CLEARWATER, Fla. -- The Phillies said Tuesday that Cole Hamels has no structural damage to his left elbow.

That, they said, is the good news.

But it also appears he is a long shot to pitch Opening Day on April 5 at Citizens Bank Park.

"He'll start when he's ready to start," Phillies general manager Ruben Amaro Jr. said. "If it's Opening Day, it's Opening Day. If it's some time beyond that, then that's when it will be. He'll let us know what the pace is. It'll depend on how he continues to progress. For us, again, it's the same old mantra: It's not about Opening Day. It's about 162 games, and hopefully beyond 162 games, that we really have to worry about."

Hamels has had inflammation in his elbow for weeks. He said Monday he has tightness in his elbow every spring, but that it typically subsides after a week or two. This time, it remained. That is why Hamels visited team physician Michael Ciccotti on Tuesday morning in Philadelphia, where he had an MRI and a dynamic ultrasound.

Amaro said the results were what they expected: Hamels has inflammation in the posterior lateral aspect of the joint.

Ciccotti administered an anti-inflammatory injection to the elbow.

Hamels is expected to continue his throwing program Thursday, which means if the injection knocks out the inflammation like the Phillies hope, he could pitch in a Grapefruit League game or Minor League Spring Training game early next week.

But that might not be enough time to get him ready.

"I don't know that it's out of the question, but I think it would be a long shot," Phillies pitching coach Rich Dubee said. "Opening Day is probably a long shot, just because we've got to get him up and running. We've got to stretch him out. I think he's been up to 52 or 54 pitches. We like our guys, if they're going to pitch, hopefully they'll be ready to throw 100 pitches by Opening Day. It could be a long shot. Again, this guy has always risen to the occasion."

But the Phillies also said they are not going to push him. Hamels missed almost the entire 2004 season with Class A Clearwater because of left elbow problems. He spent nearly a month on the disabled list with Philadelphia in 2007 because of a mild left elbow strain.

Push Hamels too much too soon and it could develop into something much more serious. It has happened with other pitchers in the past.

"Certainly we have our concerns," Phillies head athletic trainer Scott Sheridan said. "But I agree with Ruben. Our biggest thing is that it's a long season. We need him for the majority of it. We're really not that worried about Opening Day. We've got to have him for the whole season. Not just one day. Obviously, we're not happy with the fact that his elbow hurts, but we're trying to get him better."

Hamels actually missed the first month of the 2004 season because of inflammation in the elbow. He returned to make four starts, but missed the rest of the year.

Sheridan said Hamels' current bout of inflammation is different than what he experienced in 2004.

"That was a lot more significant," he said. "He was much more tender and a lot less productive at that time than he is now. He was not able to throw at that point in time."

Hamels, whose velocity has been down this spring, threw 262 1/3 innings last season, including the postseason. That is more than he threw in his entire Minor League career (201 innings) and a dramatic jump from 2007, when he threw 190 innings, including the postseason.

Could the dramatic increase in innings pitched from 2007 to '08 have played a role in this latest setback? Sports Illustrated writer Tom Verducci has researched the Year After Effect (sabermetricans also call it the Verducci Effect) for pitchers under 25 who have seen a jump of 30 innings or more from one seasons to the next. Those pitchers often land on the disabled list or see higher ERAs the following season.

"Anytime a guy is logging a lot more innings than he has in the past, you have to monitor it," Amaro said. "Hopefully it's a learning experience for Cole and for us, as far as how he prepares himself in the offseason and making sure these things don't occur."

"He was progressing. His velocity was progressing. He never throws hard early. He's a terrible Spring Training guy, and it takes him a while to get his arm speed up. He's a slow starter. What would have concerned me was if he had regressed -- if he had gone from 83 to 84 [mph] to 79 to 80, and that was not happening. His strength is still good. He just had soreness that was persistent, and that was the reason why we had to deal with it."

Sheridan stated simply that throwing the baseball caused the inflammation, which could explain why Hamels feels it every spring. The Phillies do what they can to prevent it, although Hamels joked Monday that he probably would be talking again about it next spring.

"Certainly every year we've tried to talk about different things we can do," Sheridan said. "And he does the right things. It's not like he's a lazy guy and doesn't do his work. He's a good worker. When he's had problems, he's always worked hard. It's just one of those things that comes around for him. It's the way his body reacts and we have to be prepared when it does."

Dubee would not say who would take Hamels' place on Opening Day against the Atlanta Braves should Hamels not be ready. Brett Myers, who started Opening Day the previous two years, would seem to be a candidate. So would Jamie Moyer, who won 16 games last year. Dubee also pointed out that Joe Blanton went 4-0 in 13 starts last season.

"You want him to be up there and pitching," Amaro Jr. said of Hamels. "Obviously, that'll be the telltale sign that Cole is back and pitching. But overall this is pretty good news. Until he's up on the mound, pitching and competing, then we'll know that Cole is pitching like Cole can. But overall, we're pretty pleased with the way things have worked out."