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I have been teaching pitcher for 25 years, and I have listened to and watched many great teachers and none including myself are using a drive off the rubber approach. I don't think real baseball people were using that in the 30's either. But I'm not sure about that. Sometimes kids and young men just need to throw more and then they certainly need down time.
I certainly have not seen arm injuries at the rate people speak of here and definitely not due to velocity. A kid can't just try throwing real hard, he'll only do so much for so long. Proper conditioning along with time, training, mechanics and coaching will all enhance velocity, but if a kid is going to top out at 86, then thats it. If a kid can hit 90+ then he'll be looked at for higher levels. The only thing that increases his risk of injury is that he will ultimately throw more as he progresses up the ladder. The most common young injuries I see are due to overthrowing, pitch count without proper training and kids who feel they have to throw all kinds of junk at 12-14. They must learn proper mechanics as a foundation, then how to spot and control the fastball in order to become a pitcher, and their individual velocity won't matter at the youth level if they can spot it and control it. A change will then give them the ability to deceive the hitter and they will become more successful.
My son, who is a sophomore in HS, has been playing together with 4 of his friends since Tball, all of whom pitch. These 4 friends went off to play AAU 2 years ago and have been playing at least 9 months of the year with many many games over the summer. All 4 of them have elbow or shoulder injuries, 1 had Tommy John surgery, 2 have stress fractures and 1 has a bad shoulder problem. My son, who has been playing Legion, local town ball and HS ball, is just fine. Seems to me it is plain overuse and a great waste of talent. They will now miss an entire year of HS ball when they are needed and an important season if they want to play in college.
DOC...I think you are right on the money...amazes me how many "I have a better idea" coaches and parents are out there living a "could have been" life through a young player. Even the pros shut it down for 5 months out of the year....yeah I know the do work out, but it isnt near the intensity level we are working some of these kids 10 mo out of the year....every one is focused on the number of games....but not one of us so called "coaches" talks about the number of countless practices we put these kids through....not even the pros go at it like we do with these kids....lets be honest...if your playing 3-4 games a week....you practice at least 2...seems to me maybe we should be talking the number of HOURS the arms are taking. It is supposed to be a FUN game...some make money...hopefully most of them will still be able to throw with your grandkids as a parent.
Pain Guy:

Going back to the photos you posted. The difference between Prior and Maddux is that Prior brings his elbow up to that tightly cocked position from inside, while Maddux swings his arm down, back and up into that position. Bringing the ball inboard, so to speak, results in the high elbows you focused on. Bottom line is, I think you and I have noticed the same phenomenon and are talking about the same thing but describing it by focusing on different characteristics of it.

Basically if you bring your pitching hand up on a path that is forward of your elbow, as Prior does, then when you go forward you get a hard whip-saw jerk against your shoulder and elbow. But if you bring the hand down, back and up from behind the elbow, you get more of a smooth rolling motion. When you repeat the action hundreds or thousands of times, the first approach (Prior, Liriano) is bound to lead to more injuries than the second approach (Maddux).

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