Josh Beckett grew up as a baseball star in the baseball hotbed of Texas. He was so good at his Houston-area high school that the Florida Marlins made him the second overall pick in the 1999 draft
He played high school baseball. He played fall ball. He played summer ball.
But during those three months of the summer, Josh Beckett almost never pitched. His father wouldn't allow it. His coach wouldn't allow it. For those three months a year, Beckett played the outfield instead.
"I definitely don't think I was abused," Beckett said one day in late May. "My dad would never have let that happen. [Summer league coach] Clay Hill wouldn't let it happen. My high school coach, too."
A few days after we spoke, Beckett would make the 321st start of his 14-year big-league career, and it would be a memorable one. He threw the first no-hitter in the major leagues this year, against the Philadelphia Phillies.
One other thing about Beckett: He's never had Tommy John surgery.
He's 34 years old. He's closing in on 2,000 major league innings. He's been on the disabled list with blisters and with mild strains, and he needed surgery last year for thoracic outlet syndrome. But at a time when it seems every pitcher has had Tommy John surgery once, more and more have had it twice and others are on the way to get an MRI to see if they need it, Beckett has so far avoided it.
There's no real way to know if not pitching for those three summer months in high school has helped in keeping his elbow relatively healthy for the 15 years since then. Not every pitcher whose arm is abused gets hurt, and not every pitcher who was protected stays healthy.
But at a time when doctors and trainers describe what we're seeing as an "epidemic," with another baseball draft fast approaching (it begins on Thursday), and more and more of the available pitchers having already had Tommy John surgery or likelier than ever to need it in the years to come, it's probably worth paying attention to some guys who didn't need to get cut.
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The numbers really are staggering.
In just April and May of this year, 28 professional pitchers underwent Tommy John surgery, according to an online database maintained by writer Jon Roegele. Only two of those pitchers (Josh Johnson and Peter Moylan) were past their 30th birthday. Five were 21 or younger.
Roegele's list doesn't even count pitchers who aren't yet in pro baseball. Studies by the American Sports Medicine Institute in Birmingham, Alabama, reveal that anywhere from one-quarter to one-third of Tommy John surgeries performed in recent years have been on pitchers in high school or even younger, a huge increase from 10 years ago.
East Carolina University pitcher Jeff Hoffman, who likely would have been one of the first players drafted this year, was one of this spring's victims, going under the knife on May 14. Nevada-Las Vegas pitcher Erick Fedde, another likely first-rounder, according to Jim Callis of MLB.com, also had Tommy John surgery in May.
Doctors and trainers increasingly believe that overuse of teenage pitchers is behind the rise. They also believe that overuse and overthrowing as a teenager leads to a far greater risk of serious arm trouble as a professional. And they have studies to prove it.
"I don't think there's any question it starts in youth baseball," said Kevin Rand, who has spent 33 years in professional baseball, the last 12 as the head athletic trainer for the Detroit Tigers. "You read medicals of kids in the draft, and you'll see one where this kid could have been a good pitcher, but it ended at 15.
"They're throwing too hard, too fast, too much, too soon."
Ask around the baseball world, and you'll hear the same thing from everyone—from current major league pitchers to trainers, doctors, scouting directors, college coaches and even coaches involved in youth baseball.
You'll hear of kids pitching 12 months a year. You'll hear of kids playing for multiple teams during the summer so that they can pitch multiple times per week. You'll hear of kids throwing in a high school game one day and then visiting a private pitching coach and throwing more just two days later. You'll hear of kids visiting private strength trainers, lifting weights and then pitching in a game the very next day.
You'll even hear of 12-year-olds trying to throw split-finger fastballs.
"It's nothing short of child abuse is what it is," Rand said.
But it's not illegal.
"Many [youth baseball programs] have good regulations," said Dr. Glenn Fleisig, the research director at ASMI. "But there's a lot of baseball that is unregulated. Little League Baseball brought [overall limits] up in court, but the kids and the parents won.
"The courts said it's their free right to pitch as much as they want."
Fleisig, who serves on USA Baseball's medical and safety committee and also as the pitching safety consultant for Little League Baseball, can only work to spread the word and get his recommendations out to parents.
The Tommy John epidemic has helped his cause in a way, leading to this story and many others, and leading to Fleisig being swamped with interview requests.
"Someone should do a study on my overuse," he joked.
But really, he and the other medical people want this story to get out. They want it talked about, because they understand that their only chance to combat this epidemic is to convince parents that they need to protect their kids.
"I think a lot of people are looking at it—and that's a great thing," said Stan Conte, the veteran athletic trainer of the Los Angeles Dodgers and a member of a Major League Baseball committee studying the issue.
"Hopefully we can get youth leagues to protect the kids from themselves," Conte said. "It has to be the adults in the room making the decisions. But parents all think it's someone else's kid who is going to get hurt."
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More and more kids are getting hurt, and more and more are getting fixed.
Tommy John surgery, originated in 1974 when Dr. Frank Jobe had the revolutionary idea of using a tendon from elsewhere in the body to replace the torn ulnar collateral ligament in Tommy John's 31-year-old left elbow, has indisputably saved the careers of hundreds of pitchers over the 40 years since then. It's been perfected to the point that 80 to 90 percent of pitchers who have the surgery are able to return to the same or higher level of competition in a year.
You'll hear that pitchers come back from Tommy John surgery stronger than before, throwing harder than before. You'll hear that you might as well just give all pitchers Tommy John surgery, just to get it out of the way.
Don't believe it.
First off, there is a risk. As much as Tommy John surgery has been mastered, there are a significant number of cases in which it doesn't work.
Second, nobody comes back throwing harder because he had Tommy John surgery. The doctors say the best they can hope to do is make the replacement ligament as good as the original. If there's any increase in velocity, it's due to other factors (such as getting stronger or normal development).
Finally, Tommy John surgery often isn't the final word. The best guess now is that the replacement ligament has a shelf life of about seven years, or at the most two or three years longer. Thus, a pitcher who needs Tommy John surgery at age 17 could be looking at another one by the time he's 24, or just when his major league career would get going.
And the success rate of a second Tommy John surgery is significantly lower.
Professional teams are well aware of that risk. At least 10 of the 30 major league organizations won't even consider drafting a pitcher if he has already had Tommy John surgery.
Read more: http://bleacherreport.com/articles/2080837-baseballs-pitching-dilemma-too-hard-too-fast-too-much-too-soon
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