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Baseball wonders why pitchers’ elbows keep tearing

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Miami Marlins starting pitcher Jose Fernandez sits in the dugout after pitching eight solid innings a baseball game against the Atlanta Braves, Tuesday, April 29, 2014, in Miami. The Marlins defeated the Braves 9-0. (AP Photo)

Miami Marlins starting pitcher Jose Fernandez sits in the dugout after pitching eight solid innings a baseball game against the Atlanta Braves, Tuesday, April 29, 2014, in Miami. The Marlins defeated the Braves 9-0. (AP Photo)

FILE – In this April 14, 1978, file photo, Los Angeles Dodgers left-hander Tommy John delivers a pitch against Atlanta Braves during an opening day baseball game in Dodgers Stadium, Los Angeles. UCL has increased 10-fold in the first decade of the 21st century, Dr. James Andrews, one of the world’s top orthopedic doctors, and and Dr., Jeremy Bruce wrote in the May issue of the Journal of the American Academy of Orthopaedic Surgeons, citing a paper published by J.R. Dugas in 2010. Dr. Andrews will be meeting with a research committee on Monday at Major League Baseball’s headquarters. (AP Photo/LM, File)

FILE – In this April 2, 2014 file photo, Tampa Bay Rays starting pitcher Matt Moore delivers in the fourth inning against the Toronto Blue Jays during a baseball game in St. Petersburg, Fla. More than a dozen major league pitchers have needed Tommy John surgery this year, a group that includes All-Stars Patrick Corbin, Josh Johnson and Matt Moore, joining an illustrious group that includes Chris Carpenter (2007), Stephen Strasburg (2010), Adam Wainwright (2011) and Matt Harvey (2013). (AP Photo/Chris O’Meara, File)

FILE- In this Aug. 24, 2007, file photo, Dr. James Andrews waits between surgeries at the Andrews Institute for Orthopedics and Sports Medicine in Gulf Breeze, Fla. Tommy John surgery has increased 10-fold in the first decade of the 21st century, Dr. Andrews, one of the world’s top orthopedic doctors, and and Dr., Jeremy Bruce wrote in the May issue of the Journal of the American Academy of Orthopaedic Surgeons, citing a paper published by J.R. Dugas in 2010. Dr. Andrews will be meeting with a research committee on Monday at Major League Baseball’s headquarters. (AP Photo/Mari Darr-Welch, File)

FILE- In this July 27, 2013, file photo, Dr. Frank Jobe, right, known for the development of the historic elbow procedure known as “Tommy John Surgery,†speaks as he and Tommy John, left, are honored during a ceremony at Doubleday Field at the National Baseball Hall of Fame in Cooperstown, N.Y. UCL has increased 10-fold in the first decade of the 21st century, Dr. James Andrews, one of the world’s top orthopedic doctors, and and Dr., Jeremy Bruce wrote in the May issue of the Journal of the American Academy of Orthopaedic Surgeons, citing a paper published by J.R. Dugas in 2010. Dr. Andrews will be meeting with a research committee on Monday at Major League Baseball’s headquarters. (AP Photo/Mike Groll, File)

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All of baseball is focused on a most precious 2 1/8 inches — the average length of the ulnar collateral ligament.

This year, more than a dozen major league pitchers already have undergone Tommy John surgery — which involves replacing the elbow ligament with a tendon harvested from elsewhere (often the non-pitching elbow or forearm) in the patient’s body. All-Stars Patrick Corbin, Josh Johnson and Matt Moore have had the surgery, and NL Rookie of the Year Jose Fernandez was scheduled to have his operation Friday.

“It’s a problem. There’s no question about it,” baseball Commissioner Bud Selig said. “I’m almost afraid to pick up the paper every day because there’s some bad news.”

The surgery forces a player to miss at least a full season, but many power pitchers — including Chris Carpenter (2007), Stephen Strasburg (2010) and Adam Wainwright (2011) — threw as hard with their repaired elbows as they did before. Matt Harvey is still recovering from surgery last year.

The league hopes it can find ways to protect these million dollar elbows before surgery is required.

Dr. James Andrews, one of the world’s top orthopedic physicians, will be meeting with a research committee Monday at Major League Baseball’s headquarters.

“We’re going to put together a research project to help figure this out. We don’t know quite what to say at this point,” he said. “But, yeah, it’s got everybody’s attention.”

A 2013 survey showed 25 percent of big league pitchers and 15 percent of minor leaguer pitchers had undergone the procedure.

“This does not include the guys who didn’t make it back. These are the success stories,” said Glenn Fleisig of the American Sports Medicine Institute, who conducted the survey with Stan Conte of the Dodgers.

With the advent of high-tech scans such as MRIs, doctors usually can pinpoint exactly what’s wrong. And with pro pitchers under the watch of radar guns whenever they throw, the slightest drop in velocity triggers scrutiny.

But for more than a century, pitchers came up with “sore arms” and “dead arms,” trying to pitch through pain.

“Back then, you could be on your deathbed and you never told anybody because if you said, ‘God, my arm hurts,’ there were 15 guys waiting to take your place,” Tommy John said. “So I kept my mouth shut and just kept pitching, kept pitching, kept pitching.”

UCL reconstruction has increased 10-fold in the first decade of the 21st century, Andrews and Dr. Jeremy Bruce wrote in the May issue of the Journal of the American Academy of Orthopaedic Surgeons, citing a paper by J.R. Dugas. Experts think young pitchers throw far more often now than they did a decade or two ago.

“Baseball, once considered a seasonal sport, has become a year-round event in some regions of the United States, with increased team travel play and sponsored tournaments,” Andrews and Bruce wrote.

An ASMI study published in 2011 examined 481 pitchers ages 9-14, and then checked with them 10 years later. Those who threw more than 100 innings in a year were 3.5

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