AaronGleeman.com

One pitch later, the comeback was over.

With Bobby Kielty at the plate, Liriano delivered a pitch and then hopped off the mound, rolling his arm as he bent over. As he walked away from the mound, his left arm limp at his side, the Metrodome went silent. Mike Redmond took his mask off and slowly walked out toward Liriano, wide-eyed. Luis Castillo made it to Liriano first, putting his hand on his back and leading him back to the mound.

Trainer Dave Pruemer met him there, at which point Liriano bent over, placing his hands on his knees. As the conference at the mound grew, Liriano and Pruemer had a brief conversation that probably went something like: "It happened again. I felt something pop." Ron Gardenhire arrived moments after that, at which point Liriano stood up straight again.

After a few words with Gardenhire as seemingly the entire team looked on from two feet away, Liriano received a bunch of pats on the back as he exited the field side-by-side with the Pruemer, making his way to the dugout while the 19,000 fans in attendance gave him a standing ovation. And just like that, it was over.

In re-watching the footage, it looks like Liriano first began hurting on his 1-2 pitch to Swisher. He threw a slider, with Swisher narrowly checking his swing, and after his follow-through gingerly walked a few steps off the mound as Redmond appealed to the first-base umpire unsuccessfully. He then threw a mediocre fastball right down the middle on 2-2, which Swisher dumped into center field.

Which pitch signaled the beginning of the end doesn't really matter, of course, but the whole situation unraveled so quickly that I almost had to re-watch it just to realize what had truly happened. After weeks of growing optimism and two perfect, electric innings in front of the home crowd, Liriano's season is now officially over.

I'm not a doctor and I don't even play one on the internet, but it seems unlikely to me that this injury is something that will go away with rest. Liriano has tried that twice already, first by skipping a start and then by taking a month off, and each return to the mound only served to make the situation worse. I wouldn't be surprised to learn soon that Liriano needs Tommy John elbow surgery.

While that sounds scary and like a worst-case scenario, it's really not. The surgery would essentially wipe away Liriano's 2007 season before it even began, but at this stage his ability to pitch in the short term shouldn't be the focus. The goal should be doing whatever is necessary to give Liriano the best chance for a lengthy career, whether that comes at the expense of next season or not.

Tommy John surgery, which involves replacing a ligament in the elbow with a tendon from the forearm or leg, is significant and requires a long road to recovery. However, it's a path numerous pitchers have taken over the years with plenty of success. The surgery itself is named after left-hander Tommy John, who was Dr. Frank Jobe's guinea pig back in 1974.

Then a 31-year-old with one All-Star appearance and zero 20-win seasons, John made three All-Star teams and won 20 games three times after returning. He pitched until he was 46 years old, finishing runner-up in the Cy Young balloting twice post-surgery and winning 288 career games (one more than Bert Blyleven). John is the first success story, but the list of "Tommy John survivors" is a long one.

Mariano Rivera had Tommy John surgery in the minor leagues and went on to become arguably the greatest relief pitcher in baseball history. Eric Gagne and Chris Carpenter underwent Tommy John surgeries in 2000 and 2003, respectively, and came back to win NL Cy Young Awards in 2003 and 2005. In other words, for both the short and long term it's far from a death knell.

Other successful comebacks from Tommy John surgery include John Smoltz, Billy Wagner, David Wells, Matt Morris, Jason Isringhausen, Tom Gordon, Jon Lieber, Erik Bedard, Paul Byrd, Chris Capuano, Billy Koch, and Rafael Soriano. In fact, some estimates suggest that one-tenth of all big-league pitchers have undergone Tommy John surgery at some stage of their career.

Friend of AG.com and Hardball Times writer David Gassko is working on a research article about Tommy John surgery for the upcoming Hardball Times Baseball Annual 2007. Here's what he said about his preliminary findings when I asked him last night: "Based on my research so far, pitchers appear to do no worse after returning from Tommy John surgery. In fact, they appear to do better."