Stress, Strain And Pain

My arm felt great that night," Tommy John recalls. "Oh, I'd had pain off and on, but a pitcher has to be able to distinguish between ordinary pain and real soreness. You wouldn't pitch much if you had to be 100% every time out. Pain is something you live with. But this night there was none. In fact, I hadn't had any real problems with my arm since I had bone chips removed in '72. And, of course, I'd been pitching very well."

John had won 13 games and lost only three as he prepared to face Montreal at Dodger Stadium on the night of July 17, 1974. In the 2� seasons he had pitched for the Dodgers, he had won 40 and lost 15, for a remarkable percentage of .727. At 31 he was at the very height of his powers, and with Los Angeles leading its division by 5� games and playing superbly, he could envision not only his first 20-win season, but also his first appearance in the league playoffs and the World Series.

In the third inning, with the Dodgers leading 4-0, John faced the righthand-hitting Hal Breeden with runners on first and second and nobody out. John needed a double-play ball, an infield grounder from Breeden, so with one strike and one ball on the hitter, he elected to throw his best pitch, a sinking fastball. "I was definitely not trying to overthrow the ball," says John. "Some people said that because I had not been picked for the All Star Game I was trying to prove something by throwing extra hard. But that just isn't true. The ball sinks better when it isn't thrown at full speed, and I wanted to throw him a good sinker."

John has a smooth motion and an orthodox three-quarter overhand delivery. Nothing seemed unusual about his wind-up on the next pitch to Breeden, although John concedes his body may have been too far ahead of his arm at that critical moment when the ball is released. But at the time everything seemed to be going smoothly. Then, "right at the point where I put force on the pitch, the point where my arm is back and bent, something happened. 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 rightfield, independent of the rest of me. I heard this thudding sound in my elbow, then I felt a sharp pain. My fingers started to tingle. The ball got to the plate somehow, high and away. I threw one more pitch, at about half speed, and felt the same sensation. That pitch was even higher and farther away. I walked off the mound and met Walter Alston coming out of the dugout. 'You better get somebody,' I told him. 'I just hurt my arm.' "

Steve Busby was 25 and in only his third full major league season in the summer of 1975, but he had already thrown two no-hitters and been a big winner, with 22 victories in '74. He would win another 18 in '75, despite what he now recognizes as "a gradual erosion process in the back of my right shoulder." The symptoms became evident in late June of that year, when Busby's record was 11-5.

"I had pitched a lot of innings already—about 160—and was throwing every fourth day. It was then I began to feel these pains in the back of my shoulder. There had been pain before, but always in the front—tendinitis. To compensate for this new pain, I was altering my pitching motion slightly, and that was causing me mechanical problems.

"On the 25th of June I threw 12 innings in Anaheim and won 6-2, but I struggled for the last seven. It was really a chore to throw. The next time I pitched was July 1 against Texas. Normally I recuperate fast between starts, but this day I just couldn't throw well. I was having strength problems: I couldn't grip the ball well and I had a lessened ability to snap my wrist. I couldn't even make a tight fist. Whitey Herzog took over as manager in late July, and he told me it looked as if I was favoring something. It's a difficult thing to say, that your arm is sore. You hate to admit it in public. It's a point of ego, of pride. And you don't want to give your opponents a psychological edge. So I pitched on through the middle of September with very little success."

Herzog persuaded Busby to skip his last three starts and to see a doctor. On Oct. 7, 1975 Busby, a native of Southern California, was examined by Dr. Robert Kerlan, the Los Angeles-area orthopedist who, with his partner. Dr. Frank Jobe, has the preeminent sports medical practice in the country. Dr. Kerlan, who had treated Busby for a shoulder strain when the pitcher was 15, prescribed rest, injections to remove fluid, ice treatments and gradual rehabilitation.

Busby began an exercise program in November, convinced that his ills had been brought on by nothing more than bad pitching habits. He throws with a modified corkscrew motion that if not properly timed can leave his arm out of synch with the rest of his body and thereby under dangerous stress. He worked tirelessly, if cautiously, to correct his supposed bad habits, but the soreness persisted. When the Royals broke from spring training to open the 1976 season in Chicago, Busby stayed behind in Florida lo work out some more kinks. He rejoined the team during its first home stand, and on April 18 lost to Cleveland 6-0. After five starts, he was placed on the 21-day disabled list. Again he worked to rehabilitate himself, concentrating now on distance throwing—up to 300 feet—to restore strength and durability to his right arm. He rejoined the team and pitched reasonably well through June, although the soreness in his arm was becoming more and more acute. But it wasn't until July 6 in Yankee Stadium that the pain significantly affected his throwing.

"I was really terrible in that game," he recalls. "Gravity dictated what the ball did. Somehow I got through seven innings, but I walked the first two hitters in the eighth and Whitey took me out. It was not a major league performance. In July Dr. Kerlan ordered me to have a shoulder arthrogram. Dye is injected into the joint, and if it leaks out into the surrounding tissue, there is a problem—and it showed that I had a tear in the rotator cuff. Rest wouldn't help an injury that serious. If I were to pitch again, I would have to have surgery."