Starting vs. relieving

My interview with Jason Berken last week rekindled the debate over whether a pitcher experiences more strain on his injured or surgically repaired shoulder as a starter or reliever.

Berken bypassed surgery and is rehabbing his torn labrum, just as Matt Albers did a few years ago. Troy Patton underwent the surgery.

Berken and Albers have been working out of the bullpen. Patton was a starter at Triple-A Norfolk and a spectator in the Orioles' bullpen.

So is there a definite answer?

So far, I haven't found one.

You can argue that a reliever throws fewer pitches and fewer innings, so that's a benefit. You can argue that a starter gets four or five days rest between outings and doesn't have to warm up at a moment's notice and be rushed into a game, so that's a benefit.

Former Orioles pitcher Dave Johnson said there are "pros and cons to both sides." No argument here.

If Johnson had to guess, he'd say it's more stressful for a reliever, and he's bringing personal experience into the discussion.

Johnson didn't experience problems with his shoulder until pitching in relief for Triple-A Toledo in 1992 and part of 1993, when his season was cut short in June because of surgery to repair fraying in his labrum.

"Doctors said it was normal wear and tear," Johnson recalled. "Well, was it normal wear and tear that came on because I stressed it even more during my time relieving, as opposed to starting? Could I have pitched five more years as a starter without having problems with my labrum? I don't know. There's no way you can ever tell. There's no definitive answer."

Johnson was used as a starter in the Dominican during the winter of '92 and his health and results were excellent. He re-signed with the Tigers and ended up as the Mud Hens closer. He had the surgery in June and was back in the majors in September, but no where near as effective.

"For me, it's like, go back to when you teach a kid to throw a curveball," Johnson said. "Is 10 too soon? Is 12 too soon? The fact is, we don't know. We really don't know. Some guys have great curveballs and have arm trouble their whole careers. Others don't ever have arm trouble. Some start at 12 and never have a problem. Some start at 11 or 15 and say, 'I blew my arm out. I threw too many curveballs in Little League.' There's no way to say definitely.

"I just knew that for me, I felt my arm was more sore, more consistently, and not anywhere close to 100 percent when I was relieving. So that being said, would I have been better off starting for a period of time coming off surgery? Albers didn't have surgery, and the one thing you didn't hear any complaints about were problems physically with his shoulder. And if you look at it at the end, he probably had one of the more solid years in the bullpen.

"It's one of those things where I don't know if you can prove it one way or the other. Everybody's different. Everybody heals differently. Their stress level is different. Their bodies handle it differently."

Berken becomes the latest case study.

Meanwhile, I'm heading down to Washington this morning to participate in the Breathe Deep DC 5K walk on the National Mall. The proceeds from this event will benefit the LUNGevity Foundation, the leading private provider of research funding for lung cancer.

I'll return later to check comments. Please excuse my absence. It's for a very good cause.

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