Wednesday, August 10, 2011

Elbow room

Kyle Gibson slid in the
2009 draft because of
a stress fracture in his
forearm. Now he has
a partially torn ligament.
Scott Baker. Kyle Gibson. Anthony Slama.

Three right-handed pitchers, three elbow injuries, and — at least for now — three rehab projects without surgery.

All three are said to have strained flexor muscles in the right elbow. Gibson also has ligament damage.

I'm not orthopedic surgeon, but given the description of Gibson's injury in particular — a partial tear of the ulnar collateral ligament — I'm not optimistic that rehab is going to be the solution. It depends, as I understand such things, on where in the ligament the tear is (and now big the tear is). The ligament is at its thickest closest to the muscle, and has a better chance of holding together there.

I know that Nolan Ryan pitched for years with a partial tear in the ligament, and that Andy Pettitte was described for years as a potential Tommy John candidate. Neither ever went through the ligament replacement surgery. But most pitchers who have a partial tear wind up having the surgery.

Timing matters. If Gibson has the surgery soon, he'll miss the 2012 season but should be at full speed for 2013. If he spends the winter trying to rehab the injury only to get to spring training and find that it didn't work, he'll still miss 2012, and (like Pat Neshek and Joe Nathan) probably won't be ready to roll at the start of 2013.

Kevin Slowey returns
to the starting rotation.
I understand the reluctance to have the surgery. But it sure seems that the Twins often take the conservative rehab approach only to find weeks or months later that surgery was needed after all.

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Baker's spot in the rotation will be filled by Kevin Slowey, not Anthony Swarzak. This is absolutely the right choice. While Swarzak has done well as a spot starter-long reliever, his strikeout rate remains down in the Nick Blackburn/Carl Pavano range — too low.

Even setting aside the whole issue of Slowey's inability/unwillingness to work out of the bullpen, the records of both men say Slowey's the better starter.

And even if the Twins would prefer not to have Slowey be part of their future, they're still going to be better off if he rebuilds trade value — and returning him to the rotation is a step in that direction.

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