Michael Ciccotti, the Phillies' team physician, is not recommending surgery. Noted orthopedist Neal ElAttrache, whose office performed a labrum repair for Adams in 2008 and recently operated on Roy Halladay, touted surgery as an option.
Adams said his return in 2013 is "highly unlikely" either way. If he has surgery, the Phillies will not know if he would be ready for spring training in 2014 until the full extent of the shoulder damage is assessed.
"It's not good," Adams said.
Adams was signed to a two-year, $12 million deal last winter. The 34-year-old reliever was hailed as a cure for the team's eighth-inning woes in 2012. That never happened. He posted a 3.96 ERA in 28 games and pitched through back and shoulder injuries. The pitcher has a history of being hurt - he underwent rib surgery months before the Phillies signed him.
"These are all parts of the risk we take in Major League Baseball with guaranteed contracts," Phillies general manager Ruben Amaro Jr. said.
For Adams, the decision is complex. He could attempt the conservative non-surgical route with the faint chance of returning before the end of the season. Adams said he is staring at a four-to-six week rehab period followed by a six-week throwing program. That is three months, and not enough time to pitch in 2013.
He could eventually require surgery even in taking that route. The way Adams spoke, surgery sounded like the likely choice.
There are financial incentives. Adams has a $6 million vesting option for 2015 contingent on him appearing in 65 games in 2014. He has pitched in more than 65 games just twice during his career. Having surgery now does not guarantee he will be ready by opening day - he would need a full season to approach 65 games.
"It's not black-and-white," Phillies head athletic trainer Scott Sheridan said.
Adams was one of three Phillies relievers in the last week to succumb to the disabled list. Michael Stutes (bicep tendinitis) will not throw until at least July 5. Jeremy Horst (elbow inflammation) will start a throwing program Wednesday and could return in two weeks.
Amaro said reinforcements for his bullpen, which ranked last in the majors with a 4.68 ERA before Tuesday's game, are doubtful.
"Right now we don't have any solutions," Amaro said. "If we could find a solution to fill the hole or fill a need we'll try. It doesn't mean we're not going to try. I'll be on the lookout for it. But based on the conversations I've had with teams already about these particular players who might be in play, I'm not optimistic about that. A lot of people are looking for bullpen help and, naturally, demand is very high."
Contact Matt Gelb at firstname.lastname@example.org. Follow on Twitter @magelb.