CINCINNATI -- The rash of elbow injuries and Tommy John surgeries among young pitchers this year at the Major League level has been alarming. Organizations such as the Reds can't help but take notice and continue to work towards keeping their pitchers healthy.
Two of the Reds organization's top four promising players, according to MLBPipeline.com, are power-armed starting pitchers in No. 1 prospect Robert Stephenson and No. 4 prospect Michael Lorenzen. Both right-handers, who have fastballs that reach the mid-to-high 90s, are enjoying strong 2014 seasons at Double-A Pensacola -- and both have been healthy.
"We're confident in our preparation. We are confident in our staffs to help us make the best decisions possible," Reds Minor League director Jeff Graupe said. "Injuries happen every year. But we're confident in our ability to avoid as many as possible. We're confident in our medical team to help us rehab and get guys back soon as possible and as effective as they once were."
Since the start of Spring Training, nearly 20 Major League pitchers -- including Jose Fernandez, Patrick Corbin and A.J. Griffin -- have had the ulnar collateral ligament replacement operation, aka Tommy John surgery. Recovery times can often take between 12-18 months.
According to the Fort Myers News Press, the Twins organization is one that has made an immediate change in direction. For its affiliates below Double-A, Minnesota directed teams to institute a six-man rotation, instead of the traditonal five-man rotation, to curb starting pitcher workloads.
The Reds already made some adjustments before Spring Training, before the epidemic of elbow injuries really spiked. It has relied on the experience of pitching coordinator Mark Riggins, special assistants to the general manager Cam Bonifay and Jerry Walker, pro scouting director Terry Reynolds, senior director of amateur scouting Chris Buckley and the field staffs of each affiliate to help make individual decisions on each pitcher. Innings totals could soon become less of a barometer over a season as opposed to total pitches thrown, which gives a more accurate idea on how much stress has been put on an arm.
"What we look for are red flags, such as velocity drops, groundball rates changing, and we have the coaches talking to guys," Graupe said. "Do they look tired? Do they feel tired? When you put all your information together, you come away with the best picture of how each pitcher is doing. We're not in a position right now to make radical overhauls without all the empirical data being in place telling us that's the right move."
Graupe declined to specify individual workload limits for his organization's pitchers, namely Stephenson and Lorenzen.
Through six weeks of the season, the results have been positive. Stephenson, 21, is 2-4 with a 3.74 ERA in nine games. Over 45 2/3 innings, he has allowed 35 hits with 21 walks while striking out 55.
Stephenson, the Reds' first-round Draft pick in 2011 (27th overall), struck out 11 over five scoreless innings in his first start, but allowed three or more earned runs in four of the first six starts. He seems to have found a groove in recent outings.
"Robert did a nice job adjusting," Graupe said. "He's been able to throw his breaking ball and changeup for strikes -- both in hitter's counts and when he's ahead in the count. He's mixing his pitches, while staying aggressive with his fastball in the zone has been a key for him."
Most importantly, there has been growth and progress for Stephenson, who participated in his first big league camp during Spring Training.
"The ability to react to adversity and make an adjustment and come out of it with positive results is something we really enjoy seeing," Graupe said. "While you hope each guy breezes through and never struggles, there is something positive about having some tough times and coming out the other end better. This has definitely been a positive first month and a half for Robert."
In his first full year in a rotation at the pro level, the 22-year-old Lorenzen has done more of the breezing through. He has a 2-2 record and 2.26 ERA in nine starts. Over 51 2/3 innings, he has given up 40 hits and 18 walks with 37 strikeouts. He was a supplemental first-round pick (38th overall) in the 2013 Draft.
"A lot of Michael's development and struggles have been more about figuring out who he is," Graupe said. "He's done a really nice job of that so far. He's come up with a routine that works for him. He's learning how to pitch, how to turn a lineup over two or three times, and he's learning what it takes to get deeper into games by being efficient and aggressive. It hasn't been easy for him every start, but he's done a really nice job.
"We have a plan set up to get him through the full season, but we're really, really pleased with how he is carrying himself so far."
Add in 20th-ranked prospect Jon Moscot, a right-hander who has a 2.11 ERA through nine starts, the Blue Wahoos' rotation looks even more impressive. Pensacola also has 10th-ranked prospect Daniel Corcino.
Stephenson and Lorenzen, though, seem to be on the fast track. Just how express that track is remains to be seen. It's unclear if they could soon move up to Triple-A Louisville, or perhaps even be considered for September callups to the big leagues.
"We're pretty comfortable with where they are and the challenges they face at Double-A at this moment," Graupe said. "Their performance will dictate how their year finishes."
Mark Sheldon is a reporter for MLB.com. Read his blog, Mark My Word, and follow him on Twitter @m_sheldon.