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, SCRAPED OR SEARED BACK INTO SHAPE

September 26, 1999

1. THE PHENOM

Kerry Wood's cherished right arm looks as if it has been in a
farm-machine accident. The soft underside of the forearm has
three scars laid down like railroad ties, and a long jagged
smile has been carved into the elbow. "I haven't felt any pain,"
insists the Chicago Cubs' 1998 Rookie of the Year pitcher as he
absentmindedly runs the fingertips of his left hand up and down
his forearm.

After striking out 20 Houston Astros early last season, tying
the major league nine-inning record, the 6'5" Wood seemed ready
to emulate fellow Texans Roger Clemens and Nolan Ryan and become
the most intimidating pitcher of his generation. If he is to do
so, he must now navigate a tortuous surgical detour.

On the morning of March 14, Wood was alarmed to discover that he
could not straighten his right elbow. Sometime the previous
afternoon, while pitching briefly in his first spring training
outing, the ulnar collateral ligament in his right elbow--which
holds the upper and lower arm bones together--snapped like a
rope frayed by too many tug-of-wars. Twenty-five days later,
after the swelling subsided, Wood was put to sleep by an
anesthesiologist in a hospital in Birmingham, and Dr. James R.
Andrews made three short incisions across Wood's right forearm
in order to detach and remove a band of connective tissue called
the palmaris longus tendon. ("I don't even feel it missing,"
says Wood, spitting tobacco juice into the paper cup in his
right hand.) The tendon was about four times longer than the
ulnar collateral ligament it was replacing, so Andrews was able
to loop it back and forth through holes he'd drilled in Wood's
elbow, in effect tying down a new connection thicker and
stronger than the original. Thus did Wood join the ranks of
pitchers who have undergone what is known as Tommy John surgery,
named for the Los Angeles Dodgers lefthander who in 1974 blazed
the trail for scores of pitchers who have recovered from what
had once been career-snuffing injuries to the elbow.

Wood is the most recent high-profile victim in an ongoing
epidemic of injuries to pitchers' arms. As of late June an
astounding 120 hurlers--close to one third of all pitchers with
major league contracts--had undergone some kind of surgery on
their throwing arms since turning pro. Whether more pitchers are
being hurt than ever before is debatable, but there is no doubt
that more are having surgery and recovering from serious
injuries. Until Dr. Frank Jobe came along and fixed John's
elbow, a pitcher with a bum arm was dismissed as unsentimentally
as a broken-down racehorse. And anyway, the minor leagues were
teeming with fresh arms. The addition of six expansion teams,
however, has heavily diluted the pool of pitching talent, so
every decent arm is precious and worth saving.

Why did Wood break down just as his career was starting? The
answer depends upon whom you're asking. When Andrews, like a
coroner performing an autopsy, sliced open Wood's elbow and
looked inside, he could see that the ligament, just a few
centimeters long, had suffered little tears and abrasions over
the years and had tried in vain to heal itself before giving
out. Critics point out that the Cubs let Wood throw more than
110 pitches 13 times last season, including one span in which he
threw at least 121 pitches four times in five starts. The
implication is that the Cubs gave Wood more work than his young
arm could handle.

The Cubs deny they overworked their young star. If anything,
they say, Wood--who was once sidelined in high school with elbow
problems--was damaged goods when they signed him. "I hurt my
elbow when I was in high school, after my freshman year, and I
didn't pitch for three months," Wood says. "After that I went
from the low 80s up to about 90 miles per hour."

"I know I'll be criticized for this, but I feel strongly that
we're [drafting] a lot of pitchers who have been absolutely
abused," Cubs pitching coach Marty DeMerritt says. "Look at the
College World Series: A kid throws 150 pitches or more [in a
game], because everything is about winning and not about what's
good for the player." Two days after picking Wood fourth in the
1995 draft, the Cubs watched in horror as the 17-year-old was
asked to pitch in both ends of a doubleheader--throwing an
alarming 175 pitches--for Grand Prairie High in the
quarterfinals of the Texas state tournament.

All the experts agree on one point: Pitchers no longer grow up
throwing the ball every day and building up their arms
naturally. Cardinals pitching coach Dave Duncan wonders if
pitchers are breaking down simply because baseball no longer is
truly the national pastime. "A lot of these kids come into pro
baseball never having played every day," Duncan says. You can
see it for yourself in most neighborhoods: the absence of the
old-fashioned sandlot game. When a power pitcher makes it to the
major leagues, he is expected to live up to the standards of
resiliency set almost a century ago by Cy Young, Christy
Mathewson and Walter Johnson, whose arms had developed a
marathoner's endurance because of the players' undistracted love
of the game. Today's young pitchers usually have not made the
same daily commitment. Naturally they are more fragile.

An even murkier element of Wood's pathology is his pitching
motion. "When I saw his delivery, I said, 'This guy is going to
break down,'" Chicago White Sox pitching coach Nardi Contreras
says. "If he had been pitching like that his whole life, it was
just a matter of time." The whirligig of a pitcher's arms and
legs is known as his mechanics, which suggests that Wood is a
machine that can be broken down and analyzed like a stock car
engine. In truth no one can agree on the proper mechanics for a
pitcher.

Wood and his 1998 pitching coach, Phil Regan (now with the
Cleveland Indians), acknowledge that last season he was not
square to the batter when he released the ball; he threw across
his body, which is thought by some to increase the strain on an
arm. In fact, Wood says he was ministering to this mechanical
"sin" in spring training when his elbow snapped.

Renowned former pitching coach Tom House believes Wood was
trying to fix something that didn't need to be fixed. "There's
nothing wrong necessarily with throwing across your body," says
House, who threw in the majors for eight years, earned an M.A.
in exercise physiology and was a minor league instructor for the
Houston Astros and the San Diego Padres and pitching coach for
the Texas Rangers. "Nolan Ryan threw across his body," House
says. "Was he wrong?"

Using three-dimensional computer models of Wood's delivery
generated by House's company, Bio-Kinetics, Inc., which
specializes in analyzing the movements of athletes, House argues
that Wood was much better mechanically than he's been cracked up
to be. It's a fallacy to think that good pitching deliveries are
"all pretty and smooth," says House. "For example, Billy Swift
and Kirk McCaskill [who were often injured and are no longer
pitching] looked unbelievably efficient, but when you got them
on the computer, they were really not efficient."

House says that Wood, on the other hand, was a model of
efficiency. He also dismisses contentions that the Cubs overused
Wood. House thinks it's more likely that the harm to Wood's arm
was done in adolescence, when he was subjecting it to stresses
that it was physically unable to endure.

That's just one man's opinion, albeit one backed up by
scientific research. There are 30 pitching coaches in the major
leagues, which is to say, there are 30 opinions on how best to
handle young pitchers. "Too many restrictions are being put on
pitchers early in their careers," says Atlanta Braves pitching
coach Leo Mazzone. "They're not being allowed to throw much, and
when they do throw, they throw as hard as they can--as opposed
to throwing a lot but not throwing as hard as they can. It's
like training for a marathon: You should run a little bit all
the time." The Arizona Diamondbacks, in contrast, are sticklers
about pitch counts. Nevertheless, says Arizona pitching coach
Mark Connor, whose minor league career ended in 1972 with a tear
of the rotator cuff, a career killer at the time, "nobody knows
exactly what causes a pitcher to get hurt. I've seen guys with
great mechanics get hurt; I've seen guys with poor mechanics
never get hurt."

In mid-July, Wood began throwing again, although he was
restricted to tosses of less than 45 feet. He plays catch every
other day as he travels with the Cubs and has gradually worked
up to tosses of 90 feet. While his teammates are on the field
preparing for a game, he is usually in the clubhouse, exercising
and lifting weights with the goal of coming back early next
season. He is slimmer and stronger than he was during his
record-setting rookie year. "I'm hoping to be throwing off the
mound in mid- to late- November," Wood says. "The biggest test
will be when I start to throw breaking stuff."

Wood is used to dictating the terms in a baseball game, but he
won't be able to do that in this situation. He might turn out to
be as good as he was last year, or he might be even better. Or,
through no fault of his or his doctor's, Wood may never blow
another fastball past a major league hitter. There is no telling
how his recovery will play out.

Every now and then Wood watches the videotape of his fifth big
league start, in May of last year, when he struck out those 20
Astros, walked none and gave up one hit on a questionable
scorer's decision. The Astros hit just two balls out of the
infield. Wood twice broke the 100 mph barrier. He fanned the
first five batters he faced, and eight of the last nine. (For
the record, he threw 122 pitches.) He watches with a remote
control in hand, replaying certain pitches, savoring the sight
of his curve moving like a steel ball rolling in a roulette
wheel. "It doesn't seem like it's me out there," Wood says.
"That's why I don't watch it too often. I start getting all
excited and wanting to get back right away. But I'm lucky. I'll
still be just 22 when I come back. And I will be back the same
as I was."

Wood may have no idea of the troubles lurking ahead. "He's naive
enough, he'll just get through this," Andrews says, laughing.

2.THE PATIENT

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 161 2/3 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[degrees]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.

After giving up a leadoff single, Benes surprised himself by
striking out the next hitter, getting a ground out and then
closing out the game with another strikeout. "My mechanics are a
lot better," he said later. "With my shoulder fixed, it's a lot
easier to do everything right and get my arm in a better
position to throw the ball." But he was not getting carried away
by the results of a single inning. "I just want to be able to
pitch and contribute," he said. "If that's as a long man or a
short reliever, it doesn't matter."

Benes has had to do a lot of work on his head as well as his
shoulder, convincing himself that he can still pitch at this
level. "The one thing I keep telling myself is, I can find a way
to win," he says. "I don't feel I need the same stuff I had
before the surgery to be successful. Whatever I come back with
is going to be great."

3. THE VETERAN

Steve Karsay was a 5'6" sophomore infielder at Christ the King
High in Middle Village, N.Y., not far from Shea Stadium, when
his baseball career took a radical turn. "We were getting blown
out one day, and the coach asked me if I wanted to pitch,"
recalls Karsay, sitting on a leather couch in the Cleveland
Indians' clubhouse. A major league scout--from which club,
Karsay cannot remember--saw him pitch that day, and after the
game he suggested that Karsay be allowed to pitch regularly.
That suggestion was followed, and Karsay was a pitcher from that
day on.

The scout had noted that Karsay was blessed with natural rhythm
and balance, which he maintained as he grew eight inches over
the next two years. In his senior season the Toronto Blue Jays
picked him 22nd in the 1990 major league draft.

Karsay, Benes and Wood have several things in common: Each was a
first-round draft choice; each is a tall, naturally gifted power
pitcher with a fastball in the 90s; and each had arm problems
early in his career. ("I had forgotten this, but my mom told me
that in high school all I did was complain about my shoulder,"
Benes says.) In 1991, Karsay's first full year in the
minors--just three years after he made his pitching debut in
high school--he was operated on by Andrews, who cleaned out
debris in his elbow.

The Oakland A's acquired Karsay in July 1993 in exchange for
Rickey Henderson and quickly inserted the 21-year-old rookie
into their starting rotation. The following April, Karsay found
himself locked in a scoreless duel against Clemens in Fenway
Park. "Clemens was my idol growing up, the way he gives
everything he has, always challenging hitters," Karsay says. "I
felt I had some of the same qualities. I wanted to pattern
myself after him." He would take after Clemens, all right--that
very night Karsay's arm began to loosen and fray, though he
didn't realize it at the time. He carried a shutout into the
seventh inning, when Mo Vaughn hit a double off the Green
Monster and John Valentin hit a home run over it to give Karsay
a 2-0 loss. Two days later his elbow was swollen, as if a pipe
had burst inside. In May '94 he had another arthroscopy of his
elbow, this time to repair cartilage. In June 1995 he went to
Andrews for the full-blown Tommy John surgery.

Karsay spent the '96 season pitching a miserable 34 innings in
14 starts at Class A Modesto (Calif.), and he had yet another
operation, this time to remove bone chips from the elbow. His
wife, Kori, a former All-America tennis player, visited him in
Modesto in June 1996. "I thought he was going to lose it," Kori
says. "He was saying, 'I'm feeling awful, I don't know if I'm
ever going to make it back, maybe I should just give it up.'"

In 1997 Karsay went 3-12 for the A's. They traded him to the
Indians in the off-season. The Indians demoted him to Triple A
Buffalo, where he spent most of last season. He was 26 years old,
with a career big league record of 7-16-4: seven wins, 16 losses,
four elbow surgeries. Nevertheless, in Buffalo, Karsay finally
regained strength in his elbow. With the help of pitching coach
Bud Black, he began to reclaim the natural motion that had so
impressed that scout at Christ the King a decade earlier. "After
the surgeries my mechanics were not good," Karsay says. "I was
trying to protect my arm any way I could." His record as a
starter at Buffalo was 5-4 when he was called up by the Indians
at the end of July 1998 and placed in the bullpen for the first
time in his career.

If he wanted to stay in the major leagues--and he wanted that more
than anything--Karsay couldn't afford to worry about his arm.
"Working out of the bullpen was the best thing for me," Karsay
says. "Every time I go out there, I pitch as if it is my last
game."

As of Sunday his 1999 record was 10-1, which is more victories
than he had earned over his entire career. He has had a couple of
short stints on the DL this summer--one for a pulled muscle in his
rib cage, the other for a strained tendon in his forearm--but
Karsay believes he will be ready to pitch out of the bullpen in
the postseason. At week's end, with an ERA of 2.92 and 64
strikeouts in 74 innings, he was one of the best pitchers on a
team tied for the best record in the American League, with a
league-high streak of 10 straight wins. His mechanics seem better
now than ever: the flowing rhythm, the front leg extending, the
arm following the leg over the top like two spokes in a
stationary wheel. Maybe it's physical maturity or the years of
rehabilitative exercise, but the wheel of his delivery is
spinning faster.

Most amazing of all, Karsay has added at least 5 mph to his
fastball. His doctor takes no credit for that. "It's a miracle,"
Andrews says.

In a Sunday game in Cleveland against the Cubs this June, Karsay
was pitching the eighth inning, with a man on third, one out and
the tying run at the plate in the person of Sammy Sosa. Karsay
struck Sosa out on four pitches. The second pitch registered 100
mph on the Jacobs Field scoreboard. Karsay was then pulled for a
lefthanded reliever, and as he walked off the mound, everyone in
the stadium was standing and cheering. His fingers trembled as
he tipped his cap, and he felt a chill, as if the nerve endings
running up and down his spine were overloaded. He had put in
eight years of work since the first breakdown of his elbow. His
wife, cheering in the stands, understood as much, and so did
Karsay's mother, in tears next to Kori. So too, watching from
the shadows of the visitors' dugout, did Kerry Wood.

B/W PHOTO: MRI COURTESY OF DR. JAMES R. ANDREWS Roll another joint Karsay's right elbow, seen here in an MRI, has been surgically repaired four times since 1991. COLOR PHOTO: PAUL JASIENSKI Throwing scarred Elbow surgery left Wood a marked man. COLOR PHOTO: PHOTOGRAPHS BY NICK CARDILLICCHIO COLOR PHOTO: PHOTOGRAPHS BY NICK CARDILLICCHIO Rearmed It took Karsay three years of rehab to regain his fastball. COLOR PHOTO: PHOTOGRAPHS BY NICK CARDILLICCHIO Bring the heat A surgeon repeatedly seared Benes's injured shoulder with a hot prod to promote healing. COLOR PHOTO: SCOTT ROVAK/AP COLOR PHOTO: DAVID LIAM KYLE

WOOD'S LIGAMENT IN HIS RIGHT ELBOW SNAPPED LIKE A ROPE FRAYED BY
TOO MANY TUG-OF-WARS

"NOBODY KNOWS EXACTLY WHAT CAUSES A PITCHER TO GET HURT," SAYS
ARIZONA PITCHING COACH CONNOR

"I DON'T NEED THE SAME STUFF I HAD," BENES SAYS. "WHATEVER I
COME BACK WITH IS GOING TO BE GREAT"

KARSAY'S FASTBALL IS 5 MPH FASTER THAN BEFORE HIS INJURY. HIS
DOCTOR SAYS IT'S A MIRACLE

HOLE YARDS PAR R1 R2 R3 R4
OUT
HOLE YARDS PAR R1 R2 R3 R4
IN
Eagle (-2)
Birdie (-1)
Bogey (+1)
Double Bogey (+2)