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CBSSports.com National Columnist

Want to save arms from blowing out? Don't put them in, coach

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Hate Mail: Three days in Arkansas

Stephen Strasburg, the Washington Nationals pitcher who can't pitch six innings without going on the disabled list, was the latest. Before him it was Joel Zumaya. Before him, Kerry Wood. And Mark Prior. And more. Lots more.

Too many more.

From little league on, the arm of a pitcher like Stephen Strasburg tends to get worn down. (AP)  
From little league on, the arm of a pitcher like Stephen Strasburg tends to get worn down. (AP)  
The best arms in recent years can't pitch because they can't stay healthy. This isn't an original topic, no, but I'm about to tell you something lots of you haven't considered. When another pitcher bites the dust, people blame the way young arms are babied nowadays. You know that. Just last week, two starters (Kevin Slowey and Rich Harden) were pulled from no-hitters because of their pitch count.

Combine the increase in arm injuries with the conservative way young pitchers are promoted through the minors -- rarely throwing more than 30 additional innings each year, strict pitch counts along the way -- and people say we're coddling pitchers, not toughening them up, not expecting their durability by demanding their durability. People blame organizations and managers and pitching coaches. They say it's their fault.

And I say that's wrong.

I say it's your fault.

Well, it is. If you're the parent of a young pitcher. Or if you coach in a youth baseball league. Or if you have anything else to do with the year-round baseball schedule that has become vogue in this country.

If that's your story, then this is your fault.

Because pitchers like Strasburg and Zumaya, Wood and Prior, they haven't been coddled. They've been saddled, like donkeys. They've been ridden since they were 12 or maybe younger, pitching in spring leagues, summer leagues, fall leagues, even winter leagues. A kid lucky enough to grow up in a warm-weather state like California or Texas can pitch all year, every year.

Strasburg is from San Diego. So is Prior. Zumaya is from Chula Vista, Calif., just south of San Diego. Wood is from Texas.

Kids play baseball year-round in those areas.

How lucky they are.

The human arm isn't meant to throw a baseball. It does, and we do, but we're not supposed to. The shoulder is more equipped to windmill a softball underhanded than to slingshot a baseball (or football) over-handed. That's physiology. Throwing a baseball -- especially throwing it really, really hard -- results in tears in ligaments and tendons around the shoulder and elbow. Those tears are unavoidable. They're even good, up to a point.

"For a young pitcher, having micro-tears is not a bad thing -- in fact it's a good thing," Dr. Glenn Fleisig told me. He works alongside noted sports surgeon James Andrews as the lead researcher at Andrews' American Sports Medicine Institute in Birmingham, Ala. Fleisig stressed to me, so I'm stressing to you, that he wasn't discussing Strasburg, Zumaya or anyone else in the game today. He's talking about young pitchers, and the impact year-round baseball has on those arms.

Fleisig continued: "When a 14-year-old pitches and his arm gets tired, and then he rests a good amount, it's a good thing. It's like when you or I are working out, and a few days later with proper rest, we're stronger. A young pitcher does want to have micro-tears, and then your body does something amazing -- it repairs while you rest. And it gets bigger and stronger."

It repairs ... while you rest.

But when do kids nowadays rest? They don't. Specialization is to blame. Occasionally the parents, who want a scholarship for little Johnny, are unwittingly to blame. Instead of playing two or three sports, giving each game a few months a year, kids are locking into one sport and going all year with it. And if that sport is baseball, and if that kid is a pitcher? Well, kids have the surgery to show for it.

Over the last decade Dr. Andrews has reported a tenfold increase in arm surgeries on college and even high school pitchers. Some of that is skewed by Andrews' increasing name recognition. But most of that is skewed by year-round baseball. Andrews and Fleisig recently authored a study where they polled nearly 100 young pitchers who needed surgery. They compared those results to almost 50 young pitchers who didn't need surgery.

Why are today's pitchers so brittle? Here's why:

Pitchers who pitched in leagues more than eight months a year were five times more likely to need surgery by age 20. Pitchers who regularly threw 80 pitches in a game were four times more likely to need surgery. And pitchers who regularly pitched with a tired arm -- not a sore arm, just a "tired" arm?

They were 36 times more likely to need surgery.

That's not a typo.

"That's off the charts," Fleisig told me.

In warm climates, young pitchers play in more than one league in a year. The best of the best often play in more than one league in a season. They suffer the inevitable micro-tears, but they don't get the necessary rest. Their coaches or parents aren't hurting them knowingly. They certainly aren't hurting them intentionally. But they are hurting them nonetheless.

"A lot of youth coaches have good intentions, but they don't get good feedback," Fleisig says. "Kids who pitch past the point of fatigue, they don't break down that year. They break down years later, down the road. If you give a 14-year-old a pack of cigarettes every day, which I don't recommend, at age 15 that kid won't be showing the effects. But by 20, his lungs have paid a price."

Some kids are lucky. They pitch long and hard, and their arms make it unscathed through adolescence. They get drafted out of high school, like Zumaya and Wood did. Or they get drafted out of college, like Prior and Strasburg did. They are protected in college -- San Diego State manager Tony Gwynn handled Strasburg brilliantly -- but the damage has already been done. It was done when these guys were 12 or 14 or 16. They emerge from amateur baseball with trophies and memories and signing bonuses.

They turn pro, and their arm is a ticking time bomb.

A pitch count won't help it. Quick trips to the disabled list can't stop it.

That bomb has been ticking since this grown man was just a kid. Who put the bomb inside his elbow or shoulder?

Quite possibly, you did.


Gregg Doyel is a columnist for CBSSports.com. He covered the ACC for the Charlotte Observer, the Marlins for the Miami Herald, and Brooksville (Fla.) Hernando for the Tampa Tribune. He was 4-0 (3 KO's!) as an amateur boxer, and volunteers for the ALS Association. Follow Gregg Doyel on Twitter.
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