Here's Why So Many MLB Pitchers Are Getting Hurt
Monday was a day like too many others in baseball. We learned two more pitchers will have Tommy John surgery. Los Angeles Angels lefty Patrick Sandoval and Atlanta Braves left-hander Ray Kerr both went down.
Everyone wants to know, 'Why are so many pitchers going down with this elbow injury?'
From little league to the big leagues, pitchers are throwing fewer innings and experiencing more injuries. Major League Baseball has launched an extensive study to understand this issue.
2024 is the 50th anniversary of Tommy John's surgery, which now bears his name. The procedure reconstructs the ulnar collateral ligament (UCL) in the elbow. Data shows one thing: The harder pitchers throw corresponds to the number of elbow injuries.
Pitchers Have Faster And Faster Fastballs
The problem has reached epidemic proportions. In the 13 months before the start of this season, 38 MLB pitchers had Tommy John surgery.
In 2020, there were fewer than 500 pitches over 100mph in Major League Baseball; last season, there were nearly 4,000.
Glenn Fleisig, PhD, is a recognized expert on pitching biomechanics. He says speed kills.
“Essentially, the UCL is being pushed beyond what it can take. We’ve developed a situation through mad science where we are pushing the body beyond what the ligament can handle.”
He described it as pulling a rubber band. It will break more quickly the harder and further you pull it apart, and that’s exactly what pitchers are doing to their UCL.
The Human Arm Can’t Take It
Texas Rangers team physician Dr. Keith Meister warned teams before the 2024 season.
He believes spin rate is a big part of the problem. Dr. Meister blamed two pitches—the sweeper and the hard changeup — on the uptick of injuries he’s seen.
"I'm not going to sit here and tell you to never throw a sweeper or never throw a hard changeup,” Meister told The Athletic. ”But at some point, you have to say, 'OK, when we see a pitcher throwing that pitch more than 15% of the time, the likelihood of him having an injury to his shoulder or elbow goes (up), whatever, tenfold."
Meister says the two pitches put tremendous strain on the inner elbow. To throw those pitches effectively, you have to put an enormous amount of pressure on the ball. Los Angeles Dodgers starter Tyler Glasnow believes that's another issue that could be responsible for the injuries.
No Sticky Stuff Allowed For Pitchers
Three seasons ago, Major League Baseball prohibited pitchers from using foreign substances to help them grip the baseball. Glasnow said he used sunscreen to improve his grip.
He was with the Tampa Bay Rays when umpires began checking pitcher's hands after each half-inning in the middle of the season. He said he could feel the difference immediately.
"I had to put my fastball deeper into my hand and grip it way harder. Instead of holding my curveball at the tip of my fingers, I had to dig it deeper into my hand." Glasnow said after getting hurt in 2021. "I have to change everything I've been doing the entire season. I'm telling you, I truly believe that's why I got hurt."
No Evidence The Pitch Clock Hurts Pitchers
The head of the baseball players’ association wants to blame the pitch clock, which is now two seconds shorter with runners on base than it was last season.
“Despite unanimous player opposition and significant concerns regarding health and safety," MLBPA executive director Tony Clark said, "the commissioner’s office reduced the length of the pitch clock last December, just one season removed from imposing the most significant rule change in decades.”
Major League Baseball responded to Clark by citing a Johns Hopkins study that found "no evidence to support that the introduction of the pitch clock has increased injuries."
“There’s an almost incalculable number of factors that determine whether a pitcher will get injured or stay healthy.” John Wholestaff from Baseball Prospectus wrote. “If it were something simple, major-league teams would be much better at preventing injury.”
The injuries are not workload-related. Pitchers are throwing fewer innings and getting hurt more often. Over the past ten years, the number of innings pitchers throw has dropped dramatically.
Years | Average Innings for League Leaders |
2008-2013 | 243.2 |
2018-2023 | 219.2 |
As innings pitched have dropped, the number of UCL injuries has jumped. It all comes down to velocity.
Twenty-one starting pitchers averaged over 96.5 MPH in 2023, sixteen of them have had at least one Tommy John surgery. The question now is whether teams can or will have the guts to hit the breaks.
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