Article: Alex Kirilloff To Miss 2017 After Tommy John Surgery

[laloesch]

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 March 1, 2017 by laloesch

[Comrade Bork]

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..

[Brock Beauchamp]

 

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.

[nicksaviking]

 

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?

[markominne]

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

[DocBauer]

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.

[Heezy1323]

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 March 1, 2017 by Heezy1323

[Tom Froemming]

 

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).

[Heezy1323]

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.

[Heezy1323]

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).

[diehardtwinsfan]

 

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?

 

We also tend to underestimate the fact that surgery can have real complications.  I don't have a problem at all with an attempt to rehab first. 

[Deduno Abides]

I'm more concerned about how his elbow got to this extreme of an injury than I am about the delay in surgery. A UCL tear doesn't appear out of nowhere. There are weeks or months of pain first, which can involve tendinitis, tendinosis and a sprain along the way. Sometimes the pain radiates throughout your arm and sometimes it wakes you up at night. Rest along the way can be a great cure. After one prize position player loses important development time to TJ, you'd think the team would have implemented new processes for managing its top prospects, including building an understanding and level of trust that all physical issues must be reported.

 

Second, I'm concerned more about this injury for Kiriloff than I was for Sano or would be for the average player. Kiriloff apparently is a product of his training program. The word last year was that he was more advanced than other players because of his program, whereas other players were considered to possibly have more upside, because they were roughly equivalent but hadn't had the benefit of a program that was as good as Kiriloff's. Now, it is likely that Kiriloff will not be able to continue with that program, because (1) he will be in a rehab program and (2) his past program may have been the cause of his problem. If his training program was a foundation of his success and he can no longer do it, a lot more doubt attaches to his value.

Edited March 1, 2017 by Deduno Abides

[David HK]

Oh, my gosh. You have to feel for that young man. I hope he will recover well, and keep his spirit up in the meantime.

Yet, somehow, this is just so... so... Twins.

[caninatl04]

 

I'm trying to remind myself it could be worse - this could be Berrios, May, or one of our pitching prospects that is almost major-league ready - but still this hurts.

The day is still young

[caninatl04]

 

Sometimes I think that the day after we draft and sign these guys we should just do this surgery and get it over with.

Following the draft, we'll send our top three picks directly to Dr. James Andrews.  Or, we'll hire the previous Vikings' staff so they can tear their biceps instead.

 

Maybe the U of Minnesota might want to invest in a Top 20 graduate physio program.  Oh wait:

https://www.usnews.com/best-graduate-schools/top-health-schools/physical-therapy-rankings

[DJSim22]

 

Just unreal it took him till the start of ST to decide on surgery. That's something that should be evaluated way more to see how he is progressing as opposed to just making that decision after months of rehab. Twins always seem so tentative with their injuries.

 

That's almost as bad as playing in the WBC! 

[tarheeltwinsfan]

 

 

.  

As a surgeon, I hope I never reach the point in my career that I am doing preventative TJ surgery. I will hang up my scrubs the day that happens.

How is that any worse than a woman having breast enhancement?

[Heezy1323]

 

 

.  

How is that any worse than a woman having breast enhancement?

 

I would say that the difference is that a breast aug is cosmetic. TJ is not. 

I'm not saying there aren't orthopedists out there who would do it (though I don't know any). I'm just saying it's not something I would be willing to do. When I consider signing someone up for surgery, the benefit needs to outweigh the risk, or I don't recommend surgery. There are an extremely small number of circumstances under which I would operate on a normal, uninjured joint. 

[mikelink45]

I cannot judge this, I only think of all the injuries over all the years where we have waited and delayed and then finally did what was needed.  I hope that this was not poor judgment, but there have just been too many instances where we wait and wait and suddenly the player is lost for a longer period.

[glunn]

 

I would say that the difference is that a breast aug is cosmetic. TJ is not. 

I'm not saying there aren't orthopedists out there who would do it (though I don't know any). I'm just saying it's not something I would be willing to do. When I consider signing someone up for surgery, the benefit needs to outweigh the risk, or I don't recommend surgery. There are an extremely small number of circumstances under which I would operate on a normal, uninjured joint. 

I am grateful for all of your posts in this thread. It's very informative to hear the perspective of an actual surgeon. I wish that you had been around to explain plantar fascitis and chronic leg fatigue when we were trying to comprehend those injuries.

[Richie the Rally Goat]

Rhett Bollinger wrote that he had a platelet injection before the R&R. It makes more sense then. Still practically unheard of injury for High School OFs...

thanks for sharing. It's slightly more encouraging that Kirilloff spent his offseason getting treatments beyond R&R.

 

I wish Alex well and a speedy recovery.

[puckstopper1]

The phrase "The beatings will continue until moral improves" comes to mind... 

[Trov]

 

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.sagepub.com/doi/abs/10.1177/2325967114S00021

 

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

Thanks for the link, very informative.  It just seemed to me in recent past Twins took the rehab approach and then spent months doing that before going surgery route, but this shows there is valid reason to go that route.  My guess is when rehab did the work it is not as big of a story is not noted as when they end up having it.  Again thank you for the link.

[Trov]

 

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?

Yes, of course it is always the persons decision to do surgery or not, but the Twins medical staff will have input to help make the players decision.  In terms of your question I myself opted to have surgery to a repair of ligament over doing just rehab, because I was informed the surgery had higher level of success and long term health benefits.  Had I been informed by my doctor that rehab was the best route then most likely would have chose that route.  For me it came down to the information that was provided to me.  

As Heezy provided a helpful link to suggest the information is rehab is the proper route, which was what my question was asking.  As for your take that the Twins had control over the decision that was not the intended take from my comment, but what kind of recommendations the Twins staff was giving the players to help make the players decision. 

[Heezy1323]

 

I am grateful for all of your posts in this thread. It's very informative to hear the perspective of an actual surgeon. I wish that you had been around to explain plantar fascitis and chronic leg fatigue when we were trying to comprehend those injuries.

I genuinely appreciate the compliment. I really enjoy this TD community and have learned a lot about baseball by reading others' posts. I enjoy chipping in where I can offer some insight.  As far as bilateral leg weakness... let's just say that I'm not sure I would've been much help then, either. 

[drjim]

I cannot judge this, I only think of all the injuries over all the years where we have waited and delayed and then finally did what was needed. I hope that this was not poor judgment, but there have just been too many instances where we wait and wait and suddenly the player is lost for a longer period.

This is the nature of injuries and athletes.