What is a Bone Chip?

Oh boy. Joe Magrane is at it again!

This morning I turned on MLB TV, only to listen to “the brains” of the MLB Tonight crew break down Johan Santana and his latest surgery. (Remember, he had a similar surgery on his shoulder at the end of the 2003 season, not to mention his knee surgery on his glove knee.)

If you didn’t know, in his most recent surgery, Santana had what doctors refer to as “bone chips” removed from his pitching elbow.

What Joe Magrane doesn’t know, is why the bone chips developed in the first place.
But before I reveal what Magrane can’t, let me break down Magrane’s breakdown of Santana based on four video clips…

Pre-injury, Magrane called Santana “free-wheeling,” throwing his fastball up in the zone and blowing it past major league hitters. The examples were two strike outs with no mph display.  Oh yeah, the clips were from his Twins days, which is more than two years ago.

Pre-surgery, Magrane says hard hit pitches (fastballs) are “what happens when a pitcher gets injured… throwing with a restrictor plate on.” The examples were on two 2-1 counts with a display 0f 89 and 90 mph, and with the Mets last season.

How can anyone do a fair comparison when they base their argument on two sets of totally different pitching situations?

On the one hand, there is the situation where Santana probably set up his upstairs fastball with his ridiculous change up, or slider (a.k.a the probable culprit for his bone chips and spurs).  There were also two strikes on the hitters – who are very much aware that Santana can and will use his change up as a strike out pitch, therefore making his fastball seem faster.

On the other hand, we have two 2-1 counts, where I’m thinking Santana didn’t want to run the count to 3-1.  He tried to spot a fastball… and missed.

I really don’t know what else to say except I guess MLB TV had some time to kill, and filled the space with pointless video.

But this isn’t about video fillers.  This is an explanation of bone chips, bone spurs, why they happen, and how to prevent them.

For this, allow me to use Dr. Mike Marshall’s answer found in his 2009 Question and Answer page.

Bone spurs result from bones colliding, which causes pieces of the hyaline cartilage that covers the ends of bones to break loose.  Therefore, what orthopedic surgeons call ‘bone chips,’ are actually pieces of hyaline cartilage.

Except when pieces of hyaline cartilage break loose, once the growth plates of bone have matured, hyaline cartilage prevents bones from growing longer.

Like with all types of tissues in the body, specific bone cells (osteoblasts) constantly replace old bone tissue with new bone tissue.  Therefore, when these osteoblasts encounter holes in the hyaline cartilage, they grow new bone tissue through the openings.  These are bone spurs.

The bone spurs through the hyaline cartilage of one bone rub against the hyaline cartilage of it adjoining bone.  This causes pain in the hyaline cartilage of the adjoining bone.

Orthopedic surgeons easily remove bone spurs.  Without the bone spur constantly irritating the hyaline cartilage of the other bone, the hyaline cartilage heals.  Depending on the severity of the irritation, the hyaline cartilage heals within a week or two and the baseball pitcher can then pitch without discomfort.

However, these bone spurs can return.

The points:

  1. Even after three elbow surgeries, Joe Magrane still doesn’t know why he hurt his arm, or why anyone else does either.  He actually said that the elbow injury didn’t allow Santana to “get stretched out with his lead leg.”  FYI – stretching out your lead leg only moves your foot closer to home plate.
  2. Johan Santana continues to injure himself, and despite being great, has done nothing to change his throwing delivery.
  3. Doctors treat fans like little kids when they use terms like “bone chips.”  (It’s not part of this post but my all-time favorite “medical term” is “flexor tendon,” because there isn’t one in the human forearm.)
  4. This type of injury isn’t as severe as other injuries requiring surgery, but it can lead to arthritis. It can also be prevented. However, if no change in your throwing delivery is made, they will come back!

The easy way to prevent bone chips or bone spurs: stop throwing pitches that require you to supinate your throwing hand.

The slightly more challenging way to prevent bone chips and bone spurs: learn to throw the same type of pitches by pronating your pitching hand.  Using your Pronator Teres muscle will completely prevent any banging of bones in the back of your elbow.

Remember: the definition of insanity is “doing the same thing over and over again and expecting different results.”

Coach Bones