The Elephant on the Mound


Dave Barnes is a New York Yankees fan residing in Philadelphia. He is also just a huge fan of the game and a baseball purist. Today he makes his debut on Diamond Hoggers. Expect a column from Dave from time to time.

For anyone who has been following the world’s greatest game closely over the past decade, there has been one story that has been more puzzling than any other. No, it’s not broad PED use. No, it’s not how the hell Nelson Cruz didn’t catch that World Series clinching fly ball in 2011. No, it’s not even how Jose Bautista went from being a decent utility player to a homerun hitter with Superman like bat speed in the MIDDLE of his career. While all of these certainly make one scratch their head, it is undeniably the Tommy John (Ulnar Collateral Ligament) surgery that has been the most puzzling, even to professionals. To understand this issue it is important to understand the surgery itself, as well as potential causes of the injury from both a physical and cultural perspective. Finally, some possible changes that could be made as well as some of the financial and procedural complications of these changes will be discussed. Simply put, the problem is not only complex but also deeply rooted in the athletes and even more importantly, all of us.

Before diving into a more abstract discussion of the issue, let’s take a look at what this medical condition really is. Before continuing, I must state that I am not a medical doctor (my graduate degree is in psychology) but over the years I’ve been able to scrap together a somewhat cohesive schema of the anatomy and physiology of the problem. The Ulnar Collateral Ligament (UCL/Tommy John Ligament) is a ligament that is responsible for stabilizing the elbow during overhead movements. Pitching, being the violent overhead motion that it is, strains this ligament. There are two separate types of injury, chronic (gradual) and traumatic (acute). The chronic condition can be treated more conservatively through activity modification, cessation of throwing, rest and a throwing program to (hopefully) strengthen the area back up to performance ready levels. The more acute “pop” situation is one that most often results in UCL reconstruction surgery. Simply put, humans did not evolve to throw things violently from an overhead angle, especially not 100-130 times within 2-3 hours. With that said, the sport of baseball has been played professionally for over a century, so the main question is where did all of this come from? Let’s take a look at some common responses that have been discussed in the media.

Perhaps the two causes that we have heard most commonly are kids throwing too much at a young age and excessive weight training of MLB pitchers. While I agree that these two circumstances may be correlated to the problem, I believe that the problem results from a much broader issue; the fusion between sports and the increasingly aggressive drive for money in western culture.

In 1930, if a kid was noticed to have a good arm he would be encouraged to “keep at it.” He would continue to play with his friends and perhaps even a local team. When he came of age, he could be invited to try out for the professionals and if he was good enough he would make the team. Nowadays, the moment that a child is recognized as having a good arm he becomes an instant financial asset that needs to be “nurtured” and “educated” in the art of pitching. Private pitching coaches are instantly employed and the child is treated like a professional athlete with the primary goal of cashing in on a potential 5yr/125 million dollar contract with the New York Yankees someday. The child is treated more like a mechanical device than a human being. Over time, this mechanical device gets closer to breaking down as the innings pitched and private pitching sessions begin to add up over the middle school and high school years. By the time that college and the potential of professionalism comes knocking, the UCL has been stretched more by the age of 20 than most old school pitchers may have used in their career.

Speaking of body mechanics, let’s take a closer look at weightlifting. Pitcher physiques today are unique to any other time in baseball history because of their size and power. I’m not talking about Bartolo Colon or Peter Griffin big either. They are physical specimens with one goal in mind – get your arms and shoulders as strong as possible with lean muscle so you can attempt to hit 95mph on the radar gun to get noticed. While this drive may seem intuitive to many, it undermines the situation because strength training is for muscle building, not ligament building. These ligaments are fragile and the amount of torque that these modern day monsters are creating is absolutely unsustainable for the long term athletic health of the performer. While this is being made more explicit as of late, it isn’t having that much of an impact because the bottom line is the dollar bill and the way to obtain wealth is by having a Clemens like fastball. I have a family friend who recently met Cy Young Award Winner Sparky Lyle at an American Diabetes Association dinner in New Jersey and asked him about this very issue. Lyle responded by saying “in my day, pitchers went out and got burgers and beer after games. Now, they go and hit the gym after games that they performed in when their bodies are obviously in the need of rest.” All of this makes a lot of sense but is negligible next to the drive that these players have to stay in “good shape” to eventually get the big payday. The drive for money has once again overshadowed reason and wisdom. Of course, we can’t blame these players, their families, and their 3-5 private coaches (one for each pitch type, I’m sure) fully because that is the world we now inhabit in the 21st century. Western capitalism, by and large, has disembodied the mind from body to an extent that primitive impulses (like drive for money, resources, or to look exceptional) have suppressed the ability to think holistically about the long term.

The question now becomes what to do about this situation? In Japan, where it seems a lot less of these injuries occur, they give pitchers more rest time between starts. The prospect of a six or seven man rotation may make sense from a medical perspective but will the finance driven Major League organizations try this out? Will the Dodgers fear losing ratings and attendance if generational talent Clayton Kershaw throws ten less starts per season? Will the MLBPA be pleased when teams are spending less money to get big pitching stars because that player will only make 20-22 starts instead of 30? What about an increasing education on maintenance and a little bit less of an emphasis on performance? After all, these guys have a pretty damn good idea how to pitch and obviously no clue on how to keep their instrument fine tuned and healthy long term. A lot of questions loom large but in my view something will have to be done to adjust to the amazing rate in which these injuries are occurring.

In closing, it must be said that arm and elbow injuries are nothing new in baseball. Some say that Sandy Koufax and Steve Dalkowski could both have been saved by Tommy John surgery. In the old days there were plenty of times when people couldn’t pitch anymore because of “dead arm” or “chronic sore arm.” The point here is not to say that it never happened before, but to say that the rate in which it is happening now is incredible. This incredible rate of overuse leading towards deterioration also parallels the state of mind of a culture that is sick with ignorance, greed and psychological disembodiment.

All in all, I really do believe that the quality of play in today’s game is better than it ever has been. Much of this can undoubtedly be related to the shape, skill, and size of the players. The main point that I’m trying to make is that these guys should at least open their eyes as they continue to walk off the cliff. There needs to be a balance between the desire for mountains of cash, the perfect physique, and proper rest for the Ulnar Collateral Ligament of which only exists to maintain the integrity of the elbow joint.