After being injured back in May this past season, Minnesota Twins reliever Pat Neshek was diagnosed with a partial tear of the ulnar collateral ligament. Neshek would miss the remainder of the season, but no surgery was required, and rehab would heal the injury.

Six months later, and Neshek was just a few days away from the completion of the rehab. Just days before his rehab was scheduled to finish, Neshek experienced discomfort in the same elbow while throwing. An MRI revealed that the other side of the ligament was completely torn away from the bone, and Tommy John surgery would be required.

The initial outcry from fans everywhere thus far has been about whether or not Neshek should have just had surgery to begin with rather than go through with the rehab. The question is a valid one, but the team made the right decision.

As we’ve mentioned before, Tommy John surgery requires at least a year to recover from, and a lot of time it take 15 months. The injury occurred on May 9th this past season, and by the time the surgery would have been completed, it would have been closer to June.

Do the counting, from June, or for that matter, even count from May. Count fifteen months and see what you come out with. If you counted correctly, you’ll get to August 2009 (from May). Assuming the recovery would take 15 months, Neshek would have had the opportunity to possibly return with one month remaining in the 2009 season. However, he would have likely needed some sort of minor league rehab like Francisco Liriano did in 2008, and it would be questionable whether he‘d see a major league mound.

Surgery wouldn’t have been a bad option looking back now, but whether Neshek had the surgery then or now, he would have missed the 2009 season, or had little affect on its outcome. It was a wise decision to allow him to rehab the partial tear which has an 80-percent success rate. Had the rehab worked, and had Neshek returned this spring, we would have all been happy that surgery was avoided.

More comfort in the decision can be had from Dr. James Andrews, the exact doctor who performs the widely known Tommy John surgery. While it has been said that the Twins doctors made the decision, according to Joe Christensen, Andrews did agree with their recommendation:

When Neshek was first injured in May, he received a second opinion from Dr. James Andrews, who agreed with the Twins recommendation to rehab the injury, instead of having surgery.

“I don’t think the plan was wrong,” Smith said. “He re-injured it the other day, and now it’s a complete tear, and that changes the diagnosis completely.”

It would be nice to think that surgery immediately would have been a better choice, but taking a shot at rehab and a shorter return timetable was the correct move. Whether Neshek did the surgery back in May or now in November, he would have missed the Metrodome’s final season, and would be looking ahead to Spring Training 2010 either way.