MRI Reveals Torn UCL For Trevor May

 

Was it the Twins who told us that, or was it pundits on forums such as this who were assuming that it's easier to split the atom than to move a pitcher to the bullpen?

It's the third time May has missed time with a back injury this season, as he also missed 23 games in June with back spasms. He saw a specialist at the Mayo Clinic before his return and thought he had found the root of his problem, but will seek another opinion and will see specialist Dr. Robert Watkins in California.
"It's been tremendously frustrating [for him]," Molitor said. "At some point you even wonder when you can't find the exact source of the problem, you start thinking worst-case scenario. I think he's going to be OK over time, but we need to start putting together a program where his focus this winter will be on being healthy."

May's back issues have only flared up when pitching in relief, so Twins interim general manager Rob Antony said he's hopeful May will start next year.
"He'll be told as he was last year to go home and prepare to be a starter and hopefully he comes in and wins a spot in the rotation next spring," Antony said. "He didn't earn one this spring and he had success as a reliever so it was easy enough to put him back in the pen. But I'd like to see him earn a job as a starter next year."

By Rhett Bollinger / MLB.com | @RhettBollinger | September 13th, 2016

Edited March 11, 2017 by mikelink45

 

I'm not sure how much detail you'd like me to go into (I sort of 'geek out' on this stuff), so I'll start with a little  and can add more if people would like.

 

1) So everyone is on the same page, traditional TJ uses tissue from another source (usually either a small forearm tendon called the palmaris tendon or a hamstring tendon called gracilis) to 'reconstruct' a new ulnar collateral ligament (UCL). Repair is a similar operation, though instead of making a 'new' UCL out of other tissue, a surgeon simply repairs the injured tissue back to the bone (where it tore away from). 

 

2) Only certain types of tears are amenable to the 'repair' surgery. The UCL can be injured at its attachment on the sublime tubercle (ulnar attachment), medial epicondyle (humeral attachment) or in-between (what we call mid-substance). Uncommonly the ligament can be injured at more than one of these locations, but usually just one. If the ligament is injured at one end, and the quality of the tissue is good, it can be considered for the 'repair' surgery, back to the bone where it tore away from.

 

3) The repair operation has really only gained popularity over the past 3-5 years, and has only been done a very few times on pitchers at the major league level. However, initial studies do appear promising.

 

4) For biologic reasons (that I can expand upon if people are interested, though it may put people asleep), a repair heals and becomes stronger more quickly than a reconstruction. Again, due to the small number of cases done at the ML level, the timeline is still somewhat unknown, but at lower levels, many players are back to pitching at around 6 months post-surgery, rather than 9-12 months as in TJ.

 

5) You asked about 'difference in effect', and I guess I'm not quite sure what you mean by that. The overall effect of the surgery is, of course, the same- to stabilize the elbow against the significant forces of throwing. It is only the manner in which it is done that varies. If that doesn't answer your question, please clarify and I'd be happy to try again.

 

Hope this helps. Happy to entertain follow up questions. Too bad for May, I was certainly hoping for a bounce-back year from him (as we all were).

Thank you for the info.    I meant is the result stronger from one type or the other.    Is there more likely a reoccurance from one or the other?   

I don't think you can prove or have data on whether yanking guys back and forth from the pen to the rotation can cause injury.  And the Twins are far from the only ones doing this.

 

That said, athletes train their bodies to do certain things, in a certain way, many times.  I have to imagine for some players a change like that can be a precursor for injury.  Whether it was for May or not is hard to tell, but I think he's said publicly that the bullpen role caused the back injuries and our resident medical expert has acknowledged there could be a connection there.

 

Either way, devastating news.  Trevor can't catch a break in his goal of being a major league starter.  

Feel awful for May. I think he was poised for a really solid year.

 

Not be sparky, but about Berrios AND Mejia as someone else will invariably get hurt or not be ready?

Well. This just sucks. Good luck in your recovery sir.

Unfortunate, to say the least. Get well, and best of luck.

 

I'd also like to ask, as a mod, that posters both

 

1) ease up on loosely founded and wildly skeptical blame, and

 

2) ease up on attacking those who do.

 

Neither are worthy of these forums.

 

Thanks.

Since this is partially in reference to my original statement, I hardly would call it loosely founded or wildly skeptical. I linked to one of the most well respected baseball minds who shares the opinion of putting a pitcher into the pen, then back into the rotation etc causes these sorts of issues.

 

Additionally May has said as much himself, stating that the bullpen usage may be to blame for his back issues.

 

Having a guy go from a decade or so of pitching every 4th or 5th day, to pitching back to back days or 3 in 5 days etc is going to have an effect. As is suddenly "stretching" him out again.

Yes, the Twins are far from the only team to do this, but more often then not it results in said high upside pitcher ultimately getting injured on ineffective. Part of me wonders know if Hughes injuries are because the Yankees pulled the same nonsense on him.

 

Ditto with Joba etc

 

All of this in summation: I don't think the Twins helped Trevor may and his health etc by putting him back and forth between rotation and pen.

 

People can disagree, which is fine, but for a team that has finished last 5 of 6 years, with a terrible pitching staff overall in that time, I have a tough time giving them the benefit of the doubt at this stage.

Edited March 12, 2017 by DaveW

I think people tend to underestimate the value of a guy who can be a solid #3 starter. Those types get $12-$15 mil a year on the FA market (see: Santana)

 

May isn't and wasn't going to be an ace, but he could miss bats, and could pitch well. This is a huge loss from the rotation IMO.

There's a reason scouts have started a new distinction -- #4 pitchers, and #4 pitchers for the Twins.

 

Mejia is slated to be a #4 pitcher -- for the Twins.

LOL I approve of this bit. I'm gonna steal it