I hadn't planned on writing this article. I prefer to focus on topics and personal anecdotes that don't receive a lot (if any) of press. Besides that, what the heck do I know about the ulnar collateral ligament? But with the need for Tommy John surgery reaching epidemic proportions, I've come to understand that these players don't need more experts... they need advocates.
Since the spring of this year, over 45 pitchers have undergone surgery to repair the now infamous elbow ligament. If you count players from all levels of play, including high school and college, the number since 2010 extends beyond 300. What used to be a rare procedure performed to extend the careers of aging veterans, is now common among pitchers in their teens and early 20s. This seems unfathomable in an era when pitch counts and inning limits are strictly enforced, and technology allows for more control over throwing mechanics than ever before.
There are two reasons why baseball teams have begun placing throwing restrictions on their young pitchers. The first is to gradually stretch them out over a number of years. The philosophy here is that a pitcher is more likely to incur injury if he experiences a dramatic increase in workload from one year to the next. The second reason is to prevent them from becoming too fatigued, as a player's throwing mechanics tend to slip as his body tires out over the course of a game and/or season.
The justifications for limiting a pitchers workload make perfect sense. The problem is, it doesn't appear to be working. Despite teams best efforts to protect their young stars, elbow ligaments continue to tear apart at alarming rates. There has to be something else going on. If you've been following the press on this topic, you may have come across the below reference to a study done by the American Sports Medicine Institute (such as in this article):
The justifications for limiting a pitchers workload make perfect sense. The problem is, it doesn't appear to be working. Despite teams best efforts to protect their young stars, elbow ligaments continue to tear apart at alarming rates. There has to be something else going on. If you've been following the press on this topic, you may have come across the below reference to a study done by the American Sports Medicine Institute (such as in this article):
"Years ago, bio-mechanical experts at the American Sports Medicine Institute studied cadavers to see just how much force a human arm could withstand. They increased the force on the arm until the ligaments blew apart. What they found was that the human arm broke apart at 40 pounds of force. The typical major league pitcher experiences about 40 pounds of force pushing down on his arm and shoulder as he raises the baseball to the loaded position. In other words, pitchers routinely work right up to the line of the body's limit."
Before I go further, let me offer a disclaimer: through a quick Google search, I was able to find several references to this study, but I was not able to find the study itself. Assuming it's true, you can start to understand why UCL tears have become such a frequent event. When you take into account that the harder a pitcher throws, the more force is placed on the ligament, it's amazing that there weren't more young elbows blowing out prior to the current epidemic.
So... why weren't there? It turns out there are a lot of theories on that. Some say that year-round competition has replaced what used to be an off-season, diminishing the time-frame for players to rest and heal between seasons. Others have argued that all these restricted innings have actually hurt pitchers, making them weaker and less durable. Mets' broadcaster Ron Darling, a former pitcher with 14 seasons of MLB experience, has a theory of his own. During a game earlier this season, Darling pointed out a fundamental difference in pitching philosophy between his generation of pitchers and the current one. Darling explained that he and his contemporaries saw a game as having a beginning, middle, and end. They didn't throw 95+ mph heat from the first pitch. They held something back, reserving their hardest pitches for their second or third time around the batting order; or only for the most strategic situations. The goal was to pace themselves in order to pitch a full game, or come as close as possible.
Fast forward to to the 2000s. The new philosophy is to put maximum effort into every pitch. A pitcher will throw a 97 mph because he can. Why hold back? The goal is to throw as hard as possible for as long as possible (6 innings is now considered a full outing) and then hand the ball to the bullpen. According to Darling's theory, coaches aren't really protecting players by limiting them to 100 pitches per start. They are endangering players by ALLOWING them to throw their absolute hardest for most of those 100.
Scott Boras, the player agent known for getting baseball's most lucrative deals for his clients, has also taken a special interest in this issue. Employing a team of researchers, Boras can produce statistics on pretty much anything baseball related. While taking part in a Smithsonian speaker series this summer, he put forth another theory. According to his research, pitchers who make their MLB debut at age 25 or older are significantly less likely to require Tommy John surgery than those who debut at younger ages. Why? Boras speculates that younger players compensate for their lack of experience with fastball velocity. Older pitchers, given the chance to develop in less competitive levels, have learned to vary their speeds and hit their spots. When they come up to the big leagues, they are throwing smarter instead of harder.
Boras also expressed concern that some high school and college players are being exploited by their coaches, getting pushed to stay in games too long and/or pitch on short rest. Coaches, at all levels, want to win... and may even need to win in order to keep their jobs. Teenagers, who tend to believe they are indestructible, don't necessarily have the mental maturity to understand the long-term consequences of taking on such a heavy workload at such a young age. These coaches need to understand that they are not only responsible for their teams present-day success, but also for the general well-being of their players down the road. It all adds up to a difficult situation in which young people, and their pitching elbows, are put at risk.
A position statement released by surgeon Dr. James Andrews, and other experts at the American Sports Medicine Institute, seems to support many of these theories (in particular, the harm of year-round competition, the importance of holding back from full speed, and the long-term consequences of over-use at an early age). With this report, the baseball world can no longer claim ignorance on the matter. But will it be enough? Or will the allure of power-pitchers who can light up radar guns - and draw in fans - with triple digits prove too hard to resist?
The time for sitting around and talking about theories is over. Just like the series of new rules in the 1950s mandating the use of batting helmets for all players from Little League to the Majors, it's time for a set of new rules - throughout organized ball - protecting young players' elbows from abuse and overuse.
Photos by Danial Orange unless otherwise noted: 1. 2013 Topps baseball cards altered with photo-altering software; 2. Stephen Strasburg scoreboard shot during his MLB debut; 3. Ron Darling addresses a crowd at the 2014 Queens Baseball Conference; 4. Scott Boras puts forth his theory at a Smithsonian speaker series event.
