Kyle Gibson is aware of the long list of pitchers this season that have undergone Tommy John surgery. The Minnesota Twins pitcher is happy that he is pitching well now that he is two years removed from the procedure, but he still laments that it is becoming routine for hurlers to have go under the knife.
"As a pitcher, I wouldn't call it scary," he said. "Everybody knows it's part of the game. Unfortunately I see it become more and more part of the game. I have no idea why.".
SB Nation has compiled a Tommy John "Kill Sheet," and with names like Matt Harvey, Josh Johnson and Jose Fernandez recently joining that list, teams are left wondering what is at the root of this epidemic. "I don't know the reasons why all of a sudden now this elbow thing's coming up where I don't think anybody’s treating pitchers any differently," said Twins manager Ron Gardenhire. "I don't think they are doing anything different in college or high school, I think it's just the violent motion of throwing a baseball."
Gibson, who had the procedure done in November of 2011, has no solution to Tommy John surgery. Instead, he sees it as a learning experience. The rehabilitation he went through taught him new techniques he could use to strengthen and preserve his arm, and the year away reminded him of how much he loved baseball.
He understands the importance of good mechanics and preserving the arm at a young age, but says that sometimes pitchers who were instructed by wise coaches still get injured. Gibson does not want to fundamentally change the game of baseball by having pitchers throw four innings or toss the ball from a lower mound, nor does he want to see young pitchers to see the surgery as a magical procedure that will help them reach the big leagues. Instead, he sees it as an opportunity to learn techniques to stay healthy and throw harder following the surgery.
It can happen to anyone
When Joba Chamberlain and Stephen Strasburg underwent Tommy John, experts blamed the "Inverted W," a pitching technique both players implemented where they picked up both elbows above the shoulder during the cocking phase of the pitch. But Harvey, the Mets ace, had sound mechanics and also was sidelined due to a UCL tear.
"You've got guys that are talking about mechanics and the inverted W, you've got guys that had Tommy John that don't do that so it could just be something where you throw for a long time, and you throw hard for long enough, and your arm just wears down," said Gibson. "You just try and stay on top of it as much as possible and keep your conditioning up, but some of it is luck," he continued. "I mean, who knows? Like Matt Harvey, who thought Matt Harvey, who has really good mechanics, is going to get hurt?"
Tommy John himself came out and said that he feels that the reason so many players are having the surgery named after him is because they specialize so young and play year round. Others blame high school and college coaches that emphasize winning over player health, often letting pitchers throw over 100 pitches if they continue to get players out in latter innings.
Twins assistant general manager Rob Antony says that he looks into a player's history before drafting him, but will not be dissuaded from drafting a player that is considered Tommy John prone. "You look for arm action probably as much as anything. Some guys just have a little more risky arm action, but you gotta be careful," he said. "A lot of it major leagues clubs can't control because of what a player has done coming up in high school or if you went to college, how he was used, pitches that he threw, when he started throwing the ball, if he pitched year round.
"There's so many factors you can't control. You get the pitcher at that stage of his career, and go from there."
The Twins knew that Gibson may be injury prone coming out of the University of Missouri, but took him at No. 22 overall in 2009 and gave him a $1.8 million signing bonus. "When we drafted Gibson out of college, he had a stress fracture in his forearm, and a lot of people said that was a precursor to Tommy John, and we all knew that was a possibility," he said. "He ended up having Tommy John, but if that's behind him now, and he goes on and pitches the next seven years, we'll know the issues were well worth it."
Gibson understands Tommy John's argument and does not discourage kids from playing other sports, but he also says that the only way to improve arm strength and pitching motion is to actually do it. He says it's like a runner: The only way to get better at sprinting is to go out and sprint. Yes, it may be a more natural motion, but it's the same basic concept in his mind.
"The only way to throw harder is to break those muscles down and build them back up," he said. "It's kind of a double-edged sword: If you want to throw hard and you want to make your arm stronger, you've got to go out and throw. There is no magic exercise that's going to do that for you."
Don't change the game
As the number of pitchers undergoing Tommy John increases, baseball writers have begun mulling ways to reduce the amount of UCL injuries among starting pitchers. Esteemed Sports Illustrated scribe Tom Verducci wants to see the league lower the mound while Anthony Murray of The Atlantic suggested that teams limit MLB starters to four innings. Both options have gained some traction, but neither is appealing to Gibson.
"In general, it doesn't matter what athletic profession you're in. Your career is a short career," he said. "To take somebody that is just getting into the league and limiting them to four innings, maybe not ever seeing what they can do late in the game probably doesn't make a whole lot of sense."
Besides being energized by their competitive nature, pitchers become accustomed to the mound being a certain height and pitching a certain amount of pitches. They develop habits early on that allow them to pitch accurately at a high velocity, and dramatic changes to the game could be detrimental both to their performance and to their health.
He praises pitchers like Anthony Swarzak, a Twins reliever that is able to throw any amount of pitches in just about any setting. The former starter is used both in long relief and spot duty and has traditionally handled an inconsistent workload well since being moved to the bullpen (Swarzak only had 5 starts in 2012 against 39 relief appearances. In 2011, he had 11 starts and 16 relief appearances. You could probably say he's been close to full-time relief for at least two years prior to this; arguably three. That's why I nixed "last year.")
"You've got to have the right mindset, and if you ask these guys, they're comfortable knowing their role and to do as good as they can in that inning or with one batter," he said. "To expect all of these guys to go out there and have their mindset open and say, 'I'm going to throw three innings today,' that’s going to be difficult for a lot of guys."
It's not a magical procedure
In May, Gregg Doyle, a national columnist for CBSSports.com, wrote that Tommy John is becoming a growing addiction among young pitchers. Dr. James Andrews, a preeminent sports surgeon who has operated on Stephen Strasburg, Adam Wainwright and Joe Nathan, said that he has to turn away many adolescent players that want to get on the operating table before they enter college thinking it will help them improve their game.
"The ones we have the most trouble with are high school players, sophomores and juniors," he told Doyle. "They're worried about their career and going to college, or worried about getting drafted out of high school, and their parents are pushing."
Andrews said that he could have a player like that ready for surgery in 15 to 20 minutes, but refuses to do so because the surgery is not foolproof. The procedure entails holes being drilled into the bones of a pitcher's upper and lower arm and a tendon from the pitcher's arm or leg getting snaked through those holes in a figure-eight pattern to stabilize the elbow. It isn't a simple operation.
"I wouldn't ever tell somebody to go get Tommy John just to throw harder," said Gibson, who has had two elbow surgeries. "I don't think you can really appreciate what the sport does for you until you're actually aware of it. You take a year off and you don't get to enjoy the fun and excitement of being on a team."
Gibson says it is all about the rehabilitation. Growing up, he threw long toss as long as he could during the offseason to build up arm strength and made that part of his rehab, but he also learned new techniques to build up his arm and shoulder while staying on a strict regimen. It was the rehab, he says, more than the surgery that allowed him to have success after the operation.
"Once you get to pro ball, it's a lot on yourself, and it's a lot of self-discipline," he said. "Even me this year, there's times when I don't really have my shoulder working, and when you're rehabbing you've guy a guy standing right next to you [giving instructions]. They keep on top of you because they understand how important that rehab process is.3
"If I probably took that same diligence that I had for that 12 months and applied it to every day after Tommy John, I'd probably have a lot better chance of staying healthy. That's kind of the goal, is to take what you learned in the process and use it as part of your routine."
Tom Schreier can be heard on The Michael Knight Show from 2-3:00 on weekdays. He has written for Bleacher Report and the Yahoo Contributor Network. Follow him on Twitter @tschreier3.