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.
About HSS | Hospital for Special Surgery
HSS is the world’s leading academic medical center focused on musculoskeletal health. At its core is Hospital for Special Surgery, nationally ranked No. 1 in orthopedics (for the eighth consecutive year) and No. 3 in rheumatology by U.S. News & World Report (2017-2018). Founded in 1863, the Hospital has one of the lowest infection rates in the country and was the first in New York State to receive Magnet Recognition for Excellence in Nursing Service from the American Nurses Credentialing Center four consecutive times. The global standard total knee replacement was developed at HSS in 1969. An affiliate of Weill Cornell Medical College, HSS has a main campus in New York City and facilities in New Jersey, Connecticut and in the Long Island and Westchester County regions of New York State. In 2017 HSS provided care to 135,000 patients and performed more than 32,000 surgical procedures. People from all 50 U.S. states and 80 countries travelled to receive care at HSS. In addition to patient care, HSS leads the field in research, innovation and education. The HSS Research Institute comprises 20 laboratories and 300 staff members focused on leading the advancement of musculoskeletal health through prevention of degeneration, tissue repair and tissue regeneration. The HSS Global Innovation Institute was formed in 2016 to realize the potential of new drugs, therapeutics and devices. The culture of innovation is accelerating at HSS as 130 new idea submissions were made to the Global Innovation Institute in 2017 (almost 3x the submissions in 2015). The HSS Education Institute is the world’s leading provider of education on the topic on musculoskeletal health, with its online learning platform offering more than 600 courses to more than 21,000 medical professional members worldwide. Through HSS Global Ventures, the institution is collaborating with medical centers and other organizations to advance the quality and value of musculoskeletal care and to make world-class HSS care more widely accessible nationally and internationally.