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Major league baseball is beginning to change its philosophy for the treatment of the arm and shoulder injuries that have long plagued pitchers. Instead of relying on drugs or surgery to fix the damage, the emphasis now is on preventing, rather than repairing, that damage. In the last three years new diagnostic techniques, million-dollar grants from hospitals and refinements in high-speed, stop-action videotaping have provided new answers to old problems.
"The beauty of the new philosophy," says Dr. Frank Jobe of Los Angeles, the foremost sports orthopedist in the country, "is that it's so simple. Essentially, it means writing the word 'prevention' on a flag and waving it very, very high."
But prevention is nothing more than a buzz word until it's given definition by such surgeons as Jobe and Dr. H. Paul Bauer of San Diego. In their terms, prevention is a commitment by both player and management not only to remember how sensitive the arm and shoulder are to stress but also to recognize and support the new methods. It means placing increased importance on good body mechanics—getting the body into the proper position to pitch. It means adhering to a daily regimen of strength and isometric and isokinetic flexibility exercises. New York Mets Pitcher Tom Seaver has been at the forefront of the prevention movement for years. Today he is regarded as an authority on how to coax "consistency and longevity" out of a pitcher. "What you're really looking for in a prevention program," says Seaver, who's working on a book about body mechanics and pitching, "is strength and flexibility through the entire range of motion. You don't want weak points anywhere. But before that happens, you must have a general understanding of the proper way to pitch. If you don't, and continue to throw improperly, you're going to have a breakdown."
Many experts believe the treatment of one such breakdown—that of the Pittsburgh Pirates' star lefthander, John Candelaria—triggered baseball's swelling interest in antisurgery medicine. On May 10, 1981 in St. Louis, Candelaria threw a pitch that put his career in jeopardy. Less than 24 hours later he was in Atlanta, consulting with an orthopedic specialist. Candelaria remembers the doctor telling him: "Son, it's a tear in your biceps tendon. I recommend immediate surgery."
"My first reaction was, 'Whoa, let's get another opinion,' " Candelaria says.
He did, but the second physician confirmed the wisdom of the proposed treatment. Baseball, after all, was then deep into its surgery-as-a-cure phase, which was popularized in 1974 when Jobe reconstructed the left elbow of Pitcher Tommy John. What concerned Candelaria wasn't the operation he faced, but its consequences. John's extraordinary recovery aside, other subsequent efforts to restore pitching arms and shoulders through surgery had failed abysmally. Steve Busby, Steve Stone, Wayne Garland, Don Gullett and Doug Rau—to name a few top pitchers—had seen their careers shortened or ended following surgery.
Candelaria eschewed surgery and instead turned to Bauer. A former San Diego Padres team doctor (1969-80), Bauer had gained considerable attention in medical circles, but little acceptance, as early as 1979 when he became an outspoken critic of rotator cuff surgery. (The rotator cuff is made up of four muscles that secure the arm to the shoulder socket, and pitching puts tremendous stress on that area.) "The results just haven't been very good," Bauer maintains. He was the first physician to suggest the use of good body mechanics as an alternative to rotator cuff and other arm surgery, a theory he developed through discussions with Seaver, who was then pitching in Cincinnati. Seaver had introduced Bauer to proper pitching body mechanics in 1979 when the doctor became frustrated during his treatment of Mark Fidrych. "Tom taught me a great deal," says Bauer. "I believe he's unsurpassed in his knowledge of pitching and the mechanics of throwing a baseball."
Bauer's belief in the efficacy of good body mechanics was so strong that he opened The Body Mechanics Lab in San Diego in 1979. Before Candelaria came along, Bauer's most notable patients had been Randy Jones and Bob Shirley, who were then with the Padres. That Bauer's ideas were largely untested mattered little to Candelaria. "I got good feelings from Dr. Bauer," he says. "He was so confident. I was impressed by him."
Bauer immediately diagnosed not a tear in the biceps tendon, but a nerve problem in Candelaria's left shoulder as the cause of the numbness and pain in Candelaria's left elbow and forearm. Bauer advised six to eight months of rehabilitation and some slight modifications in the Candy Man's motion.
That summer, Candelaria worked diligently with the lab's day-to-day director, Fred Kendall, a tobacco-chewing former major league catcher, whose 795 games behind home plate during his 12-year career had taught him a thing or two about pitching. They spent hours in the lab, an alley-like 12' X 80' AstroTurf-carpeted room complete with a pitcher's mound and a $55,000 Instar videotape system. The Instar system utilizes two cameras, which can be focused on various parts of the body during delivery. Because of Instar's advanced capabilities, the two-camera system can produce detailed images of objects in motion on a TV screen. Split-screen and isolation shots also are available at up to 140 frames per second. "Realizing what you're doing wrong is half the battle," says Kendall. "With videotape we can stop the delivery every step of the way, back it up, isolate areas. It makes it easier for players to understand their problems."