a bullpen session. He missed one start before resuming bullpen work without pain, but was placed on the disabled list after continued arm pain during his last start on August 7, 2006. Liriano began a rehabilitation program on August 22, and threw off a mound for the first time on August 30, throwing only his fastball and changeup, and said that he would like to pitch his breaking ball later that week. He made a rehab start for Triple-A Rochester on September 9, throwing 40 pitches for four strikeouts and one walk in three hitless innings. After the game, he reported feeling no pain in his elbow and was activated by the Twins. In his first start back on September 13, Liriano left the game in the third inning with left elbow pain. He was shut down for the season after the game. On November 6, 2006, Liriano underwent Tommy John surgery to curtail the pain in his left elbow. He missed the entire 2007 season. 2008 On April 11, 2008, Liriano was recalled from Triple-A Rochester in the place of injured pitcher Kevin Slowey. Liriano made his season debut and his first game since Tommy John surgery on April 13, against the Royals. He pitched innings, giving up six hits, four earned runs and walking five while picking up a loss. On April 25, Liriano was sent back to the minors after a rough start to the season coming off Tommy John surgery. In three starts, he compiled an 0–3 record with an 11.32 ERA. After recording an ERA of 2.67 and going 10–0 in his 11 most recent minor league starts, the Twins recalled Liriano on August 1, from Triple-A Rochester Red Wings, replacing Liván Hernández in the rotation. Hernandez was designated for assignment. In his first start after being recalled, Liriano pitched six scoreless innings and struck out five, recording the win. In 13 total starts in 2008, he went 6–4 with a 3.91 ERA. 2009 Liriano struggled in 2009, posting a 5–13 record with a 5.80 ERA in 29 games (24 starts). However, this was his first year since his Tommy John surgery that he had spent that entire year on the Twins major league roster. On June 28 against the St. Louis Cardinals, he threw seven strong innings, only surrendering two runs. On August 12 against Kansas City, Liriano went another seven innings, only allowing