His hair whips around the back of his neck nearly as violently as his breaking ball dives away from hitters, a motion about as signature as the Guy Fawkes visage beneath the Milwaukee Brewers logo on his hat.

Yet if there is one thing truly John Axford, it's when he turns his forearm over to show his wrist and the inside of his right elbow. It's not the scar that's unique, mind you, but the prominent bone jutting out beside it.

The fibrous skin that runs up his elbow is the lasting, external effect of Tommy John surgery. The joint protruding more than normal beside it may be the reason Axford, now nine years (and eight seasons; Axford sat out in 2004) removed from that procedure, can avoid the same fate as former teammate and San Francisco Giants closer Brian Wilson.

Wilson, like Axford a popular and hirsute ninth-inning wonder, also had Tommy John surgery in 2003. He seems headed that way a second time.

A recent Sports Illustrated report broke down the break down of relievers – closers especially – with data that suggests Axford is headed to a similar path.

But there's that bone, which no one else has, along with a hamstring that holds it all together.

"The way the doctor described it was, it was a few pieces of string that's now become a noose rope. I had what many people do not, which is a lack of a tendon in my wrist," Axford said, pushing up his sleeves.

"So they used my hamstring. So it was thicker and stronger, and they looped it through four times. Generally it used to be two, then they started switching to three. They could do four really easily with me because I had such a prominent elbow bone."

The doctors told him he shouldn't have an elbow problem again, though he did have shoulder discomfort shortly after his comeback as he rediscovered his pitching motion. Since finding what works, he's been strong ever since.

While the scar is a permanent reminder of the surgery, it's unseen most of the time, which fine by Axford – out of sight, out of mind. He's also not one to say that just because he is a closer he is any more prone to re-injury than someone making 30 starts.

"As a pitcher in general I think you're more susceptible to more injury than a position player because of all the torque and the effort you have to put in every single day on your shoulder and your elbow," he said. "I don't know. It's nothing I think about every single day, that's for sure."

Axford certainly doesn't feel he's an "injury waiting to happen", but did allow for the fact that despite the inherent strengths in his "new" elbow, its workings are one of sport's greatest unknowns – especially when asked to deliver a baseball overhand, down a hill, while snapping a wrist.

Its maintenance is still, clearly, a work in progress.

Pitching mechanics, balance, the strength of the legs, core, back and shoulders, all play a role in whether that noose remains taught.

"The elbow is such a tough thing," he admitted. "Throwing a baseball is the most unnatural thing you can do in sports, other than serving a tennis ball. So it's going to put a lot of strain on your elbow. You just have to take care of it. Certainly you have to understand and know of your body.

"If you're putting too much strain on it outside of your throwing program and outside of the games, then obviously that's not going to be good. But if you're not doing enough to maintain your shoulder work and elbow work, then you're going to hurt it then too."

With that, Axford turned to his mail and began opening up new stickers for the bullpen bag. His sleeves fell down over his arms.

Out of sight, out of mind.