MLB

Meet the 10 Super Surgeons Tasked with Putting MLB's Broken Arms Back Together

Will CarrollSports Injuries Lead WriterJuly 16, 2014

Meet the 10 Super Surgeons Tasked with Putting MLB's Broken Arms Back Together

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    USA TODAY Sports

    This is the All-Star team of sports medicine. After consultation with people around the world of baseball and sports medicine, I've compiled a list of 10 "Super Surgeons."

    This is my version of this kind of list, and I believe it remains important. The fact is that while these 10 physicians are stars in the sports medicine world, they are largely unknown to sports fans. While we all worry about the epidemic of arm injuries in baseball, it's ironic that we know so little about the men who attempt to heal those same injuries.

    While many would recognize the name Dr. James Andrews, few know how he got to where he is. Did you know his athletic background is not in baseball or football, but track and field? (He was a pole vaulter.) Do most super surgeons come from the same background or top medical schools? Not at all. 

    Their stories are as individual as the athletes they help. Most played sports and came to love them, but topped out and found a new way to keep their passion for competition alive after medical school. (That's a pretty good plan B, after all.) All are exceptionally qualified and passionate about their profession. They are athletes and most are younger than expected. 

    While it will surprise no one that Dr. Andrews remains at No. 1 this year, there is always the question of who the "next Dr. Andrews" will be. If anything, this list reminds us that sports medicine is in good hands for years to come.

    If Dr. Andrews retires in the next few years, there may be a reshuffling of who goes where from what teams and agents, but the quality of care should remain constant, largely because of a focus on education and research, fueled by Dr. Andrews and Dr. Frank Jobe, who passed away earlier this year.

    A significant portion of the doctors on this list were trained by one of those two doctors or those whom they trained.

    Sadly, Dr. Jobe is not the only loss. Dr. Lewis Yocum, who was on both previous lists, passed away in 2013, though his work lives on. This list, as you will see, tends to trend down to the next generation and even beyond, which means that sports medicine is in very good hands.

    This list is hardly comprehensive, as there are far more than 10 worthy physicians out there. Teams around baseball (and other sports, since there is a massive crossover) have hard-working and well-qualified medical teams. If I wanted, I could go 20 or 30 deep with this list, but I've always thought the simple top 10 worked best.

    For now, let's meet this 2014 class of Super Surgeons.

Dr. James Andrews, Birmingham/Pensacola

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    Practice: Andrews Sports Medicine (Birmingham, Alabama); The Andrews Institute (Pensacola, Florida)

    School: LSU School of Medicine

    Specialty: Elbow, shoulder, knee

    If someone asks me why Dr. James Andrews has become the pinnacle of his profession, his resume won't give a good answer. His education was solid but not Ivy League. His training at the Hughston Clinic was top-notch, but his early acceptance of the arthroscope led him to set out on his own. (Imagine—in the early 1980s, the arthroscope was controversial!) 

    Instead, there's an X-factor. Andrews' slow movements belie the precision he shows in surgery. His deep southern accent isn't out of place in Birmingham, but as Jeff Foxworthy once joked, you don't want your brain surgeon to come in sounding like, well, Jeff Foxworthy.

    Andrews built on early successes with the likes of Roger Clemens to become a secondary option to Kerlan-Jobe Clinic. While his partnership with HealthSouth caused later issues, it was one of the keys to rapidly building his practice and his own hospital.

    He's built two since—the new Andrews Sports Medicine in Birmingham, Alabama and the Andrews Institute in Gulf Breeze, near Pensacola, Florida. (Don't ask me to explain, but the two entities aren't related.) 

    That X-factor can't be explained, but it is clearly shown by one of the most amazing feats in all of sports. Alabama and Auburn are blood rivals in college football, but Andrews is the team physician for both of them. He's also the team physician for the Tampa Bay Rays, Washington's NFL franchise and a long list of others. That charm is as important as his surgical skills.

    Andrews may be best known for his work in baseball with elbows, but unlike many, he's also renowned for his work on knees and shoulders. The bulk of his research work, usually through the American Sports Medicine Institute, is focused on injuries to baseball pitchers.

    Along with Jobe and Yocum, who have both now passed away, Andrews defined the term and profession of sports medicine. All of them belong in the Hall of Fame. 

Dr. Neal ElAttrache, Los Angeles

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    Practice: Kerlan-Jobe Orthopedic Clinic (Los Angeles)

    School: University of Pittsburgh School of Medicine

    Specialty: Knee, shoulder

    A disciple of both Dr. Jobe and Dr. Yocum, Dr. Neal ElAttrache has become the go-to surgeon on the West Coast. No matter the sport or body part, Dr. ElAttrache is on the very short list of names that teams and agents call when there's a severe orthopedic injury. 

    ElAttrache took over as team physician with the Los Angeles Dodgers from Dr. Jobe and has continued to keep the team at the forefront of sports medicine. While the team's injury results have been poor over the past few seasons, the Dodgers have continually been asked to take on risks. Sometimes it works, as it has with Josh Beckett or Zack Greinke. Sometimes it doesn't, as with Carl Crawford.

    ElAttrache's research has been concentrated on the shoulder, which is where he initially focused his surgery as well. In fact, the first time I saw Dr. ElAttrache, he was on a panel with Dr. Andrews. Andrews was asked what the first thing he did when he did a shoulder consult was, and he responded: "I call Neal ElAttrache." 

    Without a football team to work on since the Rams left Los Angeles, ElAttrache has been neutral and available to NFL players. His care of Tom Brady's knee drew much notice, as has his work on Kobe Bryant in NBA circles. Inside baseball, his aggressive treatment of Greinke's collarbone got notice as Greinke came back quickly and productively.

    Los Angeles has always been the glamor capital of the U.S., so the movie-star looks of ElAttrache haven't gone unnoticed. He's a regular guest on NFL Network and CBS Sports, where his humble, quiet demeanor is often a surprise. He has not yet appeared in The Expendables series, though he's likely treated lots of those action stars. His brother-in-law is Sylvester Stallone.

Dr. Tim Kremchek, Cincinnati

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    Practice: Beacon Orthopedic (Cincinnati)

    School: University of Cincinnati Medical School

    Specialty: Elbow, knee

    Dr. Tim Kremchek doesn't mind being called "Doc Hollywood." It can come off to those that don't know him as attention-seeking, but really, Kremchek is at heart a teacher. He wants to explain why players get hurt and how he can help fix them. It comes out most when he discusses youth pitching injuries, where he's become a leading voice in the fight.

    Kremchek is a Cincinnati kid who's been lucky enough to take care of not just his boyhood team but much of the city. His offices have memorabilia and pictures enough for a Hall of Fame. The room where he sits and discusses things with players and their families has Sandy Koufax and Bob Gibson jerseys hanging right in the line of sight. I don't think that's an accident.

    Kremchek built his northern Cincinnati facility for athletes, but the details show just how unique he is. Beyond the memorabilia on the wall, he has an operating room that has a viewing suite. The family and agent can sit just feet away, with a nurse to explain and a mic so Kremchek can communicate with them during the procedure. 

    Watching him do surgery has a grace that belies his size. It's almost delicate but definitely confident. What's more impressive is watching him with the patients before and after. One athlete who went to him had insurance issues and was worried they'd have to delay the surgery. Kremchek told them not to worry and scheduled the surgery anyway. "We usually get paid, but I want to fix him now," he said. 

    The facility in Cincinnati is also indicative of his passion. At one end of the building is an MRI clinic so that he doesn't have to wait for imaging. At the other end is a large workout facility with a full physical therapy clinic and even an indoor turf field. An injured athlete might not have to leave his facility from examination to finishing rehab, which is what Kremchek wants.

Dr. David Altchek, New York

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    Practice: Hospital for Special Surgery (New York)

    School: Cornell School of Medicine

    Specialty: Shoulder, knee, elbow

    The only Ivy League doctor on this list, Dr. David Altchek has taken one of the most interesting paths to the top of his profession as well. Most of his focus on the shoulder came from his love for tennis. He worked with the Association of Tennis Players (ATP) and as a leading consultant in the NBA, which led to him becoming a go-to guy for shoulder injuries before becoming the Mets team doctor. 

    He's hardly a one-trick pony, however. Altchek is one of few who has moved from the Jobe technique for performing Tommy John surgery. He developed and popularized a technique he dubbed "docking" which is now used by several other surgeons. 

    The "good face" may be debunked in baseball, but not in surgery. Altchek may avoid the media, but he does have the face for it. In fact, he was once in a fashion campaign for one of his patients: Ralph Lauren. Despite this, Altchek largely avoids the media, despite being in high-profile New York City.

    New York's centrality also helps Altchek with consultations. It's easy to get people in and out of New York and easy to keep some of the consultations quiet. It's much more difficult to track the comings and goings of a star athlete in Manhattan than it is in Birmingham. 

    Altchek continues to focus as much on research as he has on surgery. Again, he's led on shoulder situations, but his work on elbows and knees is considered groundbreaking. His HSS colleague, Dr. Stephen O'Brien, has focused on the labrum, changing how doctors think about the shoulder structures, while Altchek has put much of that research into action. 

Dr. William Raasch, Milwaukee

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    Practice: Medical College of Wisconsin (Milwaukee)

    School: University of Chicago Medical School

    Specialty: Shoulder, elbow

    Surgeons generally have a brashness. They may not like the media—though that is changing to some extent—but they tend to not be shy. Bill Raasch isn't shy, but he's soft-spoken and thoughtful in a way not normally seen in any elite group, let alone surgeons. 

    That thoughtfulness has put him at the forefront of baseball's research, as he's led inquiries into how mound height affects the forces on a pitcher's arm, among other studies. Perhaps his best work, if less known, is in building the biomechanical lab used by the Milwaukee Brewers.

    That lab, at his practice, is a world-class facility, but it's how Raasch has put it to use that may be the most important. Raasch convinced the team to invest in the lab so that he could get every single pitcher on the team into it and create a baseline. The team has been doing it for several years and uses another lab at its Arizona facility.

    Is it paying off? The Brewers refuse to discuss what they've found, but the results speak for themselves. At the major league level, the Brewers are the only team to not have a Tommy John surgery in the last five seasons. 

    Raasch is a great surgeon as well, with results like the in-season return that Yovani Gallardo made from his ACL sprain, which has allowed the Brewers to push towards the playoffs. If Raasch and the rest of the Brewers medical staff can keep pitchers (and the rest of the team) healthy, they'll continue to have a major advantage on other teams. Even if other teams tried to copy them, they've got a sizable head start.

Dr. Lyle Cain, Birmingham

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    Practice: Andrews Sports Medicine (Birmingham, Alabama)

    School: University of Alabama Medical School

    Specialty: Knee, ankle, elbow

    If you don't know the name, you probably know the work. Along with Dr. Jeffrey Dugas, Dr. Lyle Cain has been the shadow for Dr. Andrews for years at his Birmingham facility. Working alongside Andrews has not only given him access to some of the top sports surgeries over the years but has given him some of that X-factor that Andrews exudes. 

    If Andrews does decide to retire in the near future, Cain is likely to become a much more recognizable name. Instead of being the second name on research papers, he'll be first. Instead of being the assistant on the big-name surgeries, he'll quickly become the lead. The question is whether athletes will continue to flock to Birmingham or if someone else on this list will capture some or even all of the top-level surgeries.

    The role of protege is a great one in sports medicine. The successions of surgeons are often quite linear. Between the Kerlan-Jobe Clinic and the ASMI Fellowships, over 75 percent of teams in MLB and the NFL have a direct link to these surgeons. Even Andrews himself came from the world-renowned Jack Hughston. Cain is merely where Yocum was 20 years ago. 

    Cain may operate in his mentor's shadow for now, but on his own, most think he'll be able to stay at the top of his profession. "If I had to have Tommy John surgery, I'd go to Lyle," an MLB staffer told me as part of my survey for this list. There's little higher praise.

Dr. Anthony Romeo, Chicago

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    Practice: Midwest Orthopedics at Rush (Chicago)

    School: St. Louis University

    Specialty: Shoulder and elbow

    Anthony Romeo should be a fictional character. Down to his name, his story sounds more like a Grey's Anatomy character than a respected surgeon. He's brash, experimental and willing to go out on limbs that even other surgeons shy away from. Knee implants? Sure. Aggressive new shoulder techniques? Why not? 

    Along with the other doctors for the Chicago White Sox—including Dr. Brian Cole and Dr. Charles Bush-Joseph—and Herm Schneider, the White Sox's head athletic trainer, the Sox have had an amazing run of health. What makes it more interesting is that they are willing to take risks. Pitchers like Jake Peavy learned this when he had to have his shoulder essentially re-attached. 

    The team is also willing to take risks in the draft. Sources tell me that Dr. Romeo was very involved in the draft process and that his confidence allowed the team to take chances on Chris Sale and this year with Carlos Rodon. Sale has shown himself to be risky, but he's dominant when healthy. Few other teams would have taken those kinds of risks at their slots.

    Romeo isn't shy. He did an entire video series on John Danks, showing the surgery and rehab, all the way to the return. Some colleagues called it an exercise in self-promotion, but few other doctors would be willing to show that, win or lose. That Danks has stayed healthy and productive is even better for Romeo and for his team.

    As long as the White Sox continue to stay healthy, Romeo is going to get more and more attention. His work in other sports, especially basketball, is drawing notice as well. Add in that Chicago is an easy destination for consults, and Romeo is very well set up to continue drawing attention from injured athletes.

Dr. Orr Limpisvasti, Los Angeles

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    Courtesy Kerlan-Jobe

    Practice: Kerlan-Jobe Orthopedic Clinic (Los Angeles)

    School: University of Rochester

    Specialty: Shoulder, elbow, knee

    Following a legend is a tough gig, but as we've seen, following a legend is also a standard path to the top. Orr Limpisvasti doesn't have a name made for the media, but he's got one of the showcase gigs in sports, following Yocum as the Los Angeles Angels' orthopedic consultant. 

    Limpisvasti's background in research and teaching is what puts him on this list. He's done extensive studies on the elbow and shoulder, with some of his work on what helps pitchers and others get back on the field being his most influential. 

    Limpisvasti doesn't get as many consulting clients as some others on this list, but he was mentioned by several of the people I surveyed as a trusted name. One agent told me: "one of the advantages is that he's at a world-class facility but doesn't have the attention. I can get my guys there quickly, and he's great with them. I think that in a few years, the secret will be out."

    Right now, much of Limpisvasti's work is focused on baseball, but he does work for the Anaheim Ducks and has a big interest in tennis. He's also very interested in biomechanics, which is likely to be a focus in his upcoming research. 

Dr. Bert Mandelbaum, Los Angeles

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    Practice: Institute for Sports Sciences (Los Angeles)

    School: Washington University (St. Louis); Johns Hopkins

    Specialty: Knee

    With the World Cup having just ended, putting the U.S. men's national team's doctor on here might seem timely but a bit out of place. For Bert Mandelbaum, he might best be known for his work on David Beckham, but he's not out of place in any sport.

    Mandelbaum has spent a lot of time and research on knee injuries, but not in the way that most doctors have. Instead, Mandelbaum has worked on prevention, specifically a program called PEP, which was highlighted in this MMQB piece by Robert Klemko. Knee injuries aren't as big an issue in baseball as they are in the NFL, but it's still a concern for teams. PEP's proven 72 percent reduction in injuries is getting a lot of attention.

    Mandelbaum's work isn't just on ligaments but is on cartilage as well. With any cartilage or meniscus problem, players now have two choices—repair or return. A simple removal of the injured meniscus can get a player back on the field quickly but with consequences down the line. A repair can cost half a season or more, and the success rate isn't as high as most think.

    Mandelbaum's work on cartilage repair includes a promising new technology called ChondroCelect. Using the patient's own cells, scientists can regrow a piece of cartilage that can be put in to fill in the damaged area. While the technique requires an open surgery and an extensive recovery, it's already comparable to microfracture in terms of time. 

    Mandelbaum may work on athletes, from baseball players to Olympic stars, but he's not much of one for the spotlight. That may change this fall when he releases his first book, The Win Within, which is a great read. It's the kind of book that every injured athlete should read and is a distillation of Mandelbaum's work.

Dr. Chris Ahmad, New York

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    Practice: Columbia Orthopedics (New York)

    School: New York University School of Medicine

    Specialty: Knee, shoulder, elbow

    Yes, being the New York Yankees' team physician is a glamor gig, or at least it seems like it would be. Dr. Chris Ahmad has been on the job for several years, but before him, the divided nature of the Yankees' front office led to all sorts of consulting physicians. Ahmad's biggest success might not have come on the operating table but in consolidating all the medical operations of the team.

    Like Dr. Altchek, Ahmad hasn't sought out the media but has handled it well when necessary. When forced into a media maelstrom last year when sued by Alex Rodriguez, Ahmad handled the situation calmly and with class. "He was wrongly attacked," said a medical colleague, "but he never let the anger show. I think he asked himself 'What would Jeter do?'" The suit was dropped.

    Ahmad is a Yankee through and through, just like Jeter, a player he idolizes and has befriended. That has limited some of his consulting opportunities, but he's happy to stay within the Yankees organization. Even with that, players, especially ex-Yanks, have sought him out in many cases. It's likely that will ramp up in the near future.

    The Yankees never rank at the top of injury stats in large part due to the roster construction, which has led to some criticism of Ahmad's ascendancy. It's a valid criticism, but the people I surveyed for this list regularly point to Ahmad's work as keeping the team's stats from being significantly worse. 

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