Baseball’s Underlying Villain

Jose Fernandez, former pitcher of the Florida Marlins

May 12, 2014. Florida Marlins pitcher Jose Fernandez had strolled out to the mound for a start just like he always does. Calm, cool, collective. The three synonyms perfectly described his persona and pitching ability. Coming off a rookie of the year campaign, Fernandez was ready to exceed more expectations and prove everyone wrong once again. But then his season came crashing down. One pop in his elbow and boom: season over. His multi-million-dollar arm had just failed him, and with that failure, came a failure of expectations. Would he be able to come back from this injury? Would he ever be able to pitch again?

Repair: The Impulse to Restore in a Fragile World by Elizabeth Spelman details the human’s ability and impulse to repair what is broken in their lives. There are things our body can repair on its own such as a cut or a bruise. However, if we investigate deeper, there are things we cannot repair without assistance. A broken bone, a tumor, a torn ligament, etc. Unfortunately for athletes, specifically baseball players, elbows fall into the second category of needing assistance. I plan on documenting the severity of the injury that plagues baseball time and time again and how big of an impact it has on the game. Surprisingly, the injury is easily relatable to Spelman in a sense that some view this injury as irreparable and can draw connections to many of the processes explained in Spelman’s book. By drawing from the text and research, a clear cut outlook on the injury can easily be understood and identified.

With such a drastic number of elbow injuries happening in today’s game, you might as well call it an epidemic. Over 33% of pitchers in the MLB have gone through a repair process (Smiley).The title of this repair? Tommy John Surgery. Also known as Ulnar Collateral Ligament (UCL) reconstruction surgery, surgeons replace the damaged UCL with another tendon from the body, most commonly from the arm or leg. The surgery itself takes all of about ninety minutes, but that’s not where the struggle starts. The average recovery period is usually twelve months, but depending on the severity of the injury, can last up to about two years. And even then, there’s no guarantee that the repaired elbow will return to its normal function. WebMD states that for the first six to ten days, a splint is placed on the elbow to completely immobilize it. Soon afterwards, the patient starts to work out the arm once again by performing small strengthening exercises for the hand, arm, and shoulder. Phase two begins approximately six weeks after the surgery was performed. The patient can start to perform specific elbow exercises, being careful not to agitate the elbow. The third and final phase of the recovery process takes place around four to five months’ post-surgery when the patient can start to toss the ball around lightly, with increased throwing beginning every month thereafter. When the ninth month rolls around, many pitchers can return to the mound and throw competitively, bearing any pain or setbacks. But again, all of these phase timeframes are subject to change depending on the athlete because not all of our bodies heal the same (WebMD).

A diagram of the full procedure

Being away from your job/livelihood for that long can take a toll on your mind, body, and possibly your income. Odds of coming back from the injury have drastically improved over the years, however. Back when the surgery was first introduced in 1974, only 1 in 100 patients had a chance of returning back to form before the injury. Today in 2016, those odds have increased exponentially to an 83% success rate (Surgery Statistics). How might you ask? Well with so many advances in medicine, treatment, rehabilitation, as well as many other things, it has allowed players to come back stronger than ever and those statistics prove that. Many methods have been developed since 1974 in order to perform a simpler, and easier procedure on the patient. Four new methods have been used in order to repair the UCL, with all four of them showing no difference in the unusual damage or differences. With methods always evolving and improving, who’s to say that this current ten to twelve-month injury won’t soon be as simple as casting up a broken bone?

When something is wrong with your body, who is the first person you go to? The doctor. So naturally the first person I went to for an interview was you guessed it, a doctor. I was able to interview my aunt, Dr. Maryann Dellostretto who is a nurse practitioner, about the subject to see how often patients come into her office with this injury and what one can do to prevent such an injury. “With so many kids being active in sports today, it is not uncommon to have patients come into the office with shoulder pains, elbow pains, and many other types of injuries relating to sports. “In regards to elbow injuries, it can sometimes be hard to tell. During the spring and summer time when most kids are active is usually when the most visits occur because they are overworking themselves. But during the fall and winter, there is a small spike as well due to the intense throwing programs that some athletes will endure”. Because she is just a nurse practitioner, she explained to me how they can only test for signs of the injury through simple measures and that in order to fully diagnose the injury, they must get an MRI (Magnetic resonance imaging) of the elbow. She concluded to tell me how traumatized the athletes are when she gives them her possible diagnosis of the injury because of how hard some of them work and going a year without playing the sport that they love can be extremely difficult for them.

Not to knock on my aunt, but I also was able to find an interview with one of the renown surgeons in today’s profession, Dr. James Andrews. One of the premier surgeons in baseball, Andrews believes that there are many factors that can lead to UCL damage. Quoted by ESPN, Andrews states “We found that young pitchers who throw over 85 miles per hour have far greater potential of getting hurt. When throwing more than 85, it creates a lot of stress on elbows that are still developing” (Muench). With so many young pitchers in high school, college, and the pros, many of these athletes are so susceptible to injury that they do not even know it. Add in the factor that many of these pitchers are being overworked, can some of the blame be on the coaches and the players themselves? Dr. Andrews, in my mind, can easily be related to both Willie and Fred. Yes, Willie and Fred both went about their repairs in different processes. However, by deriving traits of each of them, I believe that it accurately describes the repair that Andrews does. Like Willie, patients come to Dr. Andrews not for a renewal of their elbow, but a simple repair so that it can perform the tasks like before it was injured or in Spelman’s words in regards to a car, “make sure that the engine runs, the wheels move, and the doors and windows open and close” (9). Fred on the other hand, believes it is best to repair when using the most authentic parts possible. How much more authentic can a repair get for Dr. Andrews than using tendons from the patient’s own body? By doing this, he can repair the elbow in a sense that no alien parts are used and the elbow can start to heal.

The drastic increase of surgeries performed since 1974

Whether it is a mechanic repairing a car, or a doctor repairing a limb, the general idea of repair is evident, with each process taking on a completely different personality. Or in Spelman’s words, “repair is ubiquitous, something we engage in every day and in almost every dimension of our lives” (1). With such a complicated surgery for doctors, many must be on the top of their profession to conduct such an intricate procedure, especially when it is done on a high-profile athlete whose career is basically in your hands. In retrospect, this type of repair can actually almost perfectly correlate to Fred’s type of repair, which was the repair of a “dilapidated Indian Chief motorcycle” (13). Fred tries to use the most original parts for his repair, trying to keep the motorcycle as authentic as possible. Like Fred, surgeons take a tendon from either the arm or leg of the patient being operated on to mend the torn elbow ligament. By using the tendon from the patient, they are keeping him/her as “authentic” as possible. I found the connection between the surgeons and Fred quite powerful because both had the same intentions in mind as keeping what they were repairing as natural as possible, but both objects being repaired had in no way any similarity. And like Fred’s intentions described by Spelman, surgeons wish to “make it resemble as closely to the original state as possible… and turn the clock back” (13).

Undergoing such a change in the culture and way of life, athletes are figuring out better ways to train, perform, and recover. But the numbers keep increasing, so the question is asked, is Tommy John Surgery changing baseball? The numbers are certainly there to prove it, with over 33% of kids under the age of eighteen having the surgery performed on them and an estimated twenty professional pitchers undergoing the operation each year (Surgery Statistics). Combine that with what today’s game is deemed as “the steroid era”, it most certainly can be made an argument as ever-changing. Must we ask ourselves that on a larger scale, does the game itself need to be repaired as well? Spelman dictates during the first chapter how “repair would not be necessary if things never broke, never frayed, never splintered or fell into pieces” (5). But with these athletes basically falling apart, it begins to make you wonder if this soon will turn into a domino effect, with the pieces of the game that hold it together starting to bend and break one athlete at a time.

“Not everything can be fixed. The skills we repairing animals have to learn to include the self-reflexive one of coming to grips with the limits of those skills and figuring out what to do in the face of the irreparable. Moreover, both reparability and irreparability have their consolations, so we can’t assume that declarations of irreparability are always and everywhere met with dismay or disappointment” (102). Going through such an extensive rehabilitation process after the surgery, learning that the elbow still will not be healed for 17% of patients undergoing the procedure can be tough (Lamb). Athletes have worked so hard to come back from such a gruesome injury and boom; their career is over. Like Spelman said, it can be difficult for those to get a grip with the idea that everything you had worked so hard for can be gone in an instant. However, I particularly like how she goes into detail about how irreparability is not always met with dismay and disappointment. All of us go through life on a certain path, and on that path there are different bends and roads that we take. Some may be the wrong road; others may be the only option we have. But some of those roads we take, whether they like it or not, we must take them and follow the path set for us. Athletes must do the same when faced with the unfortunate reality that they can never play the game they love again. But through this separation from their passion, find other hobbies and joys that they never knew imaginable. I think that is the lesson that Spelman is trying to preach.

Unlike repairing a rip in an article of clothing or the changing of a broken light bulb, many repair processes can be hard to define. Tommy John Surgery falls into that category, with all of the complexities that can plague both the surgeon as well as the patient. The reparable vs. irreparable argument made by Spelman is a great comparative measure to the procedure in the fact that it can sometimes be a toss-up of whether or not the repair process is successful or not. Though the odds have increased dramatically, there really is no telling beforehand how severe and complex the process can be. But with all of the advances in medical technology today and our understanding of the human body, elbow reconstruction has almost become a norm. But like almost all norms, there can be fabrications. And when or if these fabrications occur, the unimaginable might have to be faced.

Acknowledgments

Throughout the entire writing process of this essay, many people had an effect on its success. I want to begin by thanking my group members Jasmine, Olivia, and Jen for their useful insight and opinions on my paper. Their comments were very helpful in crafting my paper through the drafting process and always gave me new ideas to add to my essay to make improve it. I also would like to thank my aunt Maryann Dellostretto for taking time out of her day to allow me to interview her. Her statement was very useful in my paper and allows the reader to take into perspective the severity of the injury as well as the magnitude of it. Also, I would like to give a special thanks to Professor Harris and Megan for their continuous constructive criticism of my drafts. I believe that I take that kind of advice much better than somebody just saying my paper is good and being scared to tell me the truth about it. That was very helpful and I am very appreciative of that. Lastly, thanks to my parents for their awesome support of me through this semester, as the transition can sometimes be tough and with their advice, are helping me to succeed each and every day. My essay would not have been doable without all of these people and I am extremely grateful for their roles in this long process.

References

“Elbow Injuries and Athletes.” Telephone interview. 10 Oct. 2016.

Lamb, Robert. “Is Surgery Changing Baseball?” HowStuffWorks. HowStuffWorks, 11 Feb. 2009. Web. 17 Oct. 2016.

Muench, Matthew. “Dr. James Andrews Talks Tommy John.” ESPN.com. ESPN, 8 Feb. 2012. Web. 07 Nov. 2016.

Smiley, Brett. “12 Things You Probably Didn’t Know about Tommy John Surgery.” FOX Sports. FOX, 25 June 2014. Web. 17 Oct. 2016.

Spelman, Elizabeth V. Repair: The Impulse to Restore in a Fragile World. Boston: Beacon, 2002. Print.

“Tommy John Surgery (UCL Reconstruction) and Recovery.” WebMD. WebMD, n.d. Web. 17 Oct. 2016.

Wpadmin. “32 Unique Tommy John Surgery Statistics — HRFnd.” HRFnd. N.p., 23 Oct. 2014. Web. 31 Oct. 2016.

http://uvba.org/wp-content/uploads/2014/09/Tommy-John.gif

http://www.chrisoleary.com/images/Pitching/Fernandez_Jose_2015.07.22_001.jpg

https://www.youtube.com/watch?v=RCAIhrO_2To