While Tommy John surgery for pitchers remains on the rise in Major League Baseball, operations for shoulder-related issues have decreased as failed procedures prompted new protocols for treatment.
Shoulder procedures have derailed numerous careers of All-Star pitchers from Steve Busby to Robb Nen to Johan Santana, the only Met to throw a no-hitter.
Busby had 56 victories _ including two no-hitters _ in his first three full seasons (1973-75) with the Royals. By 25, he was believed to be the first pitcher to undergo what would become known as "dreaded" rotator cuff surgery.
"Everybody had a pretty good idea that those types of surgeries was fraught with a lot of issues and not at all as predictable as we'd like it to be," Mets team physician David Altchek said recently. "It was not a good time. We've gotten past it by preventing it, which is the most powerful thing."
Busby cannot forget what famed orthopedic surgeon Frank Jobe _ who in 1974 performed the first Tommy John surgery by reconstructing the ulnar collateral ligament in John's left elbow _ told him after his own surgery.
"He said 'I think you want to find a different occupation,' " Busby, 68, said from Arlington, Texas. Busby's post-surgical record was 8-9 over his next four seasons, and he was done after the 1980 season. He was 30.
Major League Baseball does not release injury or surgical statistics. According to Massachusetts-based Baseball Injury Consultants, a privately owned firm that has tracked injuries on major-leaguers dating to the 1940s, 92 shoulder surgeries have been performed in this decade, compared with 184 Tommy John surgeries. Shoulder surgeries peaked at 166 from 2000-09. Tommy John surgeries have increased every year since the 1970s. BIC has recorded 412 surgeries, with 340 since 2000. Yankees starter Jordan Montgomery had the procedure on June 7.
Tommy John surgeries have been more successful than shoulder procedures. Kerry Wood, who at 20 struck out 20 batters in a game for the Cubs in 1998, came back from Tommy John surgery, but his career declined largely because of shoulder issues.
