Miguel Sano needs Tommy John surgery

On March 1, the Minnesota Twins announced that star infield prospect Miguel Sano would undergo Tommy John surgery to reconstruct a torn ulnar collateral ligament (UCL) in his right (throwing) elbow.

Sano initially experienced pain in the elbow last October while playing in the Dominican Winter League and an evaluation revealed a partial tear. After consultation with the team’s medical staff coupled with a second opinion from Dr. James Andrews, Sano underwent a period of rest and rehabilitation. However, when the symptoms resurfaced during spring training, the decision was made to proceed with surgery. According to the Minneapolis Star Tribune, Sano is expected to undergo surgery within the next two weeks. Dr. David Altchek, team physician for the New York Mets, will perform the procedure at the Hospital for Special Surgery in New York.

Tommy John surgery is nothing new in baseball, but it is far more common in pitchers than position players. In fact, according to a recent survey of major league players who had undergone the procedure, only 17 percent were non-pitchers. Of all the infielders responding to the survey, less than 5 percent had a reconstructed UCL. In other words, the injury is not common in this demographic. Considering Sano is so young in his professional career, it begs the question as to why his ligament failed. While there is no way of knowing what all the contributing variables might be (including Sano’s specific medical history), most young position players who sustain such an injury have spent a fair amount of time pitching somewhere along the way.

The good news is that the success rate for the procedure remains high and, for position players, the recovery time is considerably shorter. Pitchers spend months re-introducing their body to the throwing motion and helping the arm adapt to various pitches, particularly breaking balls; position players do not have the same demands on their arm. As for the effects on a hitter, there is no data to suggest that reconstruction of the UCL has any impact on power, which is good news for Sano, the player ESPN.com’s Keith Law labeled “the best pure offensive prospect in the minors.” The biggest challenge in returning to full game play for a non-pitcher usually comes with making hard defensive throws, such as across the body from third to first.

As for Sano’s timetable, the typical recovery period for a position player ranges from eight to 12 months, compared to the 12 to 16 months usually required for a pitcher. If all goes well, Sano could begin hitting approximately 16 weeks post-surgery and he should have no trouble being ready for next spring. In fact, he could be ready sooner if there are no setbacks. With that in mind, the Twins are leaving open the possibility that Sano could serve as a DH in the latter part of the minor league season, allowing him to continue to develop his hitting.

The bottom line is while this injury represents a temporary setback for Sano and for those who were looking forward to seeing him play, it should be viewed as just that, temporary. As they say, good things come to those who wait.