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Minnesota Twins: Cardinals' Carpenter knows the risks that Nathan faces

FORT MYERS, Fla. -- While the Twins cling to a sliver of hope that closer Joe Nathan can pitch in 2010, they also don't want him to jeopardize 2011. If he ultimately decides to have Tommy John surgery to repair the torn ulnar collateral ligament ...

FORT MYERS, Fla. -- While the Twins cling to a sliver of hope that closer Joe Nathan can pitch in 2010, they also don't want him to jeopardize 2011.

If he ultimately decides to have Tommy John surgery to repair the torn ulnar collateral ligament in his right elbow, the expected recovery time is about 12 months.

"Timing is very important in this decision," General Manager Bill Smith said Wednesday.

Nathan, 35, is under contract through 2011 with a club option for 2012.

The Twins don't want to see Nathan take the same path Cardinals pitcher Chris Carpenter took, when he missed two full seasons after his Opening Day start in 2007.

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"It sounds like the exact same thing happened to me that happened to him," Carpenter said after Tuesday's game against the Twins.

Carpenter, 34, won a Cy Young Award in 2005 and helped the Cardinals win the 2006 World Series, but on April 1, 2007, he left the mound with right elbow pain.

Like Nathan, Carpenter had arthroscopic surgery to remove bone spurs from the elbow. Carpenter finally underwent the Tommy John ligament replacement procedure in July 2007 and wound up missing all of 2008, too.

"If he does (Tommy John surgery) now or does it two weeks from now, it takes a year," Carpenter said. "So you try to find any way you can not to do that. I tried to rehab (from the first surgery). It got to the point where it just hurt all the time, and I ended up having to get the Tommy John because the ligament just wasn't doing the job anymore."

Smith reiterated that Nathan would take two weeks to finalize his decision, while focusing on strengthening the elbow and reducing the swelling. Though the Twins had an off day Wednesday, Nathan was at their complex, working out and getting treatment.

The Twins have sent the results of Nathan's latest MRI exam and CT scan to Alabama orthopedist Dr. James Andrews for a second opinion.

Their clubhouse is filled with pitchers who have come back from the Tommy John surgery. The list includes Francisco Liriano, Carl Pavano, Jeff Manship, Brian Duensing and Pat Neshek. Still, every elbow's different.

"With me, it was a partial tear, and I didn't know anything about it," said Neshek, who had his surgery in November 2008. "I talked to other players and tried to make a good decision.

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"You have guys like (Twins relief prospect) Loek Van Mil. He came back from his injury (without surgery), and we had about the same tear. His was near the muscle, mine was off the bone."

Asked if Nathan had a partial or full tear, Smith simply called it "significant."

"The thing is, you never know until you go in," manager Ron Gardenhire said. "If they do surgery, you'll really know how bad of a tear it is."

Gardenhire said this is Nathan's decision and the team will support it, either way.

"If I'm able to go out there and throw, I'll definitely give it a shot," Nathan said. "If it's like it was on Saturday (against Boston), there's just no chance."

Nathan knows the Twins have decisions to make about his potential replacements, too, so he's not going to prolong the process.

Even if he has surgery, there's hope he can return to dominant form. Carpenter went 17-4 with a 2.24 ERA last season and finished second in NL Cy Young voting.

"He'll be back; he'll be better than ever," Carpenter said. "But it just stinks that it takes a year."

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