How a Chronically Painful Knee Is Unraveling Ohtani’s Season

The long-whispered problem with Shohei Ohtani’s push-off leg has become the dominant story of his 2026 campaign. The Los Angeles Dodgers’ ace is struggling with left knee pain that dates back to a 2019 patellar surgery, and it is now bleeding into his pitching numbers. Data already showed that his command had slipped from last year, and hitters are finding it easier to distinguish his pitch types.

The underlying issue, as Ohtani himself alluded, is that the knee makes it hard to plant and stabilize during his delivery. “Sometimes the pain comes based on overall balance, sometimes suddenly — like the landing angle or twisting it like a sprain,” he said. Team medical staff originally planned to drain fluid from the joint to lower inflammation, but manager Dave Roberts revealed that instead they injected Orthovisc, a hyaluronic acid lubricant commonly used for osteoarthritis, to improve joint gliding without removing fluid.

Dr. Naotaka Mametsuka, director of the Baseball & Sports Clinic in Kawasaki, explained that the 2019 procedure — shaving a divided part of the patella — can later reduce the fit between the kneecap and femur. Combined with Ohtani’s extreme training loads, tiny cartilage damage or inflammation can flare up. While an arthroscopic cleanup in November would carry minimal risk and allow full readiness by February, the immediate concern is the 2026 postseason.

What the Medical Reading Means for His Mechanics and the Dodgers’ October

From Cy Young Dreams to Survival Mode

Ohtani entered the season as a legitimate Cy Young candidate, but the data and the eye test now tell a different story. His inability to repeatedly land with conviction robs his pitches of the late movement and location that made him dominant. Rather than refining his mix for October dominance, the priority has become injury management — and that changes the entire calculus for the Dodgers’ stretch run.

The Lubricant Gamble

The decision to inject Orthovisc instead of simply draining fluid suggests the medical staff is targeting friction and cushioning rather than acute swelling. That points toward a chronic irritation pattern, not a one-off tweak. Orthovisc provides temporary relief but doesn’t fix structural damage; it buys time. For a player who already relies on precision, degraded biomechanics directly translate into walks and hard contact.

What the Dodgers Are Really Protecting

With a record-setting contract and the unique double value Ohtani brings as both pitcher and designated hitter, the organization cannot afford to let the knee deteriorate further. A shift from chasing individual hardware to simply logging usable innings into October is a calculated retreat — one that acknowledges the knee is unlikely to fully cooperate without a significant intervention once the season ends.

What Comes Next for Ohtani’s Knee Management

Ohtani will continue to manage the knee with modified workload and pain-mitigation protocols. Expect further injections if the joint swells again, and a heavy reliance on his bat to carry his value while the pitching innings are carefully monitored. The long-term fix almost certainly waits until the offseason, when a minor arthroscopic procedure could address the cartilage wear once and for all.