After all these decades of baseball, preserving and utilizing a pitcher's arm still is a remarkably inexact science.
There's nothing more valuable than a top-of-the-line, front-of-the-rotation starting pitcher.
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So how do you get the most out of your great arms? How do you make sure they give you 30-35 starts a year without losing effectiveness?
No one has the answer. Injury rates continue to rise wildly, even as methodology supposedly advances.
As the Washington Nationals shut down Stephen Strasburg, they don't know with any assurance whatsoever that he won't get hurt again in the next year or two. That decision, in the face of the first Washington playoff run since 1933, is jaw-dropping and sad.
The White Sox' plan with Chris Sale has been effective and intriguing. But here in September, he, like so many others, is not himself. He has learned to win without his best stuff.
Stan Conte, the director of medical research for the Los Angeles Dodgers, told Sports Illustrated's Tom Verducci that "fifty percent of all starting pitchers will go on the DL every year, as well as 34 percent of all relievers."
MLBDepthCharts.com has a Tommy John surgery tracker, which soberly records the climbing totals of men who undergo that once-rare procedure.
TJ is now an often preferable option with predictable, high-quality prognoses. Studies are being done on the many pitchers who have had two of them.
It wasn't long ago that pitchers regularly went 250 or even 300 innings, and most starters either fought through pain or simply adjusted to their weakened arm. Then the industry began to get scared, and the almighty pitch count took over.
Pitch count was tracked for the first time in 1988 by Stats, LLC. Since that year, the number of times a starter throws more than 125 pitches has shrunk progressively … and dramatically.
There hasn't been a season with more than 74 of those games since 2001, after years of triple digits. Still, injury rates climb. So simply limiting the bullets in the gun is no panacea.
Texas Rangers president Nolan Ryan is angry at what fear has done to the profession he once dominated. He says pitchers are criminally under-conditioned from pre-high school age and grow up unable to withstand the demands of the job.
He's changing the philosophy within his organization as best he can, allowing his pitchers to throw "until the batters tell them they're done."
The Baltimore Orioles are one of a few teams to utilize biomechanical analysis, dissecting a pitcher's delivery in detail with computers. Those deliveries then are compared to more than 40 healthy, excellent hurlers to see what can be tweaked.
Every technology available is being considered to navigate the current chaos.
I've begun to lean hard toward fusing what Ryan and the Orioles are doing, espousing an educated "old-school" mentality. You have to throw to be strong, while using something like biomechanics to save your ace from himself.
It's all, on some level, educated guesswork. Babying an arm offers no guarantee of future health.
Casualties of supposed overuse like Cubs Mark Prior and Kerry Wood probably were victims of their own flawed mechanics.
Wood threw violently across his body, from high school on. Prior's arms would form an inverted W as he started off the mound, a trait he shares with many who ended up going under the knife.
You know who else forms that inverted W? Stephen Strasburg. It may have led to his first TJ surgery, and regardless of innings or pitches it could lead to his next.
Sometimes brilliance is fragile, by nature, and feverish protection will do nothing to strengthen it.
•Matt Spiegel co-hosts "The McNeil & Spiegel Show" 9 a.m. to 1 p.m. Monday-Friday on WSCR 670-AM, and The Score's "Hit and Run" at 9 a.m. Sundays with his Daily Herald colleague, Barry Rozner. Follow him on Twitter @mattspiegel670