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ASMI releases statement on TJ surgery

5/28/2014

The American Sports Medicine Institute, whose stated goal is "to improve the understanding, prevention, and treatment of sports-related injuries through research and education," released a position statement on Tommy John surgery. The ASMI's board president, Dr. James Andrews -- you know him as the doctor every injured pitcher seems to go see -- signed off on the statement, which, according to ESPN's Stephania Bell, was drafted by Dr. Glenn Fleisig, the institute's research director.

Anyway, if there's one major takeaway from the section titled "RECOMMENDATIONS FOR PROFESSIONAL PITCHERS AND TEAMS FOR REDUCING RISK OF TOMMY JOHN INJURY," it's this:

Do not always pitch with 100% effort. The best professional pitchers pitch with a range of ball velocity, good ball movement, good control, and consistent mechanics among their pitches. The professional pitcher's objectives are to prevent baserunners and runs, not to light up the radar gun.

In other words, the takeaway seems to be not to pitch with maximum effort. There's little doubt that one reason so many pitchers are throwing harder now is that they are throwing with max effort on every pitch, a byproduct of many things: Bigger and stronger pitchers can blow fastballs by hitters, and if you can blow fastballs by hitters, your natural tendency is to try to do so; scoreboard radar guns encourage big velocity readings; fewer innings and pitches per game means less need to pace yourself through an entire game. All that has helped create an environment in which pitchers are throwing harder than ever.

Last week, John Smoltz talked about how he felt he was never maxing out while pitching. Granted, he did have Tommy John surgery, but later in his career. There is a long history of pitchers talking about saving up their best stuff for when it was most needed. Christy Mathewson wrote about it in his book "Pitching in a Pinch." A 1913 article in Baseball Magazine quotes fellow pitcher Vean Gregg saying of Walter Johnson, "When he is merely fast you can hit him if you are lucky; but when he is in a hole or happens to want to dig up the red hot stuff ... no one can hit it." Of course, that was a different era, when home runs weren't a threat.

Pitchers in the '60s, '70s and into the '80s faced a lot more banjo-hitting middle infielders or speedy outfielders that didn't have much (if any) power. They could conceivably save their best fastballs for the home run threats or with runners on base. Look at Justin Verlander in his Cy Young season of 2011. We repeatedly saw him tone down his fastball in the early innings to the lows 90s and crank it up late in the game, if needed. Look at Josh Beckett during his no-hitter on Sunday; he threw one pitch at 94 mph -- his final one of the game.

Joe Sheehan, in his newsletter published Wednesday, conducted a study comparing the Tommy John rates of pitchers based on their average fastball velocity. In his study, five of 22 pitchers who averaged 95-plus mph soon after had TJ surgery (23 percent) and 10 of 22 had TJ surgery at some point (45 percent). Of 98 pitchers who averaged 93-94.9 mph, 13 soon after had TJ surgery (13 percent) and 22 of the 98 had it at some point (22 percent).

As Sheehan writes, "I could argue that starting pitchers who average 95 mph are about twice as likely to have Tommy John surgery as pitchers who average 93-94.9 mph. … I don't think it's that simple. I honestly don't. I do think there's reason to be wary of the demon, though."

The demon is velocity. The final recommendation in the ASMI report says, "Pitchers with high ball velocity are at increased risk of injury. The higher the ball velocity, the more important to follow the guidelines above."

The amateur draft is next week. Right now, teams and scouts are lusting after high school and college kids pumping fastballs at 95-plus mph. Many will be drafted higher than the kids throwing 91, purely because of that high-octane heater. After all, scouting directors don't usually lose their jobs for drafting a kid who throws 97.

Buyer beware.