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.

i guess since strider and ohtani already had TJ once and given the stats around twice-TJ its not like they have much choice

Bobby Miller, LAD's SP3, just hit the IL-15 for shoulder inflammation retroactive to 4/11, not sure if it's legit or just a way to manage his workload.

I had forecasted some workload issues (~23 starts?) this season based on his IP history:

2021: 56 IP
2022: 112 IP
2023: 138 IP

...but this is coming a little faster than expected. LAD are no strangers to IL shenanigans but I sincerely hope Miller is okay.

Robert Stephenson (who was supposed to be LAA's closer) had his first AAA rehab assignment today coming back from shoulder inflammation that shut him down in February:

He threw 4 straight balls, then walked off the field straight into the locker room.

...but this is coming a little faster than expected. LAD are no strangers to IL shenanigans but I sincerely hope Miller is okay.

Bednar is b0rked

Yeah the circumstances suggest this ain't a phantom stint :(((((( reports say nothing structurally woresome came up tho and he should be throwing next week. Emmett Sheehan recently had a set back in his recovery too, but Buehler should be back soon!

stephenson is done for the year, of course

TIL Triston McKenzie opted NOT to have TJ last season (I presumed he did) in spite of having a torn UCL and missing 1.5 seasons doing "rehab"... uh...

His 4SFB is down 90mph vs. rated 92mph, currently 5.00 ERA/1.61 WHIP.

Oof.

saw that spencer strider had a bone fragment that was 'growing' in his UCL. not sure if that means he has the nolan ryan self-repairing ACL super-gene

Omg speak it into existence!

LAD have won 6 straight, let's check in on their pitching status report after 1 month:

James Paxton: was supposed to start today on normal rest but now is not...?
Tyler Glasnow: (DTD, hand cramps, pulled from last start)
Yoshinobu Yamamoto: healthy (!)
Bobby Miller: IL15 (shut down, will start playing catch on Mon/Tue)
Emmet Sheehan: IL60 (shut down due to self-professed arm soreness, but team claims it's his shoulder which even Emmet is confused by official team diagnosis)
Walker Buehler: IL15 (0-2/4.68 ERA/1.68 WHIP in rehab, remaining in AAA for now)
Clayton Kershaw: IL60 (played catch yesterday on flat ground)
Shohei Ohtani: IL60 (rumored to be available in September?)
Dustin May: IL60 (in TJ recovery, may be back in 2024?)
Tony Gonsolin: IL60 (had TJ in February after non-invasive attempts to recover from UCL sprain in offseason, may be available after 2025 ASB)
Brusdal Graterol: IL60 (shut down due to slower than expected recovery)
Blake Treinen: IL15 (27.00 ERA/3.75 WHIP in 2 rehab appearances)
Kyle Hurt: IL15 (pains me to say but Kyle is... Hurt)
Connor Brogdon: IL15 (recent trade acquisition from PHI, went straight to IL)
River Ryan: IL60 (shut down)

Nooooooooo Steveeeeeeeeee, I don't need this information collated :(((((((

You forgot Gavin Stone, who was a stone cold stunner last start (don't look up the opponent)

There haven't been any noted injury worries with Paxton either yet. Just a mutually agreement between him and the FO to pitch with an extra day's rest (same as Yamamoto iirc)

I don’t know if I’d include Glasnow in the list, it was just a hand cramp and he was pulled after over 90 pitches. I was watching that game and he looked fine when he came out.

Both Glasnow & Giolito were recently on Chris Rose Rotation and said pitcher injuries were (no shit) due to guys throwing harder and faster and not resting over the offseason. Glasnow got very frank with it: he said that kids coming up pitching today know that they won’t get drafted throwing control stuff with no velo and from the perspective of someone who wanted to be in the big leagues, he saw surgery and pain as a necessary price to achieve the dream, and said all pitchers felt the same. Giolito agreed on his episode, though not so candidly.