The Minnesota Twins’ Central Division title hopes took a major hit before the season even began when their All-Star closer, Joe Nathan, went under the knife to have season-ending ulnar collateral ligament reconstruction; more commonly known to baseball fans as Tommy John surgery. But it isn’t just Major Leaguers undergoing this operation; the number of young pitchers requiring elbow reconstruction has surged during the past decade. As UCL injuries increase and recovery time for Tommy John surgery remains protracted, doctors worry that athletes will turn to platelet-rich plasma therapy (PRP), an unproven treatment that has faced scrutiny from anti-doping officials.

PRP, a treatment that injects a concentration of a person’s own platelets into an injury to aid healing, first stepped into the spotlight when Pittsburgh Steelers safety Troy Polamalu received the treatment to speed the recovery of an injured knee ligament before Super Bowl XLIII. It was back in the news a few weeks ago when Tiger Woods said before the Masters that he had received PRP injections the year before to help recover from his knee operations and aid in healing his torn Achilles’ tendon. In July 2008, Los Angeles Dodgers pitcher Takashi Saito received PRP to treat a partial tear in his UCL—instead of undergoing Tommy John surgery he was back pitching later that season.

While Tommy John surgery has saved countless careers by restoring the elbow stability that provides pitchers their velocity and control, the recovery leaves hurlers sidelined for more than a season. Now more than ever an alternative treatment to surgery is needed to combat the number of young pitchers needing the operation, which has skyrocketed since 2000, according to Dr. James Andrews, America’s leading sport orthopedist. Instead of performing eight to nine Tommy John surgeries per year on young players as he did a decade ago, lately Andrews is doing 75 to 80 a year and he says 2010 “is worse than it’s ever been.”

With teams investing so much money in their pitchers and those early years being so important to a young player’s development, Saito’s experience with PRP makes the treatment that much more enticing, but doctors still haven’t confirmed its effectiveness. “Sometimes we get ahead of ourselves and everybody jumps onboard to start doing this stuff because they want to be innovative and get ahead of the game,” says Dr. Grant Jones, a professor of orthopedics at Ohio State University Medical Center. “So far we haven’t seen any adverse affects, but we need better studies before we start throwing PRP in everybody, which seems to be happening right now.”

Andrews, whose client list has included Drew Brees, Roger Clemens, Brett Favre, Peyton Manning and Michael Jordan, says he’s “applying PRP sparingly,” believing the science on the treatment to be “10 years away from being solid.” However, he sees promise in the practice for UCL injuries. “I’ve used it on some young throwers and have had some good response,” he says. “It may be the most revolutionary advancement in our field since the orthoscope.”

Despite early positive returns, questions surrounding PRP aren’t limited to its efficacy, as anti-doping officials have debated recently whether it should be banned altogether. In 2009 both the World Anti-Doping Agency and the U.S. Anti-Doping Agency barred PRP’s use, except in cases where a therapeutic-use exemption is granted. However, PRP differs from synthetic performance enhancers like steroids, in that it’s derived from blood drawn from the patient. The doctor uses a centrifuge to separate the patient’s platelets from the red and white blood cells and then injects the PRP around the injured tendon, ligament or muscle. Doctors isolate the platelets and introduce them to aid in tissue regeneration because “they are thought to be the main constituent of the blood that promotes the whole healing process,” says Jones.

Jones authored a paper earlier this year reviewing applications of PRP, finding that “there are several animal and laboratory studies that have shown the benefit of PRP, but in terms of the human literature, the data is still somewhat sparse in terms of its effectiveness.” While positive results were noted in his paper, where PRP aided in the healing of shoulders, knees and elbows, some trials, like those using PRP in ACL reconstructions, found little benefit from the treatment.

Seeing the limited scope of previous PRP trials, Jones is conducting a more comprehensive examination of the treatment, by studying its effects on patients with tennis elbow. As with UCL injuries, tennis elbow occurs from repetitive stress that leads to tears and strains in the tendon on the part of the elbow opposite the UCL. While the study remains a year from completion, Jones says “there does seem to be a trend toward PRP working thus far.”

If PRP fails to become an effective treatment for healing UCL injuries, the last hope to save a pitcher’s career will remain Tommy John surgery, which until 1974 wasn’t even an option. But that year Dr. Frank Jobe invented the operation that gave hurlers hope when he replaced Los Angeles Dodgers lefty pitcher Tommy John’s UCL with a tendon from his right arm.

Nearly four decades on, the operation remains very similar to the original, with a surgeon taking a tendon from a player’s wrist or hamstring, then threading it through holes drilled in the humerus and ulna to replace the UCL. And the operation has been effective. A 2007 study published in The American Journal of Sports Medicine found that 82 percent of Major League pitchers who underwent Tommy John surgery between 1998 and 2003 returned to baseball with little drop-off from their pre-injury performance; however, it took them an average of 18.5 months to do so. “We haven’t figured out ways to appreciably speed recovery up,” says Dr. David Geier, the Medical University of South Carolina’s director of sports medicine. “You’ve got to wait several months for the body to incorporate that ligament.”

While the surgery hasn’t changed, Andrews says that in the last seven to eight years doctors and trainers have come to better understand how the entire body works together to throw a pitch, which allows them to better prevent UCL strains or tears. So he’s spearheaded the STOP Sports Injuries campaign to educate young athletes on how to train properly, advocating building not just muscle around the elbow, but rotator cuff and core strength as well. Pitchers emphasizing total body strength will support their arm better during the pitching motion and mitigate the cumulative stress that pitching puts on the elbow. That’s important because the UCL “can withstand the stress of one throw, but you’re talking hundreds of pitches a week—it’s wear and tear over time,” Geier says.

Allowing players to rest will also ease that wear and tear, but Andrews says that doesn’t happen enough in youth sports right now. He’s seen pitchers throwing year-round and playing in multiple leagues at the same time, which fatigues pitchers and leaves them 36 times more susceptible to injury. To preserve pitchers’ elbows, they need limited pitch counts during a game, to have rest days between outings and to spend at least two months each year without pitching.

Without that rest and conditioning, and with PRP still unproven, the jump in the number of pitchers requiring Tommy John surgery will continue. And Andrews, a man who’s performed nearly 3000 of the operations, says pitchers should heed his warning about overusing their arm, conceding that “I can’t make that ligament any better than the good Lord made it.”

This article originally appeared on Popularmechanics.com

This article originally appeared on Popularmechanics.com.

In the 2004 US Open tennis quarterfinals, Serena Williams couldn’t catch a break against Jennifer Capriati. Faced with a comedy of linesman and chair umpire errors, the world’s best player looked on as one bad call after another went against her, swinging the match in Capriati’s favor. The decisions were so egregious that US Open officials dismissed the chair umpire from the remainder of the tournament and apologized to Williams for the calls. But an even more significant development in the aftermath of the match was the increased pressure to introduce technology into the game that would assist in line calls; a shift which would change the game.

Two years later, the US Open became the first of the four major tennis tournaments to allow technology that could have prevented the 2004 controversy when it introduced Hawk-Eye. The system works by mounting 10 high-speed cameras around the court with five dedicated to each side of the net to capture the ball’s movement from multiple angles, measuring its speed and trajectory. Then a computer processes that information, pinpointing the spot on the court within 3 mm of where the ball hit the ground and calculating the ball’s compression to determine the size and shape of the mark that represents where the ball touched the court.

Now with three of the four majors and numerous pro tournaments adopting the technology, it has gained support among players, broadcasters, fans and officials alike. The overwhelming success of tennis’s adoption of Hawk-Eye to aid officiating provides a model for sports still reticent about technology, like soccer, on how to integrate it into their game.

Even before the 2004 US Open, the need in tennis for a replay system was becoming apparent, as the pace of the game was fast becoming too quick for the naked eye. “String and racquet technology has made it so you can hit a tennis ball so much harder than you used to be able to,” says Mary Carillo, a former player and now a commentator for ESPN, CBS and NBC. “There’s so much more spin on the ball that it’s that much harder to judge whether a shot’s on or over the line.” So for years inventors have come to tennis’s governing bodies proposing innovations ranging “from sensors in the line to metal flakes in the ball to try to find a better mousetrap in terms of calling lines,” says David Brewer, US Open deputy tournament director.

Dr. Paul Hawkins built that better mousetrap. He premiered Hawk-Eye for cricket in 2001 and soon after he adapted the system for tennis. Networks began calling on Hawkins and his system that showed computer animations of a ball’s flight path to augment the instant replay in their broadcasts. Hawkins approached tennis’ governing bodies to propose that his tool officially adjudicate close line calls.

With the International Tennis Federation supportive of new technology, it tested Hawk-Eye at lower level tournaments to examine its viability. Then came the Williams-Capriati match that further pushed the tennis community toward wanting assistance on lines calls. “We always hesitate to say ‘this is the thing that was the tipping point,’” Brewer says. “But that probably was the tipping point.”

After two years of extensive testing the USTA put their full support behind Hawk-Eye. Yet the system didn’t displace umpires and linesmen altogether. They’re still in place, but now players can make three incorrect challenges per set and receive an additional challenge if the set goes to a tiebreak.

“I think it’s great that big matches are not decided if a linesperson or a chair umpire makes a couple of mistakes,” says Darren Cahill, formerly the world’s No. 22 ranked player, now a coach and commentator for ESPN. And in contrast to other fears about video review detracting from the game, Cahill believes Hawk-Eye has enhanced tennis. “It creates a little bit of suspense when you call for a challenge, making tennis a better sport for spectators and also a better TV sport.”

Although “it’s clearly more accurate than the human eye,” Carillo says, the system isn’t perfect. At a tournament last year, Hawk-Eye’s onsite tech called up the wrong bounce for review, erroneously calling a ball in that had actually bounced out; an error that Hawk-Eye and tournament officials didn’t recognize until after the match ended.

While tennis has shown that it is open to new technologies, other sports, like soccer, have resisted the camera and computer aid. Despite missed calls nearly as infamous as the Williams-Capriati match, including the go-ahead goal by England in the 1966 World Cup Final over Germany that may have never crossed the line, soccer has kept electronic aids out of the game. But a terrible call by a linesman in 2005 that cost Tottenham a goal—and a win—prompted English Premier League officials to explore technological solutions. Hawk-Eye for soccer tested well, impressing league officials by accurately showing whether a ball crossed the line even in “a far more crowded penalty box than has ever happened in any goal line situation,” Hawkins says.

In spite of Hawk-Eye’s promise and Adidas’ developing a ball with a chip embedded inside that could detect when it crossed the goal line, in March FIFA ruled that it would no longer continue testing the technologies; justifying the decision by saying, “we were all agreed that technology shouldn’t enter football because we want football to remain human.”

Baseball purists similarly lobbied for preserving the game’s human element, successfully keeping replay out of baseball for years, until a spate of incorrect home run calls in 2008 caused the league to allow umpires to use instant replay to determine a homerun. But the purists have won out in preventing the use of video review for close calls on the base paths.

Since its inception, Hawkeye has had a very noteworthy detractor: world No. 1, Roger Federer. “He’s a traditionalist,” Cahill says. “For the game to change in any sense, Roger would be a little questioning about it because he has great respect for the game of tennis.” But Carillo says Federer’s dislike of Hawk-Eye goes beyond merely introducing a change to the game’s protocol, “Federer questions the accuracy as well.” Most famously so in the 2007 Wimbledon Final, where he pleaded with the umpire to disregard Hawk-Eye calling a ball in by a millimeter that Federer was convinced was out.

But Federer’s voice is a minority one. “Most players think this a hell of a lot better than it used to be,” Carillo says. “In the beginning of tennis, the notion was always that it was just a bunch of retired wing commanders at Wimbledon calling the lines and falling asleep during the matches in the sun,” Carillo says with a laugh. “Over the years it’s got better as the stakes got higher.”

To read the full article, which originally appeared on Popular Mechanics, click here

In 2007 the WNBA’s Seattle Storm had me interview former players who had joined the coaching ranks. Here are the links to a couple of the stories.

• Meet the Storm Coaching Network
• Jamie Redd
• Kate Paye

This Article originally ran in the November 2007 issue of Seattle Metropolitan Magazine

Two years ago I stood under the setting sun amidst a throng of suede-headed, disaffected young men in a stadium in Vienna. Green and white flags waved around us, an incessant drumbeat led our cheers, and we hoisted our scarves toward the sky. Did it matter that it was my first time at the Gerhard Hanappi Stadium and I didn’t know a single person around me or understand a word of what we were screaming? No, no, and no. At my first European soccer match, all that mattered was that I was rooting for the home team, SK Rapid Vienna. I belonged.

Over the course of that match I felt all the things that made me love sports in the first place: camaraderie, a sense of identity, naked displays of emotion, and a healthy dose of escapism. More than 5,000 miles from home, I felt at home.

Ever since that memorable match, I’ve searched Seattle’s sports landscape, from the shores of Lake Washington to the stadiums of SoDo and the heart of Seattle Center, trying to recapture that excitement. My quest remained unfulfilled until I learned what hordes of local soccer fans have known for years: that as far as this area is concerned, a modest pub in Fremont called the George and Dragon is Mecca.

I had enjoyed my visits to the George before, but I’d never ventured there for a major soccer match, thus I didn’t appreciate the intoxication that its mixture of fish and chips, bangers and mash, and beer and the world’s game could produce. That all changed on a Wednesday morning in May when I blew off responsibility to watch the Champion’s League Final live at the George.

A little background: The UEFA Champions League is the world’s premier football club competition; its television audience nearly matches the Superbowl’s. Europe’s best teams compete from August to May, when one is crowned the finest on the continent. This year, five-time winners Liverpool FC navigated the group stage and knockout rounds to earn a date with six-time champions AC Milan. In 2005, Liverpool overcame a three-nil halftime deficit to capture the cup from Milan in what many call the greatest Cup Final ever. This rematch had all the makings of a classic.

I thought I’d come early, but 30 minutes before kick-off the George was packed shoulder-to-shoulder. A line formed out the door and the pub began turning people away. I wondered how many of them had jobs.

I waded through the human mass to the bar. Some fans were easing into the morning on coffee or water. Others ordered pints or Bloody Marys. The guy next to me had a Manny’s Pale Ale and a Bloody Mary. Something told me this wasn’t the first time he’d started drinking before noon.

Pint in hand, the air thick with anticipation, I readied myself for the match. The George and Dragon crowd let out its first collective cheer as the camera focused on the two teams gathered side-by-side in the tunnel the field. If the Europeans have one thing over us, it’s their innate ability milk such moments for everything their worth. Entering the field may seem banal, but as the players begin their slow procession, the Champions League Anthem played, and the stadium erupted in cheers, a chill went down my spine. I looked into each combatant’s eyes and knew that for the next few hours nothing else would matter to him or me but this game.

At kickoff an odd, tense silence fell on the pub; all eyes fixed on the screens positioned around it. But it took just a few moments for the patrons to snap out of their stupor and begin oohing and ahhing at every minor chance and clever move. Keeping one eye on the match, I glanced around the room and think to myself what great unifying forces soccer and a good pub can be. Race, religion, age, economic status, political bent… nothing mattered except whether you pulled for the Reds of Liverpool or the Rossoneri of AC Milan.

The first half was a roller-coaster ride of emotions. The patrons, mostly Liverpool supporters, went into halftime disappointed at their club’s conceding a late goal to Milan’s Pippo Inzaghi. But hope still reigned as they returned to the bar. I enjoyed my halftime ale with two 50-something Norwegians who hailed from the same town as Liverpool midfielder John Arne Riise. We started out talking about the game but soon diverged into discussions of our mutual Norwegian roots and the cruelty of the lutefisk my mother and grandmother used to make me eat each Christmas.

All discussion of disgusting lye-soaked cod halted as the match resumed and the fans resumed living and dying with each build-up on offense. Each time Liverpool moved forward their exclamations rose to a crescendo, invariably ending in collective groans as the Reds squandered their chances. Just when they thought it couldn’t get any worse, it did: Milan’s brilliant midfielder Kakà received far too much space as he dribbled toward the back four and slid a perfectly weighted pass to Inzaghi, who ran onto the ball and calmly slid it under the keeper to score his second of the day. A young Merseyside fan stared into his beer, trying to come to grips with his team’s collapse. I knew how he felt, helpless and empty and gutted. The final whistle confirmed our despair.

Most patrons closed their tabs and filed out, unable to watch the triumphant Rossoneri hoist their seventh championship trophy. I felt deflated by Liverpool’s loss but triumphant at having finally found all that I had longed for in sport since I left the Hanappi Stadium two years before. Once again I was in a place where the crowd and the play seemed joined as one, where total strangers could share a beer and cheer in unison. I felt at home, and I knew I wouldn’t have to travel 5,000 miles to recapture the exhilaration of that Viennese night.