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Originally published April 29, 2008 at 12:00 AM | Page modified April 29, 2008 at 12:16 PM

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Former high school pitcher hopes rules are changed to protect young arms

Jason Koenig lost his lawsuit last month, but the courtroom debate illustrated the arguments that have raged for decades, from Little League to the big leagues, from dugouts to operating tables. Just how do you protect a young pitcher's arm?

Seattle Times staff reporter

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No way. Jason Koenig was not leaving this game.

On a crisp, spring evening, with the sun fading toward the Olympic Mountains behind home plate, Koenig's baseball career at North Mason High School reached its peak — only moments before it disappeared.

For nine innings, Koenig went pitch-for-pitch with Yelm, the state's top-ranked Class 3A team, and two future pro prospects. He had no plans to take himself out.

Not after the fifth, when, while batting, a pitch drilled him so hard in the back he couldn't swing two innings later.

Not after the top of the seventh, after throwing 97 pitches — on one day of rest after a relief appearance.

Not after the top of the eighth, when his mother, Beth, grasped the chain-link fence behind the dugout and told coach Jay Hultberg, "Jay, he's at 117 pitches. He's done."

Not even after the 132nd pitch, which landed past the scoreboard in left field for a three-run home run.

Koenig threw 140 pitches in nine innings on April 27, 2001.

He never recorded another out. Instead, he joined the rapidly expanding ranks of adolescent pitchers who need arm surgery.

Three years to the day later, Koenig sued the North Mason School District for negligence.

Never before, his attorney says, has a pitcher sued his school district for pitching overuse. Koenig lost the lawsuit last month, but the courtroom debate illustrated the arguments that have raged for decades, from Little League to the big leagues, from dugouts to operating tables.

Just how do you protect a young pitcher's arm?

An epidemic

Orthopedic surgeons nationwide have called this their "mission" and their "quest." They have seen arm injuries claim too many pitchers, too young, to the point that James Andrews, a renowned Alabama-based orthopedist, has called it an "epidemic."

Between 1995 and 1998, Andrews performed an average of nine elbow surgeries per year on high-school students. Between 2003 and 2006, an average of 148 high-school students received the same surgery. He has seen a similar increase in shoulder injuries.

Larry Pedegana, the former Mariners orthopedist, said he recently operated on patients as young as 12 for pitching-relating injuries, something he never saw 10 years ago.

New research by the American Sports Medicine Institute, which Andrews founded to prevent sports injuries, has provided some insight into the root of these pitching problems.

In a 2006 study of pitchers ages 14 to 20, the institute's biomechanics lab found that throwing 85 mph or faster, for instance, made a pitcher 2 ½ times more likely to have surgery. Competitively pitching for more than eight months a year created five times the risk for surgery.

The study found that pitchers who "regularly threw with arm fatigue" — threw after they're tired — were 36 times more likely to have surgery.

"When you get beyond fatigue, that's Mother Nature's way of saying that's enough," said Frank Jobe, orthopedic consultant for the Los Angeles Dodgers. "You can't fool around with Mother Nature."

The most common pitching-related surgery is Tommy John surgery, a reconstruction of the ulnar collateral ligament in the elbow that Jobe pioneered 34 years ago. Like slicing a tree trunk to see its rings, surgeons cut open the elbow and often see tiny abrasions and tears on the ligament — called "microtrauma" — that indicate previous overuse.

And where the ligament is torn, it's often so frayed that the ends resemble cotton candy — a sign that the tear came from frequent overuse, not simply one wrong pitch. The more frequently a child pitches past his limit, the more likely something will tear as he gets older.

Glenn Fleisig, the chair of research at Andrews' sports medicine institute, often hears from youth and high-school coaches who aren't convinced. They don't have any pitch-count limits, they say, yet they have never had a kid need surgery on their watch.

His retort: "Go ahead and give them cigarettes. They're not going to get cancer on your watch."

A baseball jones

It takes a half-hour drive down winding state roads and an hourlong ferry ride to get to downtown Seattle from Jason Koenig's boyhood home in Belfair, which sits on the innermost point of Hood Canal. But three hours round-trip could not keep him, his older brother and a pair of friends from going to almost every Mariners home game as kids.

They usually arrived each morning at the visiting team's hotel, armed with backpacks full of cards, balls, hats and bats ready for autographs. All told, Koenig estimates his collection at 25,000 signatures.

Koenig has played baseball as long as he can remember watching it, and he began pitching in the fourth grade. But before his junior year of high school, he would not be considered the classic problem profile outlined by Andrews. He never played in multiple leagues during the same season. He did not pitch in the winter, aside from 10 innings in a pair of holiday tournaments in 2000. At the end of his sophomore year, his fastball barely hit 75 mph.

But before the start of his junior season, Koenig took a new approach to conditioning and mechanics. His fastball jumped to 84 mph, and he joined North Mason's starting rotation.

"I come into the season, and I'm basically their horse," Koenig says.

The pitches quickly piled up. He threw 102 pitches March 22, and only four days later, he threw 129. Koenig took the mound in 14 of North Mason's first 18 games, often closing the games he didn't start.

All of his pitching was within the rules of the Washington Interscholastic Activities Association, which only dictate that a pitcher must rest two days after pitching more than three innings.

Koenig's season gained momentum starting April 11, when he threw 95 pitches against Fife. After a 58-pitch relief appearance on April 16, he threw 102 pitches against Lakes on April 20. After that game, a scout from the Cincinnati Reds talked to Koenig about working with him in the summer.

Koenig's arm never made it that far.

On April 25, he pitched two innings, though no one kept track of his pitches. Two days later, he threw more pitches than ever before, 140, in the nine-inning loss to Yelm.

It capped a 16-day stretch in which Koenig threw about 425 pitches.

In the March trial, Koenig's attorney, Hal Hodgins, asked Hultberg, "Did you think at all, even a little bit, for a short time, that there might be any danger in Jason pitching more than 117 pitches, pitching another inning?"

The coach replied with one word: "No."

Counting pitches

Before the first pitch of the major-league season March 25, 82 pitchers were on the disabled list with an assortment of tears, sprains and fractures. Pitching, baseball's most valuable commodity, is also its most fragile.

"If you look at the best pitchers in baseball history at age 19 and 20, almost none of those guys ended up going to the Hall of Fame," says Rany Jazayerli, a baseball historian who cofounded the annual Baseball Prospectus.

How to preserve pitchers has been a quandary at the professional level longer than it has been for America's youth. More than 40 years ago, at least three organizations — the Atlanta Braves, New York Mets and Baltimore Orioles — began keeping pitch counts.

"It became more important they watch the strikeout pitcher because he had a tendency to get his pitch count up," says Mariners pitching coach Mel Stottlemyre, who broke into the big leagues as a pitcher in 1964.

Even 10 years ago, major-league pitchers often exceeded pitch levels that would be unthinkable today.

In 1998, 15 pitchers threw at least 140 pitches in a game, and 28 pitchers averaged 105 pitches per start. In 2007, not a single pitcher threw more than 130 pitches, and only 13 averaged 105 a start.

Change arrived in the late 1990s, when the well-used arms of several young phenoms began to flame out. No one pushed pitch counts into focus more than Kerry Wood, who wowed the nation with a 20-strikeout game as a rookie in 1998, only to miss the 1999 season with injuries.

Wood's large workload in 1998 — eight starts of 120 pitches or more — raised more questions about what causes arms to break down. In 1999, Jazayerli developed a statistic called pitcher-abuse points. He theorized that it's not exactly the number of pitches that puts a pitcher at risk, but how many are thrown past fatigue.

In 2002, Baseball Prospectus' Keith Woolner updated the formula after studying the effect high pitch counts have on even the most durable pitchers, and he found that fatigue usually kicks in at about 120 pitches.

Using the updated formula, a 140-pitch start is eight times worse than a 120 and 64 times worse than a 110.

"We watch everyone pretty closely when they get to 100 pitches," Stottlemyre says.

Stottlemyre, who pulled his sons out of college when one threw 180 pitches in a game, doesn't think pitch counts should be limited to the mature arms in the majors.

"They should become a factor in high school, and certainly at the collegiate level," he says. "There's just as good of a chance of overworking a pitcher, which might lead to a damaged arm."

Arm trouble

Jason Koenig always thought he was going to come back.

Pain seared into his shoulder on the drive home from his 140-pitch start. The next day, he needed help simply putting on his suit coat before prom. But still he thought he would return to the field.

The summer of 2001 was supposed to be his big break, with a spot in the starting rotation on a Seattle summer team. He didn't throw a single ball.

He had surgery that November to repair a torn labrum, the ring of fibrous tissue that surrounds the shoulder joint, and a frayed rotator cuff, the network of muscles and tendons that stabilize the joint. The surgery left him with 12 percent less mobility in his right shoulder.

After the surgery, pain in his elbow surfaced. Doctors say someday it will require surgery.

Each day, he discovered something new he couldn't do. He couldn't swim in Hood Canal, just a long toss from his house. When he couldn't play catch with his brother, he knew getting back on the mound was out of the question.

"I was so mad," Koenig says. "This was all I've ever worked for. This has been my passion and my driving force."

Koenig's parents saw his lowest point come when he took down all of the memorabilia hanging in his bedroom, and even boxed up all of his autographed cards. A game he used to love only reminded him of pain.

"It was devastating," his mother, Beth, said. "He went through serious depression."

It was at his lowest point that Koenig says he "found Jesus." It was also at this point, late in his senior year, that Koenig discovered he had a talent for photography, which turned out to be his new career.

After he graduated from high school, Koenig stayed in Belfair to work with high-school kids in YoungLife, a nondenominational Christian organization. The more he worked with high-schoolers, the more he could not rest easy with the rule that allowed him to throw 140 pitches.

"My conclusion was if I don't try to do something, then every kid that gets hurt after this from being overpitched was partially my fault," Koenig says.

He slides to the edge of his seat to make this point: "The problem is not that there are high-school baseball coaches who want to win. The problem is there are no rules to regulate those coaches."

Little League's step

Little League had seen enough numbers and heard enough horror stories. So in 2007, the world's best-known youth sports league became the first to introduce mandatory pitch counts.

Little League said it needs at least until the end of the 2009 season to determine what statistical effect the rule has had on injuries. But anecdotally, the league reports that many coaches have looked farther down the bench for pitching depth.

"You get more kids playing," says Jim Bittner, Magnolia Little League president. "In the past you would keep pitching a dominant kid, and that's how they get hurt."

When young pitchers get hurt, Pete Wilkinson often ends up rehabilitating them at his youth baseball academy in Lynnwood. Some never return.

"The look in their eyes, if all of us coaches could see that when they throw their first pitch, it'd scare us all to death," Wilkinson says. "These kids are absolutely petrified to throw again."

A different life

The day Jason Koenig bolted for Canada would have been his first start of the 2002 season, had he been healthy. A week earlier, he sat on the hill that overlooks his high-school field and cried during tryouts.

He took a week off school and went to British Columbia, where he helped prepare a Christian camp for summer. There, he met a tall blonde named Jenny. Koenig married her four years later.

Had he pitched his senior year, he might not have met his wife, found God, or discovered his talents in photography. His life would have been remarkably different.

"It's way more fulfilling than playing baseball," Koenig says.

Yet that doesn't make life without baseball any easier. He may never get to play catch with his kids, coach them in Little League, or show them the heat that made his junior season in high school one to remember.

And forget.

"If I could have surgery and all the stars aligned and I could play ball, I would," he says. "And I would pitch."

Tom Wyrwich: 206-515-5653 or twyrwich@seattletimes.com

Copyright © 2008 The Seattle Times Company

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