Do Drafted College Pitchers Have More Major Surgeries Than High School Arms?

Mike Rosenbaum@GoldenSombreroMLB Prospects Lead WriterSeptember 25, 2012

September 2, 2012; Washington, D.C., USA; Washington Nationals starting pitcher Stephen Strasburg (37) pitches in the first inning against the St. Louis Cardinals at Nationals Park. Mandatory Credit: Joy R. Absalon-US PRESSWIRE

One doesn’t necessarily need to have a 100-mph fastball or be dependent upon the use of a devastating slider to suffer a serious elbow or shoulder injury. However, it may seem that way due to the high-profile nature of so many recent injuries (see Strasburg, Stephen).

Over the course of baseball history, there have been countless pitchers who have had possessed heinous mechanics yet, for one reason or another, never endured the type of debilitating elbow or shoulder injury that would require major surgery.

But why is that? And how should it affect a team’s drafting philosophy?


Different (Arm) Strokes for Different Folks

Before I get carried away, I think that it’s important to note that every pitcher is put together differently. Some pitchers, despite mechanics that would seemingly put them at risk for an injury, last their entire career without a trip to the disabled list. On the other hand, there continues to be hoards of pitchers who seemingly cannot stay healthy, as their initial injury is often compounded and serves as a precursor for future problems.


Common Ground for Pitching Mechanics

While there are various mechanical philosophies in existence throughout both college and professional baseball, many of them are derived from a similar notion of what’s safe and offers a pitcher the greatest chance at longevity.

For a pitcher to efficiently and safely throw a baseball requires a near-perfect succession of kinetic motions where each action seemingly prepares the body for the next.

While the common observer may focus strictly on how a pitcher’s arm works relative to the end result, the greatest tell can be seen in their lower half. From my experience as a player, coach and scout, early warning signs can be seen in a pitcher’s foot strike—when their lead foot first makes contact with the ground before setting the rest of their delivery in motion.

At the moment of the foot strike, a pitcher should have his arm elevated above his shoulder, level and ready to deliver the pitch. At the same time, as the pitcher cocks his arm back and prepares to deliver the pitch, the ball technically should be visible, pointing toward the sky. When a pitcher rears back to throw and has the ball hidden beneath a tight, coiled wrist, it should raise an immediate red flag.

Commonly referred to as an “inverted W” in the baseball community, a pitcher who has the ball facing downward as they set their arm is an unnatural, counterproductive motion. Typically, an “inverted W” means that pitcher employs poor timing in his mechanics, which, in turn, often leads to a lagging arm where the stroke fails to come through at the precise moment when a pitcher squares his shoulders toward the target (home plate).

As a result, enormous stress is placed on the elbow, shoulder, and, commonly, a majority of the surrounding muscles. In a sound, healthy delivery, a pitcher’s core (torso, lower back) and legs should endure the bulk of the stress.

Not every pitcher possesses perfect mechanics, nor is it something expected at even the highest level. At the same time, there’s no guarantee that just because a pitcher has a “safe” delivery that they will enjoy an injury-free career. Still, there’s a widespread understanding that adhering to these mechanical guidelines is the best way to avoid a major arm injury. 


College Arm Injuries

Over the last decade, the increased amount of major arm injuries endured by collegiate pitchers has been an alarming trend. For example, according to a study referenced in The Birmingham News in May, 2011, “at least 19 percent of pitchers on 2011 SEC rosters have had elbow or shoulder surgery before or during college.” And that doesn’t include the Auburn and Mississippi State programs, which opted not to participate in the study.

Citing the surgical history of renowned elbow surgeon Dr. James Andrews, a name synonymous with Tommy John surgery, the article states that:

Between 1996 and 2000, Andrews performed elbow surgeries on 95 college pitchers. That rate exploded to 351 between 2001 and 2005. From 2006 to 2010, college pitchers had 327 elbow surgeries with Andrews.

Andrews' overall number of elbow surgeries—counting youth, high school, college, pro and others—declined 15 percent during the latest five-year data. That's largely due to surgeries on pro pitchers dropping from 193 in 2001-05 to 86 in 2006-10.

Therefore, while the rate of such major injuries may be on the decline, it’s far from a resolved issue.



The Birmingham News study also utilized research from baseball fan Boyd Nation, of, who, for the last decade, has tracked excessive pitch counts throughout the SEC.

Boyd’s data highlights a dangerous overuse and exploitation of college arms, as he tracked SEC pitchers who turned in high pitch counts—defined by at least 121 pitches in a single appearance—between the 2007 and 2011 seasons.

Of the 12 programs featured in the study, there was a combined 206 instances of a pitcher throwing 121 or more pitches in a single game. While this total is inherently concerning, it’s important to note that it’s a welcomed deviation from the 277 instances that occurred between the 2002 and 2006 seasons.

So, even though Boyd’s data suggests a trend in a safer, more protective direction, the overuse of collegiate pitchers is still a frequent occurrence.


Inhumane Rationalizations

We all remember that Friday night during the collegiate season this past year, when Stanford ace and top draft pick Mark Appel threw 149 pitches in a complete-game effort.

Let me repeat that: 149 freakin’ pitches. 

Under no circumstances is that healthy, and any attempt to rationalize such a pitch count is completely and utterly asinine.

Just because a Friday night starter such as Appel has a week off between starts does not better equip him to go out and throw a million pitches. Demanding more than 120 pitches from a college pitcher is moronic and repeatedly places his future in jeopardy.

I’ve always been taught that the ideal number of pitches per inning is about 14 or 15. Therefore, if a college pitcher hurls a complete game, then they’ll still throw 135 pitches, ideally. For an 18- to 22-year-old pitcher who is still physically developing, such a total can be dooming.

Even if the pitcher is exhibiting no obvious signs of fatigue, such as a drop in velocity as the game progresses, it does not give a coaching staff the right to milk every last pitch out of their player.

Yet they do, game after game and year after year, because a college program’s emphasis is on winning—the only measure of success at that level—not preparing their pitchers for a healthy and fruitful career in the major leagues.


High School Arm Injuries

So, is there a benefit to drafting immensely talented high school arms over college ones? Well, not necessarily. But there is, at least, a notion of hope associated with them.

For starters, a high school pitcher has not endured the wear and tear of anywhere from two to four collegiate seasons. That doesn’t mean that they’ve been exempt from overuse during their prep careers—it happens at every level, unfortunately—but it’s likely been on a lesser scale.

With a highly successful and regarded prep pitcher who opts to attend college rather than begin their professional career, there’s a strong chance that their potentially problematic mechanics won’t undergo the necessary overhaul as they would under the direction of professional instruction. Basically, college programs are less likely to suggest mechanical adjustments if the pitcher has a history of success—if it’s not broken, there’s less of a need for it to be fixed.

Alternatively, as part of a major league organization, mechanics are adjusted and tweaked before extreme overuse rears its ugly head. And rather than be thrust into a competitive, must-win environment as is the case in college, teams are able to ease their pitchers through development—exactly why so many high school pitchers spend multiple seasons in the complex leagues to begin their professional careers.

While drafting and developing a high school arm may require more years for necessary development—and a longer route to the major leagues—compared to a collegiate pitcher, it allows an organization to both monitor and control physical maturation and development.


Final Thoughts

As I said before, this by no means guarantees that a pitcher will enjoy a healthy career. So many young pitchers, even before stepping on a high school field, are victims of high pitch counts and extreme overuse. Therefore, it wouldn’t be shocking to learn that a significant number of those pitchers who suffer either a shoulder or elbow injury in college may have a previously undiagnosed or undisclosed ailment.

However, at least in my opinion, beginning a career in professional baseball out of high school gives a pitcher a greater chance for both longevity and success as a big leaguer. 

Although the effect of high pitch counts has been heavily scrutinized in recent years, there's still substantial progress to be made.


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