The baseball cracked off the batter's bat and struck pitcher Mike Mullenix on the tip of his elbow.
"It happened so fast," Mullenix said. "I tried to move my arm. I knew something was wrong."
It was the summer of 2009, and Mullenix -- a baseball player since 6, and a star athlete for his high school -- was playing in an American Legion game just weeks before his senior year. He had high hopes for his career. There was a good chance he'd be recruited to a college team.
"I've been playing baseball since I was a kid," Mullenix said. "To not play senior year was not an option."
Mullenix's elbow was iced, and he was taken to an emergency room. He was given a temporary cast, and the family consulted an orthopedic surgeon.
The surgeon's prognosis was bleak: Mullenix's elbow wasn't just bruised. He had a break. A very bad break. Mullenix would take a year to heal completely, the surgeon said -- and he could forget about pitching again.
Mullenix's mother was concerned. "From a mother's perspective, and being a nurse, this was very traumatic," she said. "As far as dreams being shattered..."
Not willing to give up so easily, Mullenix's family sought a second opinion from NorthShore University HealthSystem orthopedic surgeon Bradley Dunlap, M.D. -- a former college hockey player who now specializes in sports medicine and arthroscopic surgery.
Dunlap quickly assessed that Mullenix had an olecranon fracture. The olecranon is near the end of the ulna, the bone in the forearm that forms the pointed portion of the elbow.
Mullenix's injury caused displacement of the elbow that extended up into the joint, putting him at future risk for pain and discomfort as he got older.
"To get hit with enough force to cause a fracture in that particular spot is pretty unusual," sad Dunlap. But, he added, "Mike [was] a pitcher who wanted to get back and pitch. Everything was defined by that goal, which was clear from the beginning."
Dunlap performed elbow surgery in July 2009. Relying on recent advancements in orthopedics, including modern fixation techniques, Dunlap affixed a metal plate with seven screws to hold the fracture together and allow the bone to heal.
Appropriately enough, the main screw that places the most compression on the fracture is called the "home run screw". That screw lets the weakened bone withstand movement without being torn apart.
After the surgery, Mullenix did three months of physical and occupational rehabilitation. And then he began his own physical conditioning.
In February 2010, Mullenix tried out for his senior year baseball team.
"It was nerve-wracking," he said, as he recalled the doubts and fears of returning to the field for the first time. But he persevered, and he made the team.
"Once I did it I thought, 'OK, I'm back."
But Mullenix didn't stop there. That summer he pitched in a summer showcase, and three NCAA Division III colleges extended invitations to play for their schools.
Mike Mullenix was indeed back, thanks to his own perseverance and the hard work of Dr. Dunlap and team.
"It's fun to see my patients back participating in the sports they love," said Dr. Dunlap. "It's a rewarding experience."
First in a four-part series on diagnosing and treating Chicagoan's major health problems including cancer, neurological ailments, cardiology concerns and orthopedics. For more info, refer to northshore.org.