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McGRATH: Orthopedic surgeon advises against pitching too much, too soon

Marlins phenom Jose Fernandez 21 had Tommy John surgery his right elbow Friday. He was National League Rookie Year last

Marlins phenom Jose Fernandez, 21, had Tommy John surgery on his right elbow Friday. He was the National League Rookie of the Year last season. | AP

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Updated: June 23, 2014 11:43AM



Gus Kumis’ fastball seemed Sandy Koufax-like when launched from the Little League distance of 46 feet. A big, strong kid who could hit, Gus was, like the great Koufax, left-handed, so he moved to first base when he wasn’t blowing away hitters with heaters.

Jimmy Hackett threw the first for-real curve I ever flailed at. In hindsight, it was useful to learn as a 12-year-old that a career I had been envisioning probably wasn’t going to work out.

Hackett, like most ‘‘best athlete on the team’’ kids, was a slick, rangy shortstop when he wasn’t buckling our knees with his yakker.

Nick Johnson, one of my son’s teammates in youth baseball, was a polished strike-thrower as a kid and on into high school. But Nick became a third-round Yankees draft choice and a 10-year major-league veteran by virtue of a smooth left-handed stroke and his deftness as a first baseman.

Such multiposition versatility seems to have gone the way of complete games and Sunday doubleheaders, even at the Little League level. Kids are being bred exclusively to pitch, and between park leagues, travel teams, fall ball and private lessons, some of them pitch year-round.

‘‘We’re in an age of specialization not just by sport but by position,’’ says Dr. Preston Wolin, an orthopedic surgeon and the director of the Center for Athletic Medicine in Chicago.

Is too much, too soon a factor in the epidemic of elbow explosions that has made nearly three dozen Tommy John surgical procedures among big-league pitchers necessary since mid-February?

‘‘Definitely,’’ Dr. Wolin says.

The question gained added traction with the announcement that 21-year-old Marlins phenom Jose Fernandez had elbow reconstruction Friday. Fernandez’s exquisite right arm was considered a gift from the baseball gods, but it wasn’t immune to the perils of modern pitching, which defy elimination or control despite preventive measures such as pitch counts and an increased awareness of body mechanics.

‘‘Conditioning is essential to injury prevention,’’ Dr. Wolin says. ‘‘But a large number of kids who do nothing but pitch don’t have a strong core, they have problems with their shoulders and they lack flexibility along the mechanical chain.’’

Wolin, who has performed dozens of Tommy John procedures, is an assistant baseball coach at Ida Crown Jewish Academy and toes the rubber in a senior men’s league, so his interest in the art and science of pitching is more than casual.

‘‘I tell pitchers no breaking balls until they have command and control of the fastball and changeup,’’ he says. ‘‘Ninety-plus percent of the time, that’s all they need. I also believe in the old pitching adage: No curveballs until you shave — 15 or 16. I don’t like the slider. Throw a cut fastball instead. Less strain on the forearm and elbow.’’

Uber-agent Scott Boras often is maligned as a soulless mercenary with no regard for the welfare of the game, but he accepts some of the blame for the Tommy John epidemic. Boras thinks the seven-figure bonus contracts he has negotiated for Stephen Strasburg-caliber prospects get parents thinking of pitching as the route to fame and fortune for their Chad or Jeremy. Their kids become specialists rather than ballplayers, and too much pitching by a young, underdeveloped arm is almost an invitation to injury.

‘‘We have to influence parents first because parents control what happens to their kids,’’ Wolin says. ‘‘I discourage year-round play. Pitchers should put the ball away for a minimum of two months. Hit as much as you want or play basketball. They’ll benefit. Multiple sports require multiple skills and different types of conditioning.’’

Tommy John surgery was a radical, pioneering procedure in 1974, when Dr. Frank Jobe replaced the shredded ulnar collateral ligament in John’s left elbow with a piece of tendon from his forearm. It’s now commonplace — one study found a third of all major-league pitchers had undergone it — and rarely career-ending, to the point that some parents seek it for their sons in the misguided belief they’ll throw harder and pitch better.

‘‘Some pitchers perform better, but it’s because of rehab: They’re stronger in the legs, the core and the shoulder,’’ Wolin says. ‘‘But Tommy John surgery does not make you a better pitcher.

‘‘There’s always going to be need for it, and I’m excited by the breakthroughs that have made it less invasive and speeded up recovery time. But I’d much rather be involved on the preventive side and try to keep these injuries from happening.’’



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