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Chicago doctor may have answer to pitchers' shoulder woes

Curt Schilling feels fine after undergoing procedure

Phil Rogers | On Baseball

March 8, 2009

One group of Chicagoans is hoping Curt Schilling can wring one more dramatic October out of his right arm, and it doesn't require ending 100 years of losing for the comeback to be a major success.

Schilling, 42 and the owner of three World Series rings, has said he would get a bang out of helping the Cubs change their history. As huge of an event as that would be, a rebuilt Schilling could mean just more than a moment in history.

Schilling, has been sidelined since the 2007 Series with a shoulder injury — the leading kiss of death for modern pitching careers.

There was a time when arm problems were arm problems. But since the advent and development of the so-called Tommy John surgery, pitchers have been able to recover routinely from serious elbow injuries. But the shoulder has remained far more problematic.

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According to Dr. Anthony Romeo, that's because the two joints are so different.

"The elbow is one of the most congruent joints we have," Romeo said. "The bones line up [with muscles and tendons]. The shoulder is the least congruent."

Tears to the rotator cuff and the labrum in the shoulder can be repaired but rarely without lowering a pitcher's velocity or the quality of his pitches. Recurring pain is a frequent and career-threatening aftereffect of surgery.

But Romeo and his associates at the Rush Hospital-based Midwest Orthopedics group believe they have found a way to make shoulder surgeries almost as predictably successful as elbow surgeries. Schilling underwent Romeo's new wrinkle on a procedure known as a biceps tenodesis in June. He now feels so good hopes to pitch in the second half of the season and, perhaps, the postseason, where he has compiled an 11-2 career record.

"If he's able to return to baseball and throw at the same level as before, his performance will show that [shoulder] injuries can be treated effectively with our procedure," Romeo said. "It would show that it's a way for more athletes to get back to where they were before."

Romeo has been performing his updated version of biceps tenodesis since 2002, including surgeries on high school and college pitchers. He developed it after seeing a high percentage of patients fail to recover from shoulder tears. He traced the problem to pain caused by damage to the biceps tendon and sought to find a way to treat the problem.

In the procedure, surgeons remove the injured part of the biceps tendon, move the tendon outside the crowded shoulder joint and then attach it to the upper arm bone. Romeo drills an 8mm hole in the upper arm and inserts the tendon. He secures the tendon with a screw, tightening it to a level that allows more patients to become pain-free.

"I've had great results with high school and college baseball pitchers," Romeo said. "Also with volleyball players and swimmers. I've done about 24 patients under 30."

Schilling wants a fourth World Series ring to go with ones he won in Arizona and Boston. His surgery was performed by Craig Morgan, the orthopedist who reached iconlike status in New England for his previous work with Schilling, assisted by one of Romeo's associates,

Schilling recently said he would be interested in joining the Cubs or Tampa Bay if he opts for a comeback. He thinks it would be especially satisfying to help those teams win championships.

Romeo would find the first of those scenarios a little awkward. He is on the White Sox's medical staff.

"Obviously, I want this operation to succeed," Romeo said. "I think it could save careers by restoring shoulders much like the Tommy John surgery restores elbows. But if Curt Schilling does for the Cubs what he has done for his other teams, I'll never live it down."

Hold your breath: This is going to be a difficult season for Yankee fans, even if it is ultimately rewarding.

Alex Rodriguez's hip will remain a major concern all season, if it doesn't sideline him by requiring surgery. Jorge Posada's shoulder is just as much of a concern, and he has been limited to designated hitter duties so far this spring. A.J. Burnett never has been healthy two years in a row in his career and Johnny Damon plays on guts and cortisone.

Second-year manager Joe Girardi needs no further concerns but just might have one. Joba Chamberlain came unraveled on Thursday, developing the kind of wildness that can build on itself.

But the biggest worry is Rodriguez. If he needs surgery, the Yankees may have to pursue a trade for a third baseman (Milwaukee's Bill Hall heads the list) as their top in-house options are Cody Ransom and Angel Berroa. Their best third-base prospect is Bradley Suttle, who never has played above Class A.