Adam Wainwright talks life after TJ surgery

Adam Wainwright is 5-7 with a 4.46 ERA in his first season back from Tommy John surgery. Dilip Vishwanat/Getty Images

ST. LOUIS -- Those who know Adam Wainwright's posture on the pitching mound can easily recognize him anywhere. Standing in the middle of his teammates shagging balls in the outfield at 6-foot-7 and 228 pounds he stands with his legs apart, his glove resting in the middle of his body, just like he does on the mound. Sometimes he crosses his arms but mostly he has the same posture wherever he stands.

In his first season back since having Tommy John surgery on Feb. 28, 2011, Wainwright does not feel sorry for himself. After seven years in the majors and two World Series rings, the 2010 NL Cy Young runner-up doesn’t want any young guys who haven’t reached the big leagues to feel sorry for him either. He knows a few have, but that’s not how he lives his life.

Wainwright focuses on staying positive, his Christian faith and living with no remorse. It is not just a life motto or a cliché of novel ideas; it is the backbone of his ability to pitch well. Like his pitching mound stance, his beliefs follow him wherever he goes.

He remembers throwing something -- a baseball, a football, anything -- since he was three years old. Like most professional baseball players Wainwright has played baseball year round since he was 12. Not being able to pitch for a year could have been very difficult.

"If you let it, it can become a roller coaster ride of emotions," Wainwright said about life after Tommy John surgery.

He worked hard in rehab, believing, hoping everything would work out OK. Early in spring training Wainwright threw very well. He pitched five games and had a 1.45 ERA.

"It wasn’t necessarily that I was commanding everything perfectly, it was just that everything was real sharp," Wainwright said of those spring training performances. "I had late movement on my ball. My slider and my curveball were real sharp -- snapping good -- the changeup was dropping nicely."

Once the season started and the innings began to stretch out, however, he struggled. In the first eight starts Wainwright had two wins with a 5.77 ERA and had given up seven home runs.

"I wasn’t commanding my curveball," Wainwright said. "My slider completely lost its break and was flat as a board."

Wainwright says the surgery did not make him change his pitching mechanics.

"Sometimes I have to watch my arm swing a little bit," he said. "It can get up there. It can get a little too high [with] the elbow in the back."

Wainwright’s mechanics are similar to those of Stephen Strasburg and C.J. Wilson, pitchers who have had Tommy John surgery. One researcher on pitching mechanics named Chris O’Leary labeled pitchers who begin to turn their shoulders with the pitching arm forearm in a horizontal position (rather than vertical) and with their elbow above their shoulders at the moment their front heel plants as having an "Inverted W."

Wainwright has heard the theories on how the Inverted W can lead to injuries, but he says for every pitcher with the Inverted delivery who struggled with injury you can find one with the same mechanics who did not have medical issues.

"Let me tell you the cause of Tommy John surgery, it’s throwing a baseball," Wainwright said adamantly. "People used to hurt their elbows all the time back in the day. They just didn’t have surgeries, so they’d retire.

"This game puts a lot of pressure on your joints and ligaments. That’s why it is so important that we keep our shoulders and our [scapulas] strong and our leg muscles strong and our hips flexible and all these things so that we can stay away from injury as much as possible. But to say that you could stop someone from getting hurt with a perfect throwing motion is absolutely ridiculous."

People will occasionally ask him if he is aware of how he throws the ball. He answers, and gives insight into why so many pitchers are unwilling to change their mechanics, with a question.

"The St. Louis Cardinals are paying me a lot of money to throw the ball like I throw the ball. What do you think they would say if I came in with completely different mechanics the next year? They would be so scared out of their brains that they would be wasting money on me."

One solution to catching injury before surgery is needed could be the use of ultrasound technology in screening pitchers before, during and after the season. Ultrasounds can move with the elbow and get a good visualization of the ulnar collateral ligament, the ligament repaired in Tommy John surgery. The problem is understanding what the ultrasounds results mean. For example, if doctors find a 20 percent strain, will the ligament rupture in the next year? The next two years? Ever? And even more, the pitcher may have no pain but how would the management view a player tagged with an ultrasound of a partial tear in his tendon?

"Here’s the deal, though," Wainwright said explaining the use of ultrasound technology to monitor pitchers. "When you look at [an ultrasound] when you throw a baseball -- I don’t care if you throw 50 pitches with perfect mechanics, or 100 pitches, or if you throw a baseball all year long -- if you take an ultrasound of something it is always going to look not just right. There’s not one guy on the baseball field that if you take in to get an ultrasound or an MRI on their shoulder or on their elbow that’s not going to look a little whopper-jobbed." (Authors note: Yes, Wainwright has invented a new word, whopper-jobbed.)

Dr. David Crane of Crane Clinic Sports Medicine uses ultrasound for diagnostic as well as therapeutic applications including injection targeting.

"You could argue that the incidence of injury is high enough that screening ought to be considered to be used," Dr. Crane says. "We would like to see athletes before and after throwing and we would also like to see them with no pain and with pain. There are a lot of abnormal tendons [visible] by ultrasound appearance that do not hurt."

Pitchers are getting stronger, throwing harder and faster than ever before. Wainwright says this is because of all the weight training in modern baseball.

"If you look at how strong guys' muscles are getting, the way they are exploding all the time, they didn’t used to throw like that way back in the day," Wainwright said. "There was the occasional flamethrower but for the most part guys weren’t throwing 95 every pitch.... Guys are getting freakishly strong, freakishly fast and it puts more wear and tear and stress on your ligaments and elbows and shoulders."

Everyone has their own theory on how to save the modern pitcher -- flawless mechanics, ultrasound technology, injection therapies such as Platelet Rich Plasma Therapies, pitch counts, biomechanical studies -- but there are no magic pills or straight forward answers right now.

* * * *

After his curveball had lost some of its bite there was one week between starts where Wainwright was preparing to pitch against the San Diego Padres. He was fiddling with the baseball, a habit he does throughout the season, to make sure he had the right grip. Before the Padres game on May 22 he kept thinking it just didn’t feel the same as it did in 2010, when he went 20-10 with a 2.42 ERA. All of a sudden he found his old grip.

"As soon as I found my grip that I used to use it just felt comfortable in my hand," Wainwright said. "I knew I was going to throw strikes with it. There’s a grip that I can find with my curveball that before I throw it I know it is going to be a good pitch and I found it."

He pitched nine shutout innings and the Cardinals won 4-0. His curveball was back to pre-surgery form. Since then Wainwright has a 3.07 ERA and opponents are batting .224 against him with only one home run. He starts again Saturday in Kansas City.

Wainwright says the road from having Tommy John surgery to experiencing a light at the end of the tunnel has been padded by his faith. Baseball has experienced its own miracle as well. Another brilliant pitcher, while not saved from having Tommy John surgery, continues to make that trek back to his previous abilities.

After getting his grip back in the game against the Padres the emotion of it all caught up to him. Wainwright, finally experiencing what he believed would happen all along, became teary-eyed in the locker room after the game.

"It goes back to the way I try to live every day," Wainwright said. "I’m a Christian guy, I follow Jesus and he tells me how to live my life. It is not one of remorse, it’s not one of feeling sorry for myself, it’s how can I get the most out of each and every day? When I pitched that game against San Diego here at Busch it was a moment where I looked back and all of a sudden a whole year’s worth of hard work and trials was all of a sudden rewarded. ... It is not just that God is good in only the great moments, God is good all the time."

Anna McDonald contributes to the SweetSpot blog. Follow her on Twitter here.