Friday, March 14, 2014

Frank Jobe, RIP: Elbow and Shoulder Above the Rest

By Jeff Kallman

Tommy John dropped quietly off the Baseball Writers Association of America ballots after polling 31.7 percent of the vote needed to go into the Hall of Fame. That vote percentage was the highest of his life on the ballots. But if you combine his borderline Hall of Fame pitching career with what he was able to do after undergoing the surgery bearing his name since, John probably should be in the Hall of Fame — as much in the pioneer category as any other. And so should the physician who developed and performed that surgery.

Dr. Frank Jobe, who died March 6 at 88, got his chance with Tommy John after John himself pushed Dodger medical personnel to find a way to save him, after a ligament in his left elbow snapped while throwing a pitch. Taking a cue from prior hand surgeries and joint surgeries on polio patients, Jobe conceived the then-radical idea of transferring a tendon from John's non-throwing arm and using it to repair what had never been done: a pitcher's elbow, on which the torque of throwing a baseball is as violent as a field battle.

John was 31 when the elbow ligament snapped, with 124 wins on his resume, a career ERA of 3.00+, and had just led the National League in winning percentage in back-to-back seasons. He'd been a good pitcher before the surgery. He became an above average one after it.

He pitched 12 major league seasons before the surgery; he pitched 14 after taking 1975 off to recuperate and rehabilitate. His best won-lost record before the surgery was 16-7 in 1973; he was a three-time 20-game winner after. His best ERA before the surgery, not counting the Year of the Pitcher in 1968, was 1974's 2.59; his best after it in any uninterrupted season (he compiled a 2.63 during strike-disrupted 1981) was 2.78 in 1977, the year he finished second in the National League's Cy Young Award voting.

That would be the first of two Cy Young runner-up finishes for John after the surgery, not to mention that he made three all-star teams and pitched in three World Series. Any way you look at it, Tommy John was a good pitcher before and after the surgery bearing his name, and damn near pitched his way to the Hall of Fame. (He retired twelve wins short of the magic 300 mark.) "I know they had to give Tommy John a new arm," Pete Rose once cracked. "But did they have to give him Sandy Koufax's?"

John didn't pitch quite that far off the charts following the surgery but he won 164 games after it. And he almost didn't make it back. It took slow throwing activity (playing catch with his wife at first) and a second surgery (moving the ulnar nerve in the newly-repaired elbow to the back of it), not to mention John taking the rehab seriously, just to get John back to where Jobe predicted he'd have a one in one hundred chance of returning.

Jobe chose a medical career in the first place after serving as a medical supplier with the 101st Airborne in World War II and being impressed with the nervy courage of front-line Army doctors. He eventually earned his medical degrees and, after falling into a friendship during his residency, became a willing assistant and teammate to Dr. Robert Kerlan, the legendary Dodgers' team physician who specialized in orthopedics and, among other things, managed to keep Sandy Koufax pitching through barely-treatable elbow arthritis for his final two, off-the-planet seasons.

Kerlan and Jobe opened their own clinic in 1965. A year earlier, Jobe made a name for himself in baseball circles when veteran Johnny Podres developed chips in his pitching elbow. Jobe removed the chips and allowed Podres to pitch two more seasons before his retirement. A decade later, he went from name to immortal by way of Tommy John, though Jobe by most accounts was modest about his own fame, if not what he accomplished.

Tommy John himself to one side, who were the best pitchers otherwise following Tommy John surgery?

David Wells — Tommy John surgery, just the third in the history of the procedure, in 1985. (Brent Strom, now the Astros' pitching coach, was the second, but his was a mediocre career at best before and after.) He had it in the Toronto system at age 22. Won 239 games including a perfect game in 1998; a three-time all-star and a two-time World Series champion. Retired with 53.5 WAR.

John Smoltz — With one Cy Young Award on his belt and helping anchor the great Atlanta rotation of the 1990s, Smoltz had Tommy John surgery before the 2000 season. He returned in 2001, became a closer, and made an All-Star team in that role before returning to the rotation in 2004 and pitching until he was 42. Very likely a Hall of Famer in waiting, too, and it would make him the first Hall of Famer to have undergone the procedure with a successful aftermath.

Kerry Wood — Tommy John surgery in 1999, right after he was the National League's Rookie of the Year and had that impeccable 20-strikeout game in his fifth major league start. After recuperating, Wood would make All-Star teams as a starter and reliever; he didn't quite live up to what his rookie season promised but he did manage to have a respectable if injury-addled career from there. Wood retired, in fact, with a lifetime 10.3 strikeouts-per-nine-innings rate — the second best rate in baseball history among pitchers with a thousand innings or more worth of work.

Chris Carpenter — The recently-retired Carpenter had the surgery in 2007; he returned to lead the National League in ERA in 2009 and came in second in the Cy Young voting. (He won the award in 2005, two years before his surgery.) He was a three-time all-star and led the league in games started in 2010 and 2011 while also helping the Cardinals to a World Series ring in 2011 by beating the Rangers twice and compiling a 2.84 ERA for that Series. Retired with 35.5 WAR.

Anibal Sanchez — Like Wells, Sanchez had Tommy John surgery before he reached the majors. Threw a no-hitter as a rookie in 2006; climbed the ladder steadily until his breakout 2013 in which he led the American League in ERA (2.57) and the lowest home runs per nine innings rate. (0.4.) 21.2 lifetime WAR as of this writing.

Too soon to call — Jordan Zimmermann, Stephen Strasburg, Matt Harvey.

"It's one of the reasons I'm so adamant about the mechanics, we have a better understanding now of why this happens," Strom told Ultimate Astros writer Evan Drelich. "So we try and do things to help eliminate that. Now medical (advancements) allow Tommy John surgeries — I hate to use the word routine — but it's a lot easier to work on an elbow with this than it is a shoulder. Shoulders are more difficult."

Orel Hershiser can tell you about difficult shoulders and Frank Jobe's hand in those, too. Hershiser developed cartilage and ligament displacement in his shoulder in 1990, two years after he was a Cy Young Award winner and World Series conquerer. The available surgeries of the time otherwise would have left Hershiser unable to throw even if he could use his arm serviceably day by day.

Jobe developed a procedure to repair the shoulder without damaging shoulder muscles, splitting the muscle instead of detaching it and securing ligaments to the shoulder bone. The procedure was so radical that Hershiser himself didn't dare let his rehab go public until he could actually throw again. It paid off: Hershiser pitched another ten seasons. He won 105 games after the Jobe procedure; he'd won 99 before it. Twice his ERA went below 3.00 before the procedure; he'd never again compile an ERA below 3.50 after it. He'd had seven full seasons before the procedure; he'd have 10 after it.

Hershiser retired with 51.7 WAR before becoming a pitching coach, front-office advisor, and broadcaster, first with ESPN and this season for SportsNet LA, working most road games with veteran Charley Steiner. He fell well enough short of a Hall of Fame career. But at least Frank Jobe let him, as he let many other pitchers, continue to have one.

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