So, having re-read the book over the weekend, my opinions have been intensified. The book contains some very useful information that was well researched and though out. However, it loses credibility when it pivots from well organized research to pure speculation based on an illogical premises. To me the BIG problem is that the entire book is based on the idea that arm injuries are occurring at higher rates and involve younger players than ever before. There is absolutely no logical evidence that this is a true premises. Yes, surgery rates are up and it can even be said that injuries reported to physicians have increased. However, that evidence does not speak to injury rates. It only speaks to treatment rates.
Arm injuries have always been, and will always be, a very real risk to pitching. How we treat arm injuries is what has changed. I am definitely not saying there isn't a problem - just that the problem has always existed and there is no proof of any "epidemic." Not that long ago, it would have been extremely strange for a kid to seek treatment for a pitching injury. The course of action was simply to stop pitching or pitch through pain. Very few parents would have even entertained the idea of taking their kid to the doctor for a sore elbow due to pitching, let alone taking them to a surgeon. Therefore, most youth injuries weren't documented. Heck, the same applied up until about 40 years ago for major leaguers - pitch through the pain or retire.
Today, we know so much more about the causes of such injuries and our methods for treating them are far more sophisticated. Finally, we recognize that there is a problem for which education, care, and planning can have an impact. We take better care of pitcher's arms than ever before. Instead of taking the old school notion that there isn't anything you can do about it, we advance in arm care and arm injury treatment. What a wonderful time to be a pitcher!
The mistake we make, though, is to look at the raw statistics concerning increases in surgery rates and draw from this a conclusion that is logically just wrong - that an increase in treatment equals an increase in actual injury. You' can only conclude that there are more surgeries. That's it.
So much is being done today in the field and there is still so much more to be done. However, a lot of time is also wasted with finger pointing and fear mongering. Instead of marveling at the advancements, we've drawn the above illogical conclusion and, rather than focus all of our attention on treatment and preventative advancements, we have been drawn into the zero-sum game of comparing older methods and more recent developments (i.e. changes in how youth organize and play the game) to try and assign blame. In doing so we have created some false "epidemic."
So, why can't we continue to advance this field and adjust our methods to the current state of the game without trying to find some magic root cause in how the game has changed? Why can't we realize that the root cause of injuries is simply that pitching is a violent activity for the arm - as it always has been - and focus on how much there is that we can do about understanding and minimizing those injuries today that we have ever been capable of doing at any previous time in the history of the sport?
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