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Jake Peavy’s Surgeon Gets Research Award From MLB

Chicago, Ill. (July 12, 2010) – The Rush surgeon chosen by the nation’s top docs to operate on White Sox pitcher Jake Peavy has been awarded $50,000 from MLB to test his new operation for the most common pitching injury of all.

MLB has awarded Rush Shoulder surgeons, including the head of the Shoulder Service, Dr. Anthony Romeo, the research grant to determine if their pioneering concepts and subsequent surgical treatment can prolong pitchers’ careers without slowing down their 90 mile-per-hour fastballs. MLB Commissioner Bud Selig viewed the work for himself when he recently personally visited the lab to review the researcher’s progress.

Kerry Wood, Mark Prior Angel Guzman, Pedro Martinez and countless other major league pitchers have suffered “torn labrum” injuries. “This is the most common career-ending pitching injury involving the shoulder,” says Dr. Romeo. The orthopedic surgeon heads the Shoulder Service at Rush Medical College and is a co-Team Physician for the Chicago White Sox.

The labrum, the fibrous outer rim of the shoulder socket, stabilizes the head of the upper arm. However, the repeated strain of major league pitching leads to an imbalance in the throwing shoulder which can tear the labrum. The most common labral tear in a thrower, called a SLAP tear, causes severe pain, a loss of stamina, and a loss of velocity. Pitchers will often describe a “dead arm” after a hard throw to home plate.

If rest and a carefully supervised stretching and strengthening program fail to resolve their symptoms, the standard major league operation is an all-arthroscopic “SLAP repair.” The surgeon reattaches the labrum to the shoulder socket using special small anchors and sutures.

There’s only one problem: the operation often doesn’t work. “One-third of players still have shoulder pain after their operations,” says Dr. Romeo. “Others never get back their fastball or endurance.”

The dilemma has long frustrated both MLB owners and orthopedic surgeons. But Dr. Romeo may have discovered the secret behind the successful treatment of a SLAP tear.

The orthopedic surgeon believes “a superior labral or SLAP tear often involves the biceps tendon which attaches in the same area. If the capsule injury and the biceps attachment and the fibrous tissue area around it are not fixed or repaired along with the labral tear, the pitchers will still have pain.”

For that reason Dr. Romeo routinely combines a traditional labral repair with treatment of the shoulder capsule. Most important, if the biceps attachment is compromised, the surgeon repositions the biceps outside the crowded shoulder joint where the tendon can heal itself and the debilitating pain will resolve. The pioneering approach has worked for college pitchers but major league managers remain cautious. (A similar approach led to the successful improvements in Brett Farve’s throwing shoulder which allowed him to continue to be an All-Pro quarterback at the age of 40.)

“My approach has been held back because some are concerned that moving the biceps will affect the throwing shoulder and the ability to throw a major league fast ball,” says Dr. Romeo. “But they’ve lost so many pitchers they’ve given us a grant to find out more about whether also repairing the biceps will affect a pitcher’s performance. Using the new grant funds, researchers are studying precisely how Dr. Romeo’s approach affects the shoulder’s biomechanics. Surgeons will arthroscopically operate on 36 cadaver shoulder joints. After each procedure, they’ll measure the joint’s range of motion, rotation, and stability. The goal is to compare the biomechanical effects of doing a labral repair with and without performing a biceps repair as well.

“If we find out those biomechanics don’t change,” says Dr. Romeo, “reassured league owners could make operating on the biceps a standard addition to common labral surgery, especially if the original surgery results in a persistently painful shoulder. Understanding the role of the biceps tendon may end decades of standard treatment for throwers for MLB pitchers and that’s why the owners are so interested in this study.”

“What’s at stake,” he continues, “are the current and future careers of many major league pitchers, especially the mature pitchers in their 30’s and 40’s.”

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