b-ball-lunachik
05-11-2002, 12:10 AM
Thought this article on the Tommy John surgery was interesting...especially with the recent falling of Franco...
Tommy John surgery giving players another chance
http://sports.yahoo.com/mlb/columns/20020508/tommyjohnsurgerygivingpl.html
By Stan McNeal - The Sporting News
When he enters the room to examine yet another baseball player's ailing arm, Dr. James Andrews always starts with the same question: Shoulder or elbow?
"I'm almost relieved when I hear it's an elbow," Andrews says.
If the uncertainty surrounding sore shoulders makes Andrews anxious, successfully fixing elbows has become almost routine, even when it is the dreaded medial collateral ligament that needs fixing. In the old days, when a pitcher blew out his elbow, he soon was looking for a new job. Then along came Tommy John and Dr. Frank Jobe, and a busted elbow ligament no longer had to mean a change in careers.
When Jobe performed surgery on John, then with the Dodgers, in 1974, he initially didn't realize how damaged the ligament was in John's left elbow. When Jobe found a ligament so shredded it resembled what an assisting doctor described as a "bunch of spaghetti," he determined John's only chance to pitch again was to give him a new ligament. Jobe decided to transplant a tendon from John's forearm to his elbow, a procedure that had been tried only a few times and never on a professional athlete. After removing the tendon, Jobe attached it to the largest two bones in John's elbow to replace the damaged ligament, and Tommy John surgery, a moniker eventually copyrighted by Jobe, was created.
After 18 months of doubts and recovery, John went on to pitch 14 more seasons in the majors and pile up 164 of his 288 career victories, finally retiring at age 46. Hundreds of players -- amateurs as well as pros -- with the same injury have followed John to the operating table, most of them pitchers because of the tremendous stress the position puts on an elbow. Some come back throwing even harder than before. By The Sporting News' count, there are 75 active major-leaguers who had their careers saved by Tommy John surgery.
Success stories are everywhere: Matt Morris has become one of the game's top pitchers since his surgery in 1999; Mariano Rivera, who had the surgery in 1992 while in the minors, has turned into the game's best closer; Billy Koch's fastball was clocked at a reported 108 mph after he underwent the procedure. There are even pitchers who have undergone the surgery twice, including the Brewers' Chad Fox and the Dodgers' Darren Dreifort. (Both, however, are on the disabled list.)
Because of refinements in the surgery and improvements in the rehabilitation process, chances for a successful comeback have climbed steadily and are higher than ever. Doctors now place chances of complete recovery at 90 percent. In 1974, John was satisfied when Jobe put his odds of pitching again in the majors at 1 in 100.
When John had his surgery, in the days before corner rehab facilities, the comeback was left largely to him. Sixteen weeks in a cast left his arm an atrophied mess. Today, arms are bandaged after surgery and patients are flexing their repaired elbows 10 days later. Much of rehab focuses on strengthening the shoulder and forearms to lessen future stress on the elbow. Throwing programs are closely monitored and strictly adhered to, with an emphasis on taking enough time.
"You can't rush the recovery period," Andrews says. "The average for a pitcher to get back to his level is 11.8 months, but there are variations. Someone with a good, virgin elbow might be back in 7-8 months."
Dr. George Paletta, the Cardinals' physician, predicts the timetable to come back will shorten as athletes begin to push the rehab schedule. Garrett Stephenson, for example, was back in the Cardinals' rotation less than a year after his surgery. One reason may have been a new technique Paletta used for attaching the replacement tendon to Stephenson's elbow. Instead of weaving the tendon in a figure eight, the standard procedure, Paletta attached it in four straight strands, which may have created more stability in the elbow. Paletta says he also had an eager patient.
"I would call Garrett during rehab, and he was saying he felt great, that he was doing this or that," Paletta says. "I would say, 'Garrett, you're probably not supposed to do that for another two or three weeks.' It wasn't that he was noncompliant with what we were telling him, but he wanted to push it."
As surgery techniques have improved, demand for it has soared. In the early 1990s, Andrews estimates he did 50 Tommy John surgeries in a year. Now it's twice that, with many of the procedures performed on amateur players still in their teens. Reasons for the rise include improved diagnosis techniques, the increased chances of a successful comeback and the overworking of pitchers' arms, especially among amateurs in their teens.
Andrews says he doesn't expect the trend to slow, mostly because so many parents dream of million-dollar contracts for their children. If you don't think kids are being pushed, consider that Andrews says he recently operated on two 15-year-olds the same day.
"Year-round baseball is a bad, bad thing," Andrews says. "Many youngsters are playing year-round, and they're playing in more than one league. They're throwing harder breaking balls and harder fastballs, and their bodies haven't caught up.
"What happens when they don't have the right physical ability? They get hurt."
When it's the elbow that's injured, though, a player's chance of coming back is much better than it once would have been. Thanks to Tommy John.
just a couple of comments/questions
-- I didn't realize that there were so many (an estimated 75) major leaguers active who have had this surgery already.
-- Dr Andrews alone, (who is a very popular guy, but still ;) ) is now performing 100 of these a year...and on amateurs in their teens?
If I had a child, I'd hoped he'd be a left handed pitcher, but after reading this, I'm not sure I'd let him play year round...
are these players playing year round all over the country (including indoors) or just in warmer clients and Latin America and such?
also, they say they are throwing harder breaking balls now...do you delay having them develop that pitch until they get a little older and their bodies catch up? is it worth the risk of pushing them along too quickly?
what do you guys think?
Tommy John surgery giving players another chance
http://sports.yahoo.com/mlb/columns/20020508/tommyjohnsurgerygivingpl.html
By Stan McNeal - The Sporting News
When he enters the room to examine yet another baseball player's ailing arm, Dr. James Andrews always starts with the same question: Shoulder or elbow?
"I'm almost relieved when I hear it's an elbow," Andrews says.
If the uncertainty surrounding sore shoulders makes Andrews anxious, successfully fixing elbows has become almost routine, even when it is the dreaded medial collateral ligament that needs fixing. In the old days, when a pitcher blew out his elbow, he soon was looking for a new job. Then along came Tommy John and Dr. Frank Jobe, and a busted elbow ligament no longer had to mean a change in careers.
When Jobe performed surgery on John, then with the Dodgers, in 1974, he initially didn't realize how damaged the ligament was in John's left elbow. When Jobe found a ligament so shredded it resembled what an assisting doctor described as a "bunch of spaghetti," he determined John's only chance to pitch again was to give him a new ligament. Jobe decided to transplant a tendon from John's forearm to his elbow, a procedure that had been tried only a few times and never on a professional athlete. After removing the tendon, Jobe attached it to the largest two bones in John's elbow to replace the damaged ligament, and Tommy John surgery, a moniker eventually copyrighted by Jobe, was created.
After 18 months of doubts and recovery, John went on to pitch 14 more seasons in the majors and pile up 164 of his 288 career victories, finally retiring at age 46. Hundreds of players -- amateurs as well as pros -- with the same injury have followed John to the operating table, most of them pitchers because of the tremendous stress the position puts on an elbow. Some come back throwing even harder than before. By The Sporting News' count, there are 75 active major-leaguers who had their careers saved by Tommy John surgery.
Success stories are everywhere: Matt Morris has become one of the game's top pitchers since his surgery in 1999; Mariano Rivera, who had the surgery in 1992 while in the minors, has turned into the game's best closer; Billy Koch's fastball was clocked at a reported 108 mph after he underwent the procedure. There are even pitchers who have undergone the surgery twice, including the Brewers' Chad Fox and the Dodgers' Darren Dreifort. (Both, however, are on the disabled list.)
Because of refinements in the surgery and improvements in the rehabilitation process, chances for a successful comeback have climbed steadily and are higher than ever. Doctors now place chances of complete recovery at 90 percent. In 1974, John was satisfied when Jobe put his odds of pitching again in the majors at 1 in 100.
When John had his surgery, in the days before corner rehab facilities, the comeback was left largely to him. Sixteen weeks in a cast left his arm an atrophied mess. Today, arms are bandaged after surgery and patients are flexing their repaired elbows 10 days later. Much of rehab focuses on strengthening the shoulder and forearms to lessen future stress on the elbow. Throwing programs are closely monitored and strictly adhered to, with an emphasis on taking enough time.
"You can't rush the recovery period," Andrews says. "The average for a pitcher to get back to his level is 11.8 months, but there are variations. Someone with a good, virgin elbow might be back in 7-8 months."
Dr. George Paletta, the Cardinals' physician, predicts the timetable to come back will shorten as athletes begin to push the rehab schedule. Garrett Stephenson, for example, was back in the Cardinals' rotation less than a year after his surgery. One reason may have been a new technique Paletta used for attaching the replacement tendon to Stephenson's elbow. Instead of weaving the tendon in a figure eight, the standard procedure, Paletta attached it in four straight strands, which may have created more stability in the elbow. Paletta says he also had an eager patient.
"I would call Garrett during rehab, and he was saying he felt great, that he was doing this or that," Paletta says. "I would say, 'Garrett, you're probably not supposed to do that for another two or three weeks.' It wasn't that he was noncompliant with what we were telling him, but he wanted to push it."
As surgery techniques have improved, demand for it has soared. In the early 1990s, Andrews estimates he did 50 Tommy John surgeries in a year. Now it's twice that, with many of the procedures performed on amateur players still in their teens. Reasons for the rise include improved diagnosis techniques, the increased chances of a successful comeback and the overworking of pitchers' arms, especially among amateurs in their teens.
Andrews says he doesn't expect the trend to slow, mostly because so many parents dream of million-dollar contracts for their children. If you don't think kids are being pushed, consider that Andrews says he recently operated on two 15-year-olds the same day.
"Year-round baseball is a bad, bad thing," Andrews says. "Many youngsters are playing year-round, and they're playing in more than one league. They're throwing harder breaking balls and harder fastballs, and their bodies haven't caught up.
"What happens when they don't have the right physical ability? They get hurt."
When it's the elbow that's injured, though, a player's chance of coming back is much better than it once would have been. Thanks to Tommy John.
just a couple of comments/questions
-- I didn't realize that there were so many (an estimated 75) major leaguers active who have had this surgery already.
-- Dr Andrews alone, (who is a very popular guy, but still ;) ) is now performing 100 of these a year...and on amateurs in their teens?
If I had a child, I'd hoped he'd be a left handed pitcher, but after reading this, I'm not sure I'd let him play year round...
are these players playing year round all over the country (including indoors) or just in warmer clients and Latin America and such?
also, they say they are throwing harder breaking balls now...do you delay having them develop that pitch until they get a little older and their bodies catch up? is it worth the risk of pushing them along too quickly?
what do you guys think?