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Expert Panel Headlines MLB Network Roundtable: The Pitching Dilemma On Widespread Pitching Injuries in MLB This Season

Bob Costas Moderates Panel Discussion with Dr. David Altchek, Tom House, Jim Kaat, John Smoltz & Tom Verducci; Exclusive One-on-One Interview with Dr. James Andrews & Costas Covers the Current Prevalence of Elbow Injuries in Youth Baseball

With 17 Major Leaguers having undergone Tommy John surgery so far this year, MLB Network assembled an expert panel to examine the prevalence of elbow injuries among MLB pitchers and what it means for the future of the game. In MLB Network Roundtable presented by Delta Airlines: The Pitching Dilemma, Bob Costas moderates a roundtable discussion with Hospital for Special Surgery Co-Chief of Sports Medicine and Shoulder Service Dr. David Altchek; pitching expert Tom House; Jim Kaat, who pitched more than 4,500 innings and 180 complete games in his 25-year career; 1996 NL Cy Young Award winner John Smoltz, who had Tommy John surgery in 2000 and finished his career as the only pitcher with 200 wins and 150 saves; and MLB Network insider Tom Verducci, who has covered the topic extensively.

Costas also hosts an exclusive one-on-one interview with orthopedic surgeon Dr. James Andrews, one of the foremost authorities on Tommy John surgery, to discuss his latest research on the biggest risk factors for elbow injuries among young pitchers before they reach the Major League level.

The one-hour program airs this Saturday, May 10, immediately following MLB Network's 1:00 p.m. ET telecast of the Minnesota Twins at Detroit Tigers game, and on Sunday, May 11 at 8:00 p.m. ET. A clip from the program is available here and quotes from the program are transcribed below:

Dr. James Andrews on what causes elbow injuries:

"The basic thing that parents out there and coaches and players alike need to know is if you throw with fatigue at a young age - in high school, for example, or youth baseball - you have a 36-to-1 chance of injuring your shoulder or elbow. … Fatigue could be event fatigue, seasonal fatigue or year-round fatigue, so it's a big problem."

"What we really found out is that [high school patients] only had one week off each year from competitive baseball and that one week was - you could guess what - between Christmas and New Year's. So they're playing year-round baseball - that's the number one risk factor in youth baseball."

"If you take a coat hanger and you bend it enough times, what happens? It breaks clean, and then of course that injury didn't begin with that last bend, it began with all of those multiple, multiple bends. It's a developmental ligament and the stress that it will take is only about 80-miles per hour, so our high-velocity throwers in high school - unless they've got great genetics - are really suspect to really injure their ligament along the way."

On what can be done to prevent future elbow injuries:

Tom House: "We're designed to throw on flat ground. … What happens to kids today? They pitch too much year-round and they don't throw enough. … They only time they throw is in a practice or a game, and the pitcher's are [throwing] off the mound. … Let them play on flat ground. Let them throw stuff, throw anything. Stay off the mound except for game day, throw as much as you can on flat ground the rest of the time."

Jim Kaat: "I had pitched nine innings against [Tommy John] in Chicago and the next day I'm at the mound throwing. Not pitching, [but] exercising. He's running his laps and he said, 'What are you doing? You pitched nine innings. You can't do that.' I said, 'Well, I throw every day. It will rust out before it will wear out.' Well, when he had the surgery, he called me and said, 'Guess what Dr. [Frank] Jobe told me to do?' He got his wife in the backyard and played catch every day. Throw a little more - I think that's one thing that's lacking."

On the recent increase in Tommy John surgeries:

Dr. Andrews: "It's really depressing to go in and see the number of high school kids coming in with this injury. At this point in my career I'm probably seeing more high school kids with a ulnar collateral ligament injury than I am with college and pros."

Dr. David Altchek: "It's a constant struggle in terms of trying to treat any of these athletes conservatively with this injury."

John Smoltz: "A lot of those [success rate] numbers that we see are a little skewed - they make you want to grasp something. They want to say, 'If you're going to make it to the big leagues, follow these guys who were successful.' But I had my surgery after 2,400+ innings in the big leagues [and] I knew how to get back to the big leagues. I feel sorry for the Single-A, Double-A players."

Tom Verducci: "As more people get the surgery - we know that's happening - that means that more people don't come back."

About MLB Network:

MLB Network is the ultimate television destination for baseball fans, featuring the multiple Emmy Award-winning MLB Tonight, live regular season and Postseason game telecasts, original programming, highlights, and insights and analysis from the best in the business, including Bob Costas, Peter Gammons, Jim Kaat, Al Leiter, Harold Reynolds and Tom Verducci. MLB Network debuted on January 1, 2009 in a record-setting 50 million homes and is currently distributed in approximately 70 million homes throughout the U.S., Canada and Puerto Rico. For more information and to find MLB Network in your area, go to