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Article: Alex Kirilloff To Miss 2017 After Tommy John Surgery

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#21 Walter's Whites

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Posted 01 March 2017 - 10:33 AM

Why can't we have nice things?
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#22 Thrylos

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Posted 01 March 2017 - 10:35 AM

 

I posted this link in the other thread as well, but it is helpful in answering this question. The short answer is (at least according to this study), most.

 

http://journals.sage...325967114S00021

 

It isn't just the Twins that take this approach- that is the approach taken by the vast majority of teams/colleges.

 

Sample size for non-pitchers returning to play who were not treated with the operation:  1.

 

Might be conclusive enough for pitchers (SS = 29) but just one position player...

 

Also what they do not study is the relapse % of players who were operated upon vs not.

Edited by Thrylos, 01 March 2017 - 10:36 AM.

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#23 Heezy1323

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Posted 01 March 2017 - 10:37 AM

Also, here is a link to a power point presentation from Chris Ahmad (Yankees team doc) that discusses non surgical treatment in some additional detail.

 

https://foreonline.o...2016/11/9-2.pdf

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#24 spycake

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Posted 01 March 2017 - 10:39 AM

Sano's elbow problem was diagnosed in October 2013 too, and he didn't have surgery until March 2014.

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#25 Heezy1323

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Posted 01 March 2017 - 10:40 AM

 

Sample size for non-pitchers returning to play who were not treated with the operation:  1.

 

Might be conclusive enough for pitchers (SS = 29) but just one position player...

 

Also what they do not study is the relapse % of players who were operated upon vs not.

So your contention is that a position player is at higher risk to fail non surgical treatment than a pitcher? My suspicion would be the opposite- that since a position player places less stress on the elbow than a pitcher (proven in biomechanics studies), they are more likely to be successful with non surgical treatment. You can't just conjure the non-pitchers to study. You have to study what is available and extrapolate that data as best you can to other groups. 

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#26 Eris

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Posted 01 March 2017 - 10:44 AM

From the information that is on the internet, Alex Kirilloff did pitch in high school.  Maybe that is a contributing factor.

 

http://www.maxpreps....BJg/default.htm

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#27 Mike Sixel

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Posted 01 March 2017 - 10:45 AM

Good luck to him. Lack of health sucks.

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I don't know, it is a site to discuss sports, not airline safety.....maybe we should take it less seriously?


#28 gunnarthor

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Posted 01 March 2017 - 10:50 AM

Dang.  Hope he comes back next year better than ever.

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#29 Thrylos

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Posted 01 March 2017 - 11:18 AM

 

So your contention is that a position player is at higher risk to fail non surgical treatment than a pitcher? My suspicion would be the opposite- that since a position player places less stress on the elbow than a pitcher (proven in biomechanics studies), they are more likely to be successful with non surgical treatment. You can't just conjure the non-pitchers to study. You have to study what is available and extrapolate that data as best you can to other groups. 

 

My contention is that SS = 1 is not enough to draw any conclusions in any scientific study.

 

Nothing more, nothing less.

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#30 Loosey

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Posted 01 March 2017 - 11:39 AM

This is a huge bummer.  I was really hoping I had misunderstood Watkins the other day.  Still think he has a bright future, happy he isn't a pitcher!

 

I know the theme of this thread is why didn't they address this sooner, and I have the same questions.  Was there a setback with his rehab, was it worse than originally thought?  You would think if it is torn, you fix it surgically, if not do you wait to see if it gets better, or until it tears fully?  I don't understand the whole thing enough.

 

 

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#31 laloesch

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Posted 01 March 2017 - 11:42 AM

Sigh.  Sometimes you get the bear and sometimes the bear gets you.  

 

or is it

 

Sometimes you eat the bear and sometimes the bear eats you.

 

Either way bummer.  Was looking forward to this kids progress this season.

Edited by laloesch, 01 March 2017 - 11:43 AM.


#32 Comrade Bork

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Posted 01 March 2017 - 11:43 AM

It seems pretty logical to be wary of putting a 19 year old kid under the knife unnecessarily.
 
If this is truly a lingering injury, Kirilloff was only 18 years old when it happened.
 
Unfortunate, but I have a hard time blaming either Kirilloff or the Twins for giving an 18 year old body a chance to recuperate on its own.


I guess I always felt (for no provable reason) that Tommy John was a pretty cut and dry decision. If you need it you need it kind of thing. It's the stories of guys rehabbing partial tears and end up burning an extra half season to rehab, instead of getting g the surgery done quicker..
I get my opinions from media guides.

#33 Brock Beauchamp

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Posted 01 March 2017 - 11:46 AM

 

I guess I always felt (for no provable reason) that Tommy John was a pretty cut and dry decision. If you need it you need it kind of thing. It's the stories of guys rehabbing partial tears and end up burning an extra half season to rehab, instead of getting g the surgery done quicker..

Either way, does it matter much? Kirilloff is a several years away from Minnesota either way. If his time table moves back 6-9 months, is that really going to impact the Twins going forward?

 

It was much more frustrating with Sano, who was on the verge of graduating to Minnesota had he stayed healthy.

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#34 nicksaviking

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Posted 01 March 2017 - 12:59 PM

 

I am wondering how many people avoid the surgery by rehabbing?  The Twins always seem to go for rehab for a long time, then always go with the surgery after several months.  

 

It's not the Twins call, they're not opting for anything. Kirilloff isn't a piece of property, he's a young man who gets to make his own medical decisions. Which of us would immediately choose the torturous process of getting knocked out, cut open and subject to a very lengthy period of incapacitation if there was a chance something else would work?

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#35 markominne

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Posted 01 March 2017 - 01:20 PM

Good discussion. Heezy1323, though, may be establishing a disturbing precedent here, offering up professional experience instead of amateur speculation! ;-)
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#36 DocBauer

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Posted 01 March 2017 - 01:43 PM

What troubles me is the fact that had the surgery been done sooner, for his own career sake, he might be able to play part of this season. But what I don't know is, how long should an expected treatment/rehab take place normally before a decision should be made?

I totally understand choosing rehab and treatment first. And I don't know enough medically to know when the time is right to opt for surgery. But it sure does seem to take a long time before the surgery decision is made.
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#37 Heezy1323

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Posted 01 March 2017 - 01:44 PM

My contention is that SS = 1 is not enough to draw any conclusions in any scientific study.

Nothing more, nothing less.

On this, we agree. Though I'm not sure SS=29 is much better. Very challenging topic.

Edited by Heezy1323, 01 March 2017 - 01:50 PM.

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#38 Tom Froemming

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Posted 01 March 2017 - 01:54 PM

 

Another position player in the organization who has had the surgery is Twins manager Paul Molitor. He had the surgery in 1984 when he was a third baseman for the Brewers.

Huh, I was unaware of this fact. Didn't seem to slow him down much. Had a 110 OPS+ over 682 PAs in '83, came back with a 110 OPS+ over 642 PAs in '85. Played just about as much third base too (145 starts the year before vs. 133 the year after).

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#39 Heezy1323

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Posted 01 March 2017 - 01:55 PM

I guess I always felt (for no provable reason) that Tommy John was a pretty cut and dry decision. If you need it you need it kind of thing. It's the stories of guys rehabbing partial tears and end up burning an extra half season to rehab, instead of getting g the surgery done quicker..


I can assure you, the decision is rarely cut and dry. I would say around 20% of the time it is clear surgery is needed. The rest of the time, the decision on when/if to operate is challenging.
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#40 Heezy1323

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Posted 01 March 2017 - 01:57 PM

What troubles me is the fact that had the surgery been done sooner, for his own career sake, he might be able to play part of this season. But what I don't know is, how long should an expected treatment/rehab take place normally before a decision should be made?
I totally understand choosing rehab and treatment first. And I don't know enough medically to know when the time is right to opt for surgery. But it sure does seem to take a long time before the surgery decision is made.


The usual time frame is around 4 months. It is usually around 6 weeks of initial 'active rest', followed by a return to throwing program. Usually they can resume pitching around 3 months. It then usually takes about a month for them to progress to the 80% effort range, which is where most begin to experience trouble (if they are going to have trouble).
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