One of the game’s top orthopedic surgeons has sounded the alarm over pitching injuries, pointing to the emergence of sweepers and changes in strength as big contributors to the spike in pitching injuries.
Texas Rangers team physician Dr. Keith Meester said teams are exacerbating the problem by emphasizing pitchers’ performance rather than their availability.
“Unfortunately, these managers live more in the present than take a longer-term, broader view,” Mester said. “There’s a way to solve this problem. What if a guy’s WHIP (base and hits per inning pitched) doesn’t reach 0.8? What if his WHIP is 1.1 but he can hit 162?”
Meister, a pioneer in hybrid elbow surgery that combines traditional ligament reconstruction with the addition of an internal brace, said surgical techniques have changed significantly over the past decade as pitch has evolved.
As teams increasingly emphasize velocity and other elements, pitchers’ spots on the injured list increased from 241 in 2010 to 552 in 2021, then dropped each of the past two seasons, according to an MLB spokesperson. There has been a slight decline every season. Over slightly longer periods of time, the number of days pitchers spent on the IL more than doubled.
Excessive concern with performance often begins in adolescence. Many pitchers have problems before they make it to the major leagues. A league spokesman said the number of pitchers with a history of elbow reconstruction selected in the first 10 rounds increased from six between 2011 and 2013 to 24 between 2021 and 2023.
Mester, 62, said he repaired about 230 elbow ligaments last year and “far exceeded that rate” this year. Before undergoing a second major elbow surgery, Ohtani threw more cleanup pitches than anyone in baseball between 2021 and 2023. Of course, pitchers who don’t throw sweepers or changeups get hurt, as evidenced by the rising number of injuries this spring.
Boston Red Sox’s Lucas Giolito may need a second elbow reconstruction. The Houston Astros’ Justin Verlander, the New York Mets’ Kodai Senga and the Toronto Blue Jays’ Kevin Gausman and Alec Manoa are all dealing with shoulder issues. The San Francisco Giants’ Sean Yeller is out with an elbow issue and Tristan Baker has surgery to remove an aneurysm in his arm.
This is only a partial list.
“We used to say, you get your T.J., you’re good. Then, you get 10 years. And then seven to eight,” Meester said. “Now, people will be divided into three or five, depending on who they are, what they have, what they throw.”
The game, then, seems to be teetering on the edge. Pitchers are throwing more breaking balls than ever before. They also threw harder than at any point in the history of the sport. Speed is often cited as one of the biggest factors in pitching injuries. The sport rewards those who pursue it.
“The analysis shows that velo is very important,” said a pitching coach who spoke on condition of anonymity because of his candidness. “Pitchers and analysts alike pursue velo. Pitchers who don’t retire. Those who stay risk injury to avoid working at Costco.”
Meister, director of the Texas Metropolitan Sports Medicine Institute, acknowledged the dangers of speed. But, he said, “the spin is worse.”
Meister said sweepers can put a lot of pressure on the inside of your elbow. As Meister said, changes in the “movement” of strength can also cause undue stress on the arms. “To throw these pitches,” he said, “you have to squeeze the crap out of baseball.”
A few years ago, Meester recalled hearing the late Johnny Sain, a former major league pitcher and independent-minded pitching coach, say that when a pitcher holds the ball correctly, he should throw it in a way that he could throw a raw egg without breaking it. way to hold the ball. it.
Today, Mester said, the opposite is true. The pitcher applies a “death grip” to the ball, essentially preloading every muscle in the arm. When released, these muscles lengthen dramatically in what is called an “eccentric contraction.” The result is almost like a hamstring tear, affecting different pitchers in different parts of the arm.
“We saw all the tears in the dorsal and teres muscles, all the tears in the previously reconstructed ligaments, and more flexor tendon tears,” Meister said. “I can tell you that it’s mostly a result of those two pitches — the sweeping slider and these hard-moving changeups.”
According to Statcast, the percentage of sweeper throws leaguewide has increased from 1.3% to 3% to 4.3% over the past three seasons. According to the Dallas Morning News , the Rangers who hired Meester barely pitched. Meister said the current terminology for classifying pitches is actually insufficient. He photographed his patients’ grips and saw four to five different sweep and variable-speed grips.
Meester expressed his concerns during a Zoom call shortly before spring training to Kevin Ma and John D’Angelo, two MLB executives involved in injury prevention. worries. The meeting was part of the league’s ongoing study of pitching injuries. A spokesman for the league said it has conducted about 100 interviews with doctors and athletic trainers, independent researchers and college coaches, club executives and former pitchers. Once the study is complete, the coalition expects to form a working group.
Not everyone who studies and trains pitching agrees with Meester that spin is more of a problem than velocity.
“A cleanup pitch is just a curveball with different grips,” one pitching coach noted, adding that research is divided on the link between grip strength and spin rate. “Guys weren’t messing up their changeups to make a move like this. For both pitches, they used the seams to make it move in different ways.”
Glenn Fleisig, director of biomechanics research at the American Institute of Sports Medicine, also expressed doubts that sweepers deserve greater attention.
“We haven’t studied the sweep itself in the biomechanics lab, but we have shown in many studies that curveballs and sliders are no more stressful than fastballs,” Fleisig said in an email. “
“Therefore, I have no reason to believe that sweepers are any more of an injury risk factor than other breaking pitches or fastballs. Science points to three major injury risk factors – effort (velocity is an indicator of a pitcher), pitch volume, and mechanics. “
The caveat to Fleisig and other studies looking at the risks of speed is that at least one study from driveline baseball shows that the stress on the elbow per mile per hour on the field has a negative impact on secondary pitches like changeups and sliders. It’s higher. Therefore, a pitcher throwing the ball as hard as a fastball will actually put more stress on the elbow.
Jacob deGrom has struggled to stay healthy, and it’s perhaps no coincidence that he’s throwing his slider as hard as some pitchers throw his fastball. The higher the velocity, the greater the risk, no matter what pitch is thrown — slider velocity around the league has increased by almost two miles per hour since baseball began publicly tracking it in 2007.
Many pitchers view injuries as almost an occupational hazard and don’t seem to care. Advances in “stuff” research have tried to separate movement and speed from outcomes, and the results show that harder breaking balls are better breaking balls, almost across the board. Additionally, oft-injured pitchers are often given big contracts based on a player’s quality rather than their durability. So, who is going to tell pitchers not to be like DeGrom? Who would advise people to avoid throwing a slider like Justin Verlander’s low 90-degree breaking ball?
Tampa Bay Rays president of baseball operations Erik Neander, whose team lost three starting pitchers to season-ending elbow injuries in 2023, said finding the sweet spot between performance and availability Optimal crossover is a challenge that extends all the way to youth baseball.
“With the investment you put into players and individuals and the care you put into it, it’s really hard to see someone get hurt and lose the opportunity to play,” Neander said. “How to balance that and give them the best chance to compete and succeed at the major league level, that’s a very difficult balancing act and one that we’re obsessed with. What we want more than anything is to find a better way to do that. This, at the same time, allows them to be successful.”
Now, that hasn’t happened yet.
Mester said a club analyst told him the average career for all players is now less than three years, while the average career for pitchers is less than 2.7 years.
“It’s like an NFL running back’s number,” Meester said. “The irony is, from an ownership perspective, they’ll never have to pay any of these players big bucks. Forget about them becoming free agents. They’ll never even be eligible for arbitrage.”
At one point, Meester said he believed the league was comfortable with the “next up” mentality. This upset him. He said there are only so many weapons that can reach the major league level. But recently, he’s been encouraged by the league’s efforts to find solutions.
“What I’m talking about with MLB is, look, we have all the data on performance. We also have all the data on health. We have to combine those two metrics,” Meester said. “I’m not going to sit here and tell you to never throw a sweeper or never throw a hard changeup. But at some point, you have to say, ‘OK, when we see a pitcher throw it more than 15 percent of the time “
A return to the art of pitching might be one way to address this issue. Neander said that while teams know stuff is critical in getting major league hitters out, “positioning ability can make up for any shortcomings in stuff.” But right now, pitchers often rely on throwing the ball as hard as they can because they know This will yield the greatest benefits.
Last year, Alex Cobb of the San Francisco Giants put it succinctly when talking about the impact of kids throwing curveballs hard before a certain age.
“I used to hit a lot of curveballs in little league games, and then I’d go home and throw the football after the game because I was the quarterback, too,” he said last year. “I’ve always pitched as hard as I could. Maybe you shouldn’t listen to me because I’ve had every surgery known to man…but I also made it to the major leagues.”
(Top photo of Shohei Ohtani in August 2023: Brian Rothmuller/Icon Sportswire via Getty Images)
