As ulnar collateral ligaments of professional pitchers continue to tear at an alarming rate, it's almost becoming easier to come up with a list of who hasn't had Tommy John (elbow reconstruction) surgery as opposed to who has. And for those who haven't, it's starting to feel like a matter of "when" and not "if."
According to Jon Roegele, a writer for The Hardball Times who has compiled a list of professional baseball players who have undergone Tommy John surgery dating back to Tommy John himself in 1974, 20 percent of the 677 pitchers who took the mound in an MLB game in 2013 have had the surgery.
And that was reported a month ago. Nine others have joined the list since, including reining NL Rookie of the Year Jose Fernandez, who was having a terrific sophomore season for the Miami Marlins when it was cut short after eight starts.
Dr. James Andrews, a leading expert who performs a vast majority of the Tommy John surgeries on professional pitchers, released a position statement on Wednesday with an overview on what is being called an "epidemic" among baseball pitchers.
Risk factors include pitching while fatigued, poor pitching mechanics and poor physical conditioning, while pitching at less than 100 percent effort is one of several recommendations for reducing the risk of injury. Pitchers with high velocity are at greater risk.
The 28-year-old, who ran his record to 7-1 with 8.2 dominant innings against the Los Angeles Angels on Wednesday, has now logged over 1,900 innings during his big league career to go along with 306.2 minor league innings dating back to 2003 when he was 17 years of age.
In his eight full big league seasons, the right-hander out of Venezuela has not made fewer than 30 starts or thrown fewer than 190 innings. He's averaged 32 starts and 218 innings per season over that span, including four consecutive seasons with at least 232 innings from 2009-2012.
And despite a decrease in average fastball velocity over the past few years, he still throws hard, as evidenced by last Friday's outing against the Houston Astros.
Felix Hernandez had his best fastball of the season Friday. Both his avg. velocity of 93.2 MPH and max velocity of 94.8 were season highs.— Buster Olney (@Buster_ESPN) May 24, 2014
In Wednesday's start, he continued to bring the heat.
Felix Hernandez on his 95 mph fastball, "I've still got it!"— Shannon Drayer (@shannondrayer) May 29, 2014
Hernandez isn't unlike many big league pitchers who begin to lose velocity as they approach their late 20s and early 30s. According to FanGraphs, he averaged between 94.0 mph and 95.8 mph on his fastball between 2005 and his age-24 season in 2010. It then declined in three consecutive seasons—93.3 in 2011, 92.1 in 2012, 91.9 in 2013—before jumping up slightly to 92.2 mph this season.
Where Hernandez differs, however, aside from continuing to remain healthy and take the mound every fifth day, is that he continues to dominate. He's also a perfect model for the No. 2 recommendation on Andrews' list to reduce the risk of injury:
Do not always pitch with 100% effort. The best professional pitchers pitch with a range of ball velocity, good ball movement, good control, and consistent mechanics among their pitches.
His ability to rear back and fire a 95 mph fastball despite sitting in the low-90s range for the entire game tells you that Hernandez is doing just that. He's also going to his fastball much less often and relying heavily on his assortment of secondary pitches.
In 2008, he threw his fastball 65.9 percent of the time. That percentage has continued to decrease and is now at an all-time low of 48.4 percent in 2014.
In regard to not pitching while fatigued, he and his managers over the years have also done a good job in that area.
Despite the high inning totals, Hernandez has averaged only 104 pitches per game during his career. That he can do that while averaging nearly seven innings per game is an amazing feat in this day and age. That's a credit to his efficiency.
Hernandez has thrown more than 120 pitches in a game just 12 times, and his manager has never allowed him to throw more than 128 pitches in a game.
While these are all factors that may have contributed to his durability, we can't know for certain whether an elbow injury can be avoided for any pitcher who emulates Hernandez in all aspects of his preparation and game situations.
But if I wanted to make a living throwing a baseball, I'd surely subscribe to Hernandez's day-to-day approach to a long, successful and injury-free career.