MINNEAPOLIS -- The Twins will be without rookie All-Star Francisco Liriano for what doctors deemed an indefinite amount of time as his latest MRI showed more than just muscle inflammation near his left elbow. The enhanced MRI that Liriano underwent on Thursday afternoon revealed a mild chronic strain of the ulnar collateral ligament. The test also showed that Liriano has some rotator cuff weakness and stiffness in his left shoulder that were a significant cause in the flare-up of the pain in his elbow. The 22-year-old will immediately begin physical therapy to try to strengthen the shoulder.
"We want to get rid of the soreness in the elbow and make the shoulder stronger," Twins physician Dr. John Steubs said. "Those two things have to be in line before he starts to resume pitching activities." Hearing the words "ulnar collateral ligament" can often be scary for a pitcher, as that is the ligament involved in Tommy John surgery. But there was no concern by doctors that the surgery may be in Liriano's future. "Not at all," Steubs said when asked about the possibility. Liriano had problems with his elbow a few years back in the Minor Leagues. He said earlier on Thursday that the pain he's experiencing now is similar to what he experienced then, and the latest MRI may have confirmed that. "It showed evidence of what looked consistent with an old injury," Steubs said of the enhanced MRI. "Neither this MRI or the previous one showed any signs of any new tears or any new injury." At the time of the original elbow problems, Liriano said he missed a total of four starts as he rested his arm for around 15 days without pitching. But this stint may be longer, as the club will work to make sure he gets strong enough. Dr. Steubs is optimistic that Liriano may pitch before the end of the season, but he couldn't make any guarantees, saying that the timetable for each pitcher is different. Twins manager Ron Gardenhire was a little more assured when asked whether he thought his young phenom pitcher would return before the season's end. "Absolutely," Gardenhire said. "Obviously, it's from an old injury, so there's no new damage. The way I'm told is once he gets his shoulder strength back, do some work on that, he can come back. So once we get all that calmed down with medicine and do all the exercises, then we'll see where we're at." Knowing that he has to be patient, Liriano is ready if the process takes the rest of the year. "We'll see what happens in the next couple weeks, if I work hard and make my shoulder stronger," Liriano said. "But I don't really have any idea when I'll be back. We'll just have to wait and see." More injury issues: Rondell White's strained left hamstring has become more of a problem than he first thought, as White is still hampered by tightness in the muscle. White was running around early on Thursday at the Metrodome when he felt the muscle catch again, and it was enough to make the Twins put him on the DL for the second time this season. The hamstring has been a problem on and off for White since he felt the muscle tighten on July 30 during a start in left field. White was taken out of that game after his at-bat in the second inning and rested the sore muscle until the club's last series at Detroit, when he made one start as a designated hitter. While Gardenhire would love to keep White's bat to use off the bench, the limited number of reserve players has made that option almost impossible. Knowing that outfielder Jason Kubel is still limited a bit with his knees, Gardenhire said that he can't go with two players hampered with running issues. "When you're down to four players off the bench, you need somebody that can run and do all those things," Gardenhire said. "Right now, [White] can't quite get the running part down. It's hard to DH him because once he gets on the bases, he can't run." The club will recall Lew Ford from Triple-A Rochester, where he is currently on a rehab assignment following his problem with a strained right oblique muscle. In seven games with the Red Wings, Ford is hitting .308 with two RBIs, six walks and five runs scored. The hope was to give Ford more at-bats in the Minors before bringing him back up, but the situation has deemed otherwise. As for how White is taking the news that there is another setback to his season, Gardenhire admitted that it's not the news the outfielder wanted to hear, but it's something he understood. "He's frustrated, but he understands the game and what we have to do here," Gardenhire said. "We have to have some healthy players, someone that can go out there and run around." Spotlight on Santana: One thing that may have been overlooked in the Twins' 4-3 victory on Wednesday night was the performance of Johan Santana on the mound. Despite giving up a two-run homer to Brandon Inge in the seventh inning that almost proved costly, Santana still managed to give the Twins another quality start as he gave up just three runs on four hits over seven innings. And that's something that he has made a habit of doing in the month of August. Santana's dominance in August has almost reached the point of legend. With his win last night, the Twins ace has won 17 of his last 18 decisions in the month of August, dating back to Aug. 22, 2002. For his career, he has a 2.38 ERA and 18-4 record in the month. Twins tidbits: Gardenhire said that while Kubel's knees are improving and he's an option to use in the outfield if needed, the skipper will continue to pinch-run for him in late-game situations, not wanting to take a chance. ... Torii Hunter started in center field on Thursday but will get some days off from playing the outfield during the club's 10-game homestand. Knowing that the turf at the Metrodome can aggravate Hunter's left ankle and foot, Gardenhire said that he wants to be sure to give him some rest. Down on the farm: Luis Maza tripled as part of a 2-for-3 night at the plate as he scored two runs in Triple-A Rochester's 6-3 victory over Pawtucket on Wednesday. Jason Miller gave up two earned runs on six hits over six innings. ... Matt Moses blasted a two-run homer, his 13th of the year, as Double-A New Britain defeated Erie, 9-8. Jay Sawatski pitched two scoreless innings of relief with three strikeouts to pick up his second victory. ... Caleb Moore went 2-for-4 with three RBIs in Class A Fort Myers' 6-5 win over Vero Beach. Coming up: The Twins will take on the Blue Jays in Game 2 of the four-game set on Friday night at 7:10 p.m. CT. The game will mark the much anticipated Major League debut of the Twins' top pitching prospect, right-hander Matt Garza, as he faces off against Toronto right-hander A.J. Burnett (3-5, 4.81 ERA).
Kelly Thesier is a reporter for MLB.com. This story was not subject to the approval of Major League Baseball or its clubs.