MLB insiders “quite concerned” about the rise in arm injuries among young starting pitchers

Matt Blake sent Cleveland Guardians pitcher Shane Bieber a conciliatory message this weekend. As a member of Cleveland’s player development system in the 2010s, Blake aided Bieber’s rise from college walk-on to unanimous winner of the American League Cy Young Award in 2020. For a time, Bieber represented the modern model for major player production. League Ace, a player who added strength to his frame, speed to his fastball and spin to his offspeed pitches as he moved up the ranks.

By the time Blake sent his text, however, Bieber had become part of a growing, more troubling demographic: talented young pitchers who will spend this season as spectators. Two days after the Miami Marlins announced that 20-year-old phenom Eury Pérez would undergo Tommy John surgery, the Guardians announced that 28-year-old Bieber would need the same procedure. A recent examination of 25-year-old Atlanta Braves starter Spencer Strider revealed damage to the ulnar collateral ligament of his elbow, which could result in his second Tommy John surgery. In New York, where Blake is now the Yankees’ pitching coach, the team lost their ace, Gerrit Cole, to elbow inflammation until June and one of their top relievers, Jonathan Loaisiga, to year-ending elbow surgery.

“As a pitching coach trying to get through nine innings every night in 162 games,” Blake said, “I’m pretty concerned.”

Pitching has always been dangerous for its practitioners. There is reason to believe that keeping them healthy will only become more difficult. The opening days of the 2024 season have shown the inherent fragility of the position. A recent story from De Ringer cited research from former MLB coach Stan Conte showing that 263 UCL surgeries were performed in 2023, a steady increase from the 111 procedures performed in 2011. Of the 166 players who started the season on the injured list, as the New York Post reported, 132 were pitchers. If these trends continue, 2024 will be another banner year for arm injuries – and cause for concern around the game.

The topic led to sharp-shooting between Major League Baseball and the MLBPA on Saturday as the two sides argued via press reports over the effect of the pitch clock, which was introduced in 2023 and shortened for 2024. MLBPA chief Tony Clark painted the league’s push to cut back on time off before the 2024 season, against players’ wishes, as “an unprecedented threat to our game.” MLB responded by citing an unpublished analysis from Johns Hopkins University that found no link between the introduction of the clock and the spate of injuries.

However, the clock was just one concern among players, coaches and managers surveyed The Athletics this weekend. Those conversations revealed a host of additional reasons for the injury problem, including the industry’s relentless drive for optimization, the encouragement of players to pursue maximum speed and spin, and the use of year-round training methods that encourage train at full speed. For some, the explanations are intertwined and persistent. Untying the knot can take years of research and reevaluation.

“Protecting these guys’ arms is of the utmost importance,” Dodgers manager Dave Roberts said. “And we clearly didn’t succeed.”

This season started with baseball’s most highly touted pitchers on the shelf. Los Angeles Dodgers starter Clayton Kershaw underwent shoulder surgery last October. Texas Rangers pitcher Max Scherzer is recovering from back surgery, while his teammate Jacob deGrom is recovering from a second Tommy John surgery. Houston Astros great Justin Verlander experienced shoulder soreness during spring training. All of those pitchers are 35 and older, the kind of age where the body no longer cooperates with the rigors of the big-league schedule.

For MLB, the more pressing concern is that its weapons fleet breaks down quickly after gaining prominence. Miami Marlins starter Sandy Alcántara, the unanimous winner of the 2022 National League Cy Young Award, underwent elbow reconstruction last season. So did Tampa Bay Rays pitcher Shane McClanahan, just over a year after starting in the All-Star Game. Milwaukee Brewers pitcher Brandon Woodruff will miss this season due to shoulder surgery. Same story for Kansas City Royals pitcher Kyle Wright, a 21-game winner for Atlanta in 2022.

“Our sport deserves to have our best pitchers on the mound,” Detroit Tigers manager AJ Hinch said. “Regardless of the era you are in, the matchup between the starting pitchers is the first thing you watch every day. You want the big boys to be out there. You want the guys who are elite, and more and more people are getting hurt.”

To investigate the problem, MLB commissioned a study last October that expanded to interviews with 100 people around the game, including medical officials. Once the investigation is complete, the league plans to create a task force and make recommendations to clubs on how to keep pitchers healthy.

The sport has struggled with this problem since its inception. In another era, it was believed that pitchers were injured from overuse. Teams changed the way they used pitchers in hopes of retaining them. Gone are the days of the exhausted starter, pushed to the brink with 125 pitches or more, trying to finish the seventh or eighth inning. The new archetype asks the pitcher not to ease up on outings, but to explode from the start. Go as hard as you can, as long as you can, is the new mantra. An influx of data on the shape and movement of pitches provided teams with detailed ways to make pitchers better. However, the data did not answer the question of how to stay healthier.

“I’ve heard over the years that we ask less of starting pitchers because we don’t keep them in the game long enough and they don’t throw 100 pitches as often anymore,” Hinch said. “Yet we ask them for maximum speed, maximum form, maximum everything, and virtual training all year round.”

Hinch pointed to Tarik Skubal, a 27-year-old Tigers left-hander who underwent Tommy John surgery in college and flexor tendon surgery in 2022. Skubal trained this past winter so that when he arrived at spring training, he touched 93 mph in his first session. of live batting practice. “Go to Tarik Skubal and tell him, ‘Hey, take it easy and throw 90 miles per hour,’ and see how that works out for you,” Hinch said. “No. Because we ask our athletes to compete at the highest level.”

For some retired players, the quest for increased velocity and spin has put pitchers at risk. Dan Haren, a 13-year veteran who now works as a pitching strategist for the Arizona Diamondbacks, posted on X about his Instagram feed with images of “boys throwing weighted balls against a wall with maximum effort, in a crow jump, while his brothers cheer him on.” Roberts added: “The body, in my opinion, is designed to withstand only a certain force and speed before it collapses.”

Some, like Chicago Cubs manager Craig Counsell, suggested that pitchers will always try to throw harder. “I don’t think the pursuit of speed will ever end,” Counsell said. “Because it’s something that makes pitchers better. I don’t think we should demonize the pursuit of speed.”

Still, the industry has defended this trend by shortening the appearances of starting pitchers and encouraging them to maximize their output. Not only do pitchers throw their fastballs as hard as possible, they also throw offspeed pitches with extreme force, hoping to generate unique moves and missing bats. “The types of deliveries that are the outliers are likely to be more stressful in some ways,” Blake says. “I think maximizing the power to create the shapes probably doesn’t help. If you’re chasing a 20-inch break, a 20-inch ride, or a high velo, I think there’s some physical cost to it.

Despite protests from MLB officials, players will continue to complain about the clock. The innovation cut 24 minutes off the average match last season. The timer in 2023 gave pitchers 15 seconds to act with the bases empty and 20 seconds with runners on board. MLB’s 11-member competition committee voted to remove two seconds from the 20-second clock for 2024, despite player objections.

Los Angeles Angels pitcher Tyler Anderson suggested that pitchers might put more pressure on their arm instead of their legs because of the clock. But he doubted any research could show a link between shorter time between pitches and more injuries. The pitching was unhealthy enough. “Rob Manfred knows it’s very difficult to prove, I think,” Anderson said.

The union sees the clock as a bogeyman. The commissioner’s office views their complaint as a straw man. For coaches like Blake, who have to navigate the season as injuries persist, the clock is only part of the problem, along with the dangerous pursuit of speed and spin.

‘I don’t think any of them have the most responsible,” said Blake. “But the cocktail of them all is difficult to obtain.”

(Top photo of Strider: Justin K. Aller/Getty Images)