Hurlers are spending more time on the DL, but many come back stronger: medical advances have allowed moundsmen to return from serious arm injuries that were once deemed career-ending - The Pitching Wounded

Baseball Digest, Sept, 2002 by Irv Moss

MAJOR LEAGUE BASEBALL'S MEDical recovery rooms are overcrowded with broken-down pitchers.

Major league fans are familiar with the epidemic. Starting pitchers Pete Harnisch and Scott Elarton, Rockies; Joe Mays, Twins; Tom Gordon, Cubs; Kevin Brown, Dodgers; Andy Pettitte, Yankees; Brad Penny, Marlins; John Franco, Mets; Jeff Zimmerman, Rangers; and Matt Mantei, Diamond-backs have been lost for most or all of the 2002 season because of injuries.

The numbers of pitchers going on the disabled list has increased steadily in the past 10 years. In 1992, an average of 4.76 pitchers per team were placed on the disabled list. That increased to 7.90 last year, according to Stats Inc.

Not everyone is convinced there are more injuries, however. Some believe improved diagnoses have allowed teams to do a better job of documenting the number of injuries that in the past may have gone undetected.

Los Angeles Dodgers pitching coach Jim Colborn says better medical care and technology creates an illusion of more injuries.

"The diagnosis is so exact now," Colborn said. "In my era, if your arm was sore, you would rub tobacco juice or dirt on it and go on back out there. Some injuries could repair themselves in an offseason or pitchers would adapt to throwing with some kind of pain."

Colborn played from 1969-1978 and was a 20-game winner for the Milwaukee Brewers in 1973.

Whether or not there are more injuries than in Colborn's time, what is certain is there are more and more pitchers showing up on the disabled list.

"The diagnosis methods are so good today," Dodgers pitcher Terry Mulholland said. "There probably are more injuries today, but the medical staffs are better able to figure out what's wrong with a pitcher's arm today. I think they find a lot of old injuries, too."

Colborn said: "If a pitcher had a torn ligament or a major tear of the rotator cuff in my day, he was done."

Mike Pfefferkorn of the American Specialties Co., the author of a book on trends in baseball based on statistics, said 207 big league pitchers--nearly 50 percent of all the pitchers in baseball--went on the disabled list a year ago. By comparison, in 1993 when Colorado and Florida joined the National League, 152 pitchers went on the disabled list.

EASIER DETECTION

Dr. Glenn S. Fleisig of the American Sports Medicine Institute in Birmingham, Alabama, explained why pitchers seem prone to injury, "The motion of a pitcher's arm is the most dynamic activity generated by the athlete that has been measured in sports.

"The speed that the arm goes forward at the shoulder joint at some point is fast enough to make 20 full circles in one second, if the arm could go full circle. Virtually every pitcher has a serious arm injury at some point in their career," he said.

While advancements in detection may lead to verification of more injuries, advancements such as arthroscopic surgery and more precise rehabilitation methods are allowing pitchers to remain in the game.

"It still takes a certain amount of time for the body to heal," Rockies trainer Tom Probst said. "I think players are coming back stronger because of the rehabilitation techniques and not having to slice a person open as we did 15-20 years ago. Arthroscopic surgery isn't as invasive."

Cincinnati Reds right-hander Jose Rijo is the medical miracle story of the 2002 season and the latest in a growing line of pitchers still playing after it appeared their careers were over. Rijo was a mainstay on the Reds pitching staff until he underwent "Tommy John" or elbow ligament replacement surgery in 1995. He failed at several comeback tries until last year when he posted a 2.12 ERA in 13 appearances as a reliever. This year Rijo, 37, was back in the starting rotation and in June had a 4-3 record and 5.21 ERA, his first decisions since 1995.

A comeback such as Rijo's likely would not have happened 30 years ago.

Rockies pitching coach Jim Wright was a promising pitching prospect in the late 1970s.

"I was in Triple-A and going for my 14th win of the season in my last start in June in 1979," Wright recalled. "I felt a twinge in my right forearm. A year later they detected a tumor in my arm that proved to be benign. It was removed, but it wasn't supposed to be a career-ending injury. I later broke my arm where the tumor was removed."

He later sustained a torn rotator cuff.

"I tried to pitch through it, but by 1981 my arm was breaking down all the time," Wright said. "There wasn't anything like arthroscopic surgery then. If a pitcher went under the knife, they had to cut through so many muscles to get to the damaged area. That usually meant he was finished. Today, pitchers can come off surgery better because there's more knowledge through the MRI."

Wright's last big league season was 1982, when he was 0-0 in seven games for the Kansas City Royals.

"I remember crying mad when I was told I couldn't pitch anymore," he said. "I knew I had lost something that was special."

Maybe with today's surgical and rehabilitation methods, Wright might have been able to resume his career after some time off.