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Doctor to Baseball’s Superstars Details Rise of Injuries in MLB

Elbow injuries from torn UCLs to inflammations in the throwing arm eventually led to Tommy John surgery. The surgeries seem to be on the rise with multiple pitchers coming down with more frequent elbow injuries of late. We can talk about the ongoing scandals or relocation fiasco in Oakland, but there’s more to it than just that. There’s a strong thought that those injuries may start well before someone makes it to the big leagues. Renowned surgeon Dr. James Andrews believes it’s horrible in youth leagues.

Dr. James Andrews Thoughts on MLB’s Elbow Injury Problem

Andrews was prevalent in resurrecting and prolonging the careers of many athletes in baseball and beyond thanks to his surgical skill and conscientious care. He was at the forefront of an evolution in sports medicine that improved what’s possible in terms of repair and recovery from surgeries. He’s done thousands of operations from the likes of Micahel Jordan to Troy Aikman to Hulk Hogan. Andrews believes that the newfound need for velocity and spin isn’t good for young pitchers. He explained that they’re throwing around 90mph when they are 16 or 17. At that age, the ligament isn’t built for that sort of movement.

“I started following the injury patterns and injury rates in the year 2000. Back in those days, I did about eight or nine Tommy Johns per year in high school and younger. The large majority of Tommy Johns were at the Major League level, then the Minor League level, then the college level and then just a handful of high school kids.”

Andrews says, based on research, that baseball is a developmental sport, and the UCL ligament that pitchers need repairing doesn’t mature until age 26. The maximum that high school players should be throwing at that age is 80. Otherwise, it’s putting the ligament and pitcher at risk of injury.

“In today’s situation, the whole thing is flip-flopped. The largest number is youth baseball. They’ve surpassed what’s being done in the Major Leagues. That’s a terrible situation.”

The Problem is Getting Worse

Within 24 hours, former Cy Young winner Shane Bieber would undergo elbow reconstruction surgery, ending his season and mostly all of 2025. Next is New York Yankees reliever Jonathan Loaisiga, who also has a torn UCL and will undergo surgery. Then, it was ace Spencer Strider, who finished second in the National League Cy Young voting, damaged his UCL and will undergo further tests with Dr. Keith Meister in Texas, likely ending his season with elbow surgery. Two days before that, the Miami Marlins announced their pitching prospect Eury Pérez needed Tommy John surgery.

There were more than 260 major league and minor league pitchers in 2021 who had elbow surgeries, that’s an increase of more than 400% from a decade ago. For pitchers who have had a second Tommy John or elbow surgery have since doubled. The MLBPA went as far as suggesting that the latest rule changes, specifically the pitch clock, were to blame for the recent increase in injuries.

MLB Issues Response

Following the statement from the MLBPA, MLB responded with their statement.

“This statement [from the MLBPA] ignores the empirical evidence and much more significant long-term trend, over multiple decades, of velocity and spin increases that are highly correlated with arm injuries,” the league said. “Nobody wants to see pitchers get hurt in this game, which is why MLB is currently undergoing a significant comprehensive research study into the causes of this long-term increase, interviewing prominent medical experts across baseball which to date has been consistent with an independent analysis by Johns Hopkins University that found no evidence to support that the introduction of the pitch clock has increased injuries.

In fact, JHU found no evidence that pitchers who worked quickly in 2023 were more likely to sustain an injury than those who worked less quickly on average. JHU also found no evidence that pitchers who sped up their pace were more likely to sustain an injury than those who did not.”

Ben Lindbergh of The Ringer outlined a great sample earlier this week. The rate of professional pitchers undergoing the surgery has steadily increased over the years. It’s a trend that began before the pitch clock was introduced. The average game time increased by 14 minutes from the late 90s to 2021 and 2022, while pitcher injuries went up from 11,668 IL days in 1995-99 to 31,558 IL days in 2023.

Introduced in 20213, the pitch timer gives pitchers 15 seconds to throw a pitch with no runners on base and 20 seconds with runners on. The league’s competition committee made a slight change in 2024, shortening the time with runners on base to 18 seconds.

Main Photo: © Bill Streicher-USA TODAY Sports


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