Oh no, Sano

Miguel Sano's elbow
is acting up again, and
that is worrisome.

And let the medical second-guessing begin.

Miguel Sano, much hyped Twins power prospect, made an off balance throw in Thursday's intrasquad game and felt something in his elbow — the same elbow that led to his winter league season being aborted after two games.

Sano had been examined in December by multiple doctors, including the acclaimed Dr. James Andrews, generally regarded as the top of the sports orthopedic heap, and the consensus then was against surgery and for rest and rehab.

Sano had a new MRI taken Friday, and we'll see what comes of that. But he's clearly worried.

The Internets appear to be filled with Twins fans who are experts on orthopedics, who are absolutely sure that (a) the Twins medical staff is a collection of incompetents and that (b) it was obvious in December that Sano should have had the Tommy John surgery then.

Count me out of that tribe. There are many limits to my knowledge, and the ability to examine an athlete and his scans and evaluate the condition of his joints is well beyond those limits. My experience as an orthopedic patient tells me that there is virtue in avoiding surgery and its risks. If Dr. Andrews says a player should wait on the surgery, that's more meaningful than the opinion of a fan with access to the Web.

If indeed the ligament is torn and Sano needs the surgery, it's a setback for both player and team. 2014 will be essentially wasted for him. Had the surgery been done when the strain was diagnosed some months ago, he would probably have been ready to play in the second half of the season. Tommy John rehab isn't as difficult or long for position players as for pitchers, but it's still a major surgery.

If we really must second guess the medicos, let's examine the options in December:

Rest and rehab. A conservative approach. Upside: If it works, he misses no significant part of the 2014 season. Downside: He probably misses the entire season if he needs surgery later.

Immediate surgery. He misses at least spring training and three months of the season, perhaps more.

Even if Sano needs surgery, what he misses out on by waiting until now for the cutting is July (maybe), August and September (which presumes he would be a major league call up had he had the surgery in December, and I don't know that that's a safe bet). That is at most three months of additional action lost to the delay.

We all want Sano soonest. We may need more patience than we wish to exhibit.