When surgery will replace steroids

That topic on the Greatest superstars reminded me of this article.....

http://www.wired.com/wired/archive/13.03/start.html?pg=2
Why wait for an injury? The next-gen performance enhancer is elective surgery.
By Steven Johnson

Let's say you're a big-league pitcher, blessed with a good but not great arm. You've played several seasons in the majors, yet you've never managed to hold down a steady place in a starting rotation, mainly because you can't get quite enough velocity on the ball. You work with different pitching coaches and sports psychologists. You try new exercise and diet regimens. Ultimately, you decide that your innate talents aren't going to take you to the all-star level you've always dreamed of. You need a little help.

So you find a surgeon willing to drill a series of small holes in the humerus and ulna bones at your elbow, slice open your wrist and remove a tendon from it, and then weave the tendon in a _figure eight loop through the holes. After a year or so of rehab, you're throwing a 97-mph fastball for the first time in your life, and your career is transformed.

This is not a hypothetical situation. This particular elbow surgery has been a standard procedure in sports since the mid-'70s, when it was performed on Los Angeles Dodgers pitcher Tommy John. (He opted for the then-_experimental operation after suffering a potentially career-_ending torn ligament in his left elbow.) One in nine major-league pitchers active in 2001 and 2002 carried the scars of Tommy John surgery, as it is now called, including Chicago Cubs ace Kerry Wood, who reached his top velocity as a pitcher after recovering from the procedure.

To date, pitchers have opted for the surgery only after suffering ligament damage, but elective-enhancement surgery in baseball is inevitable - and it will show up in lots of other professional sports, too. It's a matter of three fundamental trends colliding. First, the rewards for playing at an all-star level are steadily approaching the half-billion-dollar mark. Second, steroids are becoming an increasingly untenable option; the drugs have a chemical profile that can be readily detected by simple tests. True, athletes have ways to mask steroid use, but the tests are evolving as fast as the masks are. (In January, baseball finally approved a serious random-testing program.) Finally, new surgical pro_cedures will be so effective and feature such rapid recovery time that Tommy John surgery will look like blood_letting by comparison.

In fact, there's a chance you've had one of these next-generation procedures: laser eye surgery. Great _hitters anticipate the type of pitch being thrown - fastball or curveball? - by detecting the rotation of the seams of the baseball, which means that good eyesight is as valuable to them as strength or agility. One study of more than a dozen players who had opted for laser surgery found that "players coming off eye surgery are likely to see sub_stantial improvements in batting average and power."

But poor vision can hardly be considered an injury. At least a pitcher with a torn ligament can say that he required surgery to repair an injury to his arm. Some batters naturally possess more muscle tissue than others; artificially manipulating that endowment with steroids violates the ethics of the sport. Other batters naturally possess better vision than others, but for some reason artificially augmenting that endowment is perfectly acceptable. If the sport objects to taking a pill or applying a cream that temporarily changes your body's chemistry, surely it should be an even graver offense to reshape your cornea or reengineer tendon and bone structure.

The surgical procedures that are now in beta will only make the ethical questions murkier. "We've been doing some of these procedures for 30 years," says Freddie Fu, an orthopedic surgeon at the University of Pittsburgh. "But we're only now starting to understand kinematics and mobility. In the next five to ten years, we're really going to understand how, say, the knee works in all three dimensions." In a decade, a quarter_back might have muscle cells removed from his legs. Those cells would then be engineered in the lab to be stronger and re_inserted, enabling a quarterback with the wisdom of a 35-year-old to run like he's 20. The same technique could be used around shoulder joints, adding power and durability to the arms of pitchers, weight lifters, and volleyball players. (Some sports medicine experts believe stem cells might be manipulated to grow even more enhanced replacement cells.) As minimally invasive and arthroscopic techniques improve, surgeons will be able to tweak bicyclists' hearts to increase stroke volume and reroute digestive systems to optimize energy absorption.

Medical ethicists are already starting to worry about the implications. Kerry Wood has extra juice on his fastball because of advanced medicine, not his natural abilities. Should baseball officials require all pitchers who have gone under the knife to demonstrate that they haven't artificially increased their velocity? And if they have, what's the penalty? Should they return to the operating table and have the ligaments loosened a notch or two?

For now, those messy questions can be left unanswered. Baseball has the excuse that surgery isn't prohibited, and steroids are. But as the science of physical enhancement progresses, that distinction will become difficult to justify. One of these years, a young pitcher is going to arrive on the scene having had some kind of experimental procedure before even making the major leagues. Great athletes have always been freaks of nature (think of Michael Phelps' extralong torso or Ted Williams' superhuman vision), but this kid will be something else: a freak of science. He'll throw pitches with such speed that even a player with surgically enhanced eyes won't be able to catch up to them. As he mows down batter after batter, a chorus of dissenters will complain that he has an unfair advantage. And the sport will have to make some hard decisions: Either let athletes have full recourse to the wonders of modern science, or draw the line at bionic arms.