Passan: Pitching injuries are out of control — and it’s time to take action

It’s all so ugly. Every day, it seems, another ulnar collateral ligament falls prey to the mere act of throwing a baseball. In a recent 48-hour period, Eury Perez, Shane Bieber and Spencer Strider — the best young pitcher in baseball, the 2020 American League Cy Young winner and the game’s current strikeout king, respectively — all went down with damaged elbows. A game already too thin on starting pitching continues to lose its greatest talent at an alarming rate.

The elbow crisis has been building for decades, from youth levels to the major leagues, and nobody in a position of power has done anything of substance to address it. This is not a bad stretch of luck or an anomaly. It’s an existential problem for baseball.

In addition to Perez and Bieber, who will soon undergo Tommy John surgery, and Strider, who might need his second at 25 years old, the list of players currently recovering from elbow reconstruction include an MVP (Shohei Ohtani), Cy Young winners (Jacob deGrom, Sandy Alcantara, Robbie Ray), All-Stars (Shane McClanahan, Walker Buehler, Lucas Giolito, Felix Bautista) and young standouts (Dustin May, Andrew Painter, Shane Baz, Kumar Rocker). Reigning American League Cy Young winner Gerrit Cole is out until at least the end of May with elbow issues.

On and on it goes, this unrelenting train of bad news, and if this isn’t a call to action for everyone with a whit of influence in the baseball universe to pour their energy into confronting it, nothing is. For the sake of the game, the whole of the sport must work together to crack a dilemma with no obvious solution.

Which made the dueling statements from the Major League Baseball Players Association and MLB on Saturday so disappointing. An issue this complex, this difficult to wrangle, demands cooperation from all parties with the ability to affect change. Instead, the public proclamations in the wake of the latest Tommy John surgeries oozed pettiness.

The union’s statement focused on the pitch clock, implemented in 2023, and the 2-second reduction with runners on base amended this season. It did not mention the sport’s drastic increase in pitch velocity or the constant maximum-effort approach pitchers take or the extreme emphasis on spin or the proliferation of year-round baseball or any other number of potential contributing factors. It relitigated a single issue — a not-unreasonable one, but one nonetheless — of a multipronged problem, saying: “The league’s unwillingness thus far to acknowledge or study the effects of these profound changes is an unprecedented threat to our game and its most valuable asset — the Players.”

MLB’s response did not help matters. It did discuss velocity and spin — and trumpeted the league’s efforts to combat elbow injuries through a research study it’s currently undertaking. But in trying to defend the pitch clock — one of the defining accomplishments of commissioner Rob Manfred’s tenure — the league cited a study from Johns Hopkins University “that found no evidence to support that the introduction of the pitch clock has increased injuries.”

Without any sense of the exact questions the study sought to answer, the data it combed through and the specificity of its conclusions, it’s difficult to glean anything meaningful from the league’s proclamations. Considering the study remains in peer review, using its unverifiable findings, even as a rejoinder to the union’s statement, speaks to a lack of transparency that’s imperative in tackling the problem.

Here’s what progress would look like: The voices of current pitchers — the ones who step out on the mound knowing their elbows are ticking time bombs — factoring heavily in MLB’s decision-making. They are the ones who feel the pain, who internalize the fear that what’s expected of them — throw harder, spin faster — predisposes them to major surgery. They’re the ones who exist in an industry that asks ever more of them — more velo, nastier stuff, full-tilt all the time — and leaves behind those who don’t offer it.

Pitchers have always gotten hurt — and will always get hurt — but at the highest levels the causes have morphed from longer-term overuse injuries to shorter-burst, higher-intensity, muscles-and-ligaments-can’t-handle-it ones. Teams incentivize pitchers to throw in a way that many experts believe is the root cause of the game’s injury issues. As much as velocity correlates with injuries, it does so similarly with productivity. Throw harder, perform better. It’s a fact. It’s also bad for the health of pitchers — and the game.

At the same time, it’s not the only factor. The fact that the union wants more information on the pitch clock should matter to MLB. Even if the league did bargain for unilateral control over on-field rules changes during negotiations with the MLBPA, it can’t ignore what players continue to begrudge. This isn’t idle bellyaching. Pitchers want to understand why the extra 2 seconds shaved off the clock this year were so imperative. And why they aren’t entitled to one or two timeouts a game when they feel discomfort — a nerve sending a shock of pain up their arm, a muscle spasming and in need of a break. And why there still isn’t an accepted grip agent to help with balls they believe remain inconsistently manufactured. All issues of health.

Pitchers know the injury data. They’ve seen the number of Tommy John surgeries ballooning at the big league level. It’s even more pronounced in the minor leagues, and the surge over the last decade does align with the implementation of the pitch clock at lower levels. But it also coincides with baseball’s pitch-design era, in which the use of technology — Trackman and Rapsodo machines that gauge spin characteristics and super-slow-motion cameras that capture grips and releases — allows pitchers to fabricate new pitches not based on their comfort or ease throwing them but detailed movement measurements to which they aspire.

Maybe it’s the clock. Maybe it’s pitch design. Maybe it’s velocity. Maybe it’s all of the above. Regardless of what it is, one truth the baseball universe knows is that the greatest predictor of a future arm injury is a past arm injury. In other words: The litany of pitchers who are hurt now are at far greater risk to get hurt again.

When a sport has evolved to the point where half of its participants are encouraged to compete in a way deeply detrimental to their short-term — and, in many cases, long-term — health, there is no room for politicking, bickering, blaming. With a sound process and commitment from both sides to it, all of the important questions will be asked and, hopefully, answered. This is about the people, and it is about the game, and it is about the awful place where the two are intersecting.

If anything in baseball deserves max effort, this is it.