Our resident medhead looks at the top 10 baseball orthopedists.
It's hard to say "ignore the rankings" when I'm about to give you a Top-10 list, but I'm telling you—ignore the rankings. From 1-10, these are some of the top orthopedic surgeons in the world. The rankings were based on a short survey I gave to several players and front-office types, but barely have any meaning. If anything, think of this as the program to the next time an athlete goes on a tour to find a doctor he likes. They say you can't tell the players without a program, but for years we've been asked to just accept that our favorite players and teams are relying on doctors. While I could write a book on this topic, a few hundred words on each is more than most know about any of them. So, tip your cap to the medical heroes, the super surgeons that have to put our athletic Humpty Dumpties together again:
Dr. James Andrews Practice: Andrews Sports Medicine (Birmingham, Alabama); The Andrews Institute (Pensacola, Florida) Team: Rays School: LSU School of Medicine Speciality: Elbow, shoulder, knee Signature Surgeries: Roger Clemens (shoulder, 1985); John Smoltz (elbow, 2000) Why He's No. 1: In baseball, Andrews is perhaps known best for things he really didn't found. Many think he invented Tommy John surgery. (That was Dr. Frank Jobe, of course.) Many think he was the first consulting surgeon. Instead, Andrews should be known for being the athlete's choice. There's a confidence that athletes seem to get when dealing with Andrews. Perhaps it's that he's known as the best, but if you get the chance to speak with him, his deep Louisiana drawl goes from being "Wow, I didn't expect that" to comforting when paired with his matchless confidence. Birmingham became synonymous with injuries, but while going to Birmingham was bad, there was always a tag on it, that a player fully expected to come back healed. An article a few years ago tabbed Andrews as "the most valuable man in sports." No one's going to argue with Andrews being at the top of the list and moreover, his American Sports Medicine Institute Fellows program helped put a couple more on the list below. His influence is going to last far beyond the careers of the men he did surgery on.
The procedure that changed baseball was performed for the first time 30 years ago this week. Here's an explanation of just what it is.
Five years ago, Tom Gorman wrote the following piece on the wonder that is Tommy John surgery. Frank Jobe's fix is one of few things that truly changed the game of baseball, and should be remembered alongside the advent of night games, the live ball, and maybe even Jackie Robinson. For the anniversary, Baseball Prospectus was lucky enough to gain an historic interview-the first recorded interview with both Dr. Jobe and Tommy John. While Jobe and John have appeared together, there are no publicly available recordings.
Gorman's article from five years ago holds up remarkably well, largely because Jobe's work holds up just as well. The operation performed today is not significantly different than what Jobe did, hoping it would work. In the interview, you'll hear how the operation was inspired by a dreaded disease, what Tommy John thought when he woke up, how Bill Buhler's name should be remembered by many, and who the second pitcher to have Tommy John surgery is.
After starting his baseball career as a beat writer, Fred Claire moved on to public relations with the Los Angeles Dodgers. He'd go on to spend 30 years in the Dodger organization, capped by his stint from 1987 to 1998 as general manager. Following 11 years as GM, including a 1988 World Series victory, newly-minted Fox ownership fired Claire soon after the landmark Mike Piazza trade of '98. Claire now works as a consultant for Performance Health Technologies of Boulder, Col., marketing a shoulder rehab device called SportsRac to pro athletes and weekend warriors. BP recently spoke to Claire about his career in Dodger Blue, the death of family ownership in the game, the Pedro Martinez trade, and the Dodger Way.
You can catch Fred Claire, along with BP's Joe Sheehan and Jonah Keri, and other guests, at the Barnes & Noble bookstore, 245 N. Glendale Ave. in Glendale, Calif., Thursday, April 1 at 7:30 p.m. We'll be talking baseball, Dodgers, Baseball Prospectus 2004 and Claire's new book, Fred Claire: My 30 Years in Dodger Blue, over pizza.
Between a careful analysis of what data is available, the creative use of proxy variables in estimating injuries throughout time, and the application of some principles of sports medicine, we are at least in a position to make some educated guesses about the nature of pitcher injuries. Our particular focus in this article will be the progression of pitcher injury rates by age.
Pitching is an unnatural act that invites injury. The stress it places on the bones of the shoulder, arm, and back is immense. The strain it places on the 36 muscles that attach to the humerus, clavicle, and scapula is remarkable. It is widely accepted by sports medicine practitioners that every pitch causes at least some amount of damage to the system.
It seems fair to say that the study of pitcher injuries is an important part of sabermetric analysis. The statistical evidence available to test theories about pitcher injuries, however, is often missing. While there are databases that contain every recorded statistic from the days of Al Spalding and beyond, and others that document every play of every game in the past 30 years, a comprehensive database of player injury history simply doesn't exist.
However, between a careful analysis of what data is available, the creative use of proxy variables in estimating injuries throughout time, and the application of some principles of sports medicine, we are at least in a position to make some educated guesses about the nature of pitcher injuries. Our particular focus in this article will be the progression of pitcher injury rates by age.
Methodology and Statistical Results
To create an actuarial backbone for our study, we applied the same approach that is used to calculate attrition rate in the PECOTA forecasts. Attrition rate describes the percentage of pitchers who experience a decline in their innings pitched of at least 50 percent. Such a dramatic decline will not always indicate that a serious injury has occurred--it can also reflect demotion, retirement, and so on. However, by placing a few restrictions on our dataset, we can serve to limit these cases, and use attrition rate as a reasonable proxy for catastrophic injury.
In order to be included in the study, a pitcher needed to have pitched at least 150 innings in the previous season, with a park-adjusted ERA no more than 10 percent worse than his league average. That is, our study was focused on pitchers who had already pitched at least one effective season in the major leagues, and who were likely to have every opportunity to do so again in the absence of significant injury. All pitchers from 1946-2002 were considered, with innings pitched totals prorated over a 162-game schedule. The chart below tracks attrition rate at different ages throughout a pitcher's career.