The St. Louis Post-Dispatch is reporting that ace Adam Wainwright has been sent back to St. Louis to be examined by team doctors for what appears to be a "significant" elbow injury. The words "Tommy John surgery" appear prominently in the story.

This is a crushing blow for the Cardinals. If it really is a torn ligament, and if Wainwright needs ligament-replacement surgery (the same procedure Stephen Strasburg underwent last year), Wainwright -- with the exception of Albert Pujols, the Cardinals' most indispensable player -- would miss all of 2011 and possibly part of 2012 as well. He was the Cy Young runner-up in the National League in 2010 and the third-place finisher in 2009.

The implications here are huge. Among other things, the path to the NL Central title for the Milwaukee Brewers and Cincinnati Reds just got a great deal clearer, the messy Pujols contract situation gained another layer of complexity, and Kevin Millwood (arguably the top free agent pitcher still on the market) may have just found a new home.