The Most Valuable Player in Sports is ... this Doctor

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"If athletes come back from surgery, word travels like wildfire," says physical therapist Kevin Wilk. "And if they don't, they blame the doctor." | photo by Mark Heithoff

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Andrews's 2004 Auburn football SEC Champions ring (part of his collection) signals his hands' imprint on sports. | photo by Mark Heithoff

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When Jonathan Papelbon, the virtually unhittable closer for the Boston Red Sox, hurls a baseball at nearly 100 mph, his right arm becomes a fantastic and ferocious blur, rotating at about 7,500 degrees per second. If it were to keep going, spinning like a pinwheel, his limb would complete nearly 21 revolutions in the time it takes to say "Jonathan Papelbon." Adhering to the baseball adage that pitching wins games, the Red Sox have spent more than $43 million this season on Papelbon and other enviable arms. The team has been keenly aware of another adage as well: Pitching is a game of attrition. Over the grueling 162-game season, bending the arm way back and accelerating it forward, the fastest recorded human motion, is hard on shoulders and elbows. In fact, pitchers make up half of major-league rosters yet account for 7 in 10 injuries. To protect and maximize its investments, Boston has adopted a startlingly different approach. It originated off the field, 1,176 miles from Fenway Park, in the operating room of Dr. James Andrews, a groundbreaking orthopedic surgeon in Alabama. The idea is this: Prevent injuries by predicting them. The program, which Boston guards closely as a competitive advantage, is built upon a multitude of biomechanical breakthroughs from Andrews's practice. Sox pitching coach John Farrell, rehabilitation coordinator Mike Reinold, and their staff apply science to a realm long defined by hunches. "Instead of saying, 'He looks tight' or 'He looks loose,' we measure everything," says Reinold, who joined Boston in 2007 after eight years with Andrews. He and Farrell prescribe each pitcher a customized routine based on quantifying strength, fatigue, and flexibility; Papelbon and starter Josh Beckett focus on different muscles, because their bodies and pitching mechanics differ. Much like the Moneyball strategy employed by Oakland Athletics general manager Billy Beane, in which teams comb through unusual stats to better evaluate undeveloped talent, the Red Sox hope that Andrews's brand of unconventional testing will crack the mystery of injuries.

For more than three decades, Andrews has been a leader not only in spurring cutting-edge research but also in pioneering and refining operations and therapies that return athletes to action. Along with free agency and TV, this evolution of sports medicine has transformed sports from pastime to megabusiness. Andrews Sports Medicine and Orthopaedic Center in Birmingham functions as a powerful lever, a multimillion-dollar enterprise that affects multibillion-dollar leagues. An injured player is the equivalent of a dormant assembly line: If he isn't filling seats, he isn't generating revenue. Yet he's still getting paid. Last year, MLB teams spent $337 million -- almost 14% of payroll -- on players too hurt to play. When Andrews repairs those athletes (or helps them avoid injury), teams can optimize their investments, and players can extend their careers, reaping free agency's rewards. Take it from superagent Scott Boras, who estimates that his clients have signed about half a billion dollars in contracts after being treated by Andrews.

If you could assemble a superstar, Frankenstein-style, from Andrews's patients, it would have repaired knees from quarterbacks Peyton Manning and Donovan McNabb; a hip from dual-sports sensation Bo Jackson; shoulders from Michael Jordan and Charles Barkley; and elbows from the New York Yankees' Andy Pettitte and the Chicago Cubs' Kerry Wood. "I've always liked fixing people," Andrews says. "I want to get these athletes back to doing what they did before."

Like winning and earning. Greats such as Roger Clemens and Troy Aikman wouldn't have had the chance to become legends if Andrews's surgeries hadn't revived their early promise. Andrews treated Clemens in the Rocket's second year as a pro, Aikman in his third. "Andrews repaired something that other people had no idea how to fix," says Will Carroll, author of Saving the Pitcher, referring to Clemens's shoulder. Clemens and Aikman went on to make more than $200 million combined and win five world championships. In fact, in the last 20 years alone, Andrews's patients have led their teams to 20 World Series, Super Bowl, and NBA titles. Andrews has treated or advised thousands of players, and trained hundreds of doctors and therapists who've worked on thousands more. Between player contracts, revenue, and team valuations, his total financial impact on sports runs well into the billions.