's work in a rotation have been more recent, as the other former Toronto utility pitcher in 2009, and in some regards his work was roughly equivalent to Batista's 2007 season qualitatively: strikeout rates around 15-16 percent, SIERAs around 4.70. Magician or no, no mere Todd Wellemeyer-level spell of temporary redemption will do.

Beyond the graybeards, there are viable younger alternatives, and no, it wouldn't involve the power of prayer and Mitchell Boggs. Earlier this spring, there was talk of stretching out Kyle McClellan, which seems terribly convenient if this becomes a crash gear-up for rotation work. However, McClellan hasn't been a regular starter since 2004, and that was in the Florida State League. The risk there would be that this could be a case of robbing Peter to pay Paul: a rotation counting on Lohse and McClellan is going to involve a lot of five-inning chuck-and-duck outings, creating the automatic need for a relief corps innings muncher… which absent McClellan, becomes a problem, because this gets us back to counting on Boggs, Tallet, Batista, and thaumaturgy. Although it's easier to find a useful reliever than starter, via trade, waivers, or perhaps awaiting discovery in camp, but that would be another element of uncertainty sure to keep John Mozeliak's cell phone humming.

However, McClellan isn't the only arrow in the quiver. Last year, the organization saw Lance Lynn bust out and start living up to the highest possible expectations for him,  looking like more than just a college-trained strike-thrower, adding mid-90s velocity on a four-seam fastball he came to rely on, and per Kevin Goldstein's rating him as the system's fifth-best prospect, even touching 97 mph at times, while also featuring a pair of good off-speed pitches. PECOTA already sees him a somebody capable of generating more than seven strikeouts per nine while posting a 4.39 ERA. It isn't Wainwright-level greatness, but it would more than do as the fourth man in a rotation behind Chris Carpenter, Jaime Garcia, and Westbrook. Skeptics might fulminate over preferences for veterans from Tony La Russa on down, but I wouldn't attach much to that; the old men on the brass placed their faith in Garcia and saw it rewarded, after all, and stuff—when you find someone who has—wins converts. If the Cardinals have a good internal answer, it's Lynn.

If it isn't Lynn or a crash conversion of McClellan, the Cardinals' next-best option to round out their rotation is not yet on the roster. Among those unsigned free agents wondering what they're going to do with themselves this year. Kevin Millwood's the name that automatically comes up, but PECOTA was envisioning a season of his giving up five runs per nine with lower than league-average strikeout rates. As much confidence in Duncan's ability to work magic as anyone might reasonably possess, trusting Lynn looks like a better idea than that. Perhaps calling Pedro Martinez represents a better idea, but Martinez, unlike Millwood, doesn't have to accept any offer; he'll need wooing, but perhaps a season playing with Albert Pujols in front of baseball's best fans is an attractive enough prospect beyond any necessarily incentive-laden deal.

Beyond the unemployed, there are the trade possibilities. From among that lot, the best outcome might be that they swing a deal for Joe Blanton. That wouldn't come cheaply, however, and the Cardinals' system isn't all that deep in talent. One of the misfortunes of having to deal from need with someone who has no incentive to make you happy is that yesterday's reasonable abstract proposition suddenly becomes a case of getting the screws put to you. Calling Cleveland to talk to Fausto Carmona makes sense, but they may not wish to part with him quite so soon.

On the other hand, someone like Chien-Ming Wang wouldn't cost much to acquire, and from among the Nats' numerous contenders for their fifth slot in the rotation, there's no picking a winner who might propel them to third place in the NL East, no matter how well any of them turn out. The Diamondbacks might generously part with Zach Duke or Armando Galarraga at the end of March, after the one loses to the other in the mighty contest for fifth Snake in the rotation, but there's no upside in those propositions. Get to this level of dreck, and you may as well start asking Brian Cashman when he plans to cut Freddy Garcia and/or Bartolo Colon.

So while we wait for word of Wainwright's elbow, the best solution might be standing pat. Trying to tantalize the Tribe into some cash-eating deal that brings Carmona over would be the high-stakes solution most worth pursuing, although it might entail giving up Lynn, the obvious best internal solution. You can bet that, however hot the firestorm of fear to follow, Mozeliak's best bet will be to wait and see, call and collect information. As much as the Wainwright breakdown would inspire panic, the Cards will be best served by taking the time to see if Lynn's really ready. If he isn't, they can get serious about making a deal. Either way, this thing ain't over before it starts.—Christina Kahrl

Many will point to the end of last season, when Wainwright skipped his final start with an injury deemed a forearm strain, as the time when his elbow began to give him trouble.

However, his elbow has been problematic since way back in 2004: that was when he was diagnosed with a partial tear of the ligament while pitching for Triple-A Memphis. His elbow was stable at the time, though, as the area scarred down to the point that he was able to resume his pitching. This can happen with very small tears if the area surrounding the elbow is strong enough to counter the effects of the partial ligament tear. Wainwright's elbow responded well to this approach over time, excepting a bout of inflammation in 2007, and he threw nearly 900 innings in the majors following the initial injury. This all changed during the last week of 2010, as he experienced soreness and inflammation around the nerve, though things still appeared to be stable upon examination in November despite the known partial tear to the ligament.

On Monday, Wainwright's elbow caused him pain while he was throwing, and the Cardinals' medical staff sent him back to St. Louis for further examination. What likely changed was the stability of his elbow from a worsening of the partial tear. Once the elbow is unstable surgery becomes an option—and usually a necessity—for pitchers. The necessary procedure is likely Tommy John surgery, and recovery from that procedure is typically 12-18 months, meaning that pitching in 2011 is out of the question, and a portion of 2012 may be in doubt as well.—Corey Dawkins and Marc Normandin