So I was asked today: If Liriano has a mild tear of his ulnar collateral ligament,isn't it a matter of when and not if he needs Tommy John surgery? I considered it - and unfortunately, the answer is not an easy yes or no. Here's why.
If a player is being reported as having a mild "tear" that sounds like a little more than the typically reported "sprain" - and even though a sprain is, in fact, a tear, it can be microscopic - hard to visualize, resolves easily - and for whatever reason is rarely reported as a tear. The fact that they're calling it a tear suggests a little more (although I have no evidence of that obviously, just a hunch) - and when you're talking about a pitcher, the further the degree of damage, the more likelihood he's headed for the TJ - especially a young guy with a big future. It's all a continuum - and at some point you decide (the MD decides) that you're essentially past the point of no return and the surgery is recommended.
Of course, it's also an issue of timing. Surgery soon would put him back potentially in time for the end of next year - depends on a number of factors - but could mean not back until spring '08. However, if they DON'T do surgery, shut him down, and then in spring he fails, ends up needing it, then he's lost another season (wouldn't be back before mid-'08).
Now to flip it. If it is indeed a Gr I sprain that just didn't have enough total rest, they can splint him now for 6 weeks to allow the ligament to scar over better (obviously he came back to pitch within 6 weeks so more rest could be all he needs), then progress him back gradually and he could (emphasis on could) be fine. Another option would be to scope it, check it out for real, and decide then whether he needs the full procedure or whether a little clean up and scar repair would do the trick.
So - try and sort that all out. Here's my hunch for what it's worth. They will likely scope it and decide from there. My guess is the 2nd opinion he's waiting on is with the revered James Andrews. If he's done for the season, there's no setback with a scope - and then they'll know free and clear what he really needs.