tommy john surgery is out of control...
i wonder if it would make any difference if you limited pitchers to 3 innings per game...
but i know relief pitchers have had to have tommy john too...think mariano rivera although wasn't he a starter at the beginning of his career?
either way, i'd be tempted as a manager to handle my pitchers unconventionally.... pitch them more often (in the case of starters) but for less innings)...