MLB's Pitching Elbow Injuries Are on the Rise — And More Costly than Ever
Recent injuries to Shane Bieber, Framber Valdez and Spencer Strider highlight a growing problem across baseball.
For the most part, the 2024 MLB season is still in its Small-Sample Theater phase — the time when we reserve judgment on early trends, lest we declare the Pittsburgh Pirates and Cleveland Guardians on a World Series collision course.
But one troubling trend has already given reason to sound the alarm: A near-daily deluge of elbow troubles for pitchers.
As writers like Bob Nightengale and Jeff Passan have pointed out, a recent 48-hour period alone saw Eury Perez, Shane Bieber, Jonathan Loaisiga and Spencer Strider all suffer serious elbow injuries, joining a star-studded group of hurlers — Gerrit Cole, Shohei Ohtani (as a pitcher), etc. — already sidelined with the same issue. Within a few days, Nick Pivetta and Framber Valdez would join that group, too.
Every few years, it seems like elbow injuries sweep through the game like an epidemic early in a season, prompting some collective hand-wringing over how much we’re pushing young pitchers’ arms in the age of spin rates and max-effort throws. But even against that backdrop, this feels different. The sheer star power of pitchers currently out — and the pace at which new names are being added — has increased the urgency around mitigating a problem science has traditionally struggled to solve.
The different scale of 2024’s elbow woes is apparent when we look at the pace of Injured List days — and dollars — that pitchers have lost specifically to elbow-related injuries. To compare with previous seasons, I compiled data using Spotrac’s IL tracker, prorating to a full season’s worth of games, and adjusting lost salaries for “inflation” (i.e., increases to the average payroll over time):
While the pace for total IL days lost to elbow injuries is ticking up, it is currently running behind the high mark of 2019, when 15,982 IL days were attributed to elbow injuries (including Tommy John surgeries). That will probably change some soon, as the most recent spate of injuries highlighted above have a chance to more fully shape 2024’s numbers.
And the star power of those missing is highlighted by the financial impact already being felt this season. The current pace of $312,660,114 salary dollars lost to elbow injuries would blow away any season in our sample dating back to 2015, even after adjusting earlier seasons for inflation. And this year’s number should get increasingly astronomical once the impact of those recent star injuries gets baked into the pace more.
In other words, it’s not just our imaginations, nor is it an example of salience bias — the effect of pitching elbow injuries really is notably high so far this season.
The question of what to do about it is a lot tougher to answer. The problem likely has many causes, ranging from, yes, the pitch clock — which the players’ union recently cast its blame upon1 — to an obsession with pitchers who throw as hard as possible and spin the ball as much as possible from a very young age. The debate over how much is too much (and too early) has raged for a long time, but the average fastball has only gotten faster over that span, indicating that little has changed in the chase for more and more velocity.
Astros starter Justin Verlander (who himself is on the list of injured pitchers — albeit with a shoulder problem, not an elbow) may have given the best summary of the many reasons why MLB is facing an arm-injury crisis, as well as a few ideas about where a solution might come from:
But even Verlander acknowledged that it was a hard problem to solve, one which might take years to unwind from the Little League level on up. If Verlander’s theory about throwing max velocity from a young age is the biggest root cause, fixing it basically requires rewiring the entire incentive structure around how young pitchers are scouted — and how they measure themselves.
Unfortunately, based on the way star pitchers are going down so far this season, MLB may not have that kind of time.
Filed under: Baseball
Which is depressingly par for the course with baseball — even when it does something that improves the aesthetics of the game, it might have come with a terrible price.