Bob Padecky: Casa Grande pitcher’s journey offers perspective

Casa Grande’s Justin Bruihl had Tommy John surgery during his junior season and spent 15 months in rehab before returning to the mound. (Photo by Crista Jeremiason, The Press Democrat)

Casa Grande’s Justin Bruihl had Tommy John surgery during his junior season and spent 15 months in rehab before returning to the mound. (Photo by Crista Jeremiason, The Press Democrat)


On March 2, 2014, Justin Bruihl was very clear on how he saw himself every time he threw a baseball. “I felt invincible,” said the left-hander. And why not? Bruihl was a 16-year-old athlete who owned, according to his dad, a rubber arm. Bruihl’s fastball reached mid-80s. There might have been some pain in that left elbow but, hey, when you’re 16 and invincible, the road ahead is streamlined with sunshine.

A day later the rain and thunder and lightning came. The Casa Grande junior threw a pitch in a game. The pain increased. He left the game. Just to be safe. No worries. Sixteen-year-old boys have a remarkable sense of certainty and security. Especially the ones with rubber arms.

“A couple hours later my pitching arm was shaking,” Bruihl said, “and it felt extremely weak.”

Thus began a journey for Bruihl that has become all too familiar and far too alarming. He became a statistic that led Major League Baseball in 2014 to develop a website, It is because of athletes like Bruihl that Kaiser Permanente in Santa Rosa will be conducting, for the first time, three two-hour seminars in the coming months that focus on injury prevention for baseball players. Former San Francisco Giants pitcher Noah Lowry will be there.

Bruihl underwent Tommy John surgery, the reconstruction of the ulnar collateral ligament. Bruihl could think he is good company. According to PitchSmart, 25 percent of all MLB pitchers and 15 percent of minor league pitchers have undergone Tommy John surgery. Since 1999, 235 MLB pitchers have had the operation.

Bruihl is not alone. That’s the bad news.

“I asked the surgeon who operated on Justin (Giants orthopedic surgeon Dr. Kenneth Akizuki) how many of these he does a year,” said the father, Gene Bruihl. “He said he does 30-40 Tommy Johns a year — on high school players.”

Dad was stunned to silence.

“I was in shock,” Bruihl said. “I thought Tommy John was happening just to college and pro pitchers. And those 30-40, that’s just with one surgeon.”

Kids face pressure to win

Money creates momentum and urgency. In 2014, $665 million was spent on MLB players going on the disabled list. But the creation of PitchSmart and the urgency local outfits like Kaiser Permanente feel in addressing this issue reveals a deep concern that damage in pitching arms begins long before a pitcher signs a pro contract. Tommy John, the pitcher after which the surgery is named, has said many times the problem begins with how kids are used — or abused.

“I call them the MTK kids,” said Dr. Todd Weitzenberg, Kaiser’s Chief of Sports Medicine who will lead the hospital’s seminars. “MTK stands for Meal Ticket Kids. For me, the problem started in the genesis of the single-sport athlete. We have the Tiger (Woods) parents out there. Now you have fall ball, and travel ball and showcases. The pressure to win is extreme.”

The age of specialization finds children in the cross hairs of pleasing their parents and coaches, hanging with their buddies and — this is the gas that fuels all — wanting to feel worthwhile by winning.

“It’s a temptation that’s hard to resist,” Dr. Weitzenberg said of the off-the-field influences. “Parents will hear of kids playing in multiple leagues and with additional instruction and they’ll say to themselves, ‘My God, we (their son) don’t stand a chance.’ So they go along with it because they are keeping up with the Joneses. The emphasis to win in our society has come at the cost of our children, whose bodies are still developing.”

While it’s tempting to target travel baseball as a culprit, it is by itself not a red flag.

“I’ve had travel teams for 11 years,” said Petaluma’s Dave Ayala, who manages travel teams for the North Bay Baseball Association. “I have never had a Tommy John pitcher.”

Plan to protect from injury

Ayala recognizes the validity of what surgeon Dr. James Andrews advocates. Andrews is the internationally known and admired voice in sports orthopedic medicine. Founder of the American Sports Medicine Institute (ASMI), Andrews and his team of advisors have laid out a plan full of common sense to protect children from injury. His first criterion is also Ayala’s.

“I make sure my kids always have four months off every year,” said Ayala, taking into account his pitcher playing for other teams, including high school squads.

According to ASMI, a pitcher who competes for more than eight months in a year is five times more likely to suffer an injury requiring surgery than those who do not.

Another Andrews mandate — do not pitch on consecutive days — seems obvious in its message. So are other ASMI guidelines, suggestions so logical it would seem easy to follow and difficult to dispute.

Do not throw more than 100 innings in one calendar year.

“Do not throw a curve until you are old enough to shave,” Andrews said on the ASMI website.

Do not try to pitch your way through pain from ANY part of your body; pain is the body’s way of saying, “Pay attention.”

Do not exceed recommended pitch counts.

Do not play in multiple leagues at the same time; one coach doesn’t always inform the other coach how many innings you’ve pitched.

Do not pitch in a showcase tournament if there has been considerable idle time before pitching.

With radar guns, scouts and the obvious emphasis on speed at showcase tournaments, it’s natural to want “to throw as hard as you can,” said Lowry. But if the arm is not in proper shape, the risk of damage is high.

“Understand what a showcase tournament is,” Lowry said. “No one goes out there one time and becomes draft eligible. ‘We saw him today and we’ll sign him.’ That doesn’t happen. It puts you on the map. That’s all it does.”

Takes time to develop skills

But how can parents and coaches satiate the competitive nature of a 16-year-old boy?

“Take that need to compete and focus it elsewhere,” Lowry said. “We could be playing a board game or cards or running, playing another sport.

“I tell kids all the time that your baseball career is a long journey, not a sprint. Take your time. Develop. No need to throw a curve or slider. If you’re going to make it as a pitcher, even to college, you’re going to do it on your fastball. Learn how to throw a two-seam or a four-seam (fastball) and a change-up. That’s all you need to get through youth baseball,” Lowry said.

It’s also important to keep a young athlete’s potential career arc in perspective.

“How many Little League pitchers who pitched the winning game of the Little League World Series went to play in the major leagues?” Dr. Weitzenberg said. “Zero. This stat really surprises people.”

Just like this one: More than half of major league pitchers who had Tommy John from 1999-2011 went on the disabled list after surgery. And those were men, not kids, with maturely developed bodies.

“I tell kids that if they get Tommy John, it’s a career-ended surgery,” Weitzenberg said. “It’s a total myth that Tommy John improves your pitching. It’s ludicrous.”

Andrews said one of his biggest challenges is convincing parents their kids do not need Tommy John just because their elbow hurts. There must be a tear or rupture. There must be an injury.

According to ASMI, 25 to 30 percent of the kids who have Tommy John aren’t playing baseball two years later.

The three Kaiser seminars will offer one hour of information and one hour during which each youth athlete in attendance can undergo an examination of range of motion, balance, strength and throwing mechanics. The seminars, which will be held Aug. 27, Sept. 24 and Oct. 22, are free to both Kaiser members and non-members.

Perspective through pain

Bruihl — who recently signed a baseball scholarship with Cal Poly-San Luis Obispo — is not on the four-person panel but he could be. He could tell parents and their sons about the perspective he gained after 15 months of rehabilitation.

“I should have taken better care of my arm,” Bruihl said. “Then I was pitching 10-11 months a year. I wasn’t big on icing my arm. I am very cautious right now.”

Bruihl learned perspective and patience through pain. It’s not a process unique to Bruihl. Humans tend to advance that way. Is there another way? Weitzenberg may have hit on it. He was speaking to a high school girls soccer team on injury prevention.

“How many of you think you are going to tear your ACL?” Weitzenberg said.

No one raised their hand.

“Well, would you do exercises if they specifically helped improve your performance and made you better players?’

Every hand shot up.

Ambition, the very thing that has created this problem, can be the very thing that solves it.

To contact Bob Padecky email him at


WHAT: Seminar, “Injury Prevention For Baseball Players.”

WHERE: Kaiser Permanente Medical Office Building No. 5, physical therapy classroom, 2975 Old Redwood Highway, Santa Rosa.

WHEN: Aug. 27, Sept. 24, Oct. 22, from 6-8 p.m.

WHO: Dr. Todd Weitzenberg, Director of Sports Medicine; Jennie Smallcomb, Director of Physical Therapy; Noah Lowry, former San Francisco Giants pitcher; Greg Bruso, former professional baseball player and personal trainer.

CONTACT: 707-566-5528 or

ADMISSION: Open to Kaiser members and non-members. Free of charge.