The Tommy John Epidemic
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Bob Nightengale
@BNightengale
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Brutal news for Cleveland Guardians ace Shane Bieber. He will need to undergo Tommy John surgery and is out for the season.
@BNightengale
2m
Brutal news for Cleveland Guardians ace Shane Bieber. He will need to undergo Tommy John surgery and is out for the season.
Eury, Bieber, possibly Strider. I know we've been dealing with a huge increase in pitching injuries for a while now, but I'm not sure if we've seen such a brutal 48 hour stretch like this one.
Baseball needs to figure this out and figure it out fast.
Baseball needs to figure this out and figure it out fast.
In 2018, 26% of MLB pitchers had undergone TJS at some point in their career.
What's that number of 2024? Feels like it's probably north of 35-40%?
What's that number of 2024? Feels like it's probably north of 35-40%?
The analytics of velocity & spin are pushing what the human body can endure. But at the same time, such great pitching "stuff" feels like it's needed to shut down the best hitters in MLB, so I'm not sure teams are going to pivot back to "pitchability" 90mph fastballs with great control anytime soon.
Yup. Same is true for teams who deal them out. If I’m a SP, I’m operating like an NFL RB and taking the most guaranteed money I can get on a multi-year deal and moving on, even if I sacrifice some upside in the process. Way too much injury risk. Bieber is about to be 29 and a FA so this is a killer for him. Would be curious to know the kind of extension offers, if any, Cleveland made him.
I think any extension offers Bieber received were a few years ago. Supposedly they offered him 3-years at around $10M per at the start of 2022, but that seems to stretch credibility since it would have only bought out one year of free agency and been less than he'd make that first year of a free agent contract (he'll still make more than that even if he takes a pillow contract for $8M next year). There's never been any hint of animosity but he made it clear early on that he was betting on himself. Between opening day and now, he's gone from looking really smart to looking like the exemplar of why pitchers should never do that.
Interesting. Would have figured that Cleveland would have offered him something last year. There are definitely “bet on yourself” successes like Lester but wonder if the calculus will start to shift a bit. Needing 6 years to get to FA AND staying healthy puts a lot of risk on the player.
Expand rosters. Allow teams to carry more pitchers. This would allow teams to reduce the workload of starters.
They already did that. Teams use the extra arms to have everyone throw at max effort and blow their arms out. It has the exact opposite desired effect.
Guys are going to throw max effort no matter what, because if they don't, they're going to get hammered and be out of a job. I agree that rosters should expand (to 30, 15 pitchers/15 hitters) but no way owners agree to that.
Loasiga getting (non-TJ, I assume a brace) UCL repair done too.
https://www.mlbtraderumors.com/2024/04/jonathan-loaisiga-to-undergo-season-ending-ucl-surgery.html
https://www.mlbtraderumors.com/2024/04/jonathan-loaisiga-to-undergo-season-ending-ucl-surgery.html
Then why have they just started doing it in earnest and ripping their elbows apart in the last few years?
Exactly. It's not pitching too much that's doing these pitchers in. It's throwing max effort. Maximum velocity, maximum spin rate, maximum shredded tendons.
If pitchers will always throw max effort, why hadn't they done so until the last couple of years? The TJS epidemic is fairly new, trying to pitch to major league hitters is not.
It’s a really really complicated answer, but for one, there didn’t used to be batting machines that you could program to throw the opposing pitcher’s repertoire and practice against between at bats, in the middle of the game. There’s just so much more info now on both sides, and there’s no going back there.
According to baseball reference Bieber has made just under 30M for his Cy Young winning career to date. Brayan Bello is now guaranteed 55M.
I don’t know how a young pitcher turns down his first 8 figure contract.
It’s not really just about max effort. “Max effort” is a shorthand for max effort enabled by driveline style training techniques that are causing velocity and spin rates to increase to levels that weren’t previously achievable by a given player. Guys who would have thrown 91 twenty years ago are throwing 96 today. Training is outgunning anatomy and physiology—your UCL doesn’t strengthen as you train to create more throwing force.
Agreed. It sucks that they have to lose out on potential earnings but having a Bieber situation happen to a talented SP sucks even more. And given how weird the SP FA markwt was this year, it’s become even harder to hold out for that big pay day. Teams have to be taking notice of all these TJ injuries.
Bieber's elbow injury goes back to last year, but rest and rehab were considered the best solution then. I don't know if game times for pitchers can be found anywhere, and I'm sure the clock shortened his times as it did for nearly everyone, but my impression has been that he's always worked relatively quickly. He certainly didn't struggle with the clock implementation last year like others did. Could the clock be a factor in the original injury? Who knows… but I find it much easier to believe the reason his elbow is worse now than it was when he came off the IL last September with very little game pitching in between, is his work with Driveline over the winter that added 2-3 mph back to his fastball.
Hardest hitting anti-velocity super cut ever just dropped:
Of course, it seems easier to teach high end velo than the best off speed stuff and command. So that's just how it's going to be.
They're VERY poorly advised. That's how. Pitchers are all ticking time bombs and should be trying to lock down as much guaranteed money as they can as early as they can. Not hoping to make it to their arb years then again hoping to last 6 and be one of the lucky few who signs a mega deal.
If they anti-juiced the baseballs and made it harder for hitters to put it out of the park or hit with massive exit velocity, pitchers could dial it back a bit. Of course, they're not going to do that. And maybe they shouldn't. I don't know what the right answer is, but this is one, pretty simple, solution.
this just popped up in my twitter feed. The Trevor Bauer comment is just rage bait, but I found Glasnow's perspective interesting.
View: https://twitter.com/notNate99/status/1776795267636809941
View: https://twitter.com/notNate99/status/1776795267636809941
Ben Lindbergh wrote a great overview of the situation for The Ringer, a few days ago. Ben has actually been a proponent of decreasing pitching staffs, in the hope that it will force pitchers to pace themselves better (I don't think this would work - like Jon Abbey said above, pitchers are going to throw max effort no matter what).
"At the end of the 2023 season, 35.7% of all non-position player pitchers had had Tommy John surgery at some point in their lives. 11 more have had it since, bumping that percentage up to 37.0%."
View: https://twitter.com/MLBPlayerAnalys/status/1776644835790782663
Jon Roegele, who keeps a Tommy John tracker and is quoted in the article above, had a tweet from the other day with updated percentages for 2024.
"At the end of the 2023 season, 35.7% of all non-position player pitchers had had Tommy John surgery at some point in their lives. 11 more have had it since, bumping that percentage up to 37.0%."
View: https://twitter.com/MLBPlayerAnalys/status/1776644835790782663
My .02 is that the writing is already on the wall for a lot of these pitchers. It’s so competitive getting there. It’s not like someone knows they’ll be a CYA candidate.
My son plays 12u. Even at 12u there are pitchers with weekly pitch counts because they’re used so damn much.
My son plays 12u. Even at 12u there are pitchers with weekly pitch counts because they’re used so damn much.
I don't quite understand why Tony Clark has that job. He seems well liked but not up to the task.
Anyway, MLB provided a response:
I guess now I'm looking forward to hearing what other nonsense Tony Clark blames for things in the future.
When stock cars got "too fast," the restrictor-plate era began. Can baseball limit velocity? Every pitch over 100mph is an automatic ball? Extra draft pool money for drafting pitchers who throw low-90s? (Probably "no, no and no").
Nothing but sustained success and longevity from not-max velocity pitchers will change anything. But as long as the youth pitching industrial complex is responding to a Need for Speed, that change is a long ways off.
Nothing but sustained success and longevity from not-max velocity pitchers will change anything. But as long as the youth pitching industrial complex is responding to a Need for Speed, that change is a long ways off.
I'm all for solutions wherever they can be had, but 2 more roster spots for pitchers (along with the continued trend towards high velo, shorter outings, and specialization) would likely mean the end of the already-declining concept of a starting pitcher.
Pitchers throwing more than 4 innings would likely become a relative rarity, and full-"bullpen" games would probably become more of a norm. There would be pitchers that could go 3-4 innings, and then everyone else falling into the ~1 inning camp. Not that pitcher wins really matter at all, but they'd probably even have to change the rule that a starter can't get a win if they go less than 5 innings, since assigning the win in games where the starter went 4 good innings would be even more of a farce.
It wouldn't be a completely different sport, but I think it would probably be less appealing to most fans, who enjoy the continuity and narrative that come with talented starting pitchers being around for the peaks and valleys of most of a game.
To me, it comes down to: do hard-throwing relievers actually get hurt less (both per season AND per inning pitched) than hard-throwing starters? If they get hurt just as much or more, then making baseball even more reliever-oriented by increasing roster spots doesn't really help anybody except for the 14th and 15th guys that now have a big league roster spot.
You think it’s velocity not spin that is causing the issues? That Tyler Glasnow video was quite telling to me. I played LL during the 70’s and even then coaches were warned against allowing LL’ers to throw curveballs because it would negatively affect their arms. I realize posters much smarter than me are going to say, why can’t it be both, and it likely is but the lack of grip and desire for increased spin rates leading to increased arm injuries makes sense to me.
I'm not remotely a doctor, so this is probably an uninformed opinion, but when has that ever stopped anyone? 
I think this is a result of a variety of factors:
1. Kids trying to throw harder and harder at younger ages. And velocity being valued instead of being a "pitcher". My oldest son never threw more than like 75 in high school, and because of that, he was relegated to a depth bullpen pitching role. But every time he came in, all he did was get guys out. He had a good two-seamer with real movement, changed speeds, and located very well. On senior day he was allowed to start and promptly threw a no-hitter. Now that was a one-off thing that you'd never expect again, but he could PITCH. But the coach valued hard throwers, which only encouraged kids to try to throw harder and harder and harder. I doubt this coach was unique in any way. So they're stressing their arms at younger ages.
2. Many kids are now one sport athletes, playing baseball only all year-round. I work with athletes and coaches at UConn and you listen to the coaches, they want multi-sport athletes. The football coaches tell me that. Basketball coaches say that. T&F coaches say that. But kids and their parents think that to get ahead in a sport you need to focus only on that sport. And so these kids pitch and pitch and pitch all year round. Back in "the day", athletes pitched in season and then gave their arms a break for a large portion of the year, focusing on other sports and activities. I have to believe constant pitching over the years just wears the arm (and all its necessary associated parts) down.
3. Glasnow talked about how he had to grip the ball differently because he couldn't use the sticky stuff, and that put way more stress on his body. I assume he's not lying. So maybe there's something to that.
4. Pitchers are seeking spin rate and velocity now more than ever. Starters max effort 100 pitches in 5 innings, and yay, they're effective, but that's brutal. Packing that number of pitches in half a game is harder on the body than the same number of pitches stretched out over longer time frames. That's true for any physical workout. Tossing 100 bails of hay in 30 minutes is way harder on the body than the same number of bails in 60 minutes. This stuff adds up start after start.
Obviously #1 and #2 aren't MLB's problem to solve. This is a cultural thing that needs to be addressed at much lower levels. I do wonder if just the simple act of de-juicing the baseballs can take care of the other two because pitchers won't have to throw as hard to get guys out.
I think this is a result of a variety of factors:
1. Kids trying to throw harder and harder at younger ages. And velocity being valued instead of being a "pitcher". My oldest son never threw more than like 75 in high school, and because of that, he was relegated to a depth bullpen pitching role. But every time he came in, all he did was get guys out. He had a good two-seamer with real movement, changed speeds, and located very well. On senior day he was allowed to start and promptly threw a no-hitter. Now that was a one-off thing that you'd never expect again, but he could PITCH. But the coach valued hard throwers, which only encouraged kids to try to throw harder and harder and harder. I doubt this coach was unique in any way. So they're stressing their arms at younger ages.
2. Many kids are now one sport athletes, playing baseball only all year-round. I work with athletes and coaches at UConn and you listen to the coaches, they want multi-sport athletes. The football coaches tell me that. Basketball coaches say that. T&F coaches say that. But kids and their parents think that to get ahead in a sport you need to focus only on that sport. And so these kids pitch and pitch and pitch all year round. Back in "the day", athletes pitched in season and then gave their arms a break for a large portion of the year, focusing on other sports and activities. I have to believe constant pitching over the years just wears the arm (and all its necessary associated parts) down.
3. Glasnow talked about how he had to grip the ball differently because he couldn't use the sticky stuff, and that put way more stress on his body. I assume he's not lying. So maybe there's something to that.
4. Pitchers are seeking spin rate and velocity now more than ever. Starters max effort 100 pitches in 5 innings, and yay, they're effective, but that's brutal. Packing that number of pitches in half a game is harder on the body than the same number of pitches stretched out over longer time frames. That's true for any physical workout. Tossing 100 bails of hay in 30 minutes is way harder on the body than the same number of bails in 60 minutes. This stuff adds up start after start.
Obviously #1 and #2 aren't MLB's problem to solve. This is a cultural thing that needs to be addressed at much lower levels. I do wonder if just the simple act of de-juicing the baseballs can take care of the other two because pitchers won't have to throw as hard to get guys out.
Yeah, I'm personally completely fine with all of that. The 5 inning win rule already should be gone as it's quite anachronistic, Luke Weaver is currently 3-0 with a 6.35 ERA and has pitched a total of 5.2 innings. They also should dump the 162 innings needed to qualify for pitching leaders, as fewer and fewer pitchers make it there.
Also I am sure I'm in the minority but basically I don't care at all how a team puts together nine innings of pitching. I enjoy watching most relievers just as much as most starters. Of course, I also don't get why people prefer routine flyouts or groundouts (the majority of ours) to strikeouts, I love strikeouts.
Agreed. Hockey goalies used to play 80 games. Pitching staffs had nine guys and starters got ten plus complete games each. The game changes, and if seven inning starters are a thing of the past, so be it.
The difference from stock car racing is that the restrictor plates apply to all competitors equally. But there are two sides to the competition in baseball - hitters will probably destroy slower stuff now. Any change has to account for that.
Maybe if you give pitchers some advantages (larger strike zone, softer baseballs, sticky stuff), but also require pitchers to throw a significant minimum number of pitches per appearance barring injury?
Glasnow’s point is interesting. The increases do seem to track with the sticky stuff ban. It also makes some intuitive sense.
I wonder if there is a middle ground way to regulate tackiness without going back to the days of excessive goop. I bet there already are some guys cheating and avoiding detection. Guys always look for an edge but maybe there is a middle ground to even the playing field.
I wonder if there is a middle ground way to regulate tackiness without going back to the days of excessive goop. I bet there already are some guys cheating and avoiding detection. Guys always look for an edge but maybe there is a middle ground to even the playing field.
Well, I personally enjoy the traditional starter concept more than bullpen-game-by-design, but I guess opinions can vary on that. I also do enjoy a balance of contact outs vs strikeouts (strikeouts can be just as "routine" as many flyouts or groundouts). Strikeouts are cool, but so are great fielding plays and interesting baserunning situations. Going further towards pure three-true-outcomes essentially reduces the game entirely to the batter-pitcher dynamic, which I personally think loses something. I'm not super traditionalist, I like the role of statistics in team / player strategy, but I think things can get imbalanced and turn the game into a more boring but optimized equation. Thus the need for the rule tweaks we're discussing, to rebalance things.
Again though on the roster change - would trending towards full reliever-ization of baseball actually reduce elbow surgeries, or just ensure that teams have a neverending supply of guys that throw 99 and they can just throw fresh bodies at it? To me it seems more like the second, so are we really solving the problem? Perhaps we disagree on what the problem is?
Glasnow is probably right. Pitchers got used to being able to spin the ball at completely unnatural rates and want to keep doing it even if they don't have the spider tack available to them anymore. That timeline also lines up with the drop in balls in play.
The solution is multi-part at the major league level. You make the ball a little stickier and softer so it doesn't go as far. And you limit the roster spots available for pitchers. Everyone has to throw more innings, but they feel like they can go at lower effort and spin without giving up homers.