Significant new study reveals the truth about baseball pitching injuries
- Ali Kord
- Jan 23
- 3 min read
Updated: Jan 24
Major League Baseball (MLB) recently published a landmark study on injuries amongst baseball pitchers. It found that ‘Injuries to pitchers have increased at a significant rate over the last decade, with elbow and shoulder injuries rising to alarming levels’.
The study surveyed 200 experts including:
players - former ML pitchers
medical professionals - orthopedic surgeons, sports medicine physicians, biomechanists
coaches - MLB pitching coaches and independent pitcher development coaches, athletic trainers
club officials and executives
player agents and other amateur baseball stakeholders.
The study found that:
Pitching injuries are on the rise for MLB players – up by 82% from 2017 to 2024
This is generating a significant ‘trickle down effect’ to amateur level: young pitchers emulate professional pitchers, leading to a rise in injuries at the high school and college levels
In more detail, this research shows:
a massive increase in overall pitching arm injuries:
- shoulder IL (Injury List) days rose from 2 634 in 2005 to 5 445 in 2024
- elbow IL days rose from 3 940 to 12 185 over the same period
- pitching injuries accounted for 55.3% of all ML baseball in 2024
- Tommy John (UCL repair) surgeries within ML and minor league baseball rose from 104 to 314 over 1 decade
- Tommy John surgery among youth and high school pitchers rose from 10% of all UCL surgeries to 52% in just over 2 decades.
the biggest age group needing Tommy John surgery is between 15 and 19 years old
Career impact
The number of days MLB pitchers spent on the injured list for elbow injuries increased from 5,940 in 2018 to 12,185 in 2024
20% of pitchers who undergo Tommy John surgery don't make it back to their previous level of play
Financial impact
In the 2024 season, injured pitchers cost their teams $253 million- arm injuries cost teams $193 million
The cost of Tommy John surgery typically ranges from $15,000 to $50,000
Causes
Pitchers with ‘high-risk’ throwing mechanics were 2.7 times more likely to suffer a significant arm injury compared to those with ‘low-risk’ mechanics
- a lower ball release angle at the point of release causes a 22% higher overall injury rate
- extreme shoulder external rotation at ball release causes a 35% higher risk of shoulder injuries
- early trunk rotation relative to pelvis rotation showed a 40% increase in elbow injury risk.
Velocity: the report states that ‘despite a direct correlation with injury risk, average fastball velocity in MLB jumped from 2008 to 2024’:
- An orthopedic surgeon stated: ‘There's no question that the average increase in fastball velocity has completely paralleled the increased incidence of injury.’
Solutions
This was a big study involving many different baseball stakeholders. So much so that Director of Biomechanics Research at the American Sports Medicine Institute and injury research adviser to MLB Dr. Glenn Fleisig was ‘concerned that we'd get 200 different answers.’
In fact, he concluded that ‘there was agreement in this report, so it gives us a gameplan or roadmap for what we should try to solve.’
An MLB pitching coach stated: ‘We're seeing a clear link between certain mechanical patterns and injury risk. It's not just about how hard you throw, but how efficiently you're using your body to generate that velocity. The data is showing us that small tweaks in mechanics can have a big impact on a pitcher's longevity.’
Solution stats (the good news!)
The report states that
Conventional wisdom holds that the best way to preserve pitcher health is to manage pitchers conservatively - fewer pitches and more rest. There is, however, a growing consensus that conservative treatment may actually expose pitchers to greater injury risk by encouraging them to throw with maximum effort with every pitch.
It highlights a paradoxical finding: traditional approaches may actually contribute to the injury problem rather than solving it.
The study found that timing in the kinetic chain was crucial:
Pitchers with optimal sequencing of body segments had a 24% lower injury rate
Those with early trunk rotation relative to pelvis rotation showed a 40% increase in elbow injury risk
inconsistent release points correlate with a 31-33% increase in injury likelihood
Conclusion
There's a common saying in baseball that ‘the best predictor of future injury is past injury.’
This report highlights the importance of proper pitching mechanics in injury prevention. It suggests that biomechanical analysis is a valuable tool for identifying and addressing potential injury risks in pitchers. This may be particularly valuable for young players.
Additional references