Pulled pork UCLs & noodle arms: thread of pitcher injuries

There’s this interesting piece in The Athletic regarding pitcher injuries.

This leaped out:

Meister said an analyst with one club told him the average major-league career is now under three years for all players and just under 2.7 for pitchers.

“It’s like NFL running-back numbers,” Meister said. “Cynically from the ownership side of things, they’re never going to have to pay big bucks to any of these players. Forget about them becoming free agents. They’re never even going to become arb-eligible.”

Meister said for a time, he believed the league was comfortable with a “next man up” mentality. That disturbed him; only so many arms, he said, are capable of throwing at the major-league level. But lately, he is encouraged by the league’s effort to find solutions.

Throwing a baseball is an act of violence that has been graphically defined by Dr. James Andrews, Dr. Glenn Fleisig and the other doctors and clinicians at the American Sports Medicine Institute (ASMI) in Birmingham. From the loaded position, the shoulder, at its peak speed, rotates forward at 7,000 degrees per second. "That," Fleisig says, "is the fastest measured human motion of any human activity."

While in the loaded position, the shoulder and elbow bear the equivalent of about 40 pounds of force pushing down. When the ASMI biomechanists wanted to know how much more force an arm could take, they brought cadavers into the lab and pulled and pushed upon the elbow joint to find the breaking point. The cadavers's ligaments blew apart just after 40 pounds of force. "So a pitcher is just about at the maximum," Fleisig says.

From the loaded position, when the ball has come to a stop, it is accelerated from zero mph to 90 mph in 3/10 of a second. Rick Peterson, the former New York Mets pitching coach who has worked with ASMI since 1993 and is the acknowledged expert on pitching biomechanics among his peers, once referred to that measurement in a speech he gave to college coaches. A doctor of physics who was in the audience approached him after the talk.

"Rick, do you know what that means in g-forces?" the doctor asked.

"I have no idea."

"If your entire body was accelerated at that rate of speed for over 60 seconds you would die."

No wonder pitchers break down. Pitching, unlike most athletic activities, has reached the limit of what is humanly possible. So while we are accustomed to increasingly swifter sprinters, faster swimmers, longer drivers of the golf ball and bigger football players, you will not see a pitcher throwing 110 mph. The arm and shoulder are maxed out. Pushed any further, the shoulder would blow, like an engine in a race car.

"People run faster and jump farther because we have figured out ways to make your muscles bigger and stronger," Fleisig says. "The baseball pitcher, every time he pitches, his muscles are pushing his ligaments and tendons to the limit. In the future, I can't anticipate making the muscles bigger and stronger because you can't strengthen the ligaments and tendons that much. That's why the role of research in baseball is not to get the pitcher to throw faster but to lower the risk of injury."

mlb should pre-tack the baseballs like they do in the NPB

i wonder how fast a chimpanzee could throw a baseball

GERRIT COLE MRI

I saw that, do not wish that on Cole. Some reports seem to indicate that it sounds like a dead arm, but apparently they’re getting multiple opinions, and I feel like you don’t get an MRI for no reason? He’s probably not going to be Opening Day ready even if he doesn’t need surgery.

Why can’t his awful former college teammate get injured?

Cole's the best pitcher in the game and about 80% into a HOF career, so I very much hope he's okay.

I don’t think he’s ever had Tommy John before so if he needs it at least he’s probably only going to need one before retirement

cole shut down

Feel that the in person visit to the arm doctor ElAttrache does not bode well…Like are they going to literally open him up to get a look at it?

That's lousy how much time deGrom and Scherzer and Kershaw and Verlander and now Cole have lost the last few years (you can throw in Sale, too). It cost Sale a HOF career and will probably cost deGrom one; Cole should come through okay, but who knows. Just in general, though, it's bad for the game.

Cole's situation sounds bad.

Maybe this is a silly question, but should we be surprised that these injuries develop in spring training? During the season, they pitch at maximum effort every five days and it's reasonable that accumulated wear and tear will lead to injuries. But during spring training, when pitchers are still ramping up to maximum effort? Or is it more likely because of something from his offseason training regimen?

Or is "ramping up to maximum effort" just as risky as pitching at maximum effort?

Cole throws fast and has never been injured. It’s unfortunate but I doubt it’s remotely related to spring training, ligaments only have so much in them

Sources: Eury Perez is slated to visit noted surgeon Keith Meister in Texas in coming days https://t.co/NDTFVjJfUY

— Jon Heyman (@JonHeyman) March 16, 2024

Come on

Shane Bieber needs elbow surgery.

He had pain after his Opening Day start that continued through his outing in Seattle. Imaging revealed an injury to the same ligament that gave him trouble last year. Surgery was determined to be the best path forward this time.

— Mandy Bell (@MandyBell02) April 6, 2024

Plus now we're waiting on news about Strider 😔

This is incredibly depressing

Shane Bieber - Tommy John
Eury Pérez - TJ
Felix Bautista - TJ
Lucas Giolito - TJ
Shane McClanahan - TJ
Jacob deGrom - TJ
Sandy Alcantara - TJ
Walker Buehler - returning from TJ
Robbie Ray - returning from TJ
Dustin May - returning from TJ
Gerrit Cole - elbow inflammation
Spencer…

— nugget chef (@jayhaykid) April 6, 2024

https://www.espn.com/mlb/story/_/id/39888847/braves-ace-spencer-strider-ucl-damage-right-elbow

Oops sorry gyac for some reason I didn't see your comment below

Real bummer, just absolutely nightmarish casualty count among SPs this season.

It’s ok! Yeah it’s really terrible, you have to wonder when it’s too much for Manfred, especially with arms as valuable as they are

I also wonder if the brace procedure will take over from Tommy John in future

guess i'm thankful senga is out with shoulder fatigue and not elbow fatigue?

MLBPA released a statement. pic.twitter.com/BtI7T4nRmp

— FOX Sports: MLB (@MLBONFOX) April 6, 2024

lol - yeah it’s totally the pitch clock’s fault this is happening.

guess i'm thankful senga is out with shoulder fatigue and not elbow fatigue?

nooo. TJ is rough but has a pretty good recovery rate; shoulder stuff is more complex with no easy fix. it was strasburg’s shoulder that really did him in

shoulder stuff is more complex with no easy fix

:(

twice-TJ'd tejay antone left the mets-reds game after throwing one pitch, clutching his elbow. not good!

framber valdez scratched from tonight’s start with elbow soreness

https://www.theringer.com/mlb/2024/4/2/24118963/pitcher-injuries-crisis-mlb-study-tommy-john-ucl

Good read. 80% of injuries in the bigs are pitches. 36% of pitchers pitching last year had had Tommy John's surgery

pivetta and josiah gray, too? fuck, man. i hate this.

Breslow said that the Pivetta injury is probably not going to keep him out much longer than the 15 days and the UCL is intact, so hopefully that’s the case but yeah, it sucks.

mlb should pre-tack the baseballs like they do in the NPB

― 龜, Friday, March 8, 2024 4:02 PM (one month ago)

what do pitcher injury rates look like in the NPB?

https://journals.sagepub.com/doi/pdf/10.1177/23259671211008810#:~:text=The%20MLB%20team%20had%20a,001).

Conclusion: This is the first empirical study examining injury trends and pitching characteristics between MLB and NPB athletes.
MLB-affiliated pitchers threw faster and relied more on breaking pitches in comparison with NPB-affiliated pitchers. From injury
data, MLB players were younger, taller, and heavier with a higher percentage of throwing-related injuries, contact injuries, and
injuries sustained outside of competition. Overall, the MLB team indicated a 3.7-fold higher rate of reported injuries with fewer days
missed per injury than did the NPB team. Competitive conditions are distinctly different between MLB and NPB, and thus, more
extensive research collaborations in the future can identify best practices to advance health and performance for both leagues.

Overall, the MLB team indicated a 3.7-fold higher rate of reported injuries with fewer days missed per injury than did the NPB team.

3.7-fold higher rate of reported injuries! ...............is that good

Tyler Glasnow said that using a mixture of sunscreen and rosin on the baseball helped him grip it better and other pitchers have said similarly.

Glasnow also attributed some blame for injuries to the rule changes for sticky stuff. He said when it was implemented, he had to start gripping the ball tighter which led to an arm feeling far worse after a start.

Hey Siri, please run some MRIs on David Bednar, George Kirby & Max Fried.

(siri-ously tho when I get a chance in a couple hours I really want to look at the savant data on these guys)

Kirby’s problem is mental, I think. Whole team is imploding rn. He’s not good at getting out of jams. Like if you look at the most recent result, he’s fine up until he balks in the 3rd inning and it all goes to shit from there.

Bednar's velo's there, location is way off (only 4 of 23 pitches in the strikezone despite 8 swings), maybe no pulled pork tacos just yet.

Fried is one of 2 of the top 10 (Burnes as well) pitchers from 2021-2023 who is currently not shut down (back/shoulder) or in TJ Recovery. That's kind of wild to think about. His Savant page is v sad... a sea of blue except for GB% and low exit velo. His velo is also not terrible compared to rating. Is he getting BABIP'd? Will put in an order for a small plate of pulled pork tacos.

Kirby's 4SFB started off at 98mph but was gassed out at 92 towards the end when he got the hook. Only 4 swinging strikes on the night so his movement was not happening at all. This might be a full catering order of pulled pork here.

(for gyac: i ate 10 tacos next to jeff weaver last night )

RHP Spencer Strider yesterday underwent surgery to repair the ulnar collateral ligament in his right elbow with internal brace, performed by Dr. Keith Meister in Arlington, TX. He will miss the remainder of the 2024 season.

— Atlanta Braves (@Braves) April 13, 2024

See you at the 2025 ASB sweet prince.

Now I have to consider dropping him in our Fantasy League because he'll be a huge question mark for next season and beyond.

I am a bit of a height-ist w/r/t pitchers & mechanics and I always assume shorter pitchers are doomed due to human physiology.

keith meister? was neal el attrache on vacation?

xp bummer. I knew as soon as he started getting those DeGrom comparisons something like this was inevitable

xp

Trevor Story today underwent a successful arthroscopic repair of the posterior labrum, with an open reduction and internal fixation of the fracture of the glenoid rim.

The procedure was performed by Dr. Neal ElAttrache at the Kerlan-Jobe Institute in Los Angeles, CA.

— Red Sox (@RedSox) April 13, 2024

Happy 50th!

https://i.imgur.com/vAinJQ3.png

who are the success stories for this UCL brace surgery vs regular ol' tommy john?

It’s too new to know I think but Ohtani and DeGrom have both had it. Supposedly it’s likely going to replace full Tommy John in the future. Bryce Harper had it.

tbh i just wanted to say fried is fried

soon to be freed

RHP Christian Scott has been placed on the 15-day IL, retroactive to July 22, with a right UCL sprain.

LHP Alex Young has been recalled from Triple-A Syracuse.

— New York Mets (@Mets) July 23, 2024

Ok

The Oakland A’s have placed right-handed pitcher Mason Miller on the 15-day injured list retroactive to July 23 with a broken left hand and reinstated right-handed pitcher Ross Stripling from the injured list.

— Oakland A's Communications (@AthleticsPR) July 25, 2024

Chicken strip!!!!

Woke up early to watch Kershaw pitch again and was not dissapointed. Sloppy start of the 3rd but locked it down with 3 strike outs. His curve and slider look like they're going to take him the distance. Around 50 strike outs away from 3000. Wife crying from the stands, big thing for him to be back. So lucky to be watching him throw at this level still

Kodai Senga reinjured on his first start of the year 😞

It wasn’t anything arm related though. Unpulled pork.

“thread of pitcher injuries”!

Breaking: Mets manager Carlos Mendoza said “it’s pretty fair to say” Kodai Senga is done for the “regular season.”

— Jorge Castillo (@jorgecastillo) July 27, 2024

:(

that's some tulo/ellsbury-with-the-yankees shit

xp lol, zing cuts off the end of the thread name for me so i forgot that was there

reynaldo lopez pulled after 3 shutout innings with 'forearm tightness'

not sure it was mentioned, Tiedemann getting the TJ tm

Woke up in the middle of the night and saw this happen after 2 batters while checking scores of live games, really awful

Brusdar Graterol had spent all season rehabbing a shoulder injury. Eight pitches into his return tonight, he grabbed at his right leg and had to be helped off the field. Tough scene.

— Alden González (@Alden_Gonzalez) August 7, 2024

river ryan, we hardly knew ye

The ticking time bomb of a Dodger rookie starter. It never changes

He looked incredible in his four games :(

Hunter Greene. I was starting to secretly root for him for the Cy, he was getting so little attention next to Sale and Skenes.

https://www.mlb.com/news/hunter-greene-put-on-injured-list-by-reds

Sale immediately goes out and pitches lights out. (I have something of a proprietary interest in Sale winning; it would increase his HOF chances considerably--more even than the WS he was brought in to secure, something he already has--and rescue the half-dozen rookie cards I have from the dustbin of commons.)

Sale's sitting on a pitching TC at the moment (wins/ERA/K); pretty hard to beat, even if he's not leading in WAR.

Sale and Skuby Snacks are way ahead of everyone else in their respective leagues. Pitching has been weird this season obv, among the usual contenders it's not just the injuries but the absolutely disastrous meltdowns.

Pitching clock has an impact on the meltdowns right? Because there’s no real opportunity for the pitcher to leave the mound & clear their head, and the limitation of mound visits means they need to be saved.

Also, Tyler Glasnow has elbow tendinitis

Probably a moot point now, but even after Sale's start yesterday, bWAR is still:

1. Greene • CIN 5.4
2. Sale • ATL 4.5
3. Skenes • PIT 4.0

fangraphs has Sale way ahead of Greene, 5.2 to 3.7 iirc. Greene is outstanding but it's hard for me to really think of him as performing better than Sale this season esp to the degree b-ref's model believes.

When I look at them side-by-side, BRef's ranking doesn't make much sense to me.

Sale is ahead in: ERA, ERA+, FIP (huge margin), WHIP, BB/9, K/9.
Greene is ahead in: IP (2.2 more than Sale), H/9.

bWAR uses RA9, fWAR uses FIP

Sale leads in RA9, too, 2.69 to Greene's 2.89. Anyway, I won't go on about it, I know this is not the thread, and Greene's injury effectively ends his chances anyway.

Tyler Glasnow likely out for the rest of the year.

Tyler Glasnow has a “sprained elbow,” Dave Roberts said. His return this season is “highly unlikely.”

— Fabian Ardaya (@FabianArdaya) September 14, 2024

What's hurting the Orioles most right now is their inability to hit, but still, you have to wonder how this season would look if they had more than two of their original five starters pitching.

mets played three straight bullpen games against the reds, then they went to toronto and the jays also trotted out a bullpen game.

wonder what's the record for most consecutive bullpen games faced?

News: New York Mets RHP Christian Scott (@chscott8) will undergo a combined traditional TJ ligament replacement along with the internal brace, what is known as a hybrid procedure, performed by Dr. Keith Meister, early next week.
 
We look forward to supporting him through his…

— Nate Heisler (@Nate_Heisler) September 18, 2024

oof

Isn’t he a recent call up?!

yeh, 9 games pitched this year

He was doing well in triple a and probably would not have been called up if it wasn’t for other Mets pitching injuries.

reds threw three straight bullpen games against the mets, and now they lost another starter?

https://www.espn.com/mlb/story/_/id/41317380/reds-pitcher-brandon-williamson-tommy-john-surgery

pulled skyline chili with reds sauce

musgrove…

Padres right-hander Joe Musgrove has suffered damage to the ulnar collateral ligament in his elbow and will undergo Tommy John surgery, per general manager A.J. Preller.

yikes

😬

Musgrove missed a lot of time with a shoulder injury earlier in the year, which honestly feels more ominous than a first time TJ

so what's kershaw's toe look like now - custard tart?

🤢

Jeff Passan wrote about a recent MLB report on arm injuries: https://www.espn.com/mlb/story/_/id/43024395/mlb-2024-pitching-injury-report-study-takeaways-analysis

Findings probably won’t shock you, but some interesting commentary:

Partially at fault, the report posits, is that MLB teams' response to this has not been to change the behaviors antithetical to health but rather work around them. More teams have resigned themselves to arm injuries and instead sought roster depth, taking advantage of rules that allow them to churn their pitching staff. In each of the last four years, teams have averaged more than 32 pitchers used per season. In 2010 that number was 22.8, in 2000 22.5, in 1990 20 and in 1980 15.1.

I'm not sure what the solution is here. Reducing workloads and improved training will help, but the real issue is the obsession with velocity and spin rate, and I don't see that going away soon.

I'm happy that MLB did this study though, their findings are important.

it is kinda wild that teenagers are playing 70+ games a year

Anyone who hasn’t read The Arm yet should