Stop the pitching carnage. Now. We know just where to start: Youth baseball.

No more children playing all through the year, with hardly a break between seasons. No more youngsters throwing sliders and splitters and all sorts of pitches that put too much stress on their still-developing arms. And certainly no more high schoolers dishing up 194 pitches in a single game.

With baseball in the midst of what looks increasingly like an epidemic of elbow injuries and Tommy John surgeries, it's time for someone to acknowledge that a big part of the problem can surely be traced to our overworked kids. They are enduring far too much wear and tear on their immature bodies - their arms especially - in a misguided quest to make it to the big leagues.

Those few who do make it often pay a heavy price.

Los Angeles Dodgers left-hander Tommy John delivers a pitch in 1978. The elbow surgery named for him has increased 10-fold in the first decade of the 21st century and top surgeons blame excess stress on pitchers in youth baseball. (AP Photo/LM, File)
Los Angeles Dodgers left-hander Tommy John delivers a pitch in 1978. The elbow surgery named for him has increased 10-fold in the first decade of the 21st century and top surgeons blame excess stress on pitchers in youth baseball. (AP Photo/LM, File)
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"Most of the major leaguers and minor leaguers that come into our practice with ligament problems," says Dr. James Andrews, who has performed countless Tommy John operations over his long career, "if you take a good, close look at their histories, a large part of them link back to some minor injury as a kid.

"It started in youth baseball. That's the real culprit."

The major league brass is so concerned that it plans to hold a summit in New York next week, bringing in experts such as Andrews to figure out why so many of the game's top hurlers have been stricken with this devastating injury, some for the second time.

The Atlanta Braves probably qualify for a Tommy John BOGO, considering they've already sent three pitchers (Kris Medlen, Brandon Beachy and Cory Gearrin) to the operating table this year, and are still hoping for the return of reliever Jonny Venters, who underwent the procedure last year. Medlen, Beachy and Venters all have two Tommy Johns on their medical charts - and none has celebrated his 30th birthday.

The biggest blow yet occurred down in Miami, where Marlins ace Jose Fernandez, just 21 and perhaps the most gifted young pitcher in the game, was headed to surgery Friday to have his elbow ligament replaced. It will be at least a year before we see him on the mound again.

Well, enough's enough.

While it won't be of help to this generation of big leaguers, whose damage is already done, maybe those who are just getting started on their baseball careers won't have to endure so much pain.

Already, Little League and other youth baseball organizations have instituted well-intentioned rules to limit pitch counts and reduce the stress on a young player's arm. But more drastic steps are needed, especially for those moving into their teenage years. That's when the best players often compete for both their high schools and elite travel teams, the games stretching from spring to summer and on through the fall, all while mom and dad are doling out big bucks to pay for private lessons on the side.

Andrews recommends that all young pitchers should take at least two months off each year, and he says three or four months would be even better.

Unfortunately for many of these kids, there's no such thing as an off season.

"The professional ranks protect their pitchers a lot better than they do in the high schools," Andrews says.

No kidding. In Rochester, Washington, prep pitcher Dylan Fosnacht threw 194 pitches over 14 scoreless innings in a district tournament game this week. It's a feat that might've been celebrated in an earlier era, but should be raising nothing but red flags in light of what's happening in the big leagues.

The state high school association says the outlandish feat was within its rules. Ridiculous.

The coach defended leaving his starter in the game, saying he checked with Fosnacht before every inning and he didn't seem to be tiring. Talk about passing the buck. And Fosnacht took issue with anyone who wanted to blame his coach or parents for endangering his health. Which is to be expected, since the teen became an instant social media sensation.

"People need to chill," Fosnacht wrote on Twitter, which meant he could at least still raise his arm to type out a message.

But Tommy John - yep, the Tommy John, the one who first had a ligament replaced in his elbow and wound up with an operation that will forever bear his name - says the problem starts at home.

Like Andrews and others in the medical profession, John subscribes to the theory that many of these elbow injuries can be traced back to playing too much ball at too young an age. While he says any coach who would let a high school pitcher throw nearly 200 pitches in a game deserves to be fired, he puts ultimate blame on the parents.

"The parents get built into the idea that little junior is going to get pitching lessons from the guy who pitched minor league baseball, who's going to get paid two, three grand a winter, and he comes down twice a week and works on his pitching and all this," John says. "He should be working on his strength playing basketball, playing football, playing lacrosse, playing something other than throwing a baseball.

"It won't make him better. It will just increase his chances of down the road of having Tommy John surgery."

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Paul Newberry is a national writer for The Associated Press. Write to him at pnewberry(at)ap.org or on Twitter at http://www.twitter.com/pnewberry1963

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AP Sports Writer Ronald Blum in New York contributed to this report.

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