Picture this.

Your oldest child graduates from high school and you decide they need a car they can use at college. After checking Craigslist, you find the one you want. Runs well. Doesn't burn any oil. Newer brakes and brand-new front tires.

You send your child off to school with their car, confident in your purchase.

When they come back for Christmas, you check out their car to see how it held up. It's still running well, but when you check out the front tires, you find that the outside tread is fine but the inside tread is worn flat. Concerned about your child's safety, given the winter weather ahead, you buy a new set of front tires and send them off for the spring semester.

When they return for the Summer, you again look over their car to see how it's holding up. The car runs smoothly, and the A/C is strong, but the front tires are worn down on the insides and the metal cores are showing.

So you buy another set of tires.

Symptoms, Root Causes, and The Epidemic

I would hope such a story could never be told today.

At some point, someone -- a friend or an ethical mechanic -- would tell you that the problem isn't with your tires; they aren't defective.

Rather, your tires wearing out is just a symptom of problem with the car's alignment.

The alignment problem is the root cause and the rapid tire wear is the symptom.

And what does this have to do with pitching and the pitcher injury and Tommy John surgery epidemic?

The vast majority of people in baseball are just treating symptoms -- they just keep buying tires over and over again -- rather than dealing with root causes.

While many people think Tommy John surgery is fixing the root cause, in truth it's only dealing with a symptom of an underlying problem.

A Recent Change Isn't The Problem

To revisit our tire wear analogy, the precipitating incident doesn't have anything to do with the tires.

The tires wearing out is just a symptom.

The precipitating incident is whatever happened months or years ago that threw the car's front end out of alignment and that caused it to start chewing through tires.

Similarly, when it comes to the epidemic, it isn't due to something that changed immediately prior to the injury.

Instead, pitchers get hurt because they developed -- or worse, and more likely, were taught -- a flaw months or years before the injury.

Their injury problems are that flaw eventually taking its toll.

First it Gets the Elbow...

Because they are unlikely to change anything after their initial injury, a number of pitchers are at risk of experiencing a predictable sequence of worsening injuries.

First it gets the elbow, then it gets the shoulder.

Pitchers who are following this sequence include...