by Jay Lieberman, DPM
Editor and Curriculum Developer
PRESENT

What is "The Curse of the Bambino" ? In 1918 the Red Sox won their 5th World Series, the most by any club at that time. One of the stars of the Boston championship franchise was a young pitcher by the name of George Herman Ruth, aka The Babe or The Bambino. In 1920, however, Red Sox owner Harry Frazee needed money to finance his girlfriend's play, so he sold Babe Ruth's contract to Colonel Jacob Ruppert's New York Yankees for $100,000 (plus a loan collateralized by Fenway Park). Since then, the Yankees, who had never won a World Championship before acquiring Ruth, have gone on to win 26, and are arguably one of the greatest success stories in the history of sport. Meanwhile, the Boston Red Sox have appeared in only four World Series since 1918, losing each one in game seven. Many consider Boston's performance after the departure of Babe Ruth to be attributable to "The Curse of the Bambino."

 

 

Victory in Game One of the Yankee's - Red Sox series was supposed to be guaranteed because baseball's premier pitcher, Curt Schilling was on the mound for the Sox.  But the "Curse of the Bambino" tried to rear its ugly head.  Schilling got rocked in Game One.  Baseball aficionados noticed a slight hitch in his mechanics, particularly the way his right foot pushed off the pitching rubber.  

A behind the scenes medical drama began in earnest on October 5th, when Schilling stumbled painfully while fielding a grounder against the Angels in the first game of that series.  Initial reports suggested that he had suffered a mild ankle sprain.  In actuality, Schilling tore the superior peroneal retinaculum, causing the peroneal tendon to dislocate from its normal anatomic position in the retro fibular sulcus.   Each time he pushed off the pitching rubber, Schilling experienced a painful popping sensation.   Additionally, there was general weakness in the ankle. 

Red Sox' Medical Director, Bill Morgan and his staff scrambled to find a solution to Schilling's difficulties.  In Game One of the Yankee series, taping and an ankle brace was tried, to keep the tendon snug.  It failed.  Reebok attempted to design a high-top cleat, hoping it would stabilize the tendon.  Schilling tested the cleat in the bullpen at Fenway Park, but it did not offer the desired result.

A peroneal subluxation and dislocation results from a rapid dorsiflexory force across the ankle with simultaneous violent reflex contraction of the peroneal tendons.  The failure of the superior peroneal retinaculum allows the tendons to migrate anteriorly against the fibula.  The peroneal tendons are active during midstance, firing after forefoot loading.  The dislocation is reproduced with ankle dorsiflexion and subtalar joint eversion.  One can easily envision why this injury interfered with Schilling's ability to propel himself off the pitching rubber.  

Conservative care of peroneal subluxation injuries involve six weeks of non weight bearing cast immobilization with the foot held in a plantar flexed position.  Unfortunately, conservative care is rarely successful.  Typically the injury is treated with surgery designed to stabilize the tendons.  Primary repair, tissue transfers, retro fibular groove deepening and bone blocking techniques are all commonly used.   Reconstructive surgery requires three months of rest and rehabilitation, but with the Red Sox in a 3-0 hole in a best of seven series, this was not an option. 

Doctors Bill Morgan and George Theodore decided to attempt a radical approach.  Rather than trying to force the tendon back into its normal position, they left it displaced outside the ankle.  They then sutured the surrounding skin to the deep tissue of his ankle.  The sutures created an artificial sheath and successfully prevented the painful movement of the tendon over the fibula.  Although the normal fulcrum that the peroneal tendon provides to the ankle was not present, it did not seem to impair Schillings performance.

No one knew how well the makeshift procedure would work during game conditions. Schilling's delivery seemed good, but the blood pooling on his sock made the Red Sox' fans nervous and the medical professionals curious.  

Schilling took a shut out into the seventh inning, was the driving force behind Boston's 4-2 victory, and forced a winner take all finale.   The rest is history.  Better luck next year Yankee fans.