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Monday, May 19, 2014

Pitching injuries have become a big problem - Sports - The Boston Globe

Yes, let’s enlarge the strike zone. Who doesn’t want the R/G to drop even lower?

“You have to stop shrinking the strike zone,” he said. “It has to be expanded. It’s incredible what you’re asking of pitchers nowadays. You expect them to throw the baseball into this tiny box. Do you know how much stress that puts on a pitcher’s arm? Just remembering when I pitched, the strike zone is so tiny compared to back then. It’s impossible to think that you make a pitcher hit that tiny box and not have it affect the health of a pitcher over time.”

Because of the small strike zone, Nieves feels pitchers have to employ a “crisscrossing” approach for acquiring strikes, which he said means more backdoor sliders and curveballs, more cutters that use a different path into the zone.

Jim Furtado Posted: May 19, 2014 at 10:09 AM | 31 comment(s) Login to Bookmark
  Tags: injuries, red sox

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   1. Yeaarrgghhhh Posted: May 19, 2014 at 11:42 AM (#4709472)
I don't know...expanding the strike zone combined with flattening the seams could be a good thing. Hitters would have to adjust by taking far fewer pitches, but with fewer insane sliders we'd see more solid contact. The game would speed up and BAs would rise. Maybe.
   2. Ray (RDP) Posted: May 19, 2014 at 12:08 PM (#4709493)
Two base questions:

1. Are pitchers actually getting hurt more frequently today?

2. Did something change in the diagnosis of elbow injuries or in the haste in which TJ surgery is recommended? (Since the surgery is so successful it seems that teams/pitchers would hesitate less to get it or would get it even with a more mild "tear" or what not that pitchers of past eras would simply pitch through.)

--------------

I agree that it SEEMS pitchers are getting hurt more frequently now, so I'm not trying to make the point that they aren't, just asking for data.

If pitchers are in fact getting hurt more frequently now, I'd look for a cause to the changes in the game where pitchers are now simply asked to go as hard as they can for as long (short) as they can, and when they break, they get the surgery and teams pluck another pitcher off the assembly line in the meantime. This is particularly true for relievers; starters are still of course more valuable, but the same thing seems to be happening there as well. The increase in pitcher velocity (especially for relievers) points in this direction. But it's just a guess. As I said, I don't even know if the premise - that pitchers are getting hurt more frequently now - is accurate.

It's very interesting though that the stathead wails of pitcher abuse -- which I was on board with 15 years ago -- which started in earnest with Kerry Wood and culminated in Dusty Baker's slagging of Mark Prior down the stretch in 2003 -- were actually listened to by teams and were responded to (partly because statheads started infiltrating front offices) and yet it didn't do a damned thing to slow pitcher injuries. I wouldn't have expected that.

We really know almost nothing about how to protect pitchers' arms, or how/when/why they get hurt, other than "any next pitch you throw might hurt you."
   3. Jim (jimmuscomp) Posted: May 19, 2014 at 12:40 PM (#4709524)
If pitchers are in fact getting hurt more frequently now, I'd look for a cause to the changes in the game where pitchers are now simply asked to go as hard as they can for as long (short) as they can, and when they break, they get the surgery and teams pluck another pitcher off the assembly line in the meantime. This is particularly true for relievers


I agree with Ray - data would be great - but this sure seems like a logical culprit to the rise in injuries if in fact there is a rise in injuries.

   4. Jose Can Still Seabiscuit Posted: May 19, 2014 at 12:51 PM (#4709531)
1. Are pitchers actually getting hurt more frequently today?

2. Did something change in the diagnosis of elbow injuries or in the haste in which TJ surgery is recommended? (Since the surgery is so successful it seems that teams/pitchers would hesitate less to get it or would get it even with a more mild "tear" or what not that pitchers of past eras would simply pitch through.)


Ray is asking the 100% right questions here. I think this is similar to the concussion issue that we are probably more successful at diagnosing it than actually having an increase in incidents.
   5. bjhanke Posted: May 19, 2014 at 12:54 PM (#4709532)
Unfortunately, expanding the strike zone has always led to more strikeouts, lower batting averages, more homers compared to other types of hit, and fewer runs scored. In other words, back to the 1950s. Of course, you could always go back to 1887, and make it 4 strikes for a strikeout, or just get rid of the foul strike rule. - Brock Hanke
   6. Topher Posted: May 19, 2014 at 01:01 PM (#4709541)
Not arguing that we don't need better data. But as best as I can ascertain from what we do have ...

Elbow injuries are "up". Whether that means they are more easily diagnosed or teams are more willing to commit to TJ because of the success rate, who knows. But pitchers appear to be tearing ligaments more. This would seem to be a reasonable outcome of ever more pitchers hitting 95+ on the gun.

Shoulder injuries are "down". Maybe this is being masked by a rise in elbow injuries. But this could be a reasonable outcome of pitchers no longer throwing 130+ pitches in an outing on a semi-regular basis.

I think it is fair to suggest that modern usage with pitch counts has done a lot to prevent the wear-and-tear injuries that would break down a shoulder over time. It's also fair to suggest that this approach does little to prevent injuries to ligaments when every pitch in a game is thrown with maximum effort. Better data could suggest that all of my assumptions are wrong.

Getting back to the article, I'm not sure why expanding the strike zone would change matters. I really don't think it would cause the pitchers to throw with any less effort than they currently are.
   7. Greg Pope thinks the Cubs are reeking havoc Posted: May 19, 2014 at 01:23 PM (#4709556)
I'm wondering if the pitch count/effort are related in a self-feeding cycle. Pitchers aren't expected to throw 130 pitches any more. So are they pacing themselves less? Are they throwing with more effort on each batter because they know they don't have to save anything for innings 7-8-9?

We know relievers add a bit their fastball when they move to relief. I believe that the CW on that is that they let it all fly because they know they're only used for an inning. Could the increase in the average fastball be mostly explained by pitchers just trying harder in the early innings?
   8. Ray (RDP) Posted: May 19, 2014 at 01:29 PM (#4709558)
It's not clear to me that elbow injuries are up for the swath of pitchers in MLB, or in professional baseball including the minors, or in MLB plus the higher levels of the minors.

So far all we "know" is that there has been a spate of injuries to good/young MLB pitchers or pitching prospects. That has been the entire focus of all these articles. Nobody, to my knowledge, has presented a single bit of data to support the premise. "Omigod now Jose Fernandez is injured!!!!" is not proof of anything. It is a data point.
   9. Steve Balboni's Personal Trainer Posted: May 19, 2014 at 01:48 PM (#4709571)
What is most interesting to me about this is that:

1) we live in an era of amazing abilities to collect and analyze data,
2) in a sport that probably has the greatest amount of data to collect,
3) talking about a specific position (pitchers) that has by far the most data within baseball,
4) and is the position that most teams most desperately want to acquire and retain,
5) which would lead the team(s) that figure out how to keep young pitchers healthy to enjoy a massive advantage over other teams.

Despite everything above, it is not clear to me that teams are really closing in on significant new insights on how to do this. It strikes me that the team that was most successful at keeping pitchers healthy over the past, say, 40 years was the Atlanta Braves of the 1990s. Even that, though, is probably more a case of having three HOF starting pitchers in their primes, rather than any specific program. Or did Cox and Mazzone have a program?
   10. What did Billy Ripken have against ElRoy Face? Posted: May 19, 2014 at 01:55 PM (#4709579)
Or did Cox and Mazzone have a program?


How is it not obvious to more teams that rocking back and forth in the dugout prevents your pitchers from getting injured?
   11. Pat Rapper's Delight Posted: May 19, 2014 at 01:58 PM (#4709582)
"Omigod now Jose Fernandez is injured!!!!" is not proof of anything. It is a data point.

I don't think it's so much "Omigod now Jose Fernandez is injured!!!!" as much as it is:

"Omigod now Cory Luebke is injured again!!!!"
"Omigod now Kris Medlen is injured!!!!"
"Omigod now Luke Hochevar is injured!!!!"
"Omigod now Brandon Beachy is injured!!!!"
"Omigod now Jarrod Parker is injured!!!!"
"Omigod now Patrick Corbin is injured!!!!"
"Omigod now Bobby Parnell is injured!!!!"
"Omigod now Matt Moore is injured!!!!"
"Omigod now Josh Johnson is injured!!!!"
"Omigod now Ivan Nova is injured!!!!"
"Omigod now A.J. Griffin is injured!!!!"
"Omigod now Jose Fernandez is injured!!!!"
"Omigod now Martin Perez is injured!!!!"

not to mention "Omigod now Matt Harvey is injured!!!!" since his TJ was last year.
   12. theboyqueen Posted: May 19, 2014 at 02:02 PM (#4709585)
The evidence that exists suggests this is multifactorial.

The evidence suggests that maximum pitch velocity is greatest risk factor for UCL injury, and it seems that the average pitch velocity is quite higher than it used to be which would explain an increased incidence of injuries. The more overhand the throwing motion, the less stress on the elbow (but more on the shoulder). Studies of pre-professional athletes have measured torque forces and have found that fastballs put more torque on the ligament than curveballs which put more torque than changeups. There are probably rotational type forces involved in throwing curveballs and sliders which have not been measured.

It is very difficult to diagnose the extent of an UCL injury based on physical examination alone, so the advent of MRI has certainly led to increased diagnosis probably by an order of magnitude.

Rest/rehab is a valid treatment option but takes a very long time and only seems to cure about 40 percent of pitchers, compared with modern surgery's 90 percent success rate. I can understand why teams would not wish to gamble with conservative management given the high failure rate and the lost time.

In the old days probably rest and rehabilitation took care of some proportion of these injuries, and the rest never recovered. I suspect the injuries themselves were more rare due to slower pitching. It is likely to me that a few 100mph pitches are more damaging than a whole bunch of 85 mph pitches, though there is no evidence to support this that I can find.

I agree with Ray that we need better epidemiological data to determine whether in fact this is an increasingly common problem.

I blame Nolan Ryan, who is obviously an outlier but whose style of pitching seems to have become the goal. I also think that based on the evidence that does exist the idea that all pitchers are equally likely to break down is quite unlikely. I doubt there is a good way to throw a baseball 100 miles an hour without being very likely to damage something.
   13. theboyqueen Posted: May 19, 2014 at 02:04 PM (#4709586)
Using the Cox example -- Maddux and Glavine did not throw very hard. Smoltz did and eventually had Tommy John surgery.
   14. dr. scott Posted: May 19, 2014 at 02:11 PM (#4709600)
Cannot find any recent data, but there are a few studies worth looking at...

rates of injuries of all players from 2002-2009
http://www.sciencedaily.com/releases/2010/07/100718204725.htm

comparison of pitcher injury rates from 1999 and 2011 ("suggests" slightly higher injury rate in 2011)
http://www.sbnation.com/2012/5/4/2999339/pitching-injuries-data-disabled-list-study

summary of youth baseball pitcher injuries
http://www.momsteam.com/sports/pitching-injury-statistics-risk-factors

article in 2013 about ASU's "solution" to the problem..
http://mlb.mlb.com/news/article.jsp?ymd=20130913&content_id=60455388&vkey=news_mlb&c_id=mlb

long article by keri in 2010 with a bunch of information... not a lot of individual stats though
http://jonahkeri.com/2010/09/13/pitching-injuries-and-rangers/

verduccis 2012 article on closers and injuries
http://sportsillustrated.cnn.com/2012/writers/tom_verducci/04/17/closers/

The first two have the best stats, but lots to learn from the other articles including.... looks like someone should be able to get more data here given what is available.







   15. ellsbury my heart at wounded knee Posted: May 19, 2014 at 02:56 PM (#4709639)
The first two have the best stats, but lots to learn from the other articles including.... looks like someone should be able to get more data here given what is available.


Yeah, this would seem to be a pretty good term project for someone who's taking that SABR class in a few weeks. My WAGs for why it hasn't really been done in a big, systematic way yet:

1. Lack of good historical data. I know nothing about data sources for injuries, but I would guess they don't go back very far, and who knows how complete or detailed they are.

2. Data quality. This would be my biggest concern, although like I said, I have no idea what data is out there. Who actually complied this data, and did they take even minimal steps to check its accuracy or follow up? There's lots of misdiagnosis and fumbling around when it comes to diagnosing pitcher injuries. An injury first reported as a stiff back that could ultimately turn out to be an oblique injury or shoulder injury or lat injury. If a guy hurts his elbow rehabbing a knee injury, has that been coded properly?

3. Who cares? From one perspective, it may not matter if injuries are up historically or not. One could argue that current injury (or just TJ surgery) rates are too high even if they're lower than historical rates. We lack data on important confounding factors. Did the guy get his arm shredded playing youth or college baseball? Does he have some sort of freaky awesome super-strong tendons that wouldn't shred no matter how many innings he pitched? Is he poorly conditioned? Does he have such terrible mechanics that he's basically a ticking time bomb? These are all important confounding factors for which we have such bad data that it's hard to see how any study of causes of arm injury could be valid. And if the study can't generate conclusions you could have much confidence in, than it may not be a good use of time until better data sources are available.
   16. I am Ted F'ing Williams Posted: May 19, 2014 at 05:12 PM (#4709740)
Studies of pre-professional athletes have measured torque forces and have found that fastballs put more torque on the ligament than curveballs which put more torque than changeups. There are probably rotational type forces involved in throwing curveballs and sliders which have not been measured...
I blame Nolan Ryan, who is obviously an outlier but whose style of pitching seems to have become the goal.


The exact points I wanted to touch on but first a quibble: A lot of changeups are thrown with the same arm speed as a fastball but with more of the hand on the ball thus slowing the speed of the pitch enough to be called a changeup. The effect on the arm may be no different than a fastball.

Now, as far as fastballs are concerned there absolutely has been a change in which amateur pitchers get scouted. If you aren't throwing 92+ you aren't getting signed - and this is true of high school pitchers! Even with the expectation that an 18-year old will physically mature and add 4 or 5 MPH to his fastball still means that they aren't even going to look at a kid who isn't consistently throwing 88+ and even that is high. So MLB is actively (if not actually purposely) pursuing the most injury-prone pitchers.

I would think the strike rate (NOT the strikeout rate) would be a more appropriate indicator of talent or at least injury likelihood. Again, it's not a question of stats but rather focusing on the wrong stats. A pitcher throwing 66% strikes with a fastball at 92 is a LESS effective pitcher than one throwing 72% strikes with a fastball of 87. Maybe the former DOES project as a better MLB pitcher, but the former also projects as a more injury-prone pitcher because of the strike rate.

As a substitute for strike rate, I look at Pitches per Plate Appearance. Mark Prior used to be the worst at this stat year in and year out, around 4.17. The last few years the worst pitchers in the league are over 4.3. Either MLB organizations are hammering into pitchers' heads that they have to work the edges even more that usual, or the umpires are calling tighter zones, or MLB organizations are hammering into their batters' heads that they have to take pitches. Maybe it makes sense to take 3 called strikes instead of grounding out on a 1-0 pitch, you tire the pitcher earlier and then you can get easier pitches to hit when he's running out of gas. I always liked CC Sabathia's approach, he could hit high 90's but he almost never tried to throw that hard in the first few innings. (I saw him pitch more with Cleveland than the Yankees so maybe his approach has changed over time.)

As much as people use Ryan as the model, I think the pitcher that changed the thinking was Roger Clemens. Prior to Clemens, the really hard throwers were pitching off a higher mound and more importantly with a LOT more leg. Ryan, Gibson, Seaver, Carlton all pitched from a full windup and got their knees dirty. Even from the stretch they took long strides. They all stated in the 60's; by the 70's with the abundance of astro-turf fields the stolen base became a very important part of the game and shorter pitching strides became a lot more common. Roger Clemens was the one guy that first comes to mind who could throw around 100 with a shorter stride and I think his K/9IP is higher than all the aforementioned guys, look at the top 100 K/9IP and almost all the players are post-Clemens. The Vince Colemans could beat out three-hoppers to short, but they can't beat out strikeouts. For whatever reason, MLB seems to be happy with high-K/high-HR games so that is the kind of pitcher that gets signed out of amateur ball.
   17. I am Ted F'ing Williams Posted: May 19, 2014 at 05:15 PM (#4709743)
BTW, I can only (quickly) find Pitches per Plate Appearance from 2002 and later.
   18. bjhanke Posted: May 19, 2014 at 05:29 PM (#4709752)
Clemens struck me as the first superthrower who had to adjust his mechanics to throwing down in the strike zone. The Robin Roberts class of pitchers, including Gibson and Koufax, threw high strikes. I have no idea what effect that might have had. - Brock Hanke
   19. Crispix reaches boiling point with lackluster play Posted: May 19, 2014 at 06:35 PM (#4709777)
When Strasburg tore his UCL, we were surprised. When Matt Harvey tore his UCL, we thought "I guess this is was inevitable". And when Jose Fernandez first appeared, we all wondered "When will he tear his UCL? This year or the next?"
   20. Shibal Posted: May 19, 2014 at 07:31 PM (#4709801)
I'm hoping Yordani Ventura lasts the season before his Tommy John surgery.
   21. Ray (RDP) Posted: May 19, 2014 at 11:17 PM (#4709911)
Clemens is unique because he came back 100% from a shoulder injury early on -- 1984 or 1985 -- though I have no idea how serious it was. It's always been presented as a rotator cuff injury, I think. Did he come back from it because it wasn't that serious?

This isn't relevant but scanning his wiki page reveals this quote I didn't know about:

In 1986, his 24 wins helped guide the Sox to a World Series berth and earned Clemens the American League MVP award for the regular season. He also won the first of his seven Cy Young Awards. When Hank Aaron said that pitchers should not be eligible for the MVP, Clemens responded: "I wish he were still playing. I'd probably crack his head open to show him how valuable I was."[8]
   22. theboyqueen Posted: May 19, 2014 at 11:36 PM (#4709917)
A lot of changeups are thrown with the same arm speed as a fastball but with more of the hand on the ball thus slowing the speed of the pitch enough to be called a changeup. The effect on the arm may be no different than a fastball.


Are you quibbling with me or the study? I know how changeups are thrown; these are their data. But I am guessing that pre-professional athletes may not maintain the same armspeed with the changeup as with their fastball. I have no idea whether professional pitchers really maintain exactly the same armspeed but I suspect the ones with better changeups are close.
   23. theboyqueen Posted: May 19, 2014 at 11:43 PM (#4709922)
Clemens struck me as the first superthrower who had to adjust his mechanics to throwing down in the strike zone. The Robin Roberts class of pitchers, including Gibson and Koufax, threw high strikes. I have no idea what effect that might have had. - Brock Hanke


There may be something to this; the overthrown high heater used to be used as a strikeout pitch but now guys are trying to pound the lower part of the zone with 95 mph sinkers (which is not a pitch I even think existed before Kevin Brown, did it?)

It does seem much more natural to try and throw a "rising" fastball than a sinking one.
   24. PASTE Thinks This Trout Kid Might Be OK (Zeth) Posted: May 19, 2014 at 11:46 PM (#4709926)
I'm hoping Yordani Ventura lasts the season before his Tommy John surgery.


Gerrit Cole is due any day now, too.
   25. bobm Posted: May 20, 2014 at 12:12 AM (#4709935)
[16],[17] From BR PI: For single seasons, From 1901 to 2014, (requiring pitches>4*BFP and Qualified for league ERA title), Stats only available back to 2000, sorted by season

                
Year   #Matching
2014          15

2013           8
2012           5
2011           7
2010           7
2009           7
2008           6
2007           7
2006           4
2005           5
2004           1
2003           1
2002           0
2001           3
2000           4


Provided by Baseball-Reference.com: View Play Index Tool Used
Generated 5/20/2014.

   26. Colin Posted: May 20, 2014 at 08:51 AM (#4710001)
It strikes me that the team that was most successful at keeping pitchers healthy over the past, say, 40 years was the Atlanta Braves of the 1990s. Even that, though, is probably more a case of having three HOF starting pitchers in their primes, rather than any specific program. Or did Cox and Mazzone have a program?


Mazzone had a throwing-between-starts program that was widely lauded during the Braves' peak, but it's not clear whether we can draw many conclusions from it. As noted above, Glavine and Maddux weren't hard throwers to begin with, and Smoltz struggled to stay healthy - surgery in 1994, missed all of 2000. And, given that much of the focus now is on young pitchers, Mazzone's track record there is mixed. Steve Avery flamed out young, though his K rates were pretty weak to begin with, so it's hard to tell how much of that was physical or related to changes in the offensive environment. Kevin Millwood developed pretty well under Mazzone, but he's the only young starter I can think of who did. Still, opportunities to crack that rotation were sparse.

I think it is telling, though, that no team seems to want Mazzone as its pitching coach, and even the Braves seemed less than upset to let him go when he headed to Baltimore.
   27. Golfing Great Mitch Cumstein Posted: May 20, 2014 at 09:19 PM (#4710473)
Has anything come of the delivery that MIke Marshall developed a few years back? Google doesn't seem to have much recent stuff about guys who throw his way.
   28. Golfing Great Mitch Cumstein Posted: May 20, 2014 at 09:24 PM (#4710477)
Also, why did the drop and drive pitching style from the windup end? Lower mounds?
   29. Ray (RDP) Posted: May 20, 2014 at 10:03 PM (#4710507)
I think Mazzone's tenure in Baltimore put a real dent into the mystique and aura surrounding him.

Frankly I'm inclined to give more of the credit to Cox.
   30. I am Ted F'ing Williams Posted: May 21, 2014 at 12:56 PM (#4710773)
Are you quibbling with me or the study?


The study
   31. I am Ted F'ing Williams Posted: May 21, 2014 at 01:11 PM (#4710782)
Also, why did the drop and drive pitching style from the windup end? Lower mounds?


Rickey Henderson. (And a few others).

Did any catchers have a chance of throwing out Rickey without the pitcher shortening their stride? And is it hard to pitch effectively with a short stride from the stretch yet still pitch effectively with a long stride from the wind-up? Or is a pitcher better off using the same stride for both the wind-up and the stretch?

I don't know, but nobody seems to want to postulate that stolen bases are the cause of the increased pitching injuries. But I've found it odd over the last 10-15 years that as stolen bases have gone down, pitchers are using short strides just as much if not more. I am amazed at how hard Hector Santiago can throw with such a short stride, and he throws a screwball too! Either he's an injury waiting to happen or he's a freak of nature but something just looks different about his pitching.

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