When a Major League Baseball player approaches the pitcher's mound, he has a lot riding on his shoulders. Like any player, he has the outcome of the inning and ultimately the game to worry about -- something he shares with all players, right down to children swinging sticks in the Dominican Republic, Japan, the United States and other big baseball countries.
Yet also riding on his back is his very livelihood, the standing of his team and the multibillion-dollar industry that is professional baseball. Gamblers and fans stake fortunes and reputations on the outcome of the game. For many, the lone baseball player may be a hero, an obsession or even a god.
Given these conditions, what wouldn't a baseball player do to maintain his place in this unreal spectacle? Unlike the figures of fiction and legend, today's baseball players can't sell their souls to the devil in exchange for a better batting average or a lengthy string of shutouts. Yet modern medical science has unleashed quite a few game-changing innovations, both legal and illegal. For a price, anabolic steroids and human growth hormone allow athletes to reclaim their youth or cheat the limits of their genetic code. As U.S. Congress and sports governing bodies can attest, these substances continue to shake both professional and amateur sports, despite strict rules against their usage.
Yet although a pitcher may be prohibited from injecting performance-enhancing chemicals into his body, multiple surgical options exist for anyone with the big league money to pay for them. These procedures can turn back the clock on an ageing athlete's body and allow for more effective and speedier recovery from career-threatening injuries. Some even insist that the right tweaks with a surgeon's blade can elevate an athlete's performance.
Like it or not, these procedures are changing the world of baseball as we know it.
Tommy John Surgery
The opening credits for the classic TV show "The Six Million Dollar Man" echo much of the optimism of medical science. "Gentlemen, we can rebuild him," the voice-over says. "We have the technology. We have the capacity to build the world's first bionic man." The hour-long adventure series hit the airwaves in 1974, the same year Los Angeles Dodgers pitcher Tommy John allowed surgeons to perform a radical new procedure on his ruined elbow.
Created by orthopedic surgeon Dr. Frank Jobe, the procedure that we now know as Tommy John surgery has since become commonplace among big league players -- especially pitchers. Whether you're throwing a baseball or a javelin, you put a great deal of stress on the elbow. Keep it up and the repetitious strain can lead to inflammation, microscopic tissue trauma and ultimately a tear in the ulnar collateral ligament (UCL), also known as the medial collateral ligament (MCL).
In the past, such an injury would spell the end of a career. While the hurt player would still be able to perform day-to-day movements, he would never again be able to throw with significant force or speed.
The Tommy John procedure follows a basic design. Imagine you have two boots and the lace on one breaks beyond your ability to repair it. The lace on your other boot, however, is in great condition and has plenty of length. Why not simply cut some excess lace from one boot and use it to mend the other? Surgeons do much the same thing to a UCL tear. They take a tendon from the patient's forearm or hamstring and graft it into the elbow to replace the torn ligament. Of course, there are no holes for the "laces," so the surgeon first drills a series of holes into the arm's ulna and humerus bones. After these holes are completed, the tendon is weaved into a figure eight pattern through the holes.
Sound simple? Well, the surgery is far from a quick fix. Recipients face a year of strenuous rehabilitation before they can return to action. Moreover, the operation presents its share of risks. The surgeon has to detach major muscles and move the ulnar nerve out of the way, all of which can result in infection, fracture, nerve irritation and numbness. When Tommy John himself received the procedure, the odds of recovery were 1 in 100 [source: Fraser]. Today, around 83 percent of the operations go as planned [source: Altman].
Baseball Surgery Concerns
Tommy John surgery currently runs between $10,000 and $20,000, though this is nothing compared to the salary-earning years it can add to a major league pitcher's career [source: Fraser]. Yet some Tommy John recipients returned from rehab with claims that made the procedure seem an even greater bargain: They said the surgery made them pitch better than they were before.
As soon as these tales of better-pitching-through-science began to circulate, critics forecast a troubling future -- a day when healthy athletes went under the knife in an attempt to improve their game. After all, what price wouldn't be worth paying to ascend into the esteemed world of baseball superstardom? Over the years, sports medicine doctors have indeed reported inquires from young, uninjured baseball players regarding purely elective Tommy John surgery [source: Fraser]. Fortunately, many doctors are too professional to perform unnecessary surgery on uninformed patients.
If back-alley Tommy John surgeries really could supercharge the average Joe's throwing arm, the situation might be different. As it stands, however, there's little or no truth to the myth. The surgery merely allows a pitcher to return to form following an injury. Recipients of the procedure sometimes forget that their UCL probably didn't just snap. Instead, the ligament tends to weaken gradually over a period of years. It's like when you fill up an empty gas tank: You're filling it up with more gas than it had before pulling up to the pump, but you won't be able to fill it up any more than its maximum capacity.
While the Tommy John procedure hasn't created teams of stitch-skinned monster men, it's one of many medical techniques that have helped to change baseball. New takes on the surgery, such as the docking procedure, have refined the method, employing less intrusive surgical techniques -- such as working around muscles instead of removing them.
Other surgical techniques also have helped to streamline injury treatment and recovery. Doctors are better able to treat knee, spine and shoulder injuries, and sports medicine has grown into a thriving industry. After all, an estimated 80,000 ACL tears occur each year, making the knee injury one of the most feared among athletes [source: Altman]. Lasik eye surgery also helps out, giving players sharper vision on the field without the aid of contacts or glasses.
But not all the trends in sports medicine are that encouraging.
Sports Surgery and Injuries
Sometimes humans just don't know when to quit. We're genetically wired to survive, and few ideas so enthrall us as the hero who refuses to stay down. Our bodies, on the other hand, generally don't live up to all those superhero expectations. You can strive for physical fitness all you want, but in the words of musician Warren Zevon, time treats everybody like a fool.
There was a time when the battered soldier or athlete had to eventually hang up his or her boots and call it a career. With the right medical attention, today's active individuals can put that day off even longer. Aging sports stars continue to come back injury after injury, and even nonathletes take advantage of available procedures. Surgeons have observed a generational divide, with baby boomers and their progeny more likely to opt for reconstructive joint surgery than their predecessors [source: Aston]. After all, many of them observed sports stars bounce back from injuries well into their 40s. Why shouldn't they be able to handle less-strenuous activity in their 60s?
Professional baseball's popularity has led to escalation in not only sports medicine, but also in player performance. Doctors have observed overuse injuries, such as UCL tears, in baseball players as young as 8 years old. Athletes today are more likely to specialize in a sport at an early age and play it year round, encouraged by parents or the overarching glamour of the activity itself.
Before 1997, only 12 percent of Tommy John patients were younger than 18. By 2005, that number had risen to 33 percent. [source: Aston]. An 18-year-old's bones and cartilage are softer than those of an adult, making them more susceptible to trauma. Pitchers younger than 12 have an added worry: potentially damaging the sensitive, developing tissue in their arm joints. Injuries to these growth plates have become widespread enough for doctors to coin the term little leaguer's elbow [source: Fraser].
Many sports medicine experts think that increasing education is one way to prevent such injuries, as well as decreasing the influence of professional, hardcore sports on the games of children. Regardless, medical science continues to advance. How battered and stitch-ridden will the baseball stars of the future be?
Explore the links on the next page to learn even more about baseball.
Humans have regrown fingertips, but can we regrow whole limbs? Find out at HowStuffWorks.
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More Great Links
- Altman, Alex. "A Brief History of: Sports Medicine." Time Magazine. Sept. 22, 2008. (Jan. 30, 2009)http://www.time.com/time/magazine/article/0,9171,1840568,00.html
- Aston, Geri. "Hospitals put some muscle into sports medicine." Hospitals & Health Networks. October 2008. (Jan. 30, 2009)http://www.hhnmag.com/hhnmag_app/jsp/articledisplay.jsp?dcrpath=HHNMAG/Article/data/10OCT2008/0810HHN_FEA_ClinicalMgt&domain=HHNMAG
- Cha, Eugene. "Thirty years since Tommy John surgery, and recovery is still hard for today's patients." Minnesota Public Radio. Sept. 5, 2005. (Jan. 30, 2009)http://news.minnesota.publicradio.org/features/2005/05/05_chae_tommyjohn/
- "Controversial Shoulder Surgery For First-time Dislocation Proven Effective Long-term, According To Study." Science Daily. March 8, 2008. (Jan. 30, 2009)http://www.sciencedaily.com/releases/2008/03/080308091005.htm
- Dodd, Mike. "Tommy John surgery: Pitcher's best friend." USA Today. July 29, 2003. (Jan. 30, 2009)http://www.usatoday.com/sports/baseball/2003-07-28-cover-tommy-john_x.htm
- "Elbow, MRI." eMedicine. June 10, 2006. (Jan. 30, 2009)http://emedicine.medscape.com/article/401161-overview
- Fraser, Stephen. "Myth Information." Current Science. Nov. 2, 2007.
- Keri, Jonah. "Interview with Dr. Frank Jobe." ESPN.com. Sept. 13, 2002. (Jan. 30, 2009)http://sports.espn.go.com/espn/print?id=1431308&type=columnist
- "Modified Ligament Surgery Improves Outcomes For Baseball Pitchers, Other Athletes." Medical News Today. Feb. 19, 2007. (Jan. 30, 2009)http://www.medicalnewstoday.com/articles/63362.php
- Shaikin, Bill. "Baseball cash tree is ripe for picking." Los Angeles Times. Nov. 13, 2007. (Jan. 30, 2009)http://articles.latimes.com/2007/nov/13/sports/sp-baseball13
- "Tommy John Surgery." USA Today. (Jan. 30, 2009)http://www.usatoday.com/sports/baseball/tommyjohn/flash.htm
- "'Tommy John' Surgery For Elbow Reconstruction Effective, But Number Of Baseball Players Requiring It Alarming." Science Daily. July 14, 2008. (Jan. 30, 2009)http://www.sciencedaily.com/releases/2008/07/080712090831.htm
- "What It Takes." New York Times. (Jan. 30, 2009)http://graphics8.nytimes.com/images/2007/07/20/sports/surgerygraphic.gif