Spring sees Tommy John spike
Pitcher’s elbows at higher risk of injury in camp
Along the Florida coasts and in the heart of Arizona, Major League Baseball teams are preparing to start spring training. Camps soon will be populated by hundreds of players ready to start preparation for the 2017 season. And when pitchers and catchers officially report, they will begin the weeks-long shuttle to ready their arms for opening day.
It is a rite of spring, and for those involved in keeping those pitchers healthy, the first few days of spring training are a cause of serious worry.
“The first week of camp, for us internally in baseball, is always the worst week of the year,” says Mike Reinold, a former head trainer for the Boston Red Sox.
As baseball puts increasingly more scrutiny into how to protect arms and lower Tommy John rates, it has considered pitch counts, innings thrown and many other factors, but anecdotal and empirical data show that spring training is a problem of its own. To keep pitchers off the disabled list and operating table, teams first must navigate the landmines of February and March.
Over the last five years, 27% of Tommy John surgeries have occurred in March and April, according to Jon Roegele’s Tommy John database. It is a staggering number when put in context with the rest of the year. Last year, 26 of 81 total surgeries were undergone in those two months and just 32 over the last six months of the year. In 2015, there were 38 in February and March and 43 from July 1 on. In 2014, there were seven more Tommy John surgeries in the spring than there were from July through December.
It puts an uneasy tint to the next few weeks. It is good to see baseball again, but there is a foreboding sense that more pain and surgeries are on their way.
Some of the surgeries, experts say, are unavoidable. They are the result of an offseason of hoping by teams and players. Pitchers who felt pain and discomfort in their throwing elbows at the end of the 2016 season will go under the knife because an offseason of rest and rehab did not do them enough good.
But there are plenty of new injuries, too, and they come from the stress of spring.
“It’s a combination of the business, the physiology, the biomechanics and just the situation of who’s making the decisions,” said Eric Cressey, a trainer who works with pitchers, including former Cy Young Award winner Corey Kluber, in the offseason. “That’s the challenging thing about baseball is there isn’t that one easy thing we can do to modify stuff.”
Still, the prescription to curb the injury rate seems to center around two changes — one that could break through baseball dogma and the other a change in philosophy.
Alan Jaeger, a long toss guru, sees the way major league teams approach their bullpen schedule as a serious issue. The norm, he says, is for pitcher to throw a bull- pen session every other day, trying to build up his arm and endurance quickly enough to pitch in exhibition games by early March and then to be around the 90-pitch threshold in April. He thinks it makes little sense.
“That could be the single biggest problem with an arm breaking down — the first 10 days,” Jaeger said. “That’s how impor- tant it is.”
Taking just one day off becomes a brutal stress on the arm, he says, especially when pitchers are exerting themselves to try to impress and make the team. Cressey and Reinold agree that having one day off between throwing sessions, whether it’s a bullpen session or live batting practice, is not in a pitcher’s best interest.
And, Reinold notes, with pitchers throwing harder all the time, it puts more force on elbow. Pitchers who regularly throw in the mid-to-high 90s are at greater risk.
“You’ve got to question why tradition is taking precedent over a modern-day approach to pitching,” Reinold said. “I don’t want to come across as being a conservative viewpoint. Times have changed, and we’re throwing harder.”
Without an extra day, at least, for the arm to recover, Jaeger says, the arm does not get to recondition and build strength. Which leaves it hampered.
“The first 10 days are not modern,” Cressey said. “It’s just different. There’s too many guys trying to make the club. There’s too many guys throwing really, really hard nowadays that it’s problematic and probably unnecessary. But it’s something that I feel like is just happening because of tradition.”
Moving away from such a compact schedule, Jaeger says, would be beneficial for pitchers. It also would break from tradition, though he has noticed that some teams have already made a change. Just as vital would be putting pitchers on an individualized regimen instead of a cookiecutter approach.
With increasing knowledge that every pitcher and every arm is different, treating everyone the same way no longer makes sense.
“What it all comes down to: Are you going to adapt to what the players are doing to be what they are,” Jaeger said. “Or are you going to oppose it?”
Every pitcher has a different offseason training program, and teams, they say, should respond to what that pitcher needs and what has worked for them in the past.
For instance, Cressey says he pushed Kluber’s workload back this offseason because of the long and arduous season he had with Cleveland as the Indians made a World Series run. Teams should be just as respondent in spring.
“I don’t think the solution is to make spring training longer — the season is already long enough,” Cressey said. “I think it’s more just a matter of in that early stage of spring training maybe just tapering back a little bit on how much bullpen stuff is actually taking place. Maybe not bringing guys along so quickly. ... I don’t think we need to coddle baseball guys — I think we’ve done enough of that — but I do think there’s a place for mixing stress so it’s not always off the mound.”
“You’ve got to question why tradition is taking precedent over a modern-day approach to pitching.” Mike Reinold, former Red Sox trainer, on pitchers’ spring training throwing schedules not being adjusted to guard against injury.