"The prognosis is that he probably needs to rest it a few weeks and then start a throwing program," MacPhail said. "There's no need for surgery, which is good news on the first opinion."
MacPhail said he wasn't "terribly worried" about Johnson seeing Andrews and pointed out that in most cases, a second opinion mirrors the first.
"It's a strain, but it was explained to me that it's not in the area that indicates, 'Oh my gosh, we have a problem,'" MacPhail said. "It's in an area where if you let it rest for a while, it's going to be fine."
The injury has plagued Johnson since his first appearance this season, but he told the Sun he doesn't attribute his 1-1 record and 6.52 ERA to his elbow issues.
"I felt like I could have pitched through it, but obviously I wasn't able to," Johnson said. "I can't straighten out my arm like I normally should be able to, and obviously that's affected everything. I've been getting treatment for it since the first day of the season. But the more you throw, the worse it gets."
Following his discouraging start, the Orioles optioned Johnson to Triple-A Norfolk on May 1 to try to get the veteran back on track. At the time, pitching coach Rick Kranitz noted that Johnson tried to use too many types of pitches and got away from his game plan. Johnson's elbow discomfort may have been a reason for that.
Both MacPhail and Trembley said Sunday the team had no prior knowledge of Johnson's injury. While appreciative of Johnson's desire to stick it out and try to help step up for an injury-laden Orioles bullpen, Trembley wasn't convinced it was the proper course of action.
"[Pitching hurt] might be something he [and] a lot of these other guys might want to reconsider," Trembley said. "It's one thing to be a tough guy, it's another thing to look at the best interests of the team and your career, long term and down the road.
"I admire guys who want to play, who understand that you are not always going to be 100 percent physically. I admire that, but I'll be interested to see how this whole thing transpires with him, to be honest with you."
Added MacPhail: "Jim Johnson is a terrific kid and a good competitor, but you have to be smart with what it is. We were not aware of at that time anything that is potentially harmful for him."
"We never would have put him in that situation [of throwing hurt]. We'll just see what the second opinion is and how things play out."
While Tommy John surgery can often result from ulnar collateral ligament injuries, Johnson told The Sun he is hopeful that he won't need the surgery.
"I think Tommy John is on the acceleration of the arm," Johnson said. "But where I get the pain is on the extension of the arm. It's not the exact same. I'm being optimistic that it's something I can rehab and come back 100 percent from and be back in a couple of weeks."
With closer Mike Gonzalez (left shoulder strain) rehabbing in Sarasota and not expected back until at least early June, the Orioles will have to rely on the current arms in the bullpen. Japanese reliever Koji Uehara was activated from the 15-day disabled list prior to Thursday's game and has pitched two scoreless innings in his first two outings.
"Fortunately for us, Koji is back and has been effective," MacPhail said. "[Closer Alfredo] Simon has done a nice job in that role and [Will] Ohman has done a nice job. [Cla] Meredith has done fine. This is one area where internally, we had enough depth to deal with some pretty severe issues that hit us right at Opening Day."