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Pitchers' injuries an `alarming epidemic'

Wednesday, May 24, 2006  JON SOLOMON  News staff writer

For 151 pitches, Louisiana State pitcher Derik Olvey refused to give up the ball April 9. He realized LSU's game against Tennessee was on television, meaning his grandfather, dying of cancer in Alabama, might be watching.

"I really wasn't pitching for myself," said Olvey, a graduate of Pelham High School. "I told the coaches as long as I could throw the ball over the plate and they were comfortable with me out there, keep me in there."

Despite a history of elbow problems and having thrown 129 pitches the previous week, Olvey kept going in the 6-2 LSU win. He allowed five runs on six hits on 18 pitches in his next start, and then noticed his velocity drop 6 miles per hour between innings. 

Eventually, Olvey felt like a knife was stabbing his pitching elbow, and he could not lob the ball 60 feet. Olvey has no regrets. His grandfather watched the 151-pitch game on tape before dying the next day.

But on May 12, Olvey had the ulnar collateral ligament in his pitching elbow restructured - commonly known as "Tommy John surgery" - and became another in the line of young pitchers having surgeries. Dr. James Andrews calls the trend "an alarming epidemic."

Between 2000 and 2004, Andrews, a renowned Birmingham surgeon, performed elbow operations on six times more high school pitchers and four times more college pitchers than from 1995 to'99. Elbow surgeries on pro pitchers only doubled.

"I open up these kids and they look like they have a 30-year-old pitching elbow, and they're 16 years old," Andrews said. "If we try to hide our head in the sand and not recognize these kids are getting hurt more, we're probably not doing our job."

At least 19 percent of pitchers on SEC rosters entering 2006 have had arm surgery, either before or during college, according to a survey of the league's 12 teams. That doesn't begin to count those who have missed extensive time with injuries and will need surgery in the future.

"That's way too high," Andrews said. "What the NCAA coaches should be worried about is with the escalating injuries in high school, all of a sudden, they're not going to have enough good, healthy pitchers to fill their slots."

At today's SEC Tournament will be Kentucky's Craig Snipp, who is three years removed from elbow surgery and among the ERA leaders in the SEC. 

And Georgia's Mickey Westphal, who had shoulder surgery in 2004 and is 6-0 with a 4.76 ERA this season.

And Arkansas' Charley Boyce, who had a bone spur removed from his pitching elbow in 2005 and has an ERA two runs greater than his career 3.40 mark.

And, most painfully, eight of South Carolina's 19 pitchers have had surgeries on their pitching arm.

"I know we've been extremely cautious over the years and we still get guys hurt," South Carolina coach Ray Tanner said. "I probably would recruit them the same way if I did it again. Because you just don't know for sure. The arm wasn't designed to throw a baseball."

Overused pitchers:

Pitchers and parents carry dreams of winning championships and securing pro contracts or college scholarships. But the kids are also carrying too heavy a workload at young ages, according to some doctors and coaches.

It's happening all over the game. Within the Atlanta Braves' organization, 29 of 119 pitchers (24 percent) have had arm surgery, according to data from the club's front office.

Improved recognition of injuries and the status of popular surgeons such as Andrews certainly factor into more surgeries, Andrews acknowledged. But he has found enough anecdotal evidence of surgery increases across the country to believe improved recognition rates can't be solely responsible.

A study by the American Sports Medicine Institute (ASMI), Andrews' Birmingham-based lab, found college-age pitchers who report throwing regularly with arm fatigue are 36 times more likely to have surgery than rested pitchers. College-age pitchers are also five times more likely to have surgery if they play more than eight months a year.

"Of the college pitchers who come for surgery, none of them looks like a clean break," said Dr. Glenn Fleisig, chairman of research at ASMI. "They all look like their tendon or ligament is frayed. You can tell that's from overuse, one throw after another."

Andrews said the high school pitchers he operates on average one week off (typically between Christmas and New Year's) during a 12-month period.

College coaches are becoming increasingly frustrated about inheriting damaged goods without knowing it. Kentucky coach John Cohen said the sport needs more than the NCAA maximum 11.7 scholarships to account for the rash of injuries.

"In order for us not to abuse arms, we have to have enough arms to go around so you don't have to pitch guys routinely," Cohen said.

Because of overuse, many college coaches say they now prefer pitchers who play multiple sports rather than those who throw a baseball year-round.

"They play too much," Georgia coach David Perno said. "... High school coaches overthrow them because they don't care about summer ball. Summer coaches overthrow them because they don't care about high school ball. It's a vicious cycle."

Bouncing back:

Thirty years ago, Tommy John surgery might have meant the end of a pitcher's career. A decade ago, the success rate was 60 percent. Today, there's an 85 percent chance of recovery.

Players roll the dice with those odds - too much so for Andrews' liking, even if it is good for business.

"Some of these young kids are jumping up and down when you finally tell them, `Yes, you've hurt your ligament and we'll reconstruct it,'" Andrews said. "Some are not even giving themselves time to get well with a minor injury. They want an operation because they hear Tommy John's operation will make them a better pitcher. That's a misconception."

The majority of Tommy John pitchers will get well and possibly return to form. But if they become better pitchers, doctors say, that's only because of rehabilitation, the natural maturation of the arm, and much-needed rest.

Perno recently concluded that recovering from shoulder surgeries is more difficult than rebounding from elbow procedures.

"The kids who had shoulder surgery have never regained the velocity, unlike Tommy John," Perno said.

Alabama pitcher Allen Ponder, who had a labrum, biceps tendon and rotator cuff repaired in 2004, can relate. Once a big-time recruit as Alabama's "Mr. Baseball" in 2002, Ponder didn't pitch this season due to recurring shoulder pain.

Starting at 14 years old, Ponder rotated from high school to travel league teams. He would pitch five-plus innings in seven-inning tournament games, and then sometimes work in relief the next day.

"I always felt great. I had no idea that what I was doing might have caused wear and tear. But I have no regrets. As a kid, you just want to play."

Olvey remembers his elbow injury escalated the summer before enrolling at Notre Dame, where he missed 47 games as a freshman before transferring to LSU. He essentially went 18 months without a break while adjusting to the rigorous conditioning program at Notre Dame as a freshman.

The high pitch counts this season "might have been the thing that finally said, `OK, I can't recover from it anymore," Olvey said.

Given what they know now, Ponder and Olvey said they wouldn't change how they were used, even though the result is a seat on the bench for this week's SEC Tournament.

Andrews worries many well-intended coaches and parents are not educated about the dangers. He worries a generation of young pitchers could be prevented from participating in recreational sports as adults, much less become the next Roger Clemens.

"At some point you have to figure out whether you want to be a star in the Little League World Series or in the real World Series," Andrews said. "They don't necessarily match."


The article above is presented in its complete form as written by News staff writer JON SOLOMON of the Birmingham News. The article appeared in the the Wednesday, May 24, 2006 issue.

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