By Katie Felts NewsChannel 5 Sports
St. Louis (KSDK) - St. Louis Cardinals pitcher Chris Carpenter underwent season ending arm surgery.
Because of the millions invested in pitchers at the major league level, teams monitor pitch counts, the number of pitches a pitcher will throw in a game.
But that's not how it's done at the high school level.
NewsChannel 5's Katie Felts looked at pitching rules for the Missouri High School Athletic Association and surrounding states and none of them regulate the number of pitches a pitcher throws in a game.
Tylar Blankenship has grown up with a baseball in his hand.
"I have played baseball since I could probably walk, so this is my first season not playing for a summer team," he said.
Blankenship can't play because he just underwent surgery on his pitching arm.
"I tore my MCL in my elbow completely in half and the doctor said I would need Tommy John surgery to play again," he said.
"It's like the common cold for sports medicine doctors," said Dr. Rick Lehman, an orthopedic surgeon.
On a given day, Dr. Lehman sees four to five pitchers with elbow or shoulder problems. And there's a reason surgery counts are rising.
Now with the emphasis towards not watching pitch counts, etcetera, I'm doing one every week or every other week," said Dr. Lehman. "Probably doing 40-50 a year. High school, just high school, routinely."
Dr. Lehman says a freshman should throw no more than 60 pitches. As a senior that number changes to 80.
Blankenship threw 134 in one game.
"That day I felt really good, but afterwards I couldn't even lift it up. It was bad," said Blankenship.
The Missouri High School Athletic Association restricts pitchers by the number of innings. Their rule is 10 innings in one day.
"The questions that many states have is how do you measure that? Who is counting the pitches? How do we know it's accurate? Because a lot of times, in some of our schools, especially our smaller schools, is you have one coach and you have a student manager that is keeping track of the pitches in the dugout, and is that really accurate," said Tim Thomas with MSHSAA.
"Numbers of innings pitched is not a measure of stress on the joint," said Dr. Lehman. "If pros are doing pitch count, then why wouldn't everyone be using the best measuring tool too? Innings is a very inexact science."
Blankenship threw a complete game four times this season for Fox High School.
"There should be a limit somewhere for kids pitching. There's no reason for 16, 17-year-old kids to go out there and throw 100 pitches every other week or every time he throws in the rotation," said Blankenship's father.
And if the guidelines don't change, Dr. Lehman says someone has to be responsible for the well-being of the child.
"Normally it is the coach, but sometimes it isn't, so the parents have to click off pitches and they have to be strong and say look, he's thrown this amount of pitches," said Dr. Lehman.
According to the American Journal of Sports Medicine, a pitcher who throws more than 80 pitches during a game is four times more likely to suffer an injury.