New York, NY—July 1, 2000
It’s the sixth inning of a well-pitched 3-0 game. The workhorse on the mound has been pitching smoothly all night. Then, all of a sudden, he can’t find the plate. When he does, he is throwing grapefruits. The next day the papers report the star pitcher has torn his medial collateral ligament (MCL) and will spend the rest of the season watching from the dugout.
Not that long ago, an MCL tear put an athlete’s career in jeopardy. But thanks to the research of David Altchek, M.D. of the Sports Medicine Center at Hospital for Special Surgery, the procedure known as Tommy John Surgery has been modernized, allowing for a pitcher to return after a year of rehab. Kerry Wood of the Chicago Cubs, Kerry Lightenburg of the Atlanta Braves and Jason Isringhausen of the Oakland Athletics are all recent examples of pitchers who regained their old form after having surgery to repair their torn MCL.
Dr. Altchek, an orthopedic surgeon at HSS’ Sports Medicine Center and team physician for the New York Mets, has performed numerous MCL repairs. He and his team of sports medicine specialists helped refine the surgery to the 45-minute outpatient procedure it is today. Prior to Altchek’s research, the surgery took approximately four hours with a two-day hospital stay. "The procedure is not as traumatic as it once was. Through modernization of the treatments, the surgery has become much more reliable," Altchek says.
According to a paper soon to be released, 29 out of 30 athletes with MCL tears were able to return to the game as strong as they once were, due to new technologies.
Altchek and his team have been studying this surgery to make it more successful by learning more about what happens to a pitcher’s arm and why it happens.
At this time, there is no convincing evidence as to whether age, certain arm angles or throwing certain pitches increase an athlete’s risk of tearing the ligament. "The problem with an MCL tear is that it is not common. Because it really only happens to elite athletes who exert high amounts of force on their arms (estimated at approximately 3,000 deg./sec.), there aren’t very many opportunities to learn about the injury," Altchek notes.
"The injury occurs when a pitcher loads up his pitches so much the ligament in his elbow tears," he continued. "Unfortunately there are no signs to predict who is at risk, nor is this the type of injury that stretching or strength training can prevent."
Because of the pressure put on the elbow while throwing, MCL tears are most common among pitchers. However, other activities can put you at risk, such as wrestling or awkward physical collisions while playing basketball or football.
An MCL tear may not be the most common injury a pitcher could face, but it is the most career threatening. Rotator cuff injuries are the most common among professional pitchers. However, these injuries can be treated conservatively, where a torn MCL requires an operation.
To grasp just how powerful an injury this is, realize a major league pitcher can’t use a crutch, while a basketball player with an ACL tear can eventually return to the court wearing a knee brace and perform at the NBA level. An MCL tear will end a pitcher’s season, but not his career. He can expect to come back just as strong as when last on the mound. Pitchers can toss after four months, and throw off a mound after seven. After a year away from the game and successful rehab, the radar could once again read in the nineties.
The HSS Sports Medicine Center is staffed by a team of healthcare professionals dedicated to the care of active and athletic men and women. Internationally renowned physicians, physical therapists, exercise physiologists, athletic trainers, nutritionists and nurses with extensive experience in the care of the athlete are all members of the sports medicine center. The Hospital’s doctors are currently team physicians for the New York Mets baseball team, the New York Giants football team, the ATP (Association of Tennis Professionals) and the U.S. Rowing Team.