Had Romeo not designed and executed a one-of-a-kind surgery to reattach Peavy's latissimus dorsi muscle after it tore free during his 2010 season, Peavy would not have been on the mound for the Red Sox in the 2013 World Series. He soaked in the experience, even buying one of Boston's duck boats after the parade, and is working to come back down to earth in time for the 2014 season.
This has been a spring of bad news for pitchers all around baseball, with ligaments snapping in elbows all around Florida and Arizona. The list of pitchers who have undergone Tommy John surgery or seem in line for that repair includes Jarrod Parker, Kris Medlen, Brandon Beachy, Patrick Corbin, Luke Hochevar and Bruce Rondon.
Peavy provides proof that science can help overcome serious injuries, and he's quick to give credit to the man who put him back together.
"I owe a lot to Dr. Romeo, and we've developed a great friendship," Peavy said. "He came down to my place this winter. Dr. Romeo is a tremendous, tremendous person. I think we all know how good of a doctor he is, but he's a great person."
Romeo, who bases his work out of Rush University Medical Center in Chicago and is part of Midwest Orthopaedics (CQ), who are part of the medical team for the White Sox and the Bulls, was hanging on every pitch by Peavy in Game 3 of the Fall Classic against the Cardinals.
"When you have a special person, personality like Jake, it's hard to avoid becoming interested and connected to him," Romeo said. "He's a colorful and charismatic individual. As you learn more about him, you admire him as a player and a person. I was happy for him because you could tell what that meant to him.''
Peavy invited a group of family friends, including Romeo, to Southern Falls, the compound that is part of the spoils from a career that includes a National League Cy Young Award in 2007, when he was only 26. He's earned $80 million since that career year with the Padres, and Peavy loves to share good times with friends and family.
Romeo said the weekend at Peavy's place was "like Duck Dynasty, except the Alabama version, not the Louisiana version.'' The activities included hunting, four-wheeling, basketball, bowling and singing around a campfire, all with a twang.
"I've never seen so many articles of clothing, hats and gloves that you can make with camouflage patterns,'' Romeo said from Arizona, where he was visiting another former patient, John Danks, at White Sox camp. "The boots, the pants, the jackets, the hats, the gloves, everything can be made in camouflage. And I can tell you that at Jake's compound, they have all of them.''
Before being traded to the Red Sox last July, Peavy had spent four years with the White Sox. It was a difficult and at times frightening part of his career, as he rarely felt like himself.
Peavy had been on the disabled list with a strained tendon in his right ankle when the White Sox acquired him from San Diego in 2009. He pushed himself to pitch down the stretch that season and inadvertently altered his mechanics, leading to a drop in velocity the next spring. He never seemed quite right, and in July, he walked off the mound in pain during a start against the Angels. He was diagnosed with a detached lat, putting his career in jeopardy.
It is an unusual injury for pitchers and historically had been treated with rest and rehab, not surgery. And while some had returned to pitching, they were "compromised in their ability and longevity,'' according to Romeo.
Peavy sought a variety of medical opinions, including a visit to Dr. James Andrews. But rather than attempt a procedure, Andrews recommended Romeo, who had become familiar with lat procedures while repairing the rotator cuffs of older patients.
Romeo was confident that he could help Peavy, and they did surgery on July 14, only eight days after Peavy had suffered the injury. Peavy pushed himself to get back on the mound in 2011, but he now says he probably shouldn't have pitched. He didn't have his fastball and went 7-7 with a 4.92 ERA in 18 starts and one emergency appearance out of Ozzie Guillen's bullpen in 2011.
The 2012 season was the last on Peavy's guaranteed contract, and he delivered his best season since winning the Cy Young Award. It convinced the White Sox to sign him two a two-year, $29 million contract with a player option for 2015, which he happily accepted rather than market himself for bigger deals elsewhere. By re-signing him, the White Sox gave themselves a chance to deal Peavy when they collapsed last season, landing right fielder Avisail Garcia and three younger prospects as part of a three-team deal that sent shortstop Jose Iglesias to Detroit.
It was the rare win-win-win trade, and that doesn't count what the chance to pitch for the Red Sox has done for Peavy. His sense of accomplishment was huge last October, and he's throwing the ball well this spring. In his last start, he was throwing 92-93 mph, which he said he would have done anything to do during his time with the White Sox.
Romeo is also encouraged by the progress that Danks has made in his slow recovery from the shoulder surgery he had on Aug. 6, 2012. He returned last season but didn't have his usual velocity and took his lumps, going 4-14 with a 4.75 ERA in 22 starts.
Danks is a good bet for a strong comeback season. He told Romeo that he's been completely pain-free after experiencing severe pain at times last season, and he has also discovered increased movement in his pitches.
"When I talked to John this year, he said, 'Did you do something to my shoulder? My fastball's got a sink to it now. Did you rearrange some things so the ball started moving more?'" Romeo said. "I really wish I could take credit for that, but there was nothing done at the time of the surgery that put more movement on the ball. … He's really having fun again with baseball, and is happy with how he feels.''
Romeo believes the wave of pitching injuries during Spring Training is part of a trend, not the kind of outlier that could be found with a small sample size.
"I think the game should be worried,'' Romeo said.
He said it's no longer enough for a pitching prospect to reach 90 mph with his fastball. He thinks young pitchers are pushing their bodies to throw in the mid-90s, with that effort leading them toward surgeon's tables.
"When you can't make it to the Major Leagues unless you throw into the low- to mid-90s, a lot of kids are going to be pushing their genetic potential as far as they can to try to get that ball going somewhere close to 95 miles per hour,'' he said. "They're going to try to get bigger, going to try to get stronger, going to try to learn techniques to throw the ball harder, and one of the first areas that is going to break down is going to be the elbow joint.''
Romeo would like to see more money invested in research to determine the causes of pitching injuries and programs that could keep pitchers healthy.
"It costs Major League Baseball more than half a billion dollars a year to pay for pitchers that are on the disabled list," Romeo said. "That's a lot of money to be paying for pitchers that can't throw a baseball competitively. I hope that people will continue to recognize this. We can do a better job of figuring out how not just to operate on these young men, but how to prevent them from having to undergo surgery."