THE COMEBACK CLINIC

ON THE MOUND — Pre-1974 — From the dawn of baseball, the stories were legion, almost cliche.  Young fireballer comes from some farm town.  Blazing fastball.  Unhittable curve.  Can’t miss.  Two good seasons, strikeouts by the hundred.  Then one day, the golden arm goes bad.  Back to the farm. 

Throwing is an unnatural motion.  Other than the javelin, a baseball or football, and maybe a paper airplane, humans rarely throw overhand.  The strain of hurling a baseball at 90+ mph, 100 times a game blows out even the best arms.  Another phenom finished.  Twenty-five years old and washed up.

And then came the comebacks.

On July 17, 1974, L.A. Dodgers’ pitcher Tommy John was working on a 4-0 lead against the Montreal Expos.  After a dozen years in the majors, John was enjoying his best season, 13 wins already.  But then he threw a sinking fastball. . .

"It was strangest sensation I had ever known,” John recalled.  "It felt as if I had left my arm someplace else.  It was as if my body continued to go forward and my left arm had just flown out to right field." John threw one more pitch, then walked off the mound.  Doctors told him to rest a few weeks, but after struggling to throw batting practice, he knew he was done for the season, perhaps for good.  At 31, he was headed back to Terre Haute, Indiana.  Maybe take up coaching?

Sports medicine was a fledgling field, but in L.A., it had a few stars.  Dr. Frank Jobe was one.  Born in rural North Carolina, Jobe followed a doctor’s advice after World War II.  Medical school led to a family practice in L.A. where he met orthopedist Robert Kerlan. By the mid-1960s, the Kerlan-Jobe clinic was treating athletes in several sports.  Their most famous patient was named Koufax.

With Sandy Koufax’s enormous stride and muscular torso, his poor left arm didn’t stand a chance.  On and off the disabled list, Koufax followed doctors’ advice.  He soaked his swollen elbow in ice after every game, then coated it with a stinging goo so smelly it kept his teammates far away.

The treatments let Koufax torture his arm through five more amazing seasons.  Then at 30, weary of the pain, the pain killers, the ice, he retired.  Another arm blown out.

A decade later, Tommy John faced the same fate, but Dr. Jobe had an idea.  He had seen surgeons replace tendons in hands and knees.  "I'd wondered whether the same could work in the elbow, but no one had done it.”

The doctor told the pitcher “there was a chance to put the elbow back together, but that it was going to take the rest of the season.”  Jobe put the chances of success at one in 100.  John thought for a moment, then said, "Let's do it."

"Those words,” the doctor said, “changed baseball."

The medical world called it ulnar collateral ligament reconstruction.  By any other name, it was a miracle.  “When they operated,” John said, “I told them to put in a Koufax fastball.  They did but it was Mrs. Koufax’s.”

First Jobe opened up John’s elbow to survey the damage.  The ulnar ligament was in shreds.  The surgeon sliced it out, then went looking for a tendon to replace it.  A colleague in the operating room suggested the palmaris tendon, little used by the wrist.

Jobe removed the “graft” tendon, then took out a power drill.  Two holes, one in the ulna that swings the forearm, the other in the humerus of the upper arm became anchors for the tendon, which Jobe braided into place.

John did not pitch in 1975.  Would he ever pitch again?  But the following year, he won ten games and in 1977 he won 20.  He went on to pitch another dozen years, winning more games after surgery than before.  By the time he retired at age 46, with nearly 300 wins, he was nicknamed “the Bionic Man.”  And the surgery that brought him back was called “Tommy John surgery.”

Several hundred major leaguers and legions of college players have had Tommy John surgery.  Dozens more have it every years.  Two-thirds pick up where they left off.  The surgery is so successful that some young athletes consider having it before they need it.  Doctors discourage this myth that the surgery increases velocity.  The knife can wait.

Dr. Frank Jobe died in 2014, a few months after the Baseball Hall of Fame honored his contribution to the game.  Tommy John surgery is still performed exactly as Jobe pioneered it.

Young phenoms still come off the farm, fastballs blazing.  Arms blow out, and some cannot be repaired.  But although Tommy John has been retired for 30 years, his name comes up every week of every baseball season.

“Tommy John surgery,” one sports medicine pro said, “was the most dramatic change in the history of baseball.  Dr. Jobe doesn't get the credit he deserves for the genius of the procedure or the careers he saved.”