Arm injuries deserve more of our attention

When I was 14 years old, I felt a pinch in my throwing elbow in the first inning of a mid-July game. By the end of that game, I could barely move my arm. An emergency trip to the doctor revealed that I had tendinitis in my elbow and had to stop pitching for the rest of the season.

After some time spent in physio, I was back on the mound the following year. For the next two years, my elbow would hurt after each start, but not nearly as bad as it did that first day. Then, in my last season of eligibility, in literally my last competitive game, I blew out my elbow again, this time for good. All I remember is throwing a fastball and then waking up on the bench with my coach and parents in hysterics.

In his 2016 book The Arm, Jeff Passan talks about the epidemic of elbow injuries that plagues Major League Baseball. Given the salaries that the league’s top pitchers are paid, Passan suggests that it’s not unreasonable to call the elbow the most valuable commodity in baseball, yet a pitcher’s arm blowing up has almost become a given in this day and age.

Just last week, we saw the Yankees announce that two very different pitchers — one, a relief workhorse on the wrong side of 30, the other, a young flamethrower with a bright future — would be going under the knife, shutting them down for the next year-plus. This announcement got me thinking about the state of pitching, and why so little is done to protect baseball’s most valuable commodity.

Naturally, I started my research with my favourite team: the Yankees. As of writing this, the Yankees are carrying 14 pitchers on their active roster, not including those on the various injured lists. Of those 14 active pitchers, 7 have had Tommy John surgery at some point in their career: Manny Bañuelos (2012), Clay Holmes (2014), Ron Marinaccio (2013), Jordan Montgomery (2018), Clarke Schmidt (2017), Luis Severino (2020), and Jameson Taillon (2014). If we extend this examination to include those pitchers currently on the shelf, we can add five more names to that list: Domingo Germán (2015), Jonathan Loáisiga (2016), Zack Britton (2021), Luis Gil (2022), and Chad Green (2022).

The explosion of Tommy John surgeries in recent years has been well-documented, and I don’t think it’s a coincidence that these increases are happening at the same time as velocity and movement across the league are rising. Now, don’t get me wrong here: There is absolutely nothing natural about a pitching motion, and Tommy John surgery is not inherently tied to velocity or movement. As Passan writes in The Arm, “For 130 years, pitchers have thrown a baseball overhand, and for 130 years, doing so has hurt them.” We talk about good mechanics and fluid deliveries all the time, but the truth is that the stress a pitcher puts on their arm over the course of their career is simply not natural.

Nowadays, the medical field and rehabilitation science has made it so that Tommy John surgery is not the death sentence that it once was for pitchers, but as more and more pitchers are forced to get it, you have to wonder what, if anything, the league is doing (or is able to do) the remedy the situation. With that being said, as much as I’d like to blame the commissioner’s office for everything, I simply can’t on this issue. As Passan points out in his book, by the time pitchers are getting to the major leagues, they already have a ton of mileage on their arms from overuse in Little League and competitive showcases. Unfortunately, this is a baseball issue that is rotten the whole way down, from the majors to youth sports leagues.

The recent rash of arm injuries affecting Yankees pitchers got me thinking about my place in all of this. As a fan of the game, there is nothing I like more than watching a guy come into a game throwing gas with an obscene amount of movement. But, at the same time, as a fan of the game, there is nothing I hate more than seeing a guy on the shelf for at least a year and a half after undergoing Tommy John surgery. Removing myself from the Yankees bubble for a moment, just two years ago, it was a joke around the league that the Tampa Bay Rays were on “Bullpen C” because their relievers suffered so many arm injuries. They were, naturally, lauded for the bullpen depth with little time spent on whether or not it was okay for an organization to churn through pitchers at such a high rate. This year, it looks like it might be the Yankees’ turn to take on that discussion.

I don’t have any conclusions to reach here. I’m just as torn as I’ve ever been on this issue. My personal preference is watching power pitchers over finesse guys, and the league seems to be trending that way. At the same time, I can’t distance myself from the fact that a lot of these pitchers either have shredded their elbows or will shred their elbows at some point in the future. At this point, pitching might as well be a game of chance: the majority of pitchers will have their elbows blow up and only the lucky few will get through a clean career.

Another visit with the doctor revealed that my elbow issues didn’t stem from tendinitis after all, but that the growth plates were to blame. When I was 14, I grew from 5’5 to 6’0 in the span of one summer. As a result of my growth, in conjunction with some mechanical tweaks, my max velocity jumped from the mid-60s to the low-80s. That’s nothing to write home about, but for a lanky kid with a slender frame, that was enough to convince me to ride my fastball.

Unfortunately, the growth plates in my elbow didn’t grow with me, and were essentially rubbing bone-on-bone when I was pitching. As a result, there wasn’t much tendon left in there by the time it gave out when I was 17. To this day I can barely touch 60 MPH, and it takes weeks for my arm to recover after throwing a baseball. Outside of the baseball field, I still don’t have a full range of motion in my arm.