With no easy answer, Orioles grapple with pitcher injury epidemic: ‘We’ve got a problem in our game’
They’re the three most dreaded words in baseball: Tommy John surgery.
Over the past three decades, pitcher injuries have grown into an epidemic in MLB with no diagnosis more devastating than a torn ulnar collateral ligament in the elbow. Reconstructive Tommy John surgery has saved careers, but agreeing to the procedure is also the resignation that the next 12 to 18 months will be spent rehabbing rather than pitching in the major leagues.
So far in 2024, pitcher injuries have undercut the jubilance of the new season. The injured list has swelled with stars such as Spencer Strider and Shane Bieber, both of whom suffered season-ending elbow injuries during the first month of the season. In total, 10 major league pitchers have already had Tommy John surgery, according to former FanGraphs analyst Jon Roegele’s public database. Even more are on the IL trying to avoid surgery.
“It’s unfortunate,” Orioles ace Corbin Burnes said last week. “You never want to see anyone get hurt, especially with at the rate guys are going down right now. I think we’ve got a problem in our game. MLB is going to tell you it’s not pitch clock related. I would argue that injuries — long-term injuries — are up the last two years and the rate that we’re having injuries this year is nothing like we’ve ever seen before. So, there’s a problem. It’s got to be fixed.”
The Orioles have been no exception. Kyle Bradish, their Game 1 starter in the AL Division Series last season, suffered a partially torn UCL in January and underwent platelet-rich plasma injections in an effort to pitch this season. Left-hander John Means is nearing his return after being shut down late last season with soreness in his surgically repaired elbow. Right-hander Tyler Wells joined them both on the injured list Tuesday with elbow inflammation.
While the rise in pitcher injuries is perhaps the biggest problem facing the sport, there’s no simple solution — or at least, no one seems to agree what needs to be done. Tony Clark, executive director of the MLB Players Association, has pointed to MLB’s pitch clock, introduced last season, as a contributing factor especially after the league reduced the timer with runners on base from 20 seconds to 18 this year. MLB fired back, saying in a statement that “velocity and spin increases” have been correlated with the spike in arm injuries for decades.
Orioles left-hander Cole Irvin, an alternate on the MLB competition committee that also includes Burnes, has sat in on several meetings in which the trend of pitcher injuries was discussed. The players, who are outnumbered by the owners six to four on the committee, have asked for pitchers to have the option to call a timeout just like batters do.
“I don’t know if the league is looking into making some adjustments or anything like that,” Irvin said. “But in the calls that we had on the competition committee, it was we provided all this information like, ‘Hey, we need rest. We need one step off with nobody on to give ourselves a breather. If the hitters get one timeout, where’s our one step off?’ We’re not trying to say that we’re going to walk around the mound. We’re just trying to step off and just give ourselves a reset, get the right pitch, because every pitch at this level matters.”
These are far from the only possible explanations. Some pitchers, such as Los Angeles Dodgers starter Tyler Glasnow, feel the league’s 2022 midseason crackdown on foreign substances forced them to grip the baseball harder, leading to more stress on their arms. Retired orthopedic surgeon Dr. James Andrews, renowned for his success rate performing Tommy John surgeries, told MLB.com in January that increased emphasis in velocity by amateur players has caused deterioration on players’ arms long before their UCL fully develops around age 26.
Yet even if velocity and spin are the root cause, MLB’s current system rewards those most capable of just that. Front offices place a premium on pitchers who can throw the hardest because fast pitches induce strikeouts and strikeouts are the most effective way for a pitcher to retire opposing hitters. Orioles executive vice president and general manager Mike Elias said on the team’s TV broadcast Saturday that conversations centered around this issue are “really picking up” in committee meetings he’s attended.
“The style of the hitter-pitcher matchup has evolved quite a bit in the last 20 years and pitchers are throwing harder than ever with better stuff than ever and there’s a lot of reasons for that and I’d be really surprised if that wasn’t a major factor in any uptick we’re seeing in arm injuries,” Elias said in a news conference Saturday. “I don’t think an answer is going to be easy, but I expect that this dialogue and the work on this front will pick up now that we’re seeing this so dramatically.”
According to Statcast, eight starting pitchers have thrown at least 2,000 pitches and averaged more than 96 mph on their fastballs since the start of last season. Four of them are currently on the injured list, including two, Strider and 2022 National League Cy Young Award winner Sandy Alcántara, who are out for the season with UCL injuries. Three others have undergone Tommy John surgery before. The eighth: Orioles right-hander Grayson Rodriguez.
Rodriguez has seen the “concerning” trend of high-velocity pitchers hitting the IL but doesn’t plan to dial back the velocity. Already comfortable with the pitch clock after being introduced to it as a minor leaguer in 2021, Rodriguez is establishing himself as a young star in the major leagues thanks to, in part, his fastball that averages 96.3 mph. He’s not in a position to sacrifice one of the most impactful aspects of his pitch repertoire.
“I don’t know if changing something is the answer because, obviously, doing what I do best is what allows me to have success,” Rodriguez said. “I’m not somebody that knows how to pitch around 90-91. So, really just not paying much attention to it. Obviously, making sure you listen to the body, I think, is a big thing. That’s really all I can say about it. I really haven’t looked into it that much.”
Rodriguez’s position is one shared by players of all ages. Velocity is how a teenager stands out to scouts in the prep circuits. A late-round draft pick who adds a high-spin sweeper or splitter may get a second look at a minor-league promotion. Veteran pitchers hoping for a big payday in free agency might see a couple ticks on the radar gun as their ticket to more millions.
“To me, there’s a lot [more] emphasis on velocity and pitch shapes than there is on good mechanics and throwing strikes, which needs to come first,” Irvin said. “Because if parents or young players are concerned about scholarship opportunities or anything like that, every college gets 11.7 and there’s plenty of guys in here that had different paths to the big leagues.
“If you’re good enough, you’ll be found. And I think the point of emphasis needs to be on strike throwing and not so much velo and those types of things. But that’s just one man’s opinion.”
There are plenty of those to go around right now.