Twins pitchers aren't immune to Tommy John surgeries

Twins pitchers have had their share of the sometimes career-saving elbow reconstruction procedure.

Twins righthander Mike Pelfrey knows exactly why he tore the ulnar collateral ligament in his elbow in 2012 — and he’s certain that it wasn’t because of overuse during his younger days.

That’s become the popular theory to explain the alarming rash of Tommy John elbow ligament-replacement surgeries in the majors this season. According to baseballheatmaps.com, 17 big-league pitchers this year already have suffered UCL injuries that required the surery.

That includes the Tampa Bay Rays’ Matt Moore, who decided on Monday to have ligament replacement surgery on his left elbow, an operation that will sideline him for about a year. It doesn’t include Twins third base prospect Miguel Sano, a position player. The high since 2004 was 35 in 2012, so the injury is happening at a much higher rate this year.

Dr. James Andrews, one of county’s leading experts on Tommy John surgeries, said during a recent interview on Sirius/XM radio that overuse during a player’s high school years might be a reason for the increase in elbow tears. Rays manager Joe Maddon feels the same way.

“Sometimes you have to look underneath the surface, and I tend to agree it has a lot to do with youth sports and travel teams and multiple travel teams and kids pitching to win when they’re really young and throwing too many pitches,” Maddon told the Associated Press. “I think the more recent epidemic, curiously, might be tied to what they’re doing before they even get here professionally.”

Pelfrey said he believes the reasons extend well beyond teen overuse. Before the 2012 season began, he said he decided to alter his mechanics to see if he could improve his pitches. He sizzled in his final two starts of spring training for the Mets.

“I hit 97 [mph], and it was sinking,” Pelfrey said. “I was like, ‘OK, this is going to be good!’ I go out and had three starts and I was pitching good.”

Then came elbow pain, a diagnosis of a partially torn UCL and Tommy John surgery. Pelfrey, who will start Wednesday for the Twins against the Blue Jays, said he never had serious arm trouble before 2012, when he was 28 years old. He believes there’s almost an inevitability to elbow problems.

“Eventually it gets to the point where you throw so much it’s going to happen,” he said. “It’s such an unnatural motion.”

He’s not the only current Twins starter who has come back from Tommy John surgery. Righthander Kyle Gibson said he began “tinkering with my mechanics” while he was struggling in 2011, and that led to him tearing his UCL and needing the surgery.

The Twins have had five major league pitchers undergo Tommy John surgeries since 2004, ranking 20th among all teams: Grant Balfour, Scott Baker, Francisco Liriano, Joe Nathan and Pat Neshek. The Braves lead with 12, which includes Kris Medlen and Brandon Beachy this season. Organization-wise, the Twins were listed with 15 players needing Tommy John surgeries, more than 12 other teams.

In addition to overuse, some believe the increase in using cut fastballs and split-fingered pitches puts extra strain on the ligament, increasing the chances of tears. Tommy John surgery — in which the ulnar collateral ligament is replaced with a tendon from elsewhere in the body — has saved and prolonged careers. But no one has been able to figure out how to limit the injury.

“I think there’s a lot of different factors, and a lot of it teams can’t control because of what a player has done coming up in high school or in college,” said Rob Antony, the Twins assistant general manager. “When he started throwing a breaking ball, did he pitch year-round? There are so many factors ... I just think there’s a lot of different stages in a career where they might suffer some of the effects that lead to [surgery].”

Twins work hard at prevention

The Twins have programs in place designed to help reduce the risk of pitchers breaking down. Pitchers on the Twins’ rookie league teams generally make one start a week. And the Twins employ a six-man rotation at Class A Fort Myers and Class A Cedar Rapids. More pitchers get a chance to start, no doubt. But it also allows the club to be careful with pitchers who are coming out of high school and college.

“It makes it easier to manage their innings, which helps get guys through the year without being shut down early due to an innings limit,” said Brad Steil, the Twins director of minor league operations. “It provides a good transition for high school and college pitchers, who usually pitch once a week in school, and that’s over the course of a shorter season than they pitch in pro ball.”

During the season, the Twins will have their minor league pitchers skip starts to give them a break. And since there’s a seven-day disabled list in the minors, it’s easier to be careful with a pitcher who is experiencing soreness by putting him on the DL.

“Even if you think it’s not a bad injury you can put them on the DL and give them a break,” Antony said, “because when the arm is fatigued, that’s one of the indicators that he’s a higher risk for injuries.”

But despite the best efforts, elbow ligaments continue to tear, and it’s happening at any stage of a player’s career.

“It’s unfortunate,” Antony said. “Everybody thought the Braves handled Kris Medlen as well as you could have and he ended up having a second one. Sometimes it just can’t be helped. Sometimes things happen.

“I’m not sure if there is a right way or a wrong way. Everyone has their own idea of how to manage it.”

 

  • related content

  • Chart: Twins pitchers who have had Tommy John surgery

    Monday April 14, 2014

    Twins pitchers who have had Tommy John surgery since 20032003Joe Mays ▲Mike Fetters2004Jeff Manship ▲Brian Duensing2005Grant Balfour2006Francisco Liriano2008Pat Neshek2010Joe Nathan2011Kyle...

  • Video: Rand: Five pleasant surprises so far for Twins

    Tuesday April 15, 2014

    These players are the reason Minnesota had been downright decent.

  • Twins-Toronto series preview

    Monday April 14, 2014

    THREE-GAME SERIES AT TARGET FIELDTuesday, 7:10 p.m. • FSN, 96. 3-FMRHP Phil Hughes (0-0, 7.20 ERA) vs. RHP Brandon Morrow...

  • Section 219: Where is the 'settling point' for the Twins?

    Tuesday April 15, 2014

    It's been an up-and-down first dozen games for the Twins. here are some of the questions raised by their start.

  • Mike Pelfrey missed all of 2012 after undergoing Tommy John surgery on his right elbow.

  • Atlanta righthander Kris Medlen, a 15-game winner last year, wore an elbow brace on his right arm in spring training following his Tommy John surgery. Medlen is one of a number of high-profile pitchers to need the elbow surgery this year, a list that also includes teammate Brandon Beachy.

  • get related content delivered to your inbox

  • manage my email subscriptions
Final123456789RHE
Cleveland «0020320007140
Minnesota010010000272
@Ballpark Replay
Preview | Matchup | Lineup | Log | Wrap | Box
W:C.Kluber(17-9) L:A.Swarzak(3-2)
HR: CLE- None MIN- None

ADVERTISEMENT

Toronto - LP: D. Hutchison 2 FINAL
NY Yankees - WP: M. Tanaka 5
Washington - WP: S. Strasburg 2 FINAL
Miami - LP: N. Eovaldi 1
NY Mets - WP: J. deGrom 10 FINAL
Atlanta - LP: E. Santana 2
Boston - WP: J. Kelly 3 FINAL
Baltimore - LP: M. Gonzalez 2
Milwaukee - LP: W. Peralta 0 FINAL
Pittsburgh - WP: V. Worley 1
Chicago WSox - WP: J. Danks 10 FINAL
Tampa Bay - LP: N. Karns 5
Cleveland - WP: C. Kluber 7 FINAL
Minnesota - LP: A. Swarzak 2
Detroit - LP: R. Porcello 2 FINAL
Kansas City - WP: J. Guthrie 5
Seattle - LP: H. Iwakuma 3 FINAL
Houston - WP: C. McHugh 8
Los Angeles - WP: C. Perez 8 FINAL
Chicago Cubs - LP: J. Turner 5
Texas - WP: S. Tolleson 2 FINAL
LA Angels - LP: H. Street 1
Philadelphia - LP: M. Gonzalez 6 FINAL
Oakland - WP: S. Doolittle 8
San Francisco - LP: R. Vogelsong 2 FINAL
San Diego - WP: I. Kennedy 8
Arizona - LP: W. Miley 3 FINAL
Colorado - WP: C. Bergman 8
Cincinnati - WP: A. Simon 7 FINAL
St. Louis - LP: L. Lynn 2
San Diego 22 FINAL
Buffalo 10
Dallas 34 FINAL
St. Louis 31
Washington 34 FINAL
Philadelphia 37
Houston 17 FINAL
NY Giants 30
Minnesota 9 FINAL
New Orleans 20
Tennessee 7 FINAL
Cincinnati 33
Baltimore 23 FINAL
Cleveland 21
Green Bay 7 FINAL
Detroit 19
Indianapolis 44 FINAL
Jacksonville 17
Oakland 9 FINAL
New England 16
San Francisco 14 FINAL
Arizona 23
Denver 20 FINAL
Seattle 26
Kansas City 34 FINAL
Miami 15
Pittsburgh 37 FINAL
Carolina 19
Chicago 7:30 PM
NY Jets
NY Giants 9/25/14 7:25 PM
Washington
Columbus 4 FINAL
Carolina 3
Buffalo 0 FINAL
Washington 1
St. Louis 3 FINAL
Columbus 4
Calgary 1 FINAL
Edmonton 3
Edmonton 0 FINAL
Calgary 1
Old Dominion 45 FINAL
Rice 42
Troy 0 FINAL
(12) Georgia 66
Georgia Tech 27 FINAL
Virginia Tech 24
Eastern Mich 14 FINAL
(9) Michigan State 73
Iowa 24 FINAL
Pittsburgh 20
Bowling Green 17 FINAL
(19) Wisconsin 68
Maryland 34 FINAL
Syracuse 20
Tulane 13 FINAL
Duke 47
Hawaii 12 FINAL
Colorado 21
Marshall 48 FINAL
Akron 17
North Carolina 41 FINAL
(23) East Carolina 70
Army 21 FINAL
Wake Forest 24
Virginia 33 FINAL
(20) BYU 41
(6) Texas A&M 58 FINAL
SMU 6
Rutgers 31 FINAL
Navy 24
Central Mich 10 FINAL
Kansas 24
Utah 26 FINAL
Michigan 10
Florida 21 FINAL
(3) Alabama 42
Louisville 34 FINAL
FIU 3
Fla Atlantic 19 FINAL
Wyoming 20
Indiana 31 FINAL
Missouri 27
San Jose St 7 FINAL
Minnesota 24
Texas State 35 FINAL
Illinois 42
Massachusetts 7 FINAL
Penn State 48
Georgia State 14 FINAL
Washington 45
Appalachian St 20 FINAL
Southern Miss 21
(14) Miss State 34 FINAL
(17) LSU 29
Northern Ill 14 FINAL
Arkansas 52
Middle Tennessee 17 FINAL
Memphis 36
Utah State 14 FINAL
Arkansas State 21
Miami-Ohio 24 FINAL
Cincinnati 31
Idaho 24 FINAL
Ohio U 36
Ball State 23 FINAL
Toledo 34
(13) So Carolina 48 FINAL
Vanderbilt 34
(4) Oklahoma 45 FINAL
West Virginia 33
Ga Southern 28 FINAL
South Alabama 6
UNLV 14 FINAL
Houston 47
Miami-Florida 31 FINAL
(21) Nebraska 41
New Mexico 38 FINAL
New Mexico St 35
Clemson 17 FINAL
(1) Florida State 23
California 45 FINAL
Arizona 49
San Diego St 7 FINAL
Oregon State 28
(2) Oregon 38 FINAL
Washington St 31
Louisiana 9 FINAL
Boise State 34
Texas Tech 9/25/14 6:30 PM
(24) Oklahoma State
Appalachian St 9/25/14 6:30 PM
Ga Southern
(11) UCLA 9/25/14 9:00 PM
(15) Arizona State
Middle Tennessee 9/26/14 7:00 PM
Old Dominion
Fresno State 9/26/14 7:00 PM
New Mexico
Texas-El Paso 9/27/14 11:00 AM
(25) Kansas State
Tennessee 9/27/14 11:00 AM
(12) Georgia
Vanderbilt 9/27/14 11:00 AM
Kentucky
Wyoming 9/27/14 11:00 AM
(9) Michigan State
Northwestern 9/27/14 11:00 AM
Penn State
TCU 9/27/14 11:00 AM
SMU
Iowa 9/27/14 11:00 AM
Purdue
Tulane 9/27/14 11:00 AM
Rutgers
So Florida 9/27/14 11:00 AM
(19) Wisconsin
Colorado State 9/27/14 11:30 AM
Boston College
Western Mich 9/27/14 11:30 AM
Virginia Tech
Maryland 9/27/14 12:30 PM
Indiana
Akron 9/27/14 12:30 PM
Pittsburgh
Bowling Green 9/27/14 2:00 PM
Massachusetts
Arkansas 9/27/14 2:30 PM
(6) Texas A&M
Kent State 9/27/14 2:30 PM
Virginia
Western Ky 9/27/14 2:30 PM
Navy
Minnesota 9/27/14 2:30 PM
Michigan
Wake Forest 9/27/14 2:30 PM
Louisville
FIU 9/27/14 2:30 PM
UAB
(1) Florida State 9/27/14 2:30 PM
NC State
Miami-Ohio 9/27/14 2:30 PM
Buffalo
Colorado 9/27/14 3:00 PM
California
Louisiana Tech 9/27/14 3:00 PM
(5) Auburn
Texas 9/27/14 3:00 PM
Kansas
Temple 9/27/14 3:00 PM
Connecticut
(16) Stanford 9/27/14 3:15 PM
Washington
TX-San Antonio 9/27/14 4:00 PM
Fla Atlantic
South Alabama 9/27/14 4:00 PM
Idaho
Cincinnati 9/27/14 5:00 PM
(22) Ohio State
Rice 9/27/14 6:00 PM
Southern Miss
Missouri 9/27/14 6:00 PM
(13) So Carolina
Boise State 9/27/14 6:00 PM
Air Force
North Carolina 9/27/14 6:00 PM
Clemson
Central Mich 9/27/14 6:00 PM
Toledo
Troy 9/27/14 6:00 PM
ULM
New Mexico St 9/27/14 6:30 PM
(17) LSU
Memphis 9/27/14 6:30 PM
(10) Ole Miss
Duke 9/27/14 6:30 PM
Miami-Florida
Texas State 9/27/14 7:00 PM
Tulsa
Washington St 9/27/14 7:00 PM
Utah
(8) Notre Dame 9/27/14 7:00 PM
Syracuse
(7) Baylor 9/27/14 7:00 PM
Iowa State
UNLV 9/27/14 7:00 PM
San Diego St
Illinois 9/27/14 8:00 PM
(21) Nebraska
Oregon State 9/27/14 9:30 PM
(18) USC
Nevada 9/27/14 9:30 PM
San Jose St
Chivas USA 0 FINAL
Toronto FC 3
Toronto 40 FINAL
Brt Columbia 23
Edmonton 23 FINAL
Hamilton 25
Calgary 15 FINAL
Montreal 31
Ottawa 32 FINAL
Saskatchewan 35
Connect with twitterConnect with facebookConnect with Google+Connect with PinterestConnect with PinterestConnect with RssfeedConnect with email newsletters

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

question of the day

Poll: How sure are you that the Twins are on the road to improving?

Weekly Question

ADVERTISEMENT

ADVERTISEMENT

 
Close