July 14th, 2014

Arm injuries

Masahiro Tanaka

The now common MRI. It seems like if a pitcher sneezes nowadays and mentions “elbow discomfort,” an MRI is scheduled and if there is a micro tear or strain of any kind, the pitcher is shut down and soon the now-famous Tommy John surgery is next.

I have kidded Tommy, knowing him well enough to do it, that some people think he is a doctor! It’s really the Frank Jobe procedure and we shouldn’t let Dr. Jobe’s name lose its significance now that he has passed on. Now it’s James Andrews and David Altchek who do most of these procedures, grafting the ulnar collateral ligament with a tendon from the wrist or hamstring.

I had the privilege of participating in a roundtable discussion on MLB Network recently with both doctors, discussing the alarming number of amateur pitchers who are having the surgery. I deferred to the medical professionals on how best to prevent it. They identified the overuse of Little League pitchers and youngsters trying to throw too hard before their bones and muscles are full developed as the causes.

Fast-forward to the professional level, and I don’t think any Major League pitcher who has pitched a significant number of innings would have a perfectly “clean” arm on an MRI of their elbow. My point here is — and again I would respect Drs. Andrews’ and Altchek’s opinions — can a pitcher pitch with some micro tears and not do more damage if he or she throws with proper technique?

Here I would defer to the opinion of former Major League pitcher Tom House, whose ideas were misunderstood and questionable to me for years. I have come to respect his knowledge of the biomechanics of the pitching arm. How the elbow, shoulder and lower body have to work as a team to reduce the chance of injury. I say “chance” because there are no guarantees it won’t happen.

I speak out on this subject because of my own experience with the same injury. I recently saw a video on YouTube of a game I pitched in September of 1967. My last start of the year. We win, we go to the World Series. I was having the best month of pitching in my career. (I won’t bore you with my stats, but if I won the game it would have been my eighth win that month, and I was averaging nine innings every start.)

Suddenly in the third inning, while throwing a pitch to the pitcher, Jose Santiago, I felt like I bumped my elbow on a hard surface and hit my “crazy bone” as we called it. After throwing several more pitches, I had to come out of the game. The diagnosis was the injury that now seems to require TJ surgery, but that procedure was not available at the time. I never had surgery and let it heal naturally over the winter. I wasn’t as effective for a few years, but I was able to do what I enjoyed: pitching.

Looking back on my workload in 1966 and 1967 has given me some insight into the possible cause. I had pitched over 300 innings in 1966 and was in the high 200s in 1967. The smoking gun probably was September of 1967, when I was starting my eighth game that month and into the mid-60s in innings that month. I was — and still am — a big proponent of the four-man rotation with three days’ rest between starts. The arm recovers fine, control is more consistent, and delivery probably will be more repeatable because you get to the mound more often.

I write this hoping we can learn a way to use pitchers to their maximum efficiency and value to their team and yet be prudent in not overworking them. A thought I have is the types of pitches and the emphasis on power might be more harmful to pitchers today than in my era. We were basic fastball, curve, change-up pitchers. The slider came along, but it really was what we call a cutter today — not all the action with the elbow, and more emphasis on finger pressure and the wrist. Not as many splitters or hybrid sliders. Today’s slider for most big league pitchers is the most hittable pitch around if not thrown with the perfect combination of power and break.

The recent article on the screwball by Bruce Schoenfeld in the New York Times has prompted me to get on my soapbox and say, “Bring back the screwball and the slow curve!” Josh Beckett is making good use of a slower curveball in his recent string of well-pitched games. (Unfortunately a hip injury has sidelined him.) David Wells was a very durable pitcher and most of his career was a fastball/curveball pitcher.

Marv Grissom, my pitching coach in the early 70s, helped me develop a screwball. I abandoned my version of what people today would call a slider — we called it a short curve — and went with fastball, slow curve (12-to-6 or 11-to-5 break) and a screwball in 1972. I got off to the best start of my career and was headed for potentially my best season when a broken wrist on July 1 ended my season. My screwball never was as good after that. Why? It is thrown with more wrist action and less elbow torque.

I really believe if pitchers would begin to practice pitching from 45 to 50 feet and work on spinning the ball with their wrist and pay attention to grip pressure, a relaxed thumb, and stick today’s version of the slider where the sun doesn’t shine, we might have fewer injuries, more complete games and more durable pitchers. Splitters and sliders might be making hitting more difficult, but there is a price to pay for overusing them.

This article is written because of my disappointment in not seeing Matt Harvey, Masahiro Tanaka and many other injured pitchers be able to enjoy longer careers and allow us the pleasure of seeing them match up against each other and pitch the whole game.