Tuesday, September 9, 2008
Tommy John and the Twins
If you get to a Twins game, you will likely see some gentlemen in a red vest. Those guys are selling Gameday magazines and scorecards. I have written several articles for the magazine over the last couple of years. I think it’s just a great read every issue. If you are going to any of the Twins games yet this week, or during that final home stand, you will want to pick up your copy and enjoy the read.
Tommy John and the Twins
On May 8th, after throwing a ball to White Sox 3B Joe Crede, Pat Neshek felt his elbow “tweak and roll over.” A day, an MRI and a Doctor/Training consultation later, the Twins announced good news and bad news. The bad news was that Neshek would be out the remainder of the 2008 season. The good news was that he would likely not need to have Tommy John surgery, something that would have cost the Twins reliever his 2008 season and most, if not all, of the 2009 season as well.
In September of 2006, Francisco Liriano, after a month of rehab, threw two innings of one-hit ball but felt his elbow pop on a pitch to former Twin Bobby Kielty. Like Neshek, Liriano‘s season was also finished. When it was obvious the rest and rehabilitation was not enough, he had Tommy John surgery in November, 2006. He was told to forget about 2007 and focus his efforts on being ready by Spring Training 2008.
As we all know, what followed for Liriano was a rocky spring training and two poor rehab starts before being called up by the Twins. Clearly he was not ready -- his velocity was down, his control was non-existent and his breaking ball was not sharp -- and he was sent back to AAA where he will be able to do his work, build his strength, gain velocity and control in his attempt to come back.
So, what exactly is Tommy John surgery?
Well, as is easy to figure out, the violent arm action required to pitch a baseball can be quite taxing on a person’s shoulder or elbow. When the ulnar collateral ligament in the elbow snaps or “pops,” Tommy John surgery is required. The ligament in the elbow is replaced by a tendon from another part of your body, frequently from the forearm or hamstring. A pitcher will likely rest the elbow for two months before about four months of rehabilitation. A ball will not be thrown for at least six months. Typical rehab time is at least a full year, and usually more like 18 months.
In Liriano‘s case, it was 18 months before he pitched in a big league game. He is healthy, strong and recovered, but not necessarily where he was before. The mental side of coming back from the surgery may be the most difficult part of the recovery.
Fortunately for Liriano, as well as Neshek and Jesse Crain (who had shoulder surgery last season), there are several players throughout the Twins system who have gone through Tommy John surgery and made full comebacks:
Bobby Korecky, after coming to the Twins in the Eric Milton tradel had Tommy John surgery early in the 2005 season. He came back in 2006 and has been at full strength since.
Philip Humber, a year after being selected third overall in the 2004 draft, had Tommy John surgery in July of 2005. He was back on a AA mound in July of 2006 and made his major league debut in September of 2006 with the New York Mets.
Brian Duensing had Tommy John surgery in March of 2004, while at the University of Nebraska. The Twins used a third round draft pick on him in 2005 and he has risen quickly through their farm system.
Matt Macri shows that Tommy John surgery is not just for pitchers. While a freshman shortstop at Notre Dame, Macri had the surgery in 2002. He came back as a 3B for the Irish in 2003.
Fellow Notre Dame alum Jeff Manship hurt his elbow while playing for Team USA in the summer after he finished high school. He never heard the infamous “pop.” Instead, his forearm and elbow tightened up. He came back and pitched well for the Irish before the Twins nabbed him in the 14th round in the 2006 draft. He has become one of the Twins best pitching prospects.
Minor League reliever Frank Mata had Tommy John surgery in April of 2005. The flamethrower is working his way up the system. Following visa problems this spring, he has started the year with the Ft. Myers Miracle.
Danny Hernandez had Tommy John surgery in June of 2007, just three weeks after he had arthroscopic surgery on his elbow (a procedure Twins closer Joe Nathan had done while he was with the Giants). Hernandez has been a solid reliever in the lower levels of the Twins system. He began 2008 with the Miracle, but control problems got him pushed back to Beloit where he can work through the same things as Liriano.
A year ago, I asked Jeff Manship what advice he would give to Francisco Liriano for his rehabilitation. I think the advice would be great for Pat Neshek or any pitcher out with an arm injury. He said, “I would advise him to consistently follow the rehab program. You cannot afford to stray away from it no matter how monotonous it may seem. Always have a good attitude and believe that you will heal 100%. For me it was nice knowing that there was a chance I could return even better than before the surgery. It provided me with extra motivation. In addition, I would tell him that not everybody recovers at the same rate. My recovery took about a year and a half until I felt completely healthy. Although it is painful, you have to fight through it.”
There are also plenty of examples of star pitchers who have come back from Tommy John surgery to succeed. Mariano Rivera had it before he reached the big leagues. John Smoltz has recovered from it.
It takes work. It is monotonous. And no one ever said it would be easy, but there are a plenty of reasons to believe.
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