Minnesota Twins News & Rumors Forum
  • Ligaments Are Stupid

    Ligaments are stupid. The 12 people who follow me on Twitter already know that I feel this way. It's childish perhaps and it certainly ignores their important function in the human body, but I don't care; ligaments suck. A report came out this morning that super prospect and ultimate swagger-haver Miguel Sano needs Tommy John surgery, a surgery performed to replace the ulnar collateral ligament in an elbow. In this case, it's the right elbow of one of the more exciting prospects in recent Twins history.

    As I said, ligaments are stupid.

    Why can't they just be cool and stop fraying and ripping and tearing? For Sano, this means that he will almost certainly miss the entire season, a season that many felt would include his MLB debut. I had just written about Sano on Thursday and I listed him as the Twins' 5th most important player in 2014. I felt this way because of his massive power potential and the fact that he was nearly MLB-ready. Well, number 5 went down before the second Spring Training game. We're off to a great start in 2014, Twins fans!

    Originally posted at Kevin Slowey Was Framed.

    By the way, you can still read that post. Just replace all the 2014s with 2015s and add a sentence about Tommy John recovery. It's basically all the same, as this surgery shouldn't change anything I wrote, just his timeline. You'll be fine. Eat some breakfast, it's early.

    Wallowing aside, this isn't a huge deal in the long run. Sano will be just 21 in May and will resume his career just one year later. This shouldn't affect his power, it shouldn't affect his ability to hit and it shouldn't even affect his arm, should he make a full recovery. Basically, the Twins lose Sano for a year and Twins' fans lose what could have been one of the biggest events of the Twins' 2014 season - Sano's MLB debut.

    In some ways, the Twins were lucky with the timing, since Sano will miss this season prior to being added to the active roster. Basically, they will get to keep his entire pre-free agency career, instead of losing a full season of team control (Francisco Liriano, for example). In addition, they found out early in the season and Sano can have his surgery soon and be ready in time for Spring Training in 2015. There's also no reason to believe that the Twins can't rely on Sano for 2015 in the same way they had planned for 2014. Although it does put in doubt his ability to make the 2015 Opening Day roster, seemingly a lock prior to this surgery.

    Of course, if he had surgery back in November, he'd be four months into recovery...

    Therefore, I'm sure we'll see a lot of smarmy quotes about the Twins' medical staff and how inept they are. I have to say, I can't blame them in this instance. This whole elbow fracas started in November, when Sano was shut down while playing in the Arizona Fall League. At that time, he was diagnosed with just an elbow strain and that diagnosis was confirmed by renowned surgeon Dr. James Andrews. If Dr. Andrews doesn't suggest surgery, you know that a guy doesn't need surgery. You could be shopping at the same mall as Dr. Andrews, turn your back for just one second, and BANG, your ACL has been repaired. I've seen it a hundred times.

    Then, Mike Berardino reported in January that Sano was confident that he didn't need surgery. Sano said that his elbow felt pretty good and that he was throwing again. There was no reason to sound the alarm. Well, January optimism has officially given way to February and March sadness. Sano barely started Spring Training before being shut down with elbow soreness. He had an MRI yesterday and today he's gone for a year. Although, if he recovers quickly, he might be able to play some Winter ball. Who knows at this point, it all depends on how his surgery and recovery goes.

    Yesterday, I preached overreaction. Today, I want everyone to chill. Sano will miss all of 2014 and that's a huge bummer. However, he's still the same prospect he was earlier this week and he should resume what could be a monster career in fewer than 365 days. That's just a shade over 31 million seconds, so start counting if that makes you feel better! You can complain about the Twins' medical staff, but I don't think they can save a ligament that is hell-bent on tearing. You can be upset that the Twins season is ruined, but that's just not true. Basically, Sano will be out of our lives for a year, but then he'll be back, just as smiley and promising as before (with a shiny replacement ligament that we can name and use as a mascot, if we want to).

    Ligaments suck, but what can you do? I hope that Sano's surgery and recovery go well and that he'll be ready to hit some dingers in 2015.
    This article was originally published in blog: Ligaments are stupid started by Brad Swanson
    Comments 21 Comments
    1. Since71's Avatar
      Since71 -
      Thanks for the laughs I needed that. BTW Gardy already named it...you guessed it Liggy
    1. The Wise One's Avatar
      The Wise One -
      People judge without knowledge of the process or the patient. It is not be the first time, nor will it be the last time.
      Ligaments are stupid. Luckily attached to it there is a neuron attached to a brain.
    1. JB_Iowa's Avatar
      JB_Iowa -
      Ligaments do suck (so do joints & tendons) but, then again, its hard to do without them for the most part (although apparently some BB players do without a UCL -- that must not be optimal, though or why wouldn't they just remove them instead of repair/replace them?)
    1. weinshie's Avatar
      weinshie -
      OK, I'm over the anger. But Twins Daily and other outlets need to begin asking questions. Why do so many Twins prospects suffer from major elbow issues? (Sano, Gibson, Chargois, Wimmers) Why does it take so long for Twins to figure out major issues, at least in the Gibson case? Are they learning poor throwing/pitching technique? Are the Twins using advanced kineseology reports/experts? If not, WHY? Is there a lack of communication in the organization? (Gibson pitched a MONTH with a jacked up elbow.) Yes, ligaments are stupid. But now we need to determine if members of the Twins' development system are troglodytes. (micdrop)
    1. JB_Iowa's Avatar
      JB_Iowa -
      Quote Originally Posted by weinshie View Post
      OK, I'm over the anger. But Twins Daily and other outlets need to begin asking questions. Why do so many Twins prospects suffer from major elbow issues? (Sano, Gibson, Chargois, Wimmers) Why does it take so long for Twins to figure out major issues, at least in the Gibson case? Are they learning poor throwing/pitching technique? Are the Twins using advanced kineseology reports/experts? If not, WHY? Is there a lack of communication in the organization? (Gibson pitched a MONTH with a jacked up elbow.) Yes, ligaments are stupid. But now we need to determine if members of the Twins' development system are troglodytes. (micdrop)
      While I agree that the media needs to keep the pressure on the Twins by asking questions about medical treatment, please keep in mind that these players do use their elbows, knees, etc. BEFORE they come under Twins control.

      I have yet to see a complete study showing that the Twins' results are significantly worse than the norm.
    1. crarko's Avatar
      crarko -
      Quote Originally Posted by weinshie View Post
      But now we need to determine if members of the Twins' development system are troglodytes. (micdrop)
      I vote for svirfneblin.
    1. crarko's Avatar
      crarko -
      If you think ligaments are stupid wait until you get to meet arthritic joints. IQ's of amoebae.
    1. Brad Swanson's Avatar
      Brad Swanson -
      Quote Originally Posted by weinshie View Post
      OK, I'm over the anger. But Twins Daily and other outlets need to begin asking questions. Why do so many Twins prospects suffer from major elbow issues? (Sano, Gibson, Chargois, Wimmers) Why does it take so long for Twins to figure out major issues, at least in the Gibson case? Are they learning poor throwing/pitching technique? Are the Twins using advanced kineseology reports/experts? If not, WHY? Is there a lack of communication in the organization? (Gibson pitched a MONTH with a jacked up elbow.) Yes, ligaments are stupid. But now we need to determine if members of the Twins' development system are troglodytes. (micdrop)
      Well, there are two questions here. First, do the Twins have more prospects who suffer from elbow injuries than other organizations? I don't know the answer to that. It may seem that way, but we pay much closer attention to our system than any other. In other organizations, comparable guys to Wimmers and Chargois are fairly unknown to me. I can't imagine I'd even know who they are, much less whether or not they've had elbow issues.

      The second question would only really need to be asked if the answer to the first question confirms our beliefs. Why do the Twins have more players with elbow issues than other organizations? I have no idea, but I'm just an idiot with Microsoft Word and access to the internet. I have no obligation to ask that question. I'd guess we're just dealing with a particularly annoying patch of bad luck.
    1. Wookiee of the Year's Avatar
      Wookiee of the Year -
      R.A. Dickey has it figured out. Ligaments--who needs 'em?
    1. The Wise One's Avatar
      The Wise One -
      Sigh A couple years old but about 30 seconds to find. Internet reported data about 2000-present. Might not be accurate, but as I am told with some baseball statistics, it is the best we got.

      https://docs.google.com/spreadsheet/...DVkFzNnc#gid=3


    1. The Wise One's Avatar
      The Wise One -
      Joe Mays, Fransico Lirians, Lester Oliveros, Joe Nathan, Grant Balfour, Pat Neshak, Scott Baker. That is the list of major league Twins to have had the procedure. Matt Bayshore, Mike Fetters, Angel Garcia, Kyle Gibson, Carlos Gutteriz, Jeff Manship, Frank Mata, and Alex Wimmers in the minors. Brian Duensing in college. This was into 2012.
      Maybe somebody bright with analytics could tell me in what way any of these pitchers were similar in mechanics.
    1. crarko's Avatar
      crarko -
      Quote Originally Posted by The Wise One View Post
      Joe Mays, Fransico Lirians, Lester Oliveros, Joe Nathan, Grant Balfour, Pat Neshak, Scott Baker. That is the list of major league Twins to have had the procedure. Matt Bayshore, Mike Fetters, Angel Garcia, Kyle Gibson, Carlos Gutteriz, Jeff Manship, Frank Mata, and Alex Wimmers in the minors. Brian Duensing in college. This was into 2012.
      Maybe somebody bright with analytics could tell me in what way any of these pitchers were similar in mechanics.
      They all threw baseballs repititively.
    1. zchrz's Avatar
      zchrz -
      Quote Originally Posted by The Wise One View Post
      Joe Mays, Fransico Lirians, Lester Oliveros, Joe Nathan, Grant Balfour, Pat Neshak, Scott Baker. That is the list of major league Twins to have had the procedure. Matt Bayshore, Mike Fetters, Angel Garcia, Kyle Gibson, Carlos Gutteriz, Jeff Manship, Frank Mata, and Alex Wimmers in the minors. Brian Duensing in college. This was into 2012.
      Maybe somebody bright with analytics could tell me in what way any of these pitchers were similar in mechanics.
      A lot people say it is the inverted W position that pitchers get into with their elbows above their shoulders during delivery. It puts a ton of stress on the throwing elbow to lever at that high position and snap to throw the ball. It is also a big velocity factor making pitchers throw harder which is why so many use it. Guys like Prior, Strasburg, Smoltz ect all are good examples of it and have all been injury prone. Whereas guys like Maddux, Ryan, Johnson ect have been relatively injury free while avoiding the technique. Its not hard facts but more of a topic of debate with people strongly arguing for both its importance and non importance.

      Here is a piece on it http://www.chrisoleary.com/projects/...InvertedW.html

      And just for kicks here is a video of the maxline pitching technique, that former cy young Mike Marshall has come up with that completely throws the traditional pitching mechanics out the window. Its an interesting watch and he has had one prospect get to the mlb that used a hybrid of the motion.

      http://www.youtube.com/watch?v=UUgQXJlTSaU
    1. zchrz's Avatar
      zchrz -
      Heres another interesting watch I found. Steve Delbar's story of blowing his arm out in A ball, getting a plate and 9 screws put in it, retiring, finding a training program as a high school coach, and coming back to make it to the majors throwing 3-4 mph harder. The training program was based off using weighted balls and actually holding them through the motion instead of releasing them all the time, which supposedly greatly strengthens the entire motion not just up to the release. I wonder if this is used by teams in the mlb much seems it would be much healthier to transfer some momentum to an object than just put it on your body, they liken to how tennis players rarely get shoulder injuries despite a similar motion to pitching.

      http://www.youtube.com/watch?v=fEQJAgIxX2A
    1. Heezy1323's Avatar
      Heezy1323 -
      Quote Originally Posted by crarko View Post
      They all threw baseballs repititively.
      Thats exactly correct. Many times it is not necessarily that it takes so long to make a diagnosis of UCL injury- it is deciding how long to try to treat it non operatively before resorting to surgery. Most guys that have UCL reconstruction don't have a completely torn ligament on MRI. The vast majority (probably 80% or more) have a partial tear. Some can play with a partial tear... some can't. Many variables in play including mechanics, degree of partial tear, condition of shoulder/elbow musculature, etc. Many lay people (as well as many baseball people) assume the success rate of UCL reconstruction is 100%. Not true. It is a highly successful operation, but most literature puts success rate around 85-90%. So that means one out of ten is unable to return to the same level of play. This is the main reason for trying conservative treatment (rest, rehab, PRP) prior to proceeding with surgery. It is true some position players can play without an intact UCL, but these are usually not players at positions requiring hard throws (3B, RF). As far as the W and inverted W position, that is one of probably a dozen or more current theories about predisposition to UCL injury. The issue is far from understood.
    1. ChiTownTwinsFan's Avatar
      ChiTownTwinsFan -
      Quote Originally Posted by Heezy1323 View Post
      Thats exactly correct. Many times it is not necessarily that it takes so long to make a diagnosis of UCL injury- it is deciding how long to try to treat it non operatively before resorting to surgery. Most guys that have UCL reconstruction don't have a completely torn ligament on MRI. The vast majority (probably 80% or more) have a partial tear. Some can play with a partial tear... some can't. Many variables in play including mechanics, degree of partial tear, condition of shoulder/elbow musculature, etc. Many lay people (as well as many baseball people) assume the success rate of UCL reconstruction is 100%. Not true. It is a highly successful operation, but most literature puts success rate around 85-90%. So that means one out of ten is unable to return to the same level of play. This is the main reason for trying conservative treatment (rest, rehab, PRP) prior to proceeding with surgery. It is true some position players can play without an intact UCL, but these are usually not players at positions requiring hard throws (3B, RF). As far as the W and inverted W position, that is one of probably a dozen or more current theories about predisposition to UCL injury. The issue is far from understood.
      This is interesting info. Are you a doctor? Or did you just spend some time and do some proper research?
    1. Heezy1323's Avatar
      Heezy1323 -
      Quote Originally Posted by ChiTownTwinsFan View Post
      This is interesting info. Are you a doctor? Or did you just spend some time and do some proper research?
      I'm an orthopedist yes. I trained with Dr. Andrews recently so I have a fairly decent understanding of some of the thought processes in play for these guys. I certainly don't have all the answers but am happy to put my two cents in here and there if it helps. Was born and raised in MN and a lifelong twins fan so kind of a bummer to hear about Sano. Sure hoping things go well with his surgery and recovery.
    1. ChiTownTwinsFan's Avatar
      ChiTownTwinsFan -
      Quote Originally Posted by Heezy1323 View Post
      I'm an orthopedist yes. I trained with Dr. Andrews recently so I have a fairly decent understanding of some of the thought processes in play for these guys. I certainly don't have all the answers but am happy to put my two cents in here and there if it helps. Was born and raised in MN and a lifelong twins fan so kind of a bummer to hear about Sano. Sure hoping things go well with his surgery and recovery.
      It helps! Thanks so much for the input and insight. Feel free to 'debunk' our armchair docs anytime ... although I suspect most of that is just built on frustration. My only experience with an orthopedic doctor was 'I'm not sure what the trouble is with your arm; but here's a cortizone shot and if that doesn't work we'll talk surgery.' I never went back and designed my own plan ... which was basically rest and rehabilitation. I'm always glad to see doctors choose non-invasive routes first, and the best usually do when there is a choice.
    1. nicksaviking's Avatar
      nicksaviking -
      Quote Originally Posted by weinshie View Post
      OK, I'm over the anger. But Twins Daily and other outlets need to begin asking questions. Why do so many Twins prospects suffer from major elbow issues? (Sano, Gibson, Chargois, Wimmers) Why does it take so long for Twins to figure out major issues, at least in the Gibson case? Are they learning poor throwing/pitching technique? Are the Twins using advanced kineseology reports/experts? If not, WHY? Is there a lack of communication in the organization? (Gibson pitched a MONTH with a jacked up elbow.) Yes, ligaments are stupid. But now we need to determine if members of the Twins' development system are troglodytes. (micdrop)
      Graph or not, I don't think the Twins are unique in the Tommy John market.

      As to the question of letting them pitch/throw after having elbow pain, that may be a valid point. On the other hand, Ervin Santana has been pitching with a partially torn UCL for about half a decade.
    1. jimbo92107's Avatar
      jimbo92107 -
      And who names a ligament Ulnar, anyway? Hey Ulnar, get a clue! Yeah you, ya weak little ligament that likes to pop, just to piss me off! Hey Ulnar, Thor called, he wants his hammer's name back!

      Stupid ulnar...
©2014 TwinsCentric, LLC. All Rights Reserved.
Interested in advertising with Twins Daily? Click here.