Cardinals' young pitchers come to grips with risk of Tommy John surgery
MAY 23, 2014 1:32p ET
ST. LOUIS -- There are countless ways to draw a dirty look from someone. Tell them they belong in the middle seat on a packed flight when really they don't. Tell them that shouting obscenities isn't appropriate no matter how many adult beverages they've consumed. Ask them if they've showered this week.
Or, if you're talking to a young and strong-armed major league pitcher, ask them about Tommy John surgery. But with the procedure for elbow-ligament replacement becoming "rampant" in the big leagues, to borrow Mike Matheny's description, the question seemed timely for the six second-year pitchers on the Cardinals' staff.
Dealing with them under most circumstances is pleasant, but you could tell this was a topic that made the young guns more uncomfortable than pitching out of a no-out, bases-loaded jam in a one-run game.
"I really don't like talking about it too much," Michael Wacha said. "It's surgery. Pitchers don't like having surgery."
"You don't want to think about it," said Shelby Miller. "Thinking about an injury before it happens is the worst thing you can do."
Probably the only reason none of them knocked on wood is they're too young to believe in such a superstition. But they get it.
They know and accept that they run the risk of someday sporting surgically produced zippers on their pitching elbows. It's a hazard of the job, not unlike the risk of having a 100-mph line drive come back at them. They can look around the St. Loius clubhouse and see their odds are about one in three to have Tommy John. Of the 12 pitchers on the active roster, four have had the surgery -- Jason Motte, Adam Wainwright, Jaime Garcia and Pat Neshek.
"It sucks, but it's beginning to become more and more a part of the game," Cards left-hander Kevin Siegrist said.
"I feel like everyone is at risk," Wacha said.
"I don't think you can avoid it," Miller added. "Waino is a good example. He's a guy who does all the right things and he has Tommy John. Motte does all the right things, he has Tommy John. It's just a matter of ... I don't know. Being unlucky, I guess."
What adds to their vulnerability is all the unknown. No one has come up with a more plausible explanation than the fact that throwing a baseball overhand with all your force is a hazardous endeavor. But throwing with all their force is why they are able to make a career out of playing baseball.
Matheny, who coached plenty of youth baseball before he became manager of the Cardinals, is one of many who believes that year-round pitching has led to more breakdowns and at younger ages. He also says what a youngster throws is just as important.
"I went to a youth league game the other day and 10 of the first 11 pitches were breaking balls," he said. "That kind of stuff is going to catch up with these kids."
"Unorthodox motion is all I've got," Seth Maness said. "Nobody's been able to put their finger on a cause. If they could, they would be rich."
"Maybe it's because everyone is bigger, stronger and throws harder," Siegrist said.
Agreed Matheny, "With as big and strong and fast as guys are getting, it almost seems like the thought process is, 'I'm going to go till I blow, then I'll get a tune-up and let it fly again."
His assertion makes sense when you consider the rate for a successful return has climbed to nearly 90 percent, according to the Washington Post. Many believe a pitcher returns throwing even harder with a replaced UCL ligament, but that seems to be more myth than reality. None of the Cardinals' Tommy John survivors throw any harder than they did before the surgery, though Neshek's velocity has returned to his 2006 levels. He is five years removed from the surgery, though.
The Cardinals' youngsters do as much as they can to keep their elbows intact. They strengthen their shoulders and arms with weights. They take a couple of months off from throwing after the season. They build up arm strength gradually to be conditioned for the long season. Carlos Martinez said he even tries to stay away from throwing curves because of the stress on his elbow. They all understand the odds are not in their favor.
"You do everything you can, but at the same time there's nothing proven to prevent it," Trevor Rosenthal said. "You're taking a shot in the dark and hope you do enough right things."
"There's ways to help prevent it for a while, like arm care and make sure you're staying on top of your weight lifting," Wacha said. "But throwing overhand is not a normal motion. You're going to get some wear and tear, and if you pitch long enough, eventually you're going to have surgery."
Such an outlook might be bleak, but it also seems to be true, no matter how you look at it.
You can follow Stan McNeal on Twitter at @stanmcneal or email him at firstname.lastname@example.org.