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.