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WHEN BAD THINGS HAPPEN TO GOOD ARMS
Ian Thomsen
September 27, 1999
SOME OF THE BEST PITCHING ARMS OF OUR GENERATION HAVE BEEN TORN, POPPED OR SHREDDED, BUT MORE AND MORE OF THEM ARE BEING SCOPED, BACK INTO SHAPE SCRAPED OR SEARED BACK INTO SHAPE
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September 27, 1999

When Bad Things Happen To Good Arms

SOME OF THE BEST PITCHING ARMS OF OUR GENERATION HAVE BEEN TORN, POPPED OR SHREDDED, BUT MORE AND MORE OF THEM ARE BEING SCOPED, BACK INTO SHAPE SCRAPED OR SEARED BACK INTO SHAPE

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Alan Benes sat in the drafty tunnel connecting the St. Louis Cardinals' clubhouse to the sunlight of their diamond. It was the afternoon of June 16, three hours before a game against the visiting Montreal Expos, an opponent of no immediate relevance to Benes. His right shoulder, which was wrapped in bandages with heating pads underneath, chirped at him. "It's just a timer," said the 27-year-old pitcher, reaching up to reset the little clock clipped onto the bandages. His comeback from surgery on the shoulder has been calibrated to the minute. He has been maintaining this schedule meticulously, torturously, for almost two years.

"Many times I've said to myself, Why couldn't it have been my elbow instead of my shoulder?" Benes said. "From everything I've seen, they've been doing that elbow ligament surgery for so many years that they've really perfected it."

Andrews says it's not quite that simple. "If it's a partial tear of the rotator cuff, like Alan had, we can do it arthroscopically, and I'd rather do that than a full elbow reconstruction," the surgeon says. The arthroscope looks like a miniature mechanical giraffe, with a long steel neck hardly thicker than a milk shake straw; its lens gives the surgeon a close-up view. It is used in conjunction with a series of surgical jaws that, once passed through a narrow tube, can be manipulated to bite down on tissue, tie down torn sections of the rotator cuff and, if necessary, drill through bone. Rehabilitation from a shoulder arthroscopy is usually less arduous than recovery from Wood's surgery, in which his elbow was laid open by a scalpel. Benes just wasn't one of the lucky ones.

"The best example is Roger Clemens," Andrews says. In September 1985, Clemens, then a 23-year-old with a career record of 16-9, underwent what the Boston Red Sox described as an arthroscopic procedure to repair a small flap tear of the shoulder. The club didn't mention that Clemens also had a partial tear of the rotator cuff. The next year Clemens won his first 14 decisions, finished 24-4, pitched the Red Sox to their ill-fated 1986 World Series and was voted the American League MVP, the All-Star Game MVP and the Cy Young winner, the first of five such awards he would win—all after a shoulder injury that probably would have ended his career had he been born a decade earlier.

Benes first felt soreness and pain in his shoulder during spring training of 1997, his second full season with the Cardinals. "As a pitcher in the big leagues you're dealing with minute aches all the time," Benes says. "You just pitch through it, and it kind of works itself out." On a team that finished 16 games under .500, his efforts were almost heroic. He would have finished sixth in the league in ERA (2.89) and third in opponents' batting average (.219) if he had been able to pitch just another third of an inning that season, yet his record was only 9-9. Too many of Benes's games were close—the Cardinals averaged only 3.3 runs in his 23 starts. Too many times he had to give everything he had. He struck out 160 in 161⅔ innings, pounding away with one cut fastball after another, thrown all out with a little wrenching of the shoulder. He threw more than 100 pitches in each of his last 21 starts through July, and then he just couldn't throw anymore without great pain in his shoulder.

"The injury didn't happen in one pitch or one game," Benes says. "It really was a battle every time out. There was a string of games where I had to give some extra effort late. That may have helped speed up the process, but I don't feel that's why I got hurt. I feel my shoulder was injured the whole season. If I'd had easier games at the start of the year, the problem would just have happened later in the year."

In September 1997, Andrews arthroscopically repaired tears in Benes's rotator cuff and labrum, and tightened his shoulder capsule—which keeps the arm properly aligned in the socket—with the goal of returning him to the Cardinals by spring training. But the surgery didn't take. Each time Benes tried to strengthen his shoulder, it punished him severely. "I remember lying in bed every night just hoping I would feel a little bit better the next day," he says; two or three hours later his shoulder would wake him with an agonizing stabbing pain, as if the surgery were being repeated without anesthesia. "One of the worst feelings I've ever had was after nine, 10, 11 months, when a lot of guys are back pitching," Benes says. "I was trying to throw and still just feeling terrible, not able to do anything."

Last September, Andrews once more attempted to tighten the capsule surrounding Benes's loose shoulder, again using a controversial technique known as thermal capsular shrinkage. He inserted an arthroscopic wand heated to 153°F at the tip and gently swabbed at Benes's capsule, which is made of collagen, a fibrous protein. When seared by the hot poker, the capsule shrank like bacon in a hot skillet. The technique is so new that Frank Jobe, the Los Angeles Dodgers team physician who invented Tommy John surgery, advises that it be used only as a last resort. "If you heat the capsule too much, the collagen goes dead," Jobe warns. But Andrews believes his second pass with the wand was successful for Benes.

"They say when you've heated the capsule once, you can't heat it again," Andrews says, "but this one worked. I went all around Alan's shoulder with the wand, and I could see it tightening up."

Benes worked patiently through seven rehab starts in the minors in August and early September, and he was taken off the DL on Sept. 7. Three days later, in the ninth inning of a Cardinals game against the Pittsburgh Pirates, the bullpen gate at Busch Stadium swung open, and Benes jogged onto the field. Mark McGwire, who had been pulled after homering in the bottom of the eighth, welcomed Benes back by jumping out of the dugout and then falling to the grass as if he had fainted. McGwire had been acquired by the Cardinals the day after Benes pitched his last game before surgery.

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