Injuries to pitchers big issue for Braves and all of MLB

Years-long trend of injured starters is accelerating
The Braves put left-hander Max Fried on the 15-day injured list May 9 with a strained forearm. (AP Photo/John Bazemore)

Credit: AP

Credit: AP

The Braves put left-hander Max Fried on the 15-day injured list May 9 with a strained forearm. (AP Photo/John Bazemore)

When the Dodgers recently played the Braves at Truist Park, the visitors had three starting pitchers on the injured list. They weren’t back-of-the-rotation guys expected to simply eat innings. Julio Urias, Walker Buehler and Dustin May have track records for being good starters when healthy.

The Braves could relate. Two of their starters, Max Fried and Kyle Wright, are on the IL. Last season, Fried was an All-Star, and Wright finally had seemed to tap into his great potential. Braves manager Brian Snitker was asked if what the Dodgers are dealing with mirrors the circumstances for his team.

“It looks to me like that’s what everybody’s having to do,” Snitker said.

The data confirms Snitker’s perception. MLB starting pitchers are getting hurt at an unusually high rate this season. If the trend continues, then more starting pitchers will spend time on the IL than in any season since 2015, the first year of Spotrac’s MLB injury database

According to Spotrac, 100 starting pitchers had been placed on the IL as of Thursday. That’s already more than during the entire 2015 (72) and 2016 (95) seasons. It’s not far off from the total starters to land on the IL during the 2017 (106), 2018 (117) and 2019 (115) seasons.

The increasing injuries to starters this year is part of a trend in recent seasons. In 2021,175 starting pitchers spent time on the IL. In 2022, it was 167 starters. MLB teams played only 60 games in 2020 because of the pandemic, roughly one-third of a full season, and 88 starters landed on the IL.

Starting pitchers are getting hurt more often even as their workloads decrease.

Per Baseball Reference, starters worked an average of 5.8 innings in 2015. That number decreased every full season through 2021, when starters averaged 5.0 innings per start. That probably was an outlier in reaction to the unusual 2020 schedule. But starters averaged 5.2 innings in 2022, the same as in 2019 and so far in 2023.

The decrease in workload for MLB theoretically should mean fewer injuries for starting pitchers. Teams limit their pitch counts so that fatigue doesn’t contribute to injury. There’s strategy involved, too. The evidence shows that pitchers are less effective when they face batters for the third time in a game. Managers don’t hesitate to call on bullpens that are filled with hard-throwing relievers.

Starting pitchers are getting hurt more often even as teams ask less of them. What gives?

Snitker, who was a long-time manager in the minor leagues, theorizes that it’s related to the workload faced by youth pitchers in the U.S. who play year-round.

“These kids have come up (to MLB), and they throw a lot of innings in their life,” Snitker said.

Again, the evidence shows that Snitker is on to something.

Prominent orthopedic surgeon James Andrews noticed in the mid-1990s that he was performing more Tommy John surgeries on pitchers younger than 18. The research arm of Andrews’ sports-medicine center found that, before 1997, 12 of 97 (12%) of Tommy John patients were 18 or younger. By 2005, it was 62 of 188 patients (33%).

Researchers considered several factors for the increase, including pitch types, mechanics and size of the young pitchers. They concluded that the number of pitches was by far the dominant factor in determining who suffers a major injury. In addition, it was found that players who pitched more than eight months in a calendar year were five times more likely to be in the surgery group than the healthy group.

That research led USA Baseball to recommend pitch count and rest guidelines for youth pitchers. Little League and Babe Ruth League eventually required pitch-count limits and minimum rest for pitchers. However, youth pitchers can end up throwing more pitches or pitching more often by playing in overlapping leagues or the many All-Star and travel teams that attract elite players.

I’ve talked to pitching coaches and scouts who say they wish that elite youth pitchers would play more sports instead of focusing only on baseball. That would give their arms a rest and help them develop their overall athletic ability. That doesn’t seem to be happening, though, as kids and their parents chase college scholarships and MLB dreams.

Said Snitker: “It used to be the guys would come up ... and their favorite sport was the one that was in-season. And now these kids, they grew up playing a lot of baseball, a lot of competitive baseball, and there’s a lot less downtime for guys, especially pitchers.”

Experts say repetitive arm injuries are cumulative and may not show up until years later. That could explain why the elite youth pitchers who make it to the pros as starters are getting hurt more often. The starting pitchers in MLB who’ve been injured this season include some of the best in the game.

Justin Verlander, the AL Cy Young Award winner in 2022, has made only four starts for the Mets because of a shoulder injury. Fried finished second in NL Cy Young Award voting in 2022 and Urias third. Two-time Cy Young winner Jacob deGrom lasted six starts with the Rangers before elbow inflammation put him on the IL. Robbie Ray, the 2021 NL Cy Young Award winner, made one start before sustaining an elbow injury that will require Tommy John surgery.

The Braves are among several teams trying to get by while their best pitchers mend. There were 80 starting pitchers on the IL as of Friday. Every team except the Phillies had at least one starter out. More than half of teams had at least three starting pitchers on the IL.

“There’s nobody immune from it, and everybody’s dealing with it,” Snitker said.