Tommy John talk

[Tharvot]

My friends and I have been discussing this for a while and this morning the radio show I listen to on morning drive also delved into it.

Here's the general issue: more and more pitchers are blowing out their arms and are needing TJ surgery. In fact, roughly 1/3 of MLB pitchers have or are scheduled to have the procedure. The year for the most surgeries was 2012 when 60 something pitchers went under the knife and we are on track to shatter that record this year. The question is why the recent rash of injuries considering the lengths to which pitchers are being looked after these days?

I have some experience in the sport and my very amateur opinion is that its a combination of things:

1. Pitchers have become very big. The average height for a MLB pitcher has got to be in the mid 6ft range. Pitchers have also gained weight in muscle as weight training has been really stressed in recent years. This added size and weight means added stress on the elbow ligaments.

2. Velocity is out of control. Pitchers are throwing much harder than they ever did. Seems just about every team has a guy that can break triple digits and its fairly routine to have a slew of guys throwing in the mid to upper 90s. I think the avg fastball was around 93 last year. If you have never seen it, check out a pitcher throwing in slow motion and the extreme torque and stress that the elbow goes under. Its the most violent motion in sports. The increased velocity means more stress on that ligament and more force placed on the elbow ligament.

3. Overwork. This starts at the youth level with year round baseball and continues through high school in most cases. The radio said an elite level pitcher (think first round prospect out of high school) is 5-6x more likely to have TJ by 23 than a normal pitcher. This seems counter to the idea of pitch counts that have been pretty strict recently. I think an unintended consequence of the pitch count is that a pitcher will give max effort knowing that he is limited in the number of pitches he can throw. With no pitch count, a pitcher is forced to hold something in reserve and pace himself more if he wants to throw the full game. Max effort combined with the over work that elite level pitchers go under in year-round tourney teams is a recipe for disaster.

Anyone have further thoughts on this? Any remedies?

 

[Fountain City Blues]

My friends and I have been discussing this for a while and this morning the radio show I listen to on morning drive also delved into it.

Here's the general issue: more and more pitchers are blowing out their arms and are needing TJ surgery. In fact, roughly 1/3 of MLB pitchers have or are scheduled to have the procedure. The year for the most surgeries was 2012 when 60 something pitchers went under the knife and we are on track to shatter that record this year. The question is why the recent rash of injuries considering the lengths to which pitchers are being looked after these days?

I have some experience in the sport and my very amateur opinion is that its a combination of things:

1. Pitchers have become very big. The average height for a MLB pitcher has got to be in the mid 6ft range. Pitchers have also gained weight in muscle as weight training has been really stressed in recent years. This added size and weight means added stress on the elbow ligaments.

2. Velocity is out of control. Pitchers are throwing much harder than they ever did. Seems just about every team has a guy that can break triple digits and its fairly routine to have a slew of guys throwing in the mid to upper 90s. I think the avg fastball was around 93 last year. If you have never seen it, check out a pitcher throwing in slow motion and the extreme torque and stress that the elbow goes under. Its the most violent motion in sports. The increased velocity means more stress on that ligament and more force placed on the elbow ligament.

3. Overwork. This starts at the youth level with year round baseball and continues through high school in most cases. The radio said an elite level pitcher (think first round prospect out of high school) is 5-6x more likely to have TJ by 23 than a normal pitcher. This seems counter to the idea of pitch counts that have been pretty strict recently. I think an unintended consequence of the pitch count is that a pitcher will give max effort knowing that he is limited in the number of pitches he can throw. With no pitch count, a pitcher is forced to hold something in reserve and pace himself more if he wants to throw the full game. Max effort combined with the over work that elite level pitchers go under in year-round tourney teams is a recipe for disaster.

Anyone have further thoughts on this? Any remedies?

I certainly agree that velocity and overwork at the younger levels seems to have quite a bit of impact on what we are seeing at the MLB level.

The big question I have looked into is the topic of height as well, and have thus far not found a ton of hard data so far , or articles on the topic. Personally, I would assume that mechanics would mostly override everything else assuming other factors like being overworked at a young age rather than height are at play. Then again, I am trying to look for the answer to support or deny such a guess.

I did find this (Pitching Mechanics | Eric Cressey | High Performance Training, Personal Training) which was somewhat interesting in regards to weight. Although, I would have liked to have more than that to look upon in my very, very, early search on the topic so far. Hopefully I'll find some journals to post in here later today when I am off work.

I think the remedy is superficially obvious in regards to the regulations (and pitch selection-- not all pitches are created equally for your elbow) for the younger levels as well as pitch count and IP over X span. However, I would kind of like to get a better idea for sure of what is causing this before trying to come up with solutions.

 

[Tharvot]

I included size in my guessing game (both height and weight) simply because longer and heavier arms will put more stress on the ligaments holding them together when they are whipped around.

Interesting you mentioned pitch selection, its pretty hard to change that up. I know some youth coaches are anti-curveball or slider. However, the most violent and stressful pitch on your arm is the fastball, which constitutes anywhere from 55-90% of most pitchers' overall pitch count. Maybe some pitch where you contort your arm inverted like a screwball or something would be worse for your arm, but in general terms the fastball provides the most wear and tear.

 

[Lemon Harang Pie]

I think it pretty much all comes down to velocity among today's pitchers. Being bigger and stronger certainly adds to that velocity and our bodies just aren't designed to handle that much stress.

I don't think workload makes much of a difference though.

 

[thedddd]

I got to listen to Mazzone's take on this and I find it very interesting. As for track record his is good for lack of elbow issues.

Former Atlanta Braves hitting coach Leo Mazzone knows why so many pitchers are getting hurt ? and it ain?t because of high pitch counts | Pitch Count

Side note whoever put this article out there obviously doesn't proof their work as they called Mazzone the hitting coach in the title and was correct in the article.

 

[The Derski]

Jose Fernandez season officially over. Tommy John around the corner.

 

[Lemon Harang Pie]

It's going to be interesting to see what teams do going forward.

At this point a team looking at a young fireballer has to believe there's a fair likelihood he could be sitting out 12 to 18 months at least once in the very near future and there's no guarantee TJ surgery will go well. I wonder if they'll just invest in shorter, incentive laden contracts or ask them to dial back the heat a little. I don't know how well that latter will really work. Can you really ask a young, competitive guy like Jose Fernandez to dial down his fastball and accept more hits and runs?

 

[Fountain City Blues]

Surprisingly, I found this nugget on an ESPN article:

http://espn.go.com/blog/sweetspot/p...-wave-of-potential-aces?ex_cid=espnapi_public


A 2010 study by Glenn P. Greenberg in the SABR Fall 2010 Baseball Research Journal found:

Height was not correlated to durability in seasons in which players were healthy, but that fact does not end the analysis. For us to be able to say that height does not correlate to durability at all, short pitchers would have to throw as much and stay off the disabled list as much as taller pitchers. The data for players on the disabled list at any time during 1994 through 2007 can be seen in table 5. There is no statistically significant correlation for games started or innings pitched; the highest r-square being .002 and the lowest p-value being .096. However, there is a correlation between height and games -- a negative one: greater height correlates to fewer games pitched.​

 

[Fountain City Blues]

I think it pretty much all comes down to velocity among today's pitchers. Being bigger and stronger certainly adds to that velocity and our bodies just aren't designed to handle that much stress.

I don't think workload makes much of a difference though.

Depends how much stress is actually going to the elbow. Biomechanics could probably give a lot of insight for an issue like this.

 

[wiskyisgood12]

I completely agree about the overwork argument. I'm not sure velocity has much to do with it, you can generate pretty significant velocity with your legs and not have wear and tear on your elbow.

I wonder if maybe a piece to the answer is increase the length of the minor league season. A young pitcher can take a pretty heavy hit in the number of innings throws from Triple A to MLB, and I'm not saying that's the only fix necessary but I wonder if that's a small piece that can help.

Or like someone else smaller incentive laden contracts for pitchers. I think pitch selection is a much bigger issue at the Little League level, I played little league baseball in 1999-2000 and even then the coaches really limited the number of curves that pitchers could throw in a given game, that's not realistic at the big league or even college level but I think little league can play a big role in helping to fix this.

 

[gvsulaker82]

Did david wells ever have it? Maybe the solution is to be out of shape and pitch drunk.


But my best guess would be just that pitchers are throwing harder and since the arm isnt supposed to be doing that motion over and over again it gives out at these velocities.

 

[gvsulaker82]

I completely agree about the overwork argument. I'm not sure velocity has much to do with it, you can generate pretty significant velocity with your legs and not have wear and tear on your elbow.

I wonder if maybe a piece to the answer is increase the length of the minor league season. A young pitcher can take a pretty heavy hit in the number of innings throws from Triple A to MLB, and I'm not saying that's the only fix necessary but I wonder if that's a small piece that can help.

Or like someone else smaller incentive laden contracts for pitchers. I think pitch selection is a much bigger issue at the Little League level, I played little league baseball in 1999-2000 and even then the coaches really limited the number of curves that pitchers could throw in a given game, that's not realistic at the big league or even college level but I think little league can play a big role in helping to fix this.

Pitchers used to pitch complete games, now they are lucky to pitch seven innings. How does your theory support relievers who only pitch a few innings a week? I would say velocity is the main contributing factor. Pitchers are throwing harder and their arms are paying for it. Wont be long and pitchers will be required to get the surgery before they are even on the team, as a preventative maintenance thing.

 

[wiskyisgood12]

Pitchers used to pitch complete games, now they are lucky to pitch seven innings. How does your theory support relievers who only pitch a few innings a week? I would say velocity is the main contributing factor. Pitchers are throwing harder and their arms are paying for it. Wont be long and pitchers will be required to get the surgery before they are even on the team, as a preventative maintenance thing.

And they're also pitching multiple times a week. As you said, teams are luck to get their starters through 7 innings, that's more work for back of the bullpen guys. Maybe you're right, maybe it is an issue related to velocity, but if that is the case the individual work load of pitchers is putting an even greater strain on elbows with the increased velocity.

 

[da55bums]

Pitchers used to complete more games but a lot of pitchers were out of the game sooner and replaced with new arms before Tommy John.

Arm issues have been around since the beginning of baseball and would guess if you hunted the numbers between HS, minors and majors say during the 20's or 30's, there were a lot of blown out arms that anyone realizes. TJ just gives a chance to come back from them.

Just read today of a HS Junior who already had Tommy John.

 

[gvsulaker82]

And they're also pitching multiple times a week. As you said, teams are luck to get their starters through 7 innings, that's more work for back of the bullpen guys. Maybe you're right, maybe it is an issue related to velocity, but if that is the case the individual work load of pitchers is putting an even greater strain on elbows with the increased velocity.

I agree its a combination of both I believe. Its just high velocity throwing repetitively in a manner that the arm is not built to do.

 

[MilkSpiller22]

I heard that the average speed of a pitch now is 92, even in the 1990s it was only 89...

 

[Loneranger]

I included size in my guessing game (both height and weight) simply because longer and heavier arms will put more stress on the ligaments holding them together when they are whipped around.

Interesting you mentioned pitch selection, its pretty hard to change that up. I know some youth coaches are anti-curveball or slider. However, the most violent and stressful pitch on your arm is the fastball, which constitutes anywhere from 55-90% of most pitchers' overall pitch count. Maybe some pitch where you contort your arm inverted like a screwball or something would be worse for your arm, but in general terms the fastball provides the most wear and tear.

Ok I've read your 1st couple posts and can't say I have any real disagreements with you. I'll tell you I've played the game professionally (not a pitcher) and worked in the professional game so here's my take. I really don't know. How's that ? We all know throwing/pitching is not a natural motion therefore we invite trouble by doing it. Personally I don't think velocity has anything to do with it. Although I haven't played in yrs I can tell you when I was 18 playing A Ball every single pitcher could throw 90 or he wasn't there. This was the early 80's btw. So the avg maybe higher today but I don't think it's relevant. I kinda believe this boils down to some people "have it" and a lot of people don't. There are just some guys out there with "rubber arms" who can go forever. These guys have always been around and always will be. I don't believe this is overwork at a young age , or any age for that matter. I believe it's gonna happen at some point to some people no matter how much they throw. Several yrs ago I made a comment to a guy the day will come where kids have TJ before they even need it just to get it over with. Kinda like a qualification of sorts to colleges or pro scouts etc. Not sure if that will actually happen but it just seems like it's headed that way. I would say if I were a pitching coach I would preach more work as opposed to less. I wouldn't be concerned about someone's elbow blowing out , I would focus on building strength and repetition - the perfect windup/delivery if you will. Everyone wants to come up with some magic answer that will prevent this from happening but I don't think that will ever come. We've all watched team after team protect their young pitchers with pitch counts etc only to have it backfire. It's happened a million times becuz counting/limiting pitches doesn't help anyone. If anything it delays the inevitable. Ok there's my 2 cents that answered nothing. Thanks for tuning in if ya read this far. Oh one more thing and this is my opinion - I believe the most stressful pitch to throw is a changeup. Try throwing one and tell me how it feels. It doesn't feel natural I can tell ya that.