MLB’s study on arm injuries blames velocity, max effort but offers few answers to keeping pitchers healthy

Major League Baseball on Tuesday released a 62-page report outlining overarching concerns with the increase in injuries, specifically major arm injuries to pitchers. 

More than 200 people from a diverse set of the baseball world were interviewed, including former MLB pitchers, orthopedic surgeons, sports medicine doctors, biomechanists, MLB pitching coaches, athletic trainers, front office executives, agents and pitcher development coaches, according to the league.

The biggest takeaways were things we’ve already suspected — and were covered at length by CBS Sports earlier this year — which is that the likely culprits are extremely high velocity and so-called “max effort” pitching. 

As part of the report, MLB showed that the average fastball velocity in the last 15 seasons rose from 91.3 mph to 94.2; the average slider increased from 82.8 mph to 84.6 and the average changeup sped up from 81.7 mph to 85.5. With higher velocity comes a lot more pressure on the arm — specifically the elbow and shoulder joints — while pitchers looking to throw harder with more drastic spin on things like sliders (and variations like sweepers) further adds even more pressure.

There’s also more emphasis on max-effort training and then max-effort pitching on the mound. That is, instead of throwing at about 85% velocity in a normal outing before dialing it up to 100% on the biggest pitches of the game, for example, many pitchers are maxing out on every single pitch. 

The combination of excessive velocity, spin and max effort on so many pitches during outings is putting so much torque on the arms that they are crumbling, according to the league’s study.

The majors saw 21 UCL surgeries — including, but not limited to, Tommy John surgery — in 2010, 15 in 2011 and 41 last season. MLB hasn’t seen fewer than 35 since 2020, when 31 players went under the knife during the abbreviated season. 

We’re only talking about major surgery there, too, which means those statistics don’t include shorter injured list stints for more minor injuries. Pitcher placements on the injured list and days spent there have risen pretty steadily since the early 2000s and spiked heavily within the last five seasons. For example, the number of days for pitchers on the injured list (it was the disabled list at the time) in 2005 was around 15,000 and last year it approached 33,000. 

As for possible solutions, it’s a difficult path forward, as everyone agrees there’s only so much MLB can do. Much of the approach starts at the youth levels and MLB can’t really police Little Leagues across the nation. The study shows as much: In 2018, just three pitchers threw 95 mph or higher at the Perfect Game National Showcase. This year, that number rose to 36. It’s not just professional athletes being taught to sell out for velocity. That strategy has seeped down to children.

One item when it comes to possible changes in Major League Baseball, however stands out and it’s the recommendation that professional baseball considers rule changes that would “increase the value of pitcher health and durability, and decrease the value of short-duration, max-effort pitching.” Translation: More focus on starting pitchers getting deeper into games and less relievers pitching 3-4 times a week where they come out of the bullpen firing 100-mph bullets. 

We already know that MLB has been weighing rules changes along these lines, so this report and its recommendations will continue to push things in that direction, even as commissioner Rob Manfred admits that inning requirements just won’t do the trick.