Monday, November 06, 2006

Francisco Tommy-John-o

Francisco Liriano went through with his Tommy John surgery today, and apparently the procedure went as planned and without any complications. The ligament replacement surgery was performed by Dr. Lewis Yokum, a specialist, and was assisted by Twins physician Dr. John Steubs. Now, Liriano will begin a long and difficult rehabilitation that will likely take anywhere from 12-18 months.

Despite the fact that Liriano's decision to go through with the surgery surfaced last week, we chose not to write about it here mostly because it was barely even news. Much like every other piece of "news" that has come out so far in the Twins' off-season (the team picking up Torii Hunter and Carlos Silva's 2007 options, Hunter winning a probably undeserved Gold Glove, Gardenhire's contract extension, etc.) this decision was not in any way surprising. The Twins had continued to insist that there was hope that Liriano could take care of his elbow issues with rest and exercise, but it was clear to most Twins fans that surgery was going to be necessary when his second comeback attempt was halted in the third inning and Frisco slumped off the field.

In a way, the Twins come off looking a bit silly in this situation. Their "wait and see" attitude didn't make much sense over the past few months, and it makes even less sense now. If they would have gone through with the surgery back in August or September, Liriano may have been on track to pitch winterball in a year; now we'll have to cross our fingers and hope that he'll be ready to go for Spring Training 2008. Ultimately, I suppose that going through with the surgery is the pitcher's decision, but as an organization the Twins never seemed to take a firm stance and never seemed to show much urgency when talking about the situation.

As has been discussed elsewhere, the prognosis for a pitcher undergoing Tommy John surgery these days is pretty good. Most pitchers who have undergone the surgery and rehab have come back to pitch at least as well as they had beforehand. Some have even added bite to their fastball as a result of the procedure. Liriano's situation, however, makes a little weary, for a couple of reasons.

First of all, I don't think this is a cut-and-dry case of an ulnar collateral ligament causing all the problems. When his problems initially surfaced, there was a lot of talk about Liriano's elbow problems being rooted in his left shoulder. If that is truly the case, I doubt that this surgery will really solve Liriano's problems, unless he is able to additionally strengthen the shoulder during his rehab period.

Secondly, Liriano's delivery puts a lot of strain on his elbow and I think there is legitimate reason for concern that this will continue to be a problem even after the surgery and rehab. There are a few pitchers who have had to undergo the TJ surgery multiple times, and that is certainly not a path that Liriano will want to follow. Aside from the procedure and lengthy rehab, some mechanical adjustments may be necessary to ensure that the young left-hander can have a long and successful career.

As it stands, Liriano is still just 23 years old and there is a good chance that he will be able to join the long list of pitchers who have undergone Tommy John surgery and come back with great success. The issues I've laid out above will no doubt be on the forefront of the minds of the Twins' medical staff as they work to ease him back into the process of throwing from a mound over the next year or so. My hope is that no complications arise during that span and he can come back in 2008 with the same filthy stuff he showed in his brilliant rookie campaign. The now-certain loss of Liriano for the 2007 season is depressing, but if he can come back at full strength and join Johan Santana at the front of the Twins rotation in a couple years, we'll have a very entertaining team to watch in the final years of its Metrodome residence and into the new stadium era.