The issue, friends, is injuries. They are all the rage in baseball as never before, and we begin with a question:

What do Kris Medlen, Jarrod Parker, Carl Luebke, Josh Johnson, Brandon Beachy, and Peter Moylan have in common other than the fact that they are pitchers employed by the major leagues of professional baseball?

Answer! These are the six pitchers who early in this season have already had Tommy John surgery performed on them for the second time in their relatively brief careers. They are the so-called “revisionists.” There have been 14 of these “repeats” in the last two years. Over the previous 16 years, there were but 18.

Next question: What of Ivan Nova, Matt Moore, Luke Hochevar, Bobby Parnell, and Patrick Corbin?

Answer! They are the most prominent among the batch of ten other hurlers who have been committed to the radical TJ procedure for elbow repairs since the start of this season, which we should remind you was scarcely a month ago. Obviously, the single-season record for TJ surgeries – 36 in 2012 – is in jeopardy given that the demand for this spectacular remedy always rises as the season bears on and there are six months to go. Moreover, you can add to this group the likes of Andrew Bailey, Dylan Bundy, Neftali Feliz, and Joel Hanrahan, among others, still recovering from TJ surgery performed last year.

Then there are the pitchers sidelined extensively by arm woes that, while not as dramatic as the TJ cases, remain problematic? This roll call includes Derek Holland, Matt Harrison, Doug Fister, Jonathan Broxton, Jeremy Hellickson, Alex Cobb, David Robertson, Johan Santana, Yu Darvish, A.J. Burnett, Clayton Kershaw, Chris Sale, Scott Feldman, Wandy Rodriguez, Jason Grilli, Anibal Sanchez, and Matt Harvey? Surely an impressive collection (including the highest paid pitcher in baseball history, Kershaw) from which you could easily cull an all-star staff.

But why pick on the pitchers? Position players who’ve variously gone down for the count this still very young season include Manny Machado, Jose Iglesias, Avisail Garcia, Mark Texeiria, Brendon Ryan, Rafael Furcal, Shane Victorino, Will  Middlebrooks, Matt Kemp, Jose Reyes, Josh Hamilton, Ryan Zimmerman, Jason Giambi, Jurickson Profar, Geovany Soto, Andre Beltre, Hanley Ramirez, Gordon Beckham, Justin Ruggiano, Michael Cuddyer, Russell Martin, Cameron Maybin, Francisco Cervelli, Chris Davis,  Shin-Soo Choo, and Bryce Harper. Speaking of all-star teams, how easy would it be to compose one from that lusty group?

Bear in mind none of these lists is the total number. They are but samplings of some of the more interesting and relevant cases. The ranks of all the injured and disabled are quite longer. Some wounds are products of the bizarre.  The Reds sterling lefty flame-thrower, Aroldis Chapman, got decked by a line drive off his face that almost killed him. It was the most shocking such incident since the potentially wonderful career of Herb Score was abruptly sidetracked by a screaming liner off the bat of the Yankees’ Gil McDougald in 1957.

And then there is the ridiculous. The Brewers just lost their wonderful young shortstop, Jean Segura, indefinitely after he got smacked in the face by a bat carelessly swung in the dugout by Ryan Braun, the team’s gifted but clearly mistake-prone star. What next? A pair of superior performers who should know better – Anaheim’s Josh Hamilton and Washington’s Bryce Harper – suffered serious hand injuries that have sidelined them by sliding into first base, long disdained by every thinking baseball person to be about the dumbest thing you can do on a ball field. There’s never any accounting for sheer stupidity.

Quads, obliques, and lats seem high among this season’s most vulnerable body parts. Hamstrings are the new injury of choice for position players while, as has been increasingly the case in recent years, the elbow is the Achilles heel of the pitchers. This is not about these guys being wimps. Baseball, with its emphasis on minute and precise details over mere brawn and bluster, is a hard game to play while even slightly impaired. Little wounds that would not bench a hockey player a single shift can land a baseball player on the disabled list. Jarome Iginla missed only one period when he fractured his finger this season but, tough as he may be, he couldn’t have swung a bat with that injury, let alone thrown with that hand.

For no endeavor in all of sports in terms of the perfect meshing of muscles and nerves and fibers and ligaments – and gray matter – is more challenging or requires a higher degree of physical fine-tuning than the act of pitching a baseball over and over and over again with maximum force and urgency. The demands of this activity on the elbow and shoulder are unique. This is what makes the phenomenon of Tommy John surgery, by which dead elbows are brought back to life, so engrossing; after fully 40 years, it still seems to be a bit of a medical miracle.

The remarkable procedure’s eminent deviser, Dr. Frank Jobe, called it “ulnar collateral ligament reconstruction.” He died only a month ago, at age 89, and in his latter years he was reputedly a bit shocked by how routine the procedure had become with players increasingly opting for it as if it were no bigger a deal than a root canal. And who can blame them, given how many careers have been saved thanks to his bold and brilliant conception. According to the latest study, 124 pitchers who were on big-league rosters last year can thank him for their careers. That is stunning, and this year’s number is growing by the hour.

But considerable credit also goes to Doc Jobe’s original guinea pig, the crafty lefty Tommy John, who was informed when he consented to the surgery in 1974 that it had no more than a two percent chance of being successful. It was my pleasure to have known Tommy and talked with him a number of times when he was first the Dodgers’ and then the Yankees’ meal ticket, pitching 15 more years after being given a new tendon in his left elbow and piling up achievements (288 wins for openers) that would have qualified him for enrollment at Cooperstown even if his good friend Doc Jobe hadn’t immortalized him. A smart fellow, he fully grasped the import of his role. What Tommy John did for his profession 40 years ago was truly historic. He is first class, always has been.

And like Dr. Jobe, he’s mystified by how casually the procedure is now viewed, believing, as the good doctor did, that more attention should be given to preventing arm injuries than to repairing them. He feels strongly that the problem begins when pitchers are teen-age phenoms, being grossly over-used and obliged to pitch 12 months a year, with no break.  Like most old-timers, John disputes pitch counts and sees no problem with pitchers simply pitching, as long as they’re fundamentally healthy to begin with. But too often nowadays the seeds of a pitcher’s destruction have been firmly planted by the time they reach the big leagues.

On this, old-timers and medical folks seem to agree. As for the modern-day performers and those who must coach, guide, and heal them, they increasingly seem to be unsure of what to think, or do. What’s beyond dispute is the obvious: they have a crisis on their hands.
Is it about pitching too much? Or not enough? About throwing too hard, or using too many trick pitches? Is it all about mechanics? Does youth sport need to be reformed? Should conditioning procedures be strengthened or relaxed? Is radical surgery always the answer? Might it never be the answer?

There are many theories but no consensus. Meanwhile, the casualties pile up. It’s being called “an epidemic,” an over-statement fairly typical of the sporting media, which can now and again be guilty of scrambled perspective. True epidemics have to do with deeper and far more serious calamities than the mere ordeals of millionaire ballplayers, however painful.

Not that Tommy John surgery is a day at the beach, mind you. We understand that much.