Jose Fernandez: Preventable or Inevitable?

Jose Fernandez is broken. After allowing him to throw ridiculous pitches that opposing hitters simply couldn’t touch, his elbow threw in the towel in the fifth inning of his start on Friday night. You can basically see the injury occur in his in-game velocity chart.

In the fourth inning, his four-seam fastball averaged 97.7 mph; in the fifth inning, 90.0. An eight mile-per-hour velocity loss from one inning to the next is worrisome, to say the least, and MRIs have apparently suggested the worst. It hasn’t been officially announced, but the expectation is that Fernandez will need Tommy John surgery, which will take him out for the rest of 2014 and most of the 2015 season, most likely.

In the wake of nearly any serious injury to a pitcher, the discussion moves to whether or not the pitcher was handled correctly, Was he asked to throw too many pitches, or too many innings, or was he allowed to throw too many of a certain type of pitch? In Fernandez’s case, you could present both sides.

On the one hand, the Marlins handled Fernandez with some care last year. He was limited to no more than 86 pitches in his first seven starts as a big leaguer, and he didn’t break 100 pitches in a game until his 13th start. Even since breaking that threshold, he has most often been held to fewer than 100 pitches, and he’s only broken 110 pitches once; a week ago, against the Dodgers, he threw 114.

If you believe that injuries are caused by pitchers throwing while tired, and you think that pitch counts can serve as a proxy for when a pitcher begins to wear down within a given start, then you’d likely conclude that the Marlins handled Fernandez with care. A pitcher who has averaged 95 pitches per start — most of them coming with the bases empty because no one was good enough to get a hit off of him — would not generally be classified as an abused arm.

But then there’s the other side of the argument. Fernandez was brought to the majors as a 20 year old, and was asked to throw 173 innings against big league hitters before he was shut down in mid-September. He’d thrown 134 innings in A-ball the year before, so so not only did his workload increase by 30% year over year, but the quality of opponent increased dramatically, and I think it’s fair to say that innings against big league hitters probably require more of an effort from a pitcher than innings against minor league hitters. Maybe even 170 innings against big leaguers is just too many for a developing arm. Or maybe 300 combined innings in your age 19/20 seasons is just too many.

Or maybe we just have no idea. After all, Rick Porcello made almost the exact same jump as Fernandez, throwing 125 innings in A-ball at 19 and then 170 in the majors a year later, and he’s yet to have any major elbow issues. CC Sabathia threw 145 innings between A-ball and AA at age-19, then threw 180 in the majors as a 20 year old, and he’s been one of the most durable pitchers in baseball over the last decade. Felix Hernandez threw 172 innings between Triple-A and the Majors as a 19 year old, and then 191 additional big league innings at age-20, and he’s shown no ill effects from his early career workload.

There simply isn’t enough evidence to blame Fernandez’s workload for his injury, and it’s not like the list of guys who have been developed more conservatively are avoiding surgery at a higher rate. Elbows are blowing out at the same or higher rates than they ever have been, even in the age of limiting pitch counts and innings totals. While Fernandez did have a larger workload than most 20 year olds, against better competition than most 20 year olds, it’s difficult to suggest that any other type of handling would have produced better results. There are a lot of teams trying a lot of different solutions to try to keep their young pitchers healthy, and everyone is failing. Everyone.

In some ways, figuring out pitcher health with our current tools and metrics feels like trying to go to the moon in a hot air balloon. Maybe we can see the goal, and maybe we have a vehicle that moves us in the direction of that goal, but we’re not getting to space in a basket, and we’re not going to keep pitchers healthy with pitch counts and innings totals. That doesn’t mean we abandon all caution and stop counting pitches and innings entirely — you absolutely can run a pitcher in the the ground due to overwork, but MLB teams just aren’t doing that anymore — but perhaps we just accept that it’s going to take a technological leap forward before we actually know enough to measure when a pitcher is actually in danger of blowing his elbow out.

Hopefully, in 10 or 20 years, in-game live biomechanics have proven useful, and teams will be able to measure things that have proven to actually matter. There are companies already pitching products like this, though the industry is in its infancy. I could see these kinds of tools actually providing some real benefit down the line, and perhaps that kind of technology will help turn the tide of pitcher injuries.

For now, though, we’re grasping at straws. We don’t know how to keep pitchers healthy, and we don’t know if the Marlins could have kept Fernandez healthy. It sucks that another great young arm has gone down, but this is just the reality of where we’re at with keeping elbows in tact. We don’t know how to do it, and we don’t know why Fernandez blew out when Porcello and others have not. Hopefully, some day, we’ll know. For now, we just accept our ignorance, and keep the finger pointing to a minimum.