As Fernandez goes down, here's a solution to arm injury epidemic

Tuesday May 13th, 2014

Jose Fernandez, 2013's NL Rookie of the Year, was off to a 4-2 start with a 2.44 ERA this season.
Lenny Ignelzi/AP

The reaction has become a cliché. A young star pitcher blows out his elbow and his team can't believe it because it treated him with kid gloves. This time it is Jose Fernandez, 21, of the Marlins who is shut down and his manager, Mike Redmond, who provided the stock disbelief.

"We've protected him," Redmond told reporters Monday. "We've been consistent in how we've used him, with his workload. We've given him extra days. That's a question I don't think anybody has the answer to."

Stephen Strasburg, Matt Harvey, Dylan Bundy, Jameson Taillon, Fernandez ... it's the same old story. Same old rhetoric. All "babied." All hurt. It's time for some new perspectives. The idea that careful professional workload is the gold standard of prevention -- the "saving bullets" theory -- seems much too simple now. It's not working.

What should be studied is the effect of extreme velocity on a young arm. As the major league average velocity has jumped in the past four years, a similar spike is occurring in the amateur market. The stress of violent pitching, including before pitchers turn pro, is threatening young arms. Think about this: Last September, at the end of a rookie season in which he threw 172⅔ major league innings, Fernandez averaged 97 mph with his fastball. He was just 20 years old. And the sweep, spin and velocity of his slider were like nothing we have seen since Kerry Wood, who also broke down at 21.

JAFFE: Marlins' Fernandez headed to DL with elbow injury

"What you have to remember is that every incremental increase in velocity increases the force by multiples," said one MLB medical professional who did not want to be named. "It's like the Richter Scale. And quick jumps in velocity are particularly troublesome. We have a pitcher who can throw 97, but we don't want him to. He's much better off throwing 94.

"So far we've seen an inordinate amount of Tommy John surgeries this year this early. People say 'we're on pace for . . .' but you can't go by that. Will it level off? Will it increase? You don't know the answer. But the scary part is that statistically the month with the most breakdowns has been June. We're not even there yet."

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." Years ago the biomechanical 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. In other words, pitchers routinely work right up to the line of the body's limit.

Now imagine all of that force on a teenage arm. Just the other day I spoke with another former first-round pick out of high school, Matt Cain. He was drafted in 2002. On the day a Giants scout discovered him as a senior at Houston High in Germantown, Tenn., Cain said he was throwing 89 mph. (He hit 94 by the end of that season.) Elite high schoolers today throw in the upper 90s -- and they do so more often in year-round competition under stress (travel ball, tournaments, showcases, etc.). And they are breaking down at an increased rate.

Last month I wrote about how pitchers are damaged even before they sign pro contracts and before they get the kind of kid glove treatment Redmond referenced. I found that high school pitchers drafted among the top 30 picks from 2010-12 were five times more likely to blow out their elbows than top 30 high school picks from 2002-09. And if Fernandez needs Tommy John surgery, the incidence will grow to six times more likely, with 38 percent of elite high school draft picks getting Tommy John surgery before age 22 (six of 16).

VERDUCCI: Overuse fueling Tommy John problem

What used to be an injury of attrition (Tommy John was 32 and had thrown more than 2,000 major league innings before his groundbreaking surgery) has become an injury of too much too soon -- too much velocity and too much stress. The average age of the 22 major league pitchers to need Tommy John surgery this year is just 23.4 years old.

Wait, it gets worse: A study out just this month in the Journal of the American Academy of Orthopedic Surgeons found that year-round play in the amateur market has contributed to a 10-fold increase in Tommy John surgeries for youth pitchers.

What can be done? It's time for Major League Baseball to lower the mound -- and for the entire amateur market to follow its lead. When I took part in an MLB Network roundtable discussion last week on the epidemic of Tommy John surgeries, what struck me as most profound was the statement of fact by both Mets team physician Dr. David Altchek and biomechanics expert and former pitcher Tom House that the greater the slope of the mound the greater the forces that are applied to the arm. Reduce the height of the mound and you reduce the forces upon the arm.

It makes perfect sense. What makes no sense is that 13-year-old kids are pitching off the same size mound as major league pitchers. Little Leaguers should be throwing off flat ground. (What's the first step for pitchers as they come back from injury? They throw off flat ground. Why? It's less strenuous.)

There happens to be another compelling reason to lower the mound besides saving the elbows of pitchers: the game needs offense. People, especially inside the game, are not paying nearly enough attention to how the game has been bastardized in just the past five years by the increase in velocity and the specialization of bullpens. Games are getting longer and longer with less and less action -- a terrible combination in any era, but especially this one in which commerce and culture move at a quickened pace. The proliferation of pitching changes (men standing around killing time, pitchers warming up after they just spent the past 15 minutes warming up) and strikeouts are harming the pace of action more than anything else.

Strikeouts are up for a ninth straight year. Singles have reached an all-time low. But what is happening in the late innings of games is a particularly insidious problem. Offense dries up to absurdly low levels and the ball doesn't even get put into play enough. The long endgame is about managers bringing in one hard-throwing specialist after another in the eternal quest to gain the platoon advantage and keep the ball out of play. Some teams are using eight-man bullpens and clamoring for a 26-man roster so they can add yet another arm. This trend must stop.

Most every sport increases action and drama as the game draws near to its end; football teams can go to a hurry-up offense, hockey teams can pull their goalie, basketball teams can shoot more three-pointers . . . but the closer baseball games get to their conclusion the more they slow down and the less likely teams are to get a hit, which makes the excitement of the comeback less likely.

Let's use the National League as an example. From the seventh through ninth innings, nearly one out of every four at-bats ends in a strikeout (24.1%). In those innings, batters are hitting .232.

Now here's the context you need to know about that batting average. The worst hitting in the league's history occurred in 1908, when batters hit .239 for the season. So what is happening in today's game is that the late innings have turned into a brand of offensive baseball that is worse than the deadest of the Deadball Era years.

The overall MLB average in innings 7-9 is .240; only three full seasons ever have been worse: 1888, 1908 and 1968 -- the year hitting was so bad it prompted MLB to lower the mound. Scoring immediately shot up 19 percent.

It's time to act again. We have reached a convergence of the biggest on-field problems affecting baseball: the increase in strikeouts, the drag on offense and pace of play caused by increased bullpen usage and the epidemic of Tommy John surgeries on young pitchers. All of those problems can be addressed by lowering the mound. Baseball shouldn't wait for more young stars to blow out their elbows before deciding to do something about it.

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