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Come Fan with UsTuesday, August 4, 2026

Miguel Sano needs Tommy John, but all is not lost for Twins

What can LOST and Nelly teach us about dealing with Miguel Sano’s latest injury?

USA TODAY Sports

Minnesota Twins prospect Miguel Sano needs Tommy John surgery, according to a report by La Velle Neal of Star Tribune. Sano was injured in Thursday’s intra-squad game and will have surgery next week in Minnesota.

In the ABC series LOST, Matthew Fox's character Jack describes how he learned to handle fear in the operating room, and considering that Minnesota Twins' prospect Miguel Sano's injury, it seems fitting:

I’d let the fear in, let it take over, let it do its thing, but only for five seconds, that’s all I was going to give it. So I started to count: one, two, three, four, five. Then it was gone.

It’s good advice for the Twins organization, fans, fantasy owners and people who like see small spheres smashed to oblivion. The fear you’re feeling is normal. So too is the immediate despair and feeling of loss that follows. But don’t let these emotions linger. Let them in.

We know that Sano had to cut short his winter season thanks to a strained ulnar collateral ligament (UCL) in his right (throwing) elbow. The UCL is the ligament that requires the infamous Tommy John surgery in the case that it tears. While Sano only strained his ligament, “strain” can be used in the event of a stretch or a tear, so it’s possible that a small tear occurred over the winter.

Sano consulted both team physicians and Dr. James Andrews before settling on a rehabilitation plan that called for five weeks of rest before ramping up activity. This clearly didn’t take, as Sano “felt something” in his elbow on Thursday per MLB.com’s Rhett Bollinger.

It’s clearly a large setback; but keep in mind the lesson above. The Twins aren’t geared toward winning this season, so a missed season doesn’t dramatically impact their competition window. Certainly, a lost year of development is not a good thing, as Sano only has 67 games above A-ball, but he’d still be have a good chance of turning into a regular sometime in 2015, well within their period of contention.

As a hitter, the recovery from a UCL replacement is less onerous than for that of a pitcher. Not only could Sano return to the field more quickly, but he can be shielded by playing as the designated hitter, allowing him to get reps at the plate without endangering his arm until it is ready. This could also be a course of action for the Twins in lieu of surgery, allowing Sano to play out the season as a DH while doing rest/rehab on the side.

Rest and Rehab

“So I traveled back down that road / will [he] come back no one knows” - Nelly. The song? “Just A Dream.” It’s a bit of a pipe dream to think that this plan has a chance of working, especially since the player and the org have been down this road before. Legitimately, though, just because another (or perhaps the same) issue popped up this time around doesn’t mean more rest isn’t the answer.

It might be an issue that crops up every now and then, restricting him to DH duties at times but is manageable for an extended period. There are pitchers that pitch with partially torn ligaments for years (Ervin Santana comes to mind), so while it’s tempting to say that surgery is the way to go, just to get it over with, it’s not always so simple.

Injuries are scary; they suck. But don’t stress too much! The worst case scenario isn’t all that bad in the long term, and there’s a chance it’s not nearly that grave. Take control of your emotions, or just parlay them into Byron Buxton ... there’s no chance that turns out badly.

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