By Dirk Hayhurst
The 2014 season is quickly becoming the year of the Tommy John surgery. There have already been 34 instances thus far, and now, with early National League Cy Young candidate Jose Fernandez sidelined with an elbow injury that will almost certainly land him on the operating table, the number feels less like front-loaded seasonal attrition and more like a contagion.
The injury to Fernandez came as a cannonball right through the hull of U.S.S. Marlin, effectively sinking their season. It just goes to show the difference excellent pitching makes for a club. Why then, with how big a role pitching plays in a team's success, aren't more drastic measures being taken to help arms stay healthy?
Maybe it's because baseball has set up a system wherein those who wouldn't otherwise have careers at all now have the chance to play longer than ever before. Over the last several decades, humans haven't made genetic leaps that allow them to throw baseballs harder. It's the training, nutrition, scouting, and body discrimination that have changed. Baseball has specialized.
It wants bigger, faster, stronger and harder-throwing products, and now it knows how to get them. Major League Baseball knows more about what helps generate fastball velocity, what kinds of mechanics generate more torque on arms, and what training regimens help high-test heat blossom than it ever has before.
Over the last decade, the average fastball velocity has trended up. But this sample size doesn't get its start in the pros. No, the pressure to increase speed trickles all the way down to the amateur levels, maybe as close as the ballpark in your back yard. For MLB to get that steady influx of heat, regimens that impact and influence the health of amateurs must be employed early and often. This means more young pitchers must throw more, trainer harder, and test the limits of their own health more often.
Data from the American Sports Medicine Institute in Birmingham, Ala. suggests that overuse starting at a young age and specialization dramatically increases the likelihood of Tommy John surgery. In fact, ASMI's Dr. Glenn Fleisig says teenage pitchers who throw more than 100 innings in a calendar year are up to three times as likely to go under the knife.
But 100 innings in a single year is nothing for today's young pitcher, especially when some are playing ball four seasons a year. Travel leagues, Fall Ball, tournament leagues, spring ball, winter ball, school ball, all-star leagues, classics, camps... and the list goes on, with some kids playing in multiple leagues at the same time.
Why so much baseball at such a young age? Simple -- because the game has gotten more specialized at the top, it's become more specialized at the bottom. It's a highly competitive market, with very few opportunities the higher up the ladder you go. A young player who cannot pitch on one team will join another team where he can and play for both. If you want to be one of the chosen few who advance, you must be honed and above all, noticed.
And getting noticed means constantly being ready to audition. A young player never knows which outing will be the one that gets a college or pro scout sweet on him, or which radar gun will give him the magic number. He must sell his wares in every trumped-up league he can log an inning in. And this says nothing of all the extra innings logged during instructional settings, camps, talent mills, and tryouts.
Many of today's young pitchers have private, ex-professional grade instructors. Some even have personal strength trainers as early as little league.
In an effort to prevent overuse, baseball at the amateur levels has instituted pitch limits in hopes of protecting arms. The limits are employed early, and meant to be a guideline. However, in many cases, they only serve to make kids join more leagues where the pitching and innings limits don't cross over. Even with pitching limits, not all pitches are equal. How stressful was it on a pitcher? How much did he feel he had to overthrow to get noticed? How much throwing did he do before he took the mound, in warm-ups, in practice, in another league? Did he throw mostly fastballs or poorly taught, elbow wrenching breaking balls?
There are some that even contest that it's the pitch and inning limits themselves that break young hurlers because setting them makes pitchers too weak!
The weakness argument has been made often, but maybe none more loudly than when former New York Mets pitcher and Hall of Famer Tom Seaver made his in the aftermath of the Matt Harvey injury last year:
"You can't predict these things, and there's really not a whole lot you can do to prevent them other than refining your mechanics Rube did with us. But one way I know doesn't do anything to prevent them is babying these kids like they do...
"Imagine if these computer geeks who are running baseball now were allowed to run a war? They'd be telling our soldiers: 'That's enough. You've fired too many bullets from your rifle this week!'"
Seaver is right about one thing: The pitchers of the past did throw more than the pitchers of today. But the argument that pitchers of the past were more resilient simply because they pitched more and always did is not really an argument at all -- especially not when the arguer himself admits "you can't predict these things" before making it. Throwing a lot and surviving the process doesn't mean it works, it means there is survivorship bias.
There will always be freaks with amazing resilience in baseball, but the "the old ways were best" argument omits that the pitchers of the past had to be freaks because that's what the old system relied on. In the 60s and 70s and early 80s, baseball brought hundreds of bodies to spring training. So many, in fact, that lunches were served in shifts and players had numbers pinned on their backs like marathon runners, with some of the numbers reaching triple digits.
There was no real sports medicine. Back then, when a player's arm gave out, there was no method by which to fix him, not until Tommy John surgery came along in 1974. Yet, even with the success of the surgery, players who complained of arm pain were often mocked as weaklings. Tommy John himself was mocked for opting for the surgery. Players believed that you could run the pain out of their arms, or should take drugs, drink, and man up. Surgery was for pussies.
To make it to the top, then, meant you had to have an unnaturally resilient arm. While many analysts and fans bemoan the rate at which injuries seem to occur to talented players, consider how many players' careers ended simply because there was never a way to fix them. Times have changed, surgery is saving careers. But a fact that remains is, pitching -- no matter how refined a pitcher's mechanics are -- is still dangerous and unnatural, whether you end up on the cutting table or not.
Before I had my first shoulder MRI, I was told that the result would show damage. Anyone at my age who'd thrown as much as I had, had damage in their arm -- it was just a matter of how much. This was years before I had my first shoulder surgery. There was already scaring, fraying, and, most alarmingly, my humerus bone was twisted. Years of reaching back over my head to throw a baseball and the catapult like action of levering it through the air had actually rotated the head of the humerus like a wound bath towel.
The doctors performing the surgery said that repairing my arm wasn't so much about getting me back to normal as it was getting me back to whatever was normal for a body that had grown accustomed to years of throwing. While Tommy John surgery is much further along than shoulder surgeries in regards to its success rates, it still turns a body back to something that is abnormal for most humans, and enables a pitcher to keep performing an unnatural act. Pitching isn't an injury waiting to happen, it's an injury happening.
So should young players stop pitching? Will baseball have to make due with the fact that, because the specialization in power arms will continue to rise, Tommy John surgery will also continue? Should it police amateur leagues in an effort to save young pitchers' bullets until they reach the pros? Or should it go back to drafting hundreds of bodies and populate pitching staffs with those resilient freaks with invincible ligaments?
Maybe the best course of action is to shift the focus off the fastball altogether. Scouts love flame-throwing pitchers because they can leave a pitch in the middle of the zone and still miss bats thanks to their pure power. They have a higher margin of error. That said, hitters have started to adjust their timing. And while velocity is great, it isn't always enough as hitters continue to specialize in hitting it.
The problem is, velocity IS enough to get your drafted. Just like a flame-throwing arm can get away with more mistakes, a scout, knowing what velocity can translate into, will take more risks on power arms than on lower velocity, less impressive, potentially more resilient pitchers.
Furthermore, throwing hard also gives you more opportunities to stay in the game. If Matt Bush, the 2004 first-round pick of the San Diego Padres, was just a shortstop with a lackluster batting average, he would have been out of the game after his first run-in with the law. But he could throw 98 mph off a mound. Thus, despite a drinking problem and a history of self-destructive behavior, he found his way through a few organizations willing to give him another chance. It's a tragic story, but one that lasted longer than it would otherwise have if a certain skill set wasn't there.
Because of the market's bias for power pitching, throwing hard is the best way to get paid to play baseball. Even if you have to get surgery multiple times in the process -- it's what the market wants.
If the market suddenly decided that throwing in the high-80 to low-90 mph range was desirable, and put a greater focus on movement and command, the shift would be felt all the way down to the bottom of the baseball food chain. If baseball wanted durability over power, there would no longer be a major push to break arms to achieve it. It stands to reason that pitchers would pitch less and keep themselves healthier.
But that's not what the market wants. And until it decides it wants something other than power, and stops being okay with how hard generating that power is on the body, expect Tommy John surgery to be a common way for a team's season to get sunk.
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Dirk Hayhurst is a former pitcher who spent nearly a decade in professional baseball between MiLB and MLB. He is also a best-selling author, and has appeared on Baseball America, Bleacher Report, Deadspin, The Score, ESPN, TBS' MLB postseason broadcasts, Sportsnet Canada and more. More from Dirk at www.dirkhayhurst.com. Follow him on Twitter at @thegarfoose.