The Schilling tendon procedure is a temporary surgical procedure developed by the former

Boston Red Sox The Boston Red Sox are an American professional baseball team based in Boston. The Red Sox compete in Major League Baseball (MLB) as a member club of the American League (AL) East division. Founded in as one of the American League's eig ...

team physician William Morgan, MD to stabilize the

peroneus brevis In human anatomy, the fibularis brevis (or peroneus brevis) is a muscle that lies underneath the fibularis longus within the lateral compartment of the leg. It acts to tilt the sole of the foot away from the midline of the body (eversion) and to ...

tendon A tendon or sinew is a tough, high-tensile-strength band of dense fibrous connective tissue that connects muscle to bone. It is able to transmit the mechanical forces of muscle contraction to the skeletal system without sacrificing its ability ...

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 A malleolus is the bony prominence on each side of the human ankle. Each leg is supported by two bones, the tibia on the inner side (medial) of the leg and the fibula on the outer side (lateral) of the leg. The medial malleolus is the promi ...

, 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 is one of the four primary types of animal tissue, along with epithelial tissue, muscle tissue, and nervous tissue. It develops from the mesenchyme derived from the mesoderm the middle embryonic germ layer. Connective tissue ...

. These sutures provide a temporary barrier, preventing the tendon from moving anteriorly over the malleolus. This procedure was first tested on a cadaver to establish if the surgery would work or not. 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 (MLB) is a professional baseball organization and the oldest major professional sports league in the world. MLB is composed of 30 total teams, divided equally between the National League (NL) and the American League (AL) ...

pitcher

Curt Schilling Curtis Montague Schilling (born November 14, 1966) is an American former Major League Baseball right-handed pitcher who is a commentator for conservative media outlet BlazeTV. He helped lead the Philadelphia Phillies to a World Series appearance ...

, who required the surgery to be able to pitch for the

in Game 6 of the

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, and the right to play in the 2004 World Series. A rematch of the 2003 American League Champion ...

and Game 2 of the

2004 World Series The 2004 World Series was the championship series of Major League Baseball's (MLB) 2004 season. The 100th edition of the World Series, it was a best-of-seven playoff between the American League (AL) champion Boston Red Sox and the National Leag ...

References

Orthopedic surgical procedures {{Treatment-stub