Baseball's epidemic of pitcher injuries: Can anything be done about it?

The MLB playoffs are underway. Nearly all of baseball’s brightest everyday players are participating — Aaron Judge and Juan Soto (New York Yankees); Shohei Otani, Freddie Freeman, and Mookie Betts (LA Dodgers); Bryce Harper (Philadelphia); Bobby Witt Jr. (Kansas City); Manny Machado (San Diego); Jose Ramirez (Cleveland); and Francisco Lindor (New York Mets). Several other big stars participated, but their teams have already been eliminated — Gunnar Henderson (Baltimore); Jose Altuve and Yordan Alvarez (Houston); Marcell Ozuna (Atlanta).

A number of pitching aces are also involved, as the low scores of many of the wild-card games attest. However, some of the best pitchers are notable for their absence due to injury.

The Dodgers are missing two ace starters — Tyler Glasnow and Ohtani, who is healthy enough to bat, but not to pitch. Future Hall of Famer Clayton Kershaw is also out, along with Walker Buehler who seemed destined for stardom until multiple arm ailments derailed him.

The Orioles, already eliminated, were missing two of their best starters, Grayson Rodriguez and Kyle Bradish. Also absent was their relief ace, Felix Bautista, who missed the entire season due to injury.

The Cleveland Guardians are without former Cy Young award winner Shane Bieber. The Houston Astros, already eliminated, were missing multiple Cy Young winner Justin Verlander, along with starters Luis Garcia, Cristian Javier, and Lance McCullers.

Speaking of the Cy Young award, of the ten active pitchers who have won it, only one — Corbin Burnes of Baltimore — made it through the entire 2014 season without a stint on the injured list.

Chelsea Janes of the Washington Post tried to quantify the number of innings each MLB team lost due to pitcher arm injuries this season. To estimate the number of innings pitchers would have worked absent injury, she used projections from FanGraphs, an invaluable source of baseball data.

Janes’ analysis found that eight teams lost 400 or more innings pitched due to arm injuries. Two — Miami and Cleveland — lost more than 600. The median number of innings lost was around 300. The total number of innings pitched per regular season by a big league team is around 1,435.

In my opinion (and I’m hardly alone) the cause of this epidemic of arm injuries to pitchers is what might be called the arms race. Fueled by tracking technology, pitchers and their coaches have become obsessed with high velocity and, even more importantly, spin rate. High spin rates are sought because (1) spin produces sharp break on a baseball and (2) it enables fast balls to resist gravity and thus to “ride,” causing hitters to swing under the baseball.

Pitchers also throw a bigger variety of pitches than they did a decade ago. They need to, because all of the added velocity and spin forces hitters increasingly to guess what pitch is coming. The more selections in a pitcher’s arsenal, the harder it is for hitters to guess correctly.

Not that long ago, the typical starter threw, at most, four different pitches (typically the fastball, the slider, the changeup, and the curve). Relievers threw two or three. Some, like Sean Doolittle and Mariano Rivera, relied almost exclusively on one pitch.

Now the typical starter throws at least five different pitches. The typical reliever throws at least three.

Most starting pitchers now throw a cut fastball (the cutter). Many now throw a new pitch with a huge amount of horizontal break (the sweeper) — kind of like a slider on steroids. Many feature two types of fastball — the two-seamer and the four-seamer.

It’s clear that increased velocity creates increased stress on the arm. During mid-season, I read that of the ten starting pitchers with the highest average velocity on their four-seam fastball, nine were currently on the injured list.

If anything, high spin rates entail even more stress. And it’s plausible to think that throwing more different kinds of pitches, using different grips and spins, also increases stress.

Baseball is rightly concerned about the epidemic of arm injuries, but is at a loss as to what to do about it. In fact, I believe the powers-that-be are making things worse, by limiting teams to carrying 13 pitchers (14 in September).

The larger the pitching staff, the greater the number of pitchers among whom to distribute innings. Starters can work slightly shorter stints. Relievers can work slightly less often.

But baseball doesn’t want starters to pitch fewer innings because pitching fewer innings undermines the status and the romance of starters, which baseball wants to preserve.

Shorter outings reduce the number of games starting pitchers win. Twenty wins a season used to be the benchmark of a star pitcher, and both leagues almost always had several 20-game winners.

This year, no pitcher in either league won 20 games. Only one did in each of the two previous seasons. (Hampered by arm injuries, neither pitcher — Spencer Strider and Kyle Wright — won a single game in 2024.)

Win totals aside, pitchers who don’t work deep into games are unlikely to become legends. No one expects modern pitchers to match the output of a century ago, when Howard Ehmke, Dazzy Vance, and Burleigh Grimes all pitched more than 300 innings and Walter Johnson, age 36, pitched 276.

But now, starting pitchers are barely exceeding the innings totals of their counterparts from 30 years ago, when the season ended on August 11 due to a strike.

It’s understandable, then, that baseball doesn’t want to reduce starters’ workloads even more. You can’t easily be a larger-than-life hero pitching, say, 160 innings and frequently being relieved after getting only 15 outs.

But other sports have seen the status of featured positions downgraded without harm to the sport. When I was young, the NFL running back was almost as heroic as the quarterback. These days, with teams running the ball less and in some cases limiting the usage of their best back to avoid injury, the position has lost some of its luster.

Top quarterbacks are paid $45 million a year or more. Top wide receivers make up to $30 million. Top running backs have struggled to get $12 million on shorter term deals, though the situation seems to be improving slightly.

In basketball, center used to be the prime position. Teams that won NBA titles almost always were built around their center — Bill Russell, Wilt Chamberlain, Kareem Abdul-Jabbar, Willis Reed, Wes Unseld — or at least had a star at that position — like Robert Parish or Jabbar in his later years.

Now, you can win an NBA title with Kristaps Porzingis/Al Horford, or Kevon Looney, or Brook Lopez at center. And the one true superstar center in the game, Nikola Jokic, plays the position in a way Chamberlain and Russell would barely recognize.

I should add that reducing starting pitcher workloads would not render starters unimportant. Getting half of the outs in a team’s victory is still a pretty big deal.

On the other hand, it’s not clear that managers would lighten the loads of their best starters even if the number of available pitchers were increased. The temptation will always be to push the pitch count of a top starters to around 90. Adding fringe major leaguers to the roster is unlikely to change that.

At a minimum, though, relief pitchers wouldn’t have to work as often. It seems strange to say that a 13 man staff with 8 relievers is short-handed. Sixty years ago, staffs usually consisted of 9 pitchers, with five relievers. And that was with no designated hitter, which meant that pitchers were often removed for pinch-hitters.

But when the starter only goes five innings and the manager rarely asks for more than one inning from a reliever, it takes three or four relievers to get through a game. A staff of eight relievers becomes overworked very quickly in these circumstances. In addition, second-line starting pitchers might see their loads lessened a bit with a bigger staff.

Remember, MLB won’t permit more than 13 pitchers on a staff at least in part because it wants to discourage short outings by starting pitchers. It’s likely, therefore, that with larger staffs, outings will, in fact, be shorter.

What are the alternatives to larger staffs as a way of reducing injuries to pitchers? I sometimes hear talk about trying to limit velocity and spin rates. That’s not going to happen, nor should it. Artificially lowering performance levels is antithetical to sports.

Nor can pitchers be expected to restrain themselves. The stakes are too great.

High velocity and spin rate translate into being drafted early and that, in turn, translates into big bonuses. Once in a big league organization, increased velocity and spin rate translate into rapid advancement to the big leagues. Once in the big leagues, the success that comes with high velocity and spin rate often translates into the kind of success that generates a fat multi-year deal, even though teams understand that, with arm injuries likely, pitchers probably will not be effective during the entire length of the deal.

One idea I’ve flirted with is a limit on the number of the pitches a hitter can foul off without being called out on strikes. Already, batters are called out if they bunt foul with two strikes.

This rule was very imposed very early in the last century to prevent batters from prolonging at-bats by bunting foul. These days, some batters can foul off pitches with a swing almost as easily as they can with a bunt.

Keep in mind that it’s the number of pitches thrown, not the number of innings, that causes stress on a pitcher’s arm. These days, with all the long counts and foul balls, I suspect the average pitcher throws as many pitches in five innings as the old-time pitcher did in seven or possibly even eight. Maybe the modern pitcher isn’t such a wimp, after all.

On the surface, limiting the number of foul balls might seem attractive. Is there any play in baseball more boring than the average foul ball?

But, paradoxically, after the first few foul balls, the play becomes interesting — not the foul ball itself, but the batter’s ongoing attempt to frustrate the pitcher.

The most exciting at-bat I ever saw in person was when Jayson Werth fouled off something like a dozen pitches before hitting a home run that ended a win-or-go-home playoff contest for the Washington Nationals against the St. Louis Cardinals in 2012.

You can’t legislate this kind of encounter out of baseball.

You’re left, I think, with either doing nothing to reduce the epidemic of arm trouble or trying to alleviate the problem a bit by expanding the number of pitchers a team can carry.

Finally, whether or not baseball expands pitching rosters, I think it needs to reduce the number of innings a starting pitcher must work to get a “win.” The current number — five — made sense 100 years ago when starters routinely worked at least seven innings and, if they worked less than five, one relief pitcher might well finish the game.

But these days, relievers normally work just one inning — two at the most. It makes no sense to favor these relievers over a starter who works four innings when it comes to awarding a win.

I don’t know how many extra wins per year reducing the innings requirement to four or to three plus at least one out would produce for the average starter. The difference might only marginal — not enough to enhance the starters’ status. But at least this rule change would increase fairness.

With so many starting pitchers blowing out their arms these days, let’s at least give them wins they deserve more than random middle relievers who follow them to the hill.