Schilling Tendon Procedure
Encyclopedia
The Schilling tendon procedure is a temporary surgical procedure developed by the former Boston Red Sox
team physician
William Morgan, MD to stabilize the peroneus brevis tendon
so that it is prevented from anterior displacement during ankle eversion. If the peroneal
retinaculum
is torn, the peroneal tendons are no longer stabilized. This allows the peroneus brevis tendon to move untethered over the lateral malleolus, creating pain. During pitching mechanics, the snapping of the tendon over the bone is painful and distracting to the pitcher.
The procedure involves the placement of three sutures through the skin anterior to the path of the peroneus brevis tendon and into the underlying deep connective tissue
. These sutures provide a temporary barrier, preventing the tendon from moving anteriorly over the malleolus. The procedure is performed with local anaesthetic, about 24 hours before the player begins to pitch. The stitches must be removed immediately following the cessation of play, and indications are that the stitches may tear during the course of a game.
The procedure is named for Major League Baseball
pitcher Curt Schilling
, who required the surgery to be able to pitch for the Boston Red Sox
in Game 6 of the 2004 American League Championship Series
and Game 2 of the 2004 World Series
. Schilling was the winning pitcher in both games, and his blood-soaked sock gave a new meaning to the term Red Sox during the team's improbable run towards their first world championship in 86 years.
Boston Red Sox
The Boston Red Sox are a professional baseball team based in Boston, Massachusetts, and a member of Major League Baseball’s American League Eastern Division. Founded in as one of the American League's eight charter franchises, the Red Sox's home ballpark has been Fenway Park since . The "Red Sox"...
team physician
Team physician
The team physician for a sports team is the physician who is in charge of coordinating the medical staff and medical services for a sports team. They are also subject to activities involving team building...
William Morgan, MD to stabilize the peroneus brevis tendon
Tendon
A tendon is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension. Tendons are similar to ligaments and fasciae as they are all made of collagen except that ligaments join one bone to another bone, and fasciae connect muscles to other...
so that it is prevented from anterior displacement during ankle eversion. If the peroneal
Peroneal
Peroneal refers to the lateral compartment of the leg. This Greek-derived medical term often refers to its well-known Latin analog, fibular.Peroneal can refer to:* Peroneal artery* Peroneal vein* Peroneal nerve* Peroneus brevis muscle...
retinaculum
Retinaculum
Occurs where in some places, groups of tendons from separate muscle pass under a band of connective tissueRetinaculum, from the Latin verb retinere , plural: retinacula may be:* In the wrist:** Flexor retinaculum of the hand...
is torn, the peroneal tendons are no longer stabilized. This allows the peroneus brevis tendon to move untethered over the lateral malleolus, creating pain. During pitching mechanics, the snapping of the tendon over the bone is painful and distracting to the pitcher.
The procedure involves the placement of three sutures through the skin anterior to the path of the peroneus brevis tendon and into the underlying deep connective tissue
Connective tissue
"Connective tissue" is a fibrous tissue. It is one of the four traditional classes of tissues . Connective Tissue is found throughout the body.In fact the whole framework of the skeleton and the different specialized connective tissues from the crown of the head to the toes determine the form of...
. These sutures provide a temporary barrier, preventing the tendon from moving anteriorly over the malleolus. The procedure is performed with local anaesthetic, about 24 hours before the player begins to pitch. The stitches must be removed immediately following the cessation of play, and indications are that the stitches may tear during the course of a game.
The procedure is named for Major League Baseball
Major League Baseball
Major League Baseball is the highest level of professional baseball in the United States and Canada, consisting of teams that play in the National League and the American League...
pitcher Curt Schilling
Curt Schilling
Curtis Montague "Curt" Schilling is a former American Major League Baseball right-handed pitcher. He helped lead the Philadelphia Phillies to the World Series in and won World Series championships in with the Arizona Diamondbacks and in and with the Boston Red Sox. Schilling retired with a...
, who required the surgery to be able to pitch for the Boston Red Sox
Boston Red Sox
The Boston Red Sox are a professional baseball team based in Boston, Massachusetts, and a member of Major League Baseball’s American League Eastern Division. Founded in as one of the American League's eight charter franchises, the Red Sox's home ballpark has been Fenway Park since . The "Red Sox"...
in Game 6 of the 2004 American League Championship Series
2004 American League Championship Series
The 2004 American League Championship Series was the Major League Baseball playoff series to decide the American League champion for the 2004 season. It was played between the Boston Red Sox and New York Yankees, at Fenway Park and the original Yankee Stadium, from October 12 to October 20, 2004...
and Game 2 of the 2004 World Series
2004 World Series
The 2004 World Series was the Major League Baseball championship series for the 2004 season. It was the 100th World Series and featured the American League champions, the Boston Red Sox, against the National League champions, the St. Louis Cardinals...
. Schilling was the winning pitcher in both games, and his blood-soaked sock gave a new meaning to the term Red Sox during the team's improbable run towards their first world championship in 86 years.