The Alarming Rise of Pitcher injuries: A Modern Baseball Epidemic

The pitcher’s mound, once a symbol of baseball prowess, is now increasingly associated with a troubling trend: a surge in career-threatening injuries. Despite, or perhaps as of, technological advancements and data-driven strategies, pitchers at all levels are facing an unprecedented wave of elbow and shoulder ailments. This crisis threatens the very foundation of the sport, demanding immediate and extensive solutions.

As the new season dawns, Major League Baseball (MLB) grapples with how to stem this tide of injuries impacting its most valuable players.The prevalence of these injuries often necessitates surgical intervention, sidelining pitchers for extended periods. Last season alone saw prominent pitchers like Shane Bieber,Spencer Strider,and Shohei Ohtani hampered by elbow surgeries,highlighting the severity of the problem. For Ohtani, baseball’s biggest star, it marked his second major tendon transplant since joining the league.

The Unintended Consequences of Data-Driven Baseball

ironically, baseball’s embrace of technology and advanced analytics may be contributing to this injury surge. Since the early 2010s, teams have increasingly relied on data to optimize pitching strategies, leading to shorter outings for starting pitchers and a greater reliance on bullpen arms.

For example, data revealed that starting pitchers’ effectiveness diminishes significantly the third time thay face the same batters in a game.This insight, while strategically sound, has resulted in managers using more pitchers per game, inadvertently increasing the overall strain on pitching staffs.

Furthermore, advanced statistics have also influenced offensive strategies, favoring power hitters over those with higher contact rates. This shift has led to longer, less action-packed games, prompting MLB to implement rule changes aimed at improving the pace of play and increasing excitement.

These changes, such as the pitch clock and larger base sizes, have had some success. Stolen base attempts have increased significantly, and game times have been reduced. However, the underlying issue of pitcher dominance and the resulting injury crisis remain unresolved.

MLB’s Efforts to Address the Crisis: A 62-Page Horror story

In December, MLB Commissioner Rob Manfred‘s office released a comprehensive 62-page report, involving input from all 30 MLB organizations and over 200 experts. The report paints a grim picture, linking pitcher dominance, the pursuit of velocity, and the alarming rise in injuries as interconnected elements of a systemic problem. This issue is not confined to the major leagues; it extends to youth leagues, impacting aspiring players at a crucial stage of their development.

The statistics are stark. In 2005, MLB pitchers accounted for just over 200 injured list stints, totaling approximately 15,000 days of absence. By 2024,these numbers had ballooned to nearly 500 stints and around 33,000 days of absence. Tommy John surgeries,a common procedure to reconstruct the ulnar collateral ligament in the elbow,have also seen a dramatic increase. In 2010, 21 major league pitchers and 83 minor league pitchers underwent this surgery. By the 2023 and 2024 seasons, those numbers had surged to an average of 43.5 major league pitchers and 240 minor league pitchers annually.

The Velocity Arms Race: Pushing Pitchers to the Brink

The MLB report identifies the relentless pursuit of increased velocity and more pronounced movement on pitches as primary drivers of the injury epidemic.

The vast majority of experts who participated in this study conclude that the incessant pursuit of greater velocity, the pursuit of more pronounced effects or new effects on throws, as well as the increasingly widespread appeal for maximum training effort are the main factors explaining the long -term increase in injuries in launchers
MLB Report

The advent of high-definition cameras has enabled precise measurement of pitch characteristics, such as spin rate and movement. This data has fueled a training surroundings where pitchers constantly strive to maximize these metrics, often at the expense of their physical well-being.

Consider the case of Craig Yoho, a pitching prospect lauded for his changeup that drops an astounding 47 inches vertically and moves 18 inches horizontally. Such extreme movement, while extraordinary, places immense stress on the arm.

New pitch types, like the sweeper, wich features exaggerated horizontal movement, are also raising concerns. As one orthopedic surgeon explains:

Sweepper is a fully crazy throw. To succeed, you have to apply a violent rotation to the ball while the arm is in an unusual angle. The arms are not used to that

The Year-Round Grind: Specialized Training and Overtraining

The pressure to excel has led to the proliferation of specialized training centers that focus on increasing pitching velocity. Instead of resting during the off-season, pitchers often engage in intense training regimens, lifting heavy weights and throwing weighted balls, further stressing their joints.

As one orthopedic surgeon who contributed to the MLB report notes:

The launchers now train with bullets that weigh a book, which is ridiculous.I don’t think the arm can adapt to this

The result is that pitchers are training like sprinters, focusing on short bursts of maximum effort, rather than building the endurance needed for a long season. This approach often leads to ligament and tendon damage.

The consequences are evident in the types of injuries being seen. As another orthopedic surgeon observes:

I have seen more shoulder injuries in the past 5 years I had seen in the previous 25 years. And these new wounds all have this in common: they result from so violent efforts that they surpass the capacity of the muscles supposed to protect the capsule from the shoulder.

Between 2008 and 2024,the average velocity of fastballs increased from 91.3 to 94.2 mph,curveballs from 75.7 to 79.5 mph, and changeups from 81.7 to 85.5 mph. this relentless pursuit of velocity is taking a toll.

One MLB team physiotherapist describes witnessing injuries that are simply absurd, such as rib fractures caused by the force of throwing a baseball.

Do you know how difficult it is to fracture a coast by throwing a ball? We now see back muscles breaking bones. Part of this is due to the fact that the launchers are more overtrained in young age, but also to the violence of the gesture

The MLB report also highlights that a significant number of injuries occur during spring training, raising concerns about the intensity of training regimens and workload management.

The Financial Incentive: A Hazardous Game

At the heart of this crisis lies a financial incentive.Organizations prioritize pitchers who can generate high velocities and strike out batters, leading to lucrative contracts. This creates a situation where pitchers are willing to risk injury in pursuit of financial reward.

Many pitchers believe that Tommy John surgery is a guaranteed fix, but the reality is far more complex.

They do not only realize 20 % of these interventions fail

Furthermore, a recent university study found that only 72% of pitchers who undergo shoulder surgery are able to return to the game, and only 59% regain their previous level of performance.

This pressure to perform extends to youth baseball, where young pitchers are increasingly pushing their bodies to the limit in hopes of attracting attention from scouts. In 2014,only 5 pitchers at a major showcase tournament threw 95 mph or higher. By last year, that number had jumped to 36.

We see more and more young people break the elbow bone because their growth plates are lower than their ligaments

This is particularly concerning because research indicates that injuries sustained at a young age are strong predictors of future injuries. Young pitchers are often overused, pitching year-round and participating in numerous showcase tournaments to gain exposure.

A Call for Change: Realigning Incentives and Protecting Pitchers

The authors of the MLB report propose addressing the problem through financial incentives, arguing that this is the most effective way to influence behavior across the sport. The current system rewards pitchers who throw hard for short periods,while undervaluing those who can pitch deeper into games.

In 2024, only 4 starting pitchers reached the 200-inning mark, compared to 41 in 2004 and 52 in 1993.

Experts recommend changes to game rules and alignment composition rules to improve the system and preserve the health of launchers.

Possible solutions include rule changes that encourage pitchers to conserve energy and pitch longer into games, as well as roster management rules that limit the number of pitching changes a team can make.

The rules could be designed to encourage – or oblige – Landy launchers to preserve enough energy to launch longer during the matches. These incentives could be doubled by alignment management rules, such as by governing the availability of readers for a given match, and even by limiting the number of reminders that a team can make to replace launchers in its alignment

Ultimately, if the financial incentives are not aligned with healthier practices, pitchers will continue to prioritize velocity over longevity, putting their health at risk.

Without significant change, the dominance of pitchers will persist, games will remain less exciting, and MLB revenues will suffer. More importantly, pitchers will continue to jeopardize their health in pursuit of financial gain.