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Teen baseball player finds alternative to Tommy John surgery

May 29, 2017

GRAFTON, Mass. (AP) — The pitching gods have naturally blessed Sammy Rosenfield. He’s just 14 years old but already stands 6 feet 5 inches and has a wingspan that would rival that of Red Sox ace Chris Sale. He was an all-star for his local AAU baseball team before he tore a ligament in his elbow playing basketball.

“I just love pitching,” says Rosenfield, a high honors freshman at Grafton High School. “I want to be a major league pitcher.”

Doctors told him he needed Tommy John surgery, which typically has a recovery time of 12-18 months. His parents researched a ligament repair instead of a reconstruction, which could cut his recovery time in half.

They wound up at the famous Andrews Sports Medicine & Orthopaedic Center in Birmingham, where Roger Clemens, Michael Jordan, Drew Brees, and John Cena, among other top athletes, have been treated. Tommy John surgeries were performed here on pitchers John Smoltz, David Wells, and Kerry Wood.

But none of the above superstars has had the operation that Rosenfield is considering. Known by its clunky official name — Ulnar Collateral Ligament Repair with Internal Brace — it could be called “Tommy John lite.”

“Is this a breakthrough? Yes,” says Glenn Fleisig, the research director of the American Sports Medicine Institute.

“It’s a big deal because up until this, having Tommy John surgery was the only choice. You either have the big surgery or you live with the situation. This introduces a middle compromise approach.”

For Rosenfield, who has pitched only six innings the past two seasons because of arm injuries, playing next season could become a reality.

“When I’m on the mound I feel like that’s where I am supposed to be,” he says.

‘All of a sudden my arm was just dead’

June 13, 2015 was Rosenfield’s bar mitzvah day. It was also the day he pitched the New England Storm to an AAU New England championship.

Unbeknownst to his parents, he put his uniform on under his navy suit, read from the Torah, and then abruptly left the party.

His uncle drove him to the ballpark and he changed in the car.

“My coach told me he thought I’d be really nervous, so he said depending how I looked, he’d decide whether to pitch me,” Rosenfield says.

Former Storm manager Keith Lyon remembers the day well. “Time was tight, but I saw how he pulled it together. He was normal Sammy, ready to go, all business, and we won.”

Rosenfield pitched a complete game, got the game ball, and then schlepped his team back to the reception.

It wasn’t long before injuries started to set in. Fast-forward to March 2016. After hearing a pop in his shoulder while throwing a bullpen session, Rosenfield was diagnosed with a fractured growth plate.

Sammy Rosenfield couldn’t throw overhand at a practice in late March, flipping the ball back to his coach underhand.

Sammy Rosenfield couldn’t throw overhand at a practice in late March, flipping the ball back to his coach underhand.

“All of a sudden my arm was just dead,” he says.

The orthopedic surgeon prescribed rest and rehab for 12 weeks. Rosenfield returned in early June to play first base.

Then in December, Rosenfield was playing junior varsity basketball when he reached in for a loose ball.

“I got arm-barred,” he says.

One doctor told him he could be back in six weeks.

But an orthopedic surgeon for his new baseball team, the New England Ruffnecks, a college development program, discovered a partially torn ulnar collateral ligament during a physical and asked for a second opinion.

The doctor’s opening line was chilling. “The first thing he said to Sammy is, ‘Are you a good hitter?’ ” recalled Sammy’s father, Todd Rosenfield.

Sammy was told he needed Tommy John surgery, but he was too young to be a candidate because his growth plates were still developing.

Sammy cried all the way home.

They tried a platelet-rich plasma (PRP) injection. It didn’t help. So they sent his MRI to orthopedic surgeon Dr. Jeffrey Dugas in Alabama. Dugas’s mentor is Dr. James Andrews, a household name among professional athletes.

Dugas performed his first UCL repair in August 2013 on a local high school pitcher who went on to pitch successfully at the college level. Dugas has performed an estimated 150 of the 400 done nationwide.

This relatively new surgery has a 100 percent success rate to date. Tommy John surgery has a success rate of nearly 85 percent, according to the American Journal of Sports Medicine.

The bigger issue is the alarming number of elbow injuries in baseball. One in four major league pitchers has already had Tommy John surgery, according to the American Journal of Sports Medicine. The number of Tommy John surgeries increased 343 percent between 2003 and 2014, with the highest rise in the 15- to 19-year age group, according to a study published in the Journal of Shoulder and Elbow Surgery.

Another problem is that more than half of high school athletes (51 percent) incorrectly “believe that Tommy John surgery should be performed on players without elbow injury to enhance performance,” according to the Phys Sportsmed journal.

Rosenfield walks toward an examination room at the Andrews Sports Medicine and Orthopaedic Center in Birmingham, Ala.

Rosenfield walks toward an examination room at the Andrews Sports Medicine and Orthopaedic Center in Birmingham, Ala.

Kids today throw harder and are recruited at younger ages for travel teams and showcase events, where scouts swarm. Fleisig, the researcher, helped Pitch Smart, a collaborative educational effort by Major League Baseball and USA Baseball, change pitch counts from innings to pitches. He says Rosenfield’s situation is slightly different.

“Sammy did not get injured by overuse, but he is going through the same process,” he said.

His coach always followed strict pitch counts and his parents refused to let Sammy pitch in the offseason. His parents aren’t pushing their son to be a major leaguer.

“I just want you to have fun and get into an Amherst or Williams,” says Todd Rosenfield to his son in the waiting room.

Added his mother, Amy, “I think where we’ve pushed him is that we want him to be the best that he can be.”

How good is this kid?

“He’s so young and raw, but he definitely has a lot of upside with how big he is for his age and how loose his actions were,” says Matt Blake, who tutored Sammy before being hired by the Cleveland Indians as a minor league pitching instructor.

Rosenfield’s trip to Alabama in early April begins with an ominous start. Baseball-sized hail and tornado warnings have been posted. When Dugas enters the exam room he informs Sammy that the odds are 90-100 percent that he can do the UCL repair instead of the reconstruction. He explains that the operation is not for everyone — the ligament can’t be frayed from overuse —but the final decision will have to be made in the operating room. Sammy doesn’t want the Tommy John surgery; he doesn’t want a tendon graft taken from his leg or from a cadaver.

“Do I have the confidence to do this in you?” Dugas asks himself. “Absolutely. Do I know what it’s going to look like in 10 years? I don’t, nobody does. Based on what we’ve seen this looks good.”

Two major league pitchers have already had the primary repair surgery, performed by Dr. George Paletta, the St. Louis Cardinals’ head orthopedic physician — former Cardinals reliever Seth Maness, now with the Royals, and Mitch Harris, who is currently with the Cardinals’ Triple A team in Memphis.

Sitting in an exam room surrounded by signed photos and uniforms of sports stars, Dugas senses Rosenfield’s drive to return ASAP.

“It takes 6-8 weeks to heal and you are not the biological stud that heals faster than every other human being who has ever been born,” Dugas says. “You are not at liberty to make up the Rosenfield Protocol. Do what we tell you. Deal?”

“Deal,” says Rosenfield.

Sammy will have a scar on his elbow but no pain after a day or two, says Dugas.

“You can always get a tattoo over it,” the doctor adds, with a smile. Basic throwing exercises can begin nine weeks later, with a return possible in 6-8 months.

But the night before the operation, Rosenfield tosses and turns.

“He kind of shut down. He really had a tough time last night,” says his father.

The operation on April 6 lasts just 29 minutes. Within 10 minutes, Dugas has inspected the ligament and found it to be in good shape. A minute fleck of bone had broken off the elbow and with it a small piece of the ligament. Dugas drills two small holes, taps a surgical hammer a dozen times so that two plastic anchors are set in the bone, and then reattaches the ligament with collagen-dipped tape, a suture material.

“Now I’m going to sew it down so it doesn’t windshield wipe a little bit,” Dugas says, checking Rosenfield’s range of motion.

“Call the father,” says Dugas, “so he doesn’t have a heart attack waiting.”

There is little blood and zero drama. The whole process seems as routine as an oil change.

“Piece of cake,” says Dugas, giving fist bumps as he exits the room.

Rosenfield wakes up groggy but happy in the recovery room, sucking on ice chips, then dozing off before they melt. Dugas has already visited him with the good news.

“That’s a great kind of injury because we don’t have to guess the length of things, you just stick it back from where it came. And that’s what makes this operation so good. You’re just putting it back where God made it,” says Dugas.

Rosenfield is relieved.

He remembers nothing of the operation and wants to see the photos. Like every other 14-year-old, he wants his phone back immediately.

He hugs his parents and tells the nurse he’s ready to go home.

“It feels like when I go to the school dance and I’m out with friends afterwards, I’m just dead tired. But at the same time I wanted to get up and see you guys,” he says.

Earlier this spring, he attended his varsity team practices. He was limited to flipping the ball underhand back to the coach hitting fungoes. He said he wasn’t in pain but he clearly looked wounded.

“I want to tell my story because I hope this can help some other kids,” he says.





Information from: The Boston Globe, http://www.bostonglobe.com

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