SAN FRANCISCO — After every outing late in his career, never fail, Bud Black’s left elbow would swell. He would begin feeling the pain in his pitching arm at a certain number of throws each game, with it varying based on the circumstances.

The veteran Colorado Rockies manager never had an MRI exam back in the day, just an X-ray, but he didn’t need a fancy scan to tell him there was significant structural damage.

Already in his mid-30s, Tommy John surgery became a viable option for Black, yet given the stage of his career along with a long recovery timetable, he knew it would have put him close to 38 once he returned to the mound. So he decided to keep pitching through the pain.

Black has no regrets, even knowing how many players have thrived after the elbow ligament reconstruction procedure, which is celebrating its 50th anniversary.

Fewer than 100 professional pitchers had undergone Tommy John surgery when Black retired in 1995. Now, that number is more than 2,200, according to data compiled by baseball researcher Jon Roegele.

“Back then in the early 90s in my last couple years with the Giants, I had some elbow discomfort, but I was one of those guys that my elbow just progressively started to end up with some trauma that probably in this day in age would have required Tommy John,” Black shared. “There’s a lot of pitchers who have that one-time event — one pitch or one game — where it progressively got worse and by the end of that game they needed Tommy John. Mine sort of happened over a couple years and I was able to pitch through a lot.”

In fact, Black posted double-digit wins each year from 1989-1992 — the initial three of those reaching 200 innings — then went 8-2 over 16 starts in 1993 with the Giants before making 10 starts each of the next two years while going 4-2 both seasons for San Francisco and Cleveland.

“I came back in ’94 and started games and then we went on strike and then in ’95 my last year I made 12 starts and ended up getting released,” he said. “A couple of those last starts in Cleveland I could feel my elbow. I wasn’t going to be able to withstand the length of the season. My elbow started bothering me.”

All these years later as a longtime manager, the 66-year-old Black is thrilled he can still throw pain-free batting practice and hit groundballs during drills with the Rockies.

He can golf for fun, too.

Doing anything at game speed would be another story, however.

“What happens with a compromised ligament or a torn ligament as a professional baseball player, that high-intensity throw, that high-intensity swing, the effort you need to compete at, you can’t do it if you have a torn ligament, if you have a torn UCL," he said. "Same thing with the anterior cruciate ligament of your knee. If somebody tears their ligament in regular everyday life. you can compensate and get through it without an ACL repair, but to compete at the highest level, the ACL in the knee and the UCL in the elbow, they have to be repaired.”

Hall of Famer Nolan Ryan pitched the latter part of his career with a damaged UCL and chose not to have the surgery.

“He was still throwing mid-90s,” said retired right-hander R.A. Dickey, who never had a visible UCL on MRI scans and didn't need anything other than arthroscopic surgery along the way.

Dickey, drafted by Texas 18th overall in 1996 out of Tennessee, crossed paths with Ryan while pitching in the Rangers organization.

“I think it affected his recovery from time to time," Dickey said. "He had a partial rip in his UCL. He was sharing that with me to try and encourage me.”

In Black's case, had he been younger, earlier on in his career, he might have gone a different route with his elbow. He realizes every case is so individual.

“I would have considered the surgery for sure, but where I was in my career, it just didn’t make sense,” Black said. “It’s so unique to each pitcher what they’re able to do physically even though their ligament is compromised.”

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