The news this week was startling.
On the heels of Kris Medlen, the projected ace of the Atlanta Braves, needing ligament replacement surgery for the second time in his career comes the bad news this week that Jarrod Parker of the Oakland A’s will undergo the same surgery, also for the second time. For the A’s and Braves, it’s been body blows this spring: Medlen’s teammate Brandon Beachy likely is headed in that direction as well as Parker’s fellow starter A.J. Griffen, who will be out at least through May with a sore elbow.
Then there’s Patrick Corbin, the young lefty ace of the Arizona Diamondbacks, who the D’Backs said this week is out for the season after a partial tear of his elbow ligament and will undergo replacement surgery; lefty Jon Niese of the New York Mets had to leave Sunday’s game against the Cardinals with “elbow discomfort.” And the Dodgers’ top pitching prospect, Ross Stripling, first felt a sore elbow and then, after an MRI, got the news that he too would take the knife.
I’d like to think it was just a coincidence that the recent passing of the inventor of the ligament replacement surgery on pitchers, Dr. Frank Jobe, came as the news of so many pitchers becoming patients casccaded across MLB Network and ESPN. It was Dr. Jobe who first performed the groundbreaking transplant surgery on Dodgers’ lefthander Tommy John, taking a tendon from his right arm to replace the shredded ligament in his left elbow. The surgery was such a success that it became one of the few medical procedures named for the patient rather that the doctor who invented it.
I’d also like to think it was coincidence in light of the news of so many pitchers needing surgery that the Cardinals announced Tuesday they’d cut ties with longtime team physician Dr. George Paletta.
It’s that last bit of news I’d like to address here.
For years, some Cardinals fans had blamed Dr. Paletta for the drawn-out, stumbling, bumbling treatment of the team’s pitchers, from Matt Morris to Andy Benes to Mark Mulder to Matt Clement to Chris Carpenter to Jaime Garcia and I’m sure more pitchers I’ve forgotten to list. The team announces a pitcher is day-to-day, then on the disabled list, then “progressing nicely” (a phrase used so much it became an internet meme — once, I saw the phrase used as a caption of a prostrate Abraham Lincoln on his deathbed). And finally, the seemingly inevitable: surgery.
So many fans have become used to a track record of pitchers coming back after surgery that they’ve taken to chat boards, social media and sports call-in shows asking why, if surgery is inevitable, the Cardinals don’t simply send their pitchers into the operating room at the first sign of trouble? And it seems at first glace to be a pretty good argument; delaying surgery only delays the successful return of a fan favorite to the mound and to the cheers of the crowd, right?
Any ethical doctor will tell you surgery should be a last, desperate resort. Surgery, despite the track record of pitchers who have successfully returned, is hardly a sure thing; the act of surgery itself is a deliberate infliction of trauma on the body. All it really is, is hope that the deliberate infliction of trauma can somehow help cure worse damage. And as Medlen and Beachy could say, it’s trauma with no guarantee things will be better in the end.
To me, considering the anecdotal evidence of pitchers having trouble returning to where they were before their injuries, it’s absolutely insane that many folks even suggest high school and college pitchers should have Tommy John surgery “to get it out of the way” since by pitching, the thought continues, “you’re going to have it anyway.”
Dr. Paletta took a lot of blame for the recent injury history of Cardinals pitchers. Unfairly. The Cardinals pitchers themselves deserve a lot of the blame — these are finely conditioned athletes who are aware of each little ache and pain. But they’re also hugely competitive, and the last thing they want is to be among the wounded in a robe and flip flops sitting in the trainer’s room with a pitiful look on their faces.
So they feel a twinge in the elbow. No big deal,they tell themselves, I can still pitch. Then the pain becomes sharper. No big deal, I just need to ice it down, I can still pitch. And then they hear the pop, or feel the pull.
What doctor can compete with a young pitching stud’s desire to be out on the mound, regardless of the cost to himself? But let’s not criticize a young player for wanting to get the most out of his talent. Let’s talk about how they do that.
A typical big league pitching motion is profoundly unnatural; our bodies simply don’t go that way. I dare any fan to look at a pitcher in mid-motion and model for themselves the ugly contortion and awkward stretch of a guy like Chris Sale. Or, for that matter, Shelby Miller or Carlos Martinez. Hold that motion for a few seconds. Hurts, doesn’t it?
Here’s the bad news. The Cardinals enjoy an enviable wealth of young pitchers. But my bet is that all of them will be on the disabled list some time in their careers. All of them. And that’s to be expected.
The body isn’t built to throw five-ounce baseballs at such speeds from the motions they use. Our arms hang down naturally, our wrists are built to turn our palms inward. It’s not natural to lift our elbows above our shoulders — isn’t doing that what the North Vietnamese did to torture our prisoners of war? It’s not natural to combine that by forcing our palms away from our bodies. Yet that’s the only way you can take a single step and fire a baseball 90-plus miles an hour.
Except it’s not. But more on that in a second.
The Cardinals are so formidable overall because of all the 30 big league teams, they can absorb both the player cost and financial cost of a loss of a pitcher because they have so much of it.
Good thing Mo didn’t trade any of them for a shortstop.
Anyway, the other day, I was listening to Will Carroll as a guest on MLB’s channel on XM driving into the office, and the hosts were perplexed why teams don’t take simple measures toward prevention. Professional soccer, for example, paid for portable ultrasound machines on the sidelines to pinpoint player injuries to see right away if they were serious enough to leave the game or safe enough to keep playing. Yet MLB refuses to do the same.
That had me shaking my head. There’s all this money spent on Tommy John surgery, shoulder surgery, thoracic outlet syndrome surgery, surgery, surgery, surgery, and yet how much is spent on the study of preventing these injuries?
A pittance in comparison. Why?
I mean, MLB actively discourages daily long tossing in the outfield for pitchers despite growing evidence it builds up shoulder and elbow strength. It’s a regime whereby a pitcher fires at a distance of 250 feet to build lower body power, an elastic core, mobility in the hip and stability. The idea is that if you can throw 250 feet or more easily, you can throw 60 feet easier too. Kids who start out throwing in the low 80s after using the long toss workout have developed into mid-90s pitchers. And better still? Injuries have been cut significantly among the groups which follow this.
Yet big league teams still encourage the tortuous pitching motions like the inverted W (see Stephen Strasburg or Mark Prior for perfect examples), where the elbows are angled above the shoulder in mid-motion. Or the twisted forearm with the arm forcing the palm upward and the thumb turned inward (the Shelby Miller motion), almost as if someone were twisting your forearm behind your back.
Most big league pitchers, when they bring their arm down to their side in preparation to bring the arm back up to throw, have their palm and the ball facing outward with the thumb downward, which is the unnatural motion. They make a figure 8 motion above their shoulder to get the palm in the right position to throw. So there’s a lot of wasted effort before the ball is even thrown — and that’s when the injury happens, the extended time during the motion where the torque is placed on the inner elbow and shoulder.
A pitcher should have the palm and the ball facing their body with the thumb facing upward. So here’s a different way to propel a baseball homeward at high speeds. There’s a pitching technique pioneered by former big league reliever Mike Marshall which serves as a perfect illustration of what I mean. Watch the whole video, and give the guy credit for going out there and demonstrating the motion despite being half naked and sweaty.
And yet that motion looks weird, doesn’t it? There’s no inverted W, no twisted forearm. Almost looks like an outfielder making a throw home. Exactly. How many outfielders have Tommy John surgery? This combines the best of long toss with a more natural form using the body’s natural function.
But even that isn’t perfect; there’s still that overhand motion which our shoulders aren’t built to handle. You know, if you think about it, the best motion to throw a pitch is fast-pitch softball. Your arm hangs and swings low to begin with, and throwing a curve ball, by turning your wrist so that your palm faces downward, is a natural motion which occurs as you walk.
Think about the motion for a big league pitcher. It’s almost the complete opposite. Yet if a guy could throw 96 mph with a fast-pitch softball motion, which team would be gutsy enough to sign him, knowing not only all of their scouts would be chortling at him, but the media would turn it into a ridiculous Twitter-fed mess?
And so it goes.
What needs to be done is to study preventing injury by using different motions and long tossing — which MLB teams refuse to adopt because it’s “weird.” A guy like Mike Marshall shouldn’t be posting videos on YouTube; he should be at spring training, should be a roving minor-league instructor, teaching this motion so that a young man born with a lightning thunderbolt for an arm doesn’t become a dim, pitiful spark. So teams stubbornly stick to the way they’ve always done it, with their best pitchers marching off to get their elbows done. And re-done.
I expect the A’s of all teams, after the tough news they’ve taken this spring, to look more into this now. I just wish the Cardinals would, because their young arms deserve better that doing the same thing teams have been doing the same way they’ve been doing it.
Tommy John, after all, doesn’t need any more ink.