• Elephant in the Room: Sano's Elbow

    From my perspective, this has been a very positive offseason overall for the Twins. They have delivered some strong statements by handing out unprecedented contracts to multiple free agent pitchers, they made a smart move by officially transitioning Joe Mauer away from catcher, and several prospects turned in encouraging performances while participating in winter ball.

    But all the while there has been a dark cloud looming overhead -- one that just won't seem to go away. That would be the condition of Miguel Sano's elbow.

    Sano missed some time in New Britain last July due to "arm fatigue," though not very much. The problem re-emerged while he was playing in the Dominican Winter League, where Sano was shut down after appearing in just two games due to elbow soreness.

    At that point, concern started to build that the elite slugging prospect might need the dreaded Tommy John surgery. Those worries were briefly alleviated when La Velle E. Neal III blogged in mid-December that the third baseman had been examined in Ft. Myers and given a "clean bill of health."

    Unfortunately, this thing won't go away. Asked recently about whether Sano will avoid going under the knife, Terry Ryan expressed what Mike Berardino described as "optimism but not certainty." Here's the quote:

    "That would be our hope," Ryan said. "Right now we don't think it is (going to require surgery), but I can't tell you for sure until we crank him up a little more."
    That's not exactly what we're hoping to hear at this stage of the offseason, especially after reports seemed to indicate that Sano was in the clear. The official diagnosis right now, per Berardino's article, is a "strained ulnar collateral ligament," which indicates that there is stretching or minor tearing in the UCL (though I believe "sprain" would be the more accurate term). In some cases these things clear up on their own, but often, the pain or deteriorating state of the ligament eventually leads to measures being taken.

    If Sano's elbow keeps barking as he transitions into his workouts over the next month, it'll be tough to imagine that surgery can be avoided. We're on the verge of a seven-month period where the 20-year-old will be throwing on a daily basis and the organization can hardly expect him to be playing through constant pain, especially if there's real danger of worsening the condition of the ligament.

    On the bright side, Tommy John surgery is significantly less serious for a position player than it is for a pitcher. Whereas the timeline for a hurler to return to full strength is generally between 12 and 14 months, many position players are able to return to the field in 6-8 months.

    Still, that would obviously mean Sano would miss a majority -- if not all -- of the 2014 season, which would be a huge bummer considering that he stands a pretty good chance of breaking into the majors this year if healthy, following a dominant 2013 campaign in the minors.

    As the Twins are fully dependent on prospects -- particularly the "Big Three" of Sano, Byron Buxton and Alex Meyer -- to lead their turnaround, losing one for a significant stretch of time in the prime of his development would be a heartbreaking turn, though sadly not uncharacteristic based on this snakebit franchise's recent history.

    It's certainly possible that this is all much ado about nothing, and that Sano's elbow -- having been given several weeks to rest -- will feel fine once he ramps up his workouts in the coming weeks.

    But when you step back and look at this situation as a whole, and you see an issue that first sprung up in July of last year and still hasn't cleared, it's difficult not to get an ominous feeling.

    We should know more once Sano has his elbow re-examined in Ft. Myers. That's expected to happen soon.
    This article was originally published in blog: Elephant in the Room: Sano's Elbow started by Nick Nelson
    Comments 43 Comments
    1. Kwak's Avatar
      Kwak -
      Gosh, practicing medicine over the internet is difficult!
    1. orangevening's Avatar
      orangevening -
      Quote Originally Posted by crarko View Post
      I'm waiting on the article predicting the amputation.
      Total arm replacement could be named "Miguel Sano surgery"
    1. TwinsAce's Avatar
      TwinsAce -
      I guess I'm not sure what the big deal is. Sano is not a pitcher.
      Now if we were talking about a wrist problem...then I'd be worried. Or an amputation.
    1. jimbo92107's Avatar
      jimbo92107 -
      Quote Originally Posted by johnnydakota View Post
      Just move Mauer to 3rd now ....
      Same thought occurred to me. May not be fair to Mauer, but if anybody on this team could do it, Joe Mauer could learn to play 3rd base in a couple months, where most guys might not ever be able to do it.

      My bigger question would be, can Sano learn 1st base at the MLB level?
    1. Halsey Hall's Avatar
      Halsey Hall -
      Mauer could play 3rd base right now. He takes hundreds of ground balls every spring at 3rd and doesn't miss. I was kind of surprised they didn't move him there and bring back Morneau. Sano is the reason he's at first.
    1. Thrylos's Avatar
      Thrylos -
      Quote Originally Posted by Halsey Hall View Post
      Mauer could play 3rd base right now. He takes hundreds of ground balls every spring at 3rd and doesn't miss. I was kind of surprised they didn't move him there and bring back Morneau. Sano is the reason he's at first.
      Hear me for a second. First and third (and short and second) are different beasts. First is the second closest position to a catcher in the respect that people throw you balls at a fast speed (sometimes off target) that you have to catch and maybe tag someone. Third, short and second, you have to knock them down and throw them. You rarely throw a ball at catcher, you rarely throw a ball at first. Second and short, you catch double plays. Third, not that much.

      No Sano.
    1. OldManWinter's Avatar
      OldManWinter -
      Worry, worry, worry ...
    1. jokin's Avatar
      jokin -
      Quote Originally Posted by Thrylos View Post
      Hear me for a second. First and third (and short and second) are different beasts. First is the second closest position to a catcher in the respect that people throw you balls at a fast speed (sometimes off target) that you have to catch and maybe tag someone. Third, short and second, you have to knock them down and throw them. You rarely throw a ball at catcher, you rarely throw a ball at first. Second and short, you catch double plays. Third, not that much.

      No Sano.
      Quote Originally Posted by jimbo92107 View Post
      Same thought occurred to me. May not be fair to Mauer, but if anybody on this team could do it, Joe Mauer could learn to play 3rd base in a couple months, where most guys might not ever be able to do it.

      My bigger question would be, can Sano learn 1st base at the MLB level?


      A good third baseman is somewhat like a hybrid of quick reaction times and proper angles taken by a hockey and soccer goalie combined with a strong and quick-releasing arm, plus the familiarity and comfort of a catcher going both deep into foul territory to cover foul pops and pouncing on dead fair balls in the no man's land between third and home. No reason Mauer can't do this, and do it well.

      The Sano situation should certainly give pause to the braintrust to fully consider their options in the intermediate and longer-term. Perhaps a reconsidertion of the Mauer-Plouffe platoon option with Mauer DHing against LHP? This of course would open up the spot at 1B, which invites speculation to more strongly reconsidering signing Kendrys Morales at First on a part time basis with Colabello (Morales is 103 OPS pts. better hitting left over right-handed and Morales very likely isn't up to playing in the field for 150+ games, although he did play 152 games at 1st for the Angels in 2009)....or considering the dreaded Parmelee/Colabello tandem.

      With the Morales option, when Sano is finally here for good, he can fairly seamlessly slide into 1st with Morales DHing full-time, or if Sano is able with his arm, move Mauer back to 1st, Sano to 3rd, Morales still DHing full-time, Plouffe Super-UTIL. Solves some of the short-term offensive woes and doesn't obstruct the long-term offensive goals, either.
    1. cmathewson's Avatar
      cmathewson -
      Quote Originally Posted by Kwak View Post
      Gosh, practicing medicine over the internet is difficult!
      So is scouting baseball players, and a thousand other disciplines that rely on experts. In all these disciplines, we're finding that the wisdom of experts is full of biases and an over-reliance on gut instincts and intuition over data-driven reasoning. This is where the Internet, and the machines that can make sense of the data therein, is a huge benefit to society.

      Sabermetrics may not benefit society, but it has changed the way we understand the game. It no longer suffices to rely on gut instinct alone. At the very least, we need to check these intuitions against data.

      We have similar data science in medicine. Watson is a computer that is better than any human medical diagnostician because he can use the massive data stores on the Internet and superhuman reasoning power to more accurately diagnose patients, and provide treatment recommendations.

      We are not Watson. But we can recognize patterns of faulty diagnoses and treatment. Perhaps ligament injuries are just difficult to diagnose and treat. But it sure seems like this org has struggled where other orgs have not as much. It deserves more study. I am writing this comment because I object to rejecting this study out of hand.
    1. Jerr's Avatar
      Jerr -
      Quote Originally Posted by OldManWinter View Post
      Worry, worry, worry ...
      I hear ya!
      I come here to escape Winter and worry
    1. Seth Stohs's Avatar
      Seth Stohs -
      LaVelle is on for Paul Allen on KFAN this morning. In an interview with Terry Ryan, he asked about Sano. Paraphrasing the response:

      Since arriving in Ft. Myers, he had some warts removed. He was checked out last month and right now he's having no pain. Everything is going as hoped. However, he has not yet started to throw, and that will start once his foot/feet heal up. At that point, they'll see if he can make the throws from 3B and know much more. Assumption is that he'll be just fine. But until he does that, can't be 100% certain.
    1. nicksaviking's Avatar
      nicksaviking -
      Good news. Unless the training staff mis-diagnosed plantar fasciitis as plantar warts.
    1. Halsey Hall's Avatar
      Halsey Hall -
      Talked with Sano this morning and asked about the elbow. It's good, no pain, and he started throwing today and will throw again tommorrow. So things are looking up.
    1. nicksaviking's Avatar
      nicksaviking -
      Quote Originally Posted by Halsey Hall View Post
      Talked with Sano this morning and asked about the elbow. It's good, no pain, and he started throwing today and will throw again tommorrow. So things are looking up.
      Great news and thanks for the update.
    1. lyndon's Avatar
      lyndon -
      interestingly, Sanó directly translated means "He healed"
    1. Hosken Bombo Disco's Avatar
      Hosken Bombo Disco -
      Quote Originally Posted by lyndon View Post
      interestingly, Sanó directly translated means "He healed"
      There's another language where Sano translated means "He shall arrive in June"
    1. twinsfan34's Avatar
      twinsfan34 -
      Quote Originally Posted by Halsey Hall View Post
      Talked with Sano this morning and asked about the elbow. It's good, no pain, and he started throwing today and will throw again tommorrow. So things are looking up.
      Holy Cow that's good news!!
    1. Halsey Hall's Avatar
      Halsey Hall -
      We've got to keep this guy warm for Twins fest, so I gave him my gloves this morning. And.....besides a pet monkey, he's also got a dog.
    1. lyndon's Avatar
      lyndon -
      Quote Originally Posted by Hosken Bombo Disco View Post
      There's another language where Sano translated means "He shall arrive in June"
      You're speaking my language!
    1. crarko's Avatar
      crarko -
      Per Rhett Bolllinger: "@RhettBollinger: Miguel Sano says his goal is make the Opening Day roster for the Twins. Says his elbow feels fine. No pain. Has been rehabbing it."

      I approve this message.
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