J.A.: Multiple factors, but two stand out: specialization and what we call professionalism. Specialization leads to playing the sport year-round. That means not only an increase in risk factors for traumatic injuries but a sky-high increase in overuse injuries. Almost half of sports injuries in adolescents stem from overuse.Professionalism is taking these kids at a young age and trying to work them as if they are pro athletes, in terms of training and year-round activity. Some can do it, like Tiger Woods. He was treated like a professional golfer when he was 4, 5, 6 years old. But you’ve got to realize that Tiger Woods is a special case. A lot of these kids don’t have the ability to withstand that type of training and that type of parental/coach pressure.Now parents are hiring ex-pro baseball players as hitting and pitching instructors when their kid is 12. They’re thinking, ‘What’s more is better,’ and they’re ending up getting the kids hurt.
Give them time off to recover. Please. Give them time to recover.I said in the book, I want parents and coaches to realize the implications of putting a 12- or 13-year-old through the type of athletic work done by a 25-year-old. Parents and coaches, though they mean well, need to understand what the long-term effects of overuse can be.
PD:Â What are your thoughts on youngsters throwing curveballs?
J.A.: Throwing a curveball has a neuromuscular-control dynamic. In other words, it takes a lot of natural ability at a young age to throw that pitch. It’s a complicated pitch. If you throw it with good mechanics, it doesn’t have any greater force on your shoulder than throwing other pitches, but you’ve got to throw it correctly. It’s misleading to say it’s OK to throw the curveball with good mechanics because the rub is, most kids don’t throw it with good mechanics. My rule of thumb is, don’t throw the curveball until you can shave, until your bone structure has matured and you have the neuromuscular control to be able to throw the pitch properly.
PD:Â What advice would you give pitchers, in general?
J.A.:
1. Use proper mechanics. The No. 1 problem in any specific sport is improper mechanics.
2. Don’t play year-round.
3. Avoid the radar gun at a young age. Don’t try to overthrow. A lot of kids are 13 years old and checking the radar gun. That’s going to get you in trouble. The radar gun makes you want to throw harder than you are capable of throwing.
4. Be very careful with showcases. I call them “show-off” cases because kids go there Saturday after throwing the football on Friday. They jump on a mound and overthrow because scouts are there. The next thing you know, the shoulder or elbow gets injured.
PD:Â How many pro athletes have you operated on in your career?
J.A.: I’ve had people ask me that, and I don’t like to answer with numbers because it might sound like I’m bragging or self-promoting. So I don’t go into a specific number. (Chuckle) What I like to say is, “Too many to count and not enough to quit.”
PD:Â What percentage of your total operations are done on pro athletes?
J.A.:Â About 20 percent. Now I’m getting to where I’m operating on the sons of ballplayers I had.
PD:Â Have you stopped to think about the money in player contracts for which you’ve been responsible by extending careers?
J.A.: (Chuckle) No. Seeing these guys get back to doing what they do best, that’s where I derive the enjoyment. I don’t worry about how much money they might make in the future. I wish them all the best, but it’s nerve-racking just the same. Every play. In the NFC Championship Game a few years ago, the Vikings played the Saints. Brett Favre and Drew Brees were two of my patients. I was pulling for Drew on offense, then Brett on offense, so I couldn’t lose. But I was nervous.
PD:Â It is easy to forget how many surgeries you do on nonstars.
J.A.: A huge joy for me comes from operating on kids in high schools near where I live, kids who were injured and didn’t have insurance. We’ve had a policy through the years that, if you get hurt playing high school football in my area, we’ll do the best we can to help. (Andrews has offices in Alabama and Florida.)
To see these kids come back and get a scholarship, or even a pro contract, is a thrill. I once had a high school basketball player in Mississippi whom nobody would fix. The coaches brought him to me. Well, he eventually signed an NBA contract and has had several contracts and made tens of millions of dollars. He came back to see me with another injury. I told him, “This time I’m going to charge you.”
You’d be surprised in our part of the country how many kids get hurt. We’ve had kids playing in rural areas, great athletes who get hurt but never were able to get the proper medical attention.
PD:Â The most complex surgery you’ve ever done?
J.A.:Â Marcus Lattimore, running back from South Carolina — his leg. Drew Brees’ shoulder. I’ll say this about Drew: It’s amazing that he’s been able to come back and throw a football, let alone play at the level he does.
PD:Â What goes through your mind when players such as Adrian Peterson, whose knee you fixed, come back to rush for 2,000 yards in one season?
J.A.: I don’t want to take credit for things like that. If you operate on the right athletes, the high-level athletes, they will make you look pretty good as a physician. If you don’t have athletes who are motivated, who are so driven to come back, it won’t matter. And the people who get the players after the surgeries — they’re the ones who deserve the most credit. The physical therapy and rehab people. My time with them is a couple hours, then I become a cheerleader.
As an example, the people who rehabbed Adrian were incredible. The combination of Adrian’s motivation, his God-given ability and the help he got post-surgery gave you what you saw on the field in 2012.
PD:Â Which is the more complicated surgery, torn ACL or Tommy John?
J.A.: Even though they involve different parts of the body, they are similar surgeries. I’ve called Tommy John the ACL of the elbow. Throwing a baseball at 90 miles an hour with a reconstructed elbow is equally as impressive as a running back coming back from an ACL tear.
PD:Â Have you ever needed to tell an athlete after surgery that it doesn’t look good?
J.A.: My rule is, the glass is half full, not half empty. One of the things you don’t do is wake up an athlete in the recovery room and say, “That’s the worst injury I’ve ever seen, and you’re not going to make it back.” You’ve got to be positive. I told Drew [Brees]: “I could do your operation 100 times and probably couldn’t do it as well as I did it today. You are going to get through this, and you will be better than ever. Now go to work.”
At the same time, you have to be realistic. When you get to a certain point where you know they’re not going to be able to make it, you let them down slowly. You don’t tell them right away. You gradually work it in. As you get to know them better, you gradually let them know there is life after football.
PD:Â Because of your resume, do you feel pressure to deliver every time?
J.A.: Yes, I feel pressure. A lot of it. But the bulk of the pressure is what all of us feel in this profession. There is extra pressure because people come to me who’ve had multiple surgeries. All of a sudden, you are inundated with people who have had failed surgeries. They come to you and expect you to put them back together again. So the pressure mounts, believe me.
All of us in sports medicine operate in a fishbowl. If there’s a failure, it’s all over the place. But you can’t be perfect with everything you do. You do the best you can. Unfortunately, the only results I ever really remember are the bad ones. Those are the ones you need to study in order to figure out what you can do better.
PD:Â You have known Browns running back Trent Richardson since his high school days in Florida.
J.A.:Â He’s a special individual, as you all in Cleveland know by now. He played with broken ribs this past season. Imagine playing with broken ribs. That’s how tough he is. He’s a heck of a running back.
PD:Â Richardson has had surgeries on both ankles and two on the left knee. Is he injury prone?
J.A.:Â No, no, no, no. The injuries haven’t been serious. He delivers a blow. That’s what he does. He delivers more damage than anybody delivers to him. Just watch him play.
PD:Â Will he have a long, productive NFL career?
J.A.: I’m biased, of course, but, yes, absolutely. He can overcome almost anything. He has a great mental attitude, he can recover quickly and he’s a survivor. That’s the key to Trent: He’s a survivor. The Cleveland Browns have a wonderful player who hasn’t even scratched the surface.