Why the Future of Pitching and Arm-Health Scares Me

Disclaimer: I am a former Minor League Strength & Conditioning Coach. As such, my views, thoughts, and opinions do not reflect those of my former employers (the two Professional Baseball organizations that employed me). I know nothing about the health, injury, or training statuses of any Major League Players – including those of the Mets or Dodgers – nor  do any of my opinions refer to any Major or Minor League Players that I formerly worked with. 

Recently Major League Baseball has seen a string of pitchers experiencing upper extremity injuries/issues that have been enough to cause either missed starts, DL stints, surgeries, or in the very least raise the eyebrows of the sports media. Not that this is anything new, of course, but it was enough to get me curious about the statistics.

Thus, I located Fangraphs’s depth chart of starting and relief pitchers currently in Major League Baseball and went digging through baseballheatmaps.com to cross-reference the two lists.

The question: what percentage of today’s starting pitchers, relief pitchers, and total pitchers have undergone UCL reconstruction?


Mind you, this was a completely informal check of the statistics. I wouldn’t exactly propose to put this information in a book or research journal. But, either way, it should be relatively close (providing the database and lists are accurate).

What I found…

30% of all Starting Pitchers in Major League Baseball (as defined by Fangraphs “Depth Charts”) that have undergone at least one UCL reconstruction. 

24% of all Relief Pitchers in MLB have undergone at least one UCL reconstruction

Of all MLB pitchers found on Fangraphs teams depth chart, 26% have undergone at least one Tommy John surgery

Altogether, these numbers are quite staggering if you really think about it. Imagine if you were to field your own starting rotation from all of the SP’s currently in an MLB rotation. If you were to take your pick, chances are 1 out of roughly every 3 picks would be a player who has undergone Tommy John surgery at least once.

You might think that, with all of the modern technology and information available to us today, we should know what is causing the swell of significant arm injuries in Professional Baseball.

But, Tommy John (not to mention all of the other significant arm issues we see frequently) is multi-factorial in nature, thus we’ve yet to conclusively determine what has or has not caused the “epidemic”, let alone what we can do to solve it… Although, we are able to speculate many risk factors.

If the above stats and the daily news articles (and now a nationally-acclaimed investigative book) on arm health aren’t concerning enough, imagine what might be ahead of us.

Try looking 5-10 years into the future…

What I see when I look into the future of pitching and arm-health is certainly what concerns me the most. I say this because none of the risk factors or influencers that we can speculate seem to have been mitigated or reduced. For example…


If overuse is (even partly) to blame, it’s not like travel baseball has slowed at all. In fact, quite the opposite. Kids are getting deals. It’s profitable. And for those reasons, travel ball is not slowing or going away.



If high velocities are a risk factor, don’t expect anything to get better either. Velocities are on the rise and so is the focus on the radar gun.



If it’s from performance enhancing training – pushing the arm past its capabilities – we can’t expect things to change for the better either. We (myself included) all tend to want to compensate for arm injuries (or attempt to prevent them) with increased physical preparation (which undoubtedly can also help explain the rising velocities). As more injuries occur, we will undoubtedly try to better prepare our athletes for the imposed demands of pitching. Hopefully this isn’t a cause of the problem itself.



If it’s from early-specialization (a factor closely related to overuse) we can probably only expect this to get worst. At least initially – until the re-education of parents and youth coaches finally sticks and makes a legitimate impact.


If it’s from the high incentives ($$$) and parental/coaching/media/societal pressures to gain “elite” status, even at youth ages – pushing kids to compete year-round, attend showcases, and generally throw more “high stress” innings – it remains to be seen if there will be any positive change in the future.



If it’s from a “lack of fear” of Tommy John surgery, that probably won’t change any time soon either. Quite to the contrary, we have pitchers being drafted high despite having/needing UCL reconstruction, pitchers bouncing back from UCL surgery to make $100+ Million contracts, some pitchers retuning from a second UCL reconstruction, and now new techniques to less-invasively treat a UCL sprain.



This is why the future of pitching and arm-health deeply concerns me – there’s no perceivable end to the trend in sight.



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