Mets Pitching Injuries NOT Due to 2015 Hangover

New York Mets pitcher Jacob deGrom during stride showing excessive adduction of shoulder

The latest in a series of arm injuries suffered by Mets starting pitchers has struck Jacob deGrom, who will miss his next start due to forearm tightness and elbow inflammation. Manager Terry Collins and pundits surmise the Mets’ 2015 World Series is to blame for this year’s rash of injuries. Could that be true?

No, not really. It would be easy to point to the way the Mets pushed their young starting pitchers through the 2015 season and postseason and surmise that “overuse” or the “residual effect” of a “heavy workload” is the reason deGrom, Matt Harvey, Noah Syndergaard, and Steven Matz have all suffered arm injuries. Easy, that is, if you don’t understand how and why injuries occur.

If you don’t know much about anatomy, physiology, how the body heals, and the science of body movement, don’t feel bad — neither do most people involved in professional baseball. That’s why they keep coming up empty with answers as to why pitchers — on any team — suffer arm injuries.

But even if you don’t believe injuries can be avoided by looking at the way the body moves and the way it is handled — let’s say, for example, you’re in the camp of “pitching is an unnatural motion, therefore arm injuries are inevitable” — then the Mets’ 2015 World Series run still isn’t a valid excuse for the pains of their starting pitchers in 2016. But don’t take it from me — journalist Neil Paine crunched the numbers going back to 1995 and found ” … no relationship between the length of a team’s stay in the postseason and whether its pitchers met expectations the following season.”

So, if we can’t blame some vague notion of a “2015 hangover,” then why has 80% of the Mets starting rotation been hit by arm injuries?

First off, it’s not one thing (and rarely is). All pitching injuries (other than acute ones resulting from, say, being struck by a line drive or colliding with another player) result from fatigue. When a muscle gets tired, tendons and ligaments are recruited to work harder, which causes inflammation, and, eventually, a strain or tear. Simple enough, right? So, what causes fatigue that leads to a pitcher’s arm injury? One, or a combination, of the following:

  • Lack of proper recovery and rest (healing time)
  • Mechanical flaw
  • Weakness
  • Ignoring warning signs / red flags

Notice that none of the above are related to the number of pitches or innings thrown, nor the number of games in which a pitcher appears. Those statistics are important — VERY important — in knowing how much rest a pitcher needs in order to recover from the act of pitching. MLB teams do a lot of counting, but unfortunately don’t apply those counts to their most valuable use — determining how much rest a pitcher needs. Rest and recovery guidelines were determined by scientists over decades of research, and pitchers who ignore these guidelines are playing with fire. How many MLB starting pitchers ignore those guidelines? Nearly every one.

Generally speaking, a Major League starting pitcher is expected to throw about 100 pitches in a game he starts. Going by the recovery guidelines, a 100-pitch day requires at least four days of rest. “Rest” means NOT PITCHING OFF A MOUND. Most scientists would tell you, in fact, that it’s probably best not to pick up a ball at all for four days. However, just about every MLB pitcher throws a “bullpen” on the second day after a start. Why? Beats the heck out of me. It’s some kind of tradition, I guess? Maybe because an effective pitcher from 40 years ago did that, and so everyone thought they should, too?

After a strenuous activity such as throwing 100 pitches from a mound, the first 48-72 hours are most critical to healing. This is fact, not theory. So when a pitcher does a “light bullpen,” within that period, he’s interrupting the healing process. When you do that over and over and over again from April through September, there’s a good chances something will break down, because tissues are not being allowed to fully heal. And we won’t even get into the fact that most pro pitchers also engage in “long toss” between starts, which on its own has been proven (again, by science, not some theory) to be dangerous to the elbow, and UCL in particular.

And yes, Mets fans — by all accounts and corroboration that could be collected by this author — Jacob deGrom, Noah Syndergaard, Steven Matz, and Matt Harvey all threw bullpens when they should have been recovering. In fact, Syndergaard, during the All-Star break, suggested that he’d follow teammate Bartolo Colon‘s habit of not throwing bullpens in between starts. Is it a coincidence that Colon is the only Mets starter not to have reported an arm injury this year?

Looking at the #2 factor on the list, it should be pointed out that deGrom, Syndergaard, Matz, and Harvey all pitched with dangerous (and correctable) mechanical flaws. Jacob deGrom’s shoulder angle is far outside the ASMI guidelines during adduction (which caused lat strains this year and in 2014); the elbow bone spurs and shoulder issues suffered by Syndergaard and Matz can be pointed directly to both a late arm and a poor follow-through (Syndergaard’s late arm goes back to his minor league days); and Harvey had multiple mechanical problems that eventually led to being diagnosed with thoracic outlet syndrome.

Now, even if you don’t believe that the way a person does something can cause an injury, let’s skip down to the warning signs. Jacob deGrom’s velocity was alarmingly down at the beginning of the season — a velocity drop is always a red flag that something’s wrong. His arm angle had also dropped, and his release point was wildly inconsistent — these were all signals to look into what might be wrong, but instead, he continued pitching until a lat strain put him on the DL. More recently, deGrom’s performance diminished, his follow-through changed (he was falling more toward 1B), and he lost command of his pitches. Now, he has forearm tightness. Again, all red flags that something could be wrong, and an indication that he should study what he’s doing — be it his mechanics or his routine — and see if there’s a change that can be made to alleviate the pain.

Harvey’s warning was diminished performance. Generally speaking, going from one of the most dominant pitchers in baseball to one of the worst, is a big, bright, red flag that something might be wrong. Unfortunately, he didn’t have the guidance of a qualified individual to correct his mechanical flaws, so instead of getting better, he got worse as he blindly attempted one “fix” after another.

As for Matz and Syndergaard, their elbow bone spurs were more than red flags — they were fire trucks blasting their sirens at decibels that send men, women, children, and dogs running to the hills. When bone is rubbing against bone, you need to find out WHY. But MLBers adhere to the nonsensical adage “sometimes pitchers have to pitch through pain.” No, they don’t, and they shouldn’t. What’s causing the pain should be fixed. It doesn’t help that MLB people receive incomplete information from physicians who claim “no more damage can be done.” Do you know what that REALLY means? To an MLB person, it means, “the bone spur won’t cause a UCL tear.” Because MLB people are concerned with only two body parts: the UCL and the rotator cuff. If those two pieces of the arm are OK, then the pitcher needs to “suck it up” and get back on the mound. But here’s the thing: the mechanical flaw that caused the bone spurs in Syndergaard’s and Matz’s elbows are precursors to shoulder problems — possibly, even, rotator cuff tears. But MLB people aren’t equipped to understand how those dots are connected.

Instead of getting someone qualified to look at the mechanics of Matz and Syndergaard — or, at the very least, shutting down the two pitchers — the Mets encouraged the two young men to take cortisone shots and pain killers and “pitch through it.” (The irony about the mechanics is that the Mets reportedly used cutting-edge technology called “TrackMan” to ensure the pitchers continued to use the same exact mechanics that caused their injuries in the first place. That tells you that whomever was looking at the video, didn’t know enough about the science of body movement.)

The one factor not yet covered is weakness. That’s because we don’t know for certain what kind of strength training programs these pitchers follow. But one thing that everyone reading this should know: the elbow can and should be strengthened. This may seem obvious — since there are programs and books dedicated to elbow strength and conditioning exercises — but I’ve read and heard repeatedly from MLB commentators and pitchers that “you can strengthen the shoulder, but there’s no way to strengthen the elbow.” So let’s put that myth to rest before it continues to gain steam.

Unfortunately, there isn’t one bugaboo to blame for the Mets’ starting pitchers’ injury woes, which means there’s no one magic bullet to avoid injuries in the future. Life is rarely that simple.

If you want to learn more about pitching injury prevention, visit FixingPitchers.com and listen to the podcast Baseball Pitching: The Fix on iTunes or Stitcher.

Joe Janish began MetsToday in 2005 to provide the unique perspective of a high-level player and coach -- he earned NCAA D-1 All-American honors as a catcher and coached several players who went on to play pro ball. As a result his posts often include mechanical evaluations, scout-like analysis, and opinions that go beyond the numbers. Follow Joe's baseball tips on Twitter at @onbaseball and at the On Baseball Google Plus page.
17 Comments
  1. holmer September 3, 2016 at 11:01 pm
    Great article! One of the few articles I’ve read online that provides rational explanations for their critique/criticism of the way the Mets have handled their pitchers. I don’t agree with all of it (as a former athlete and pitcher I believe you need to learn to manage pain and play through it sometimes) but the science backing up what you say is legitimate. The routine of long tossing is especially true as anytime you change the angle of your arm to long toss the chance of rotator cuff damage is great. Again, outstanding.
    Reply
    • Harvey Wallbanger September 4, 2016 at 7:14 pm
      You know you should really send this article to the New York Mets organizational Doctors and also to Mr. Sandy Alderson’s front office staff plus to their player development people. Maybe they might read it and understand what a pitcher needs to do !!! It make me crazy to see all organizations going through this and no one can even fix these issues with pitchers in general. It has decimated all our great young star pitchers and their future in the game of Baseball. Most pitchers today after first surgery always wind up with another one about 1-2 years later and maybe another down the road. Things that they do like long toss, bullpen session following start is definitely hurting them. All those million dollar arms need REST…I personally think you have found out what needs to be done !!! Good work and great article, keep posting things like this and maybe you can take over the player development program for the Mets !!!! It’s starts in the minor leagues…
      Reply
      • Joe Janish September 4, 2016 at 8:59 pm
        Harvey, thank you very much for the kind words!
        Reply
    • Joe Janish September 4, 2016 at 8:59 pm
      Holmer, thanks very much, I appreciate the kind words.

      I’m also a former athlete and “learned” about pain management. As a catcher, I often played with bumps, bruises, strains, etc., and I’m with you on playing through pain sometimes. I also pitched, and, knowing what I know now, I’d NEVER pitch through most types of pain in the arm. If a pitcher is feeling pain in his arm, then he needs to figure out WHY there is pain. There is no gain in throwing through shoulder or elbow soreness — the better plan is find out what the pitcher is doing wrong in his motion to cause that pain and correct it. The difficulty is in finding a specialist who truly understands how the body moves (i.e., a kinesiologist) who can see the flaw and apply the correction. Those experts are rarely found near ballfields.

      Reply
      • Andy September 12, 2016 at 8:47 pm
        Mr. Janish! Are you going to post something about Wally Backman’s ouster? I recall you were a big supporter of his. There is much rejoicing right now over at Amazin Avenue . . .
        Reply
        • Joe Janish September 15, 2016 at 5:48 pm
          Thanks for the nudge. I was thinking about it, but figure that the hateaz is gonna hate regardless of what I write. Not to mention, few would believe that Tim Tebow is the reason Backman was fired.

          The shame is that a good baseball guy may not get another pro job because of the completely farcical comment about defiance and the lies that were presented as facts (i.e., Conforto not playing vs. LHPs). Backman was a perfect soldier, but, clearly, not liked by certain people in the organization. Hopefully another team sees through the lies and internal politics that led to his departure, because Backman is a keen evaluator of talent and great teacher. Statheads can throw numbers around all they want, but the bottom line is that skills need to be taught and honed in order for the numbers to be produced. You can’t teach an infielder to be strong defensively by saying, “hey, you need to improve your UZR!” Good teachers are like gold.

          I may still write something regarding the Jack Leathersich myth, though — just trying to find the time.

  2. DanB September 6, 2016 at 7:16 pm
    If done with proper rest, do you advocate bullpen sessions? Is there any scenario where it would be beneficial? Or would you prefer no bullpen? And if a teams did skip bullpen sessions between starts, how many starters do they need? Could they go with a four man rotation?
    Reply
    • Joe Janish September 15, 2016 at 5:37 pm
      Bullpen sessions are fine, and productive, when they’re done with proper rest. I don’t know how a MLB team could pull them off w/o regular off days, unless they moved to a 6-man rotation (which wouldn’t be a bad idea).

      The recommended rest and recovery guidelines are here:
      http://fixingpitchers.com/rest-recovery-guidelines/

      I don’t think a four-man rotation is feasible, unless starters stopped at 75 pitches.

      Reply
  3. Andy September 15, 2016 at 6:25 pm
    I’m very interested in what you have to say about Leathersich. The at-bat by at-bat recount of his appearance for the 51s after he was sent down is pretty damning. I can’t understand why Leathersich wasn’t pulled after that third walk in his second inning (if not before).
    Reply
    • Joe Janish September 18, 2016 at 3:06 pm
      You can’t look at the outing in a vacuum. There are multiple issues to consider. For one, the fact that Leathersich had a bone spur that the Mets front office knew about but neglected to communicate to Backman. Second — and the reason Leathersich was still in the game after that third walk — the 51s’ roster was egregiously short, and had few available arms. The game was out of hand early, and the information Backman had was that Leathersich hadn’t pitched for ten days — he was “fresh.” Further, Leathersich told Backman that he felt fine and would be able to “take one for the team” by pitching multiple innings.

      I agree that Leathersich should have been removed earlier — regardless of whether or not Backman knew about the bone spur. At the same time, considering the situation, I also understand why he was left in there — it was early in the game, and there weren’t many arms available.

      Backman is not without fault, but neither is Alderson, nor Leathersich himself for keeping his injury secret. All three share in the blame.

      The main thing to understand is that a 12-year-old can throw 60 pitches without blowing out his elbow. Sorry, I should say “his/her” — because Mo’Ne Davis threw 70 pitches in a Little League World Series game (a no-hitter, in fact) and walked off the mound without an injury. So if a 24-year-old man who is paid to throw a baseball for a living cannot survive a 57-pitch outing, it’s because there was already a problem (or multiple problems). In Leathersich’s case, he had a 1) several dangerous mechanical flaws; 2) a bone spur in his elbow; and 3) most likely, other physical indicators/pain that were ignored.

      Yes, the 57 pitches were more than Leathersich was used to, and he fatigued earlier than a 13-year-old girl because of his existing injury and flawed mechanics. And yes, that fatigue triggered an injury that ended his season. But the injury was likely to occur eventually — if not during that 57-pitch effort then perhaps after pitching on consecutive days or after a 25-pitch effort or after snapping off a breaking ball or during a long-toss session; who knows? Point is, Leathersich was a ticking time bomb and Wally Backman had the unfortunate position of lighting the short fuse. It could’ve happened on anyone’s watch.

      Reply
      • Andy September 18, 2016 at 3:42 pm
        All fair. I didn’t know about the pre-existing bone spur. Seems crazy that the FO would send Leathersich to the 51s without telling the manager about it.
        Reply
  4. Rembember1969 September 18, 2016 at 9:15 pm
    Hey Joe, I just now got to read this article and it makes perfect sense for the most part. I guess the one thing that I cannot reconcile, and I’ve had this question for several years, is: What is the difference between today’s pitcher and the pitchers of 40, 50, and 60 or even 80 and 90 years ago? The guys like Tom Seaver, Nolan Ryan, Steve Carlton, Don Drysdale, Warren Spahn, Jim Kaat, etc. etc. took the ball every four (or five) days and did nothing but pitch and pitch some more. I look back at the innings totals, the strikeout totals and the pitch totals (complete games now are rarer than presidential elections), and wonder what is different. Your thoughts?
    Reply
    • Joe Janish September 18, 2016 at 10:23 pm
      Remember1969, thank you for reading the post.

      You ask a simple question but there is a complicated answer. For one, pitchers from the “old days” were ALLOWED to throw all those games and innings, and managers let them complete games. If not for the 100-pitch limit that’s evolved over the past 15 or so years, and the arbitrary innings limits that teams have imposed upon their younger pitchers, I’m sure that we would have seen, and see, many pitchers throw 250+ innings more recently, and complete games would not be so rare.

      Secondly, it was a much different game 40-50 years ago. There was no DH, for one, and hitters in general simply weren’t as skilled and talented as they were previously, so pitchers could “cruise” through the bottom of a lineup. There was more “pitching to contact” and as a result, more efficiency / less pitches thrown per inning and per game (by the elite pitchers, anyway — total pitches by teams in general have not changed much over the years).

      Third, for every Seaver, Ryan, Kaat, there is a Steve Busby, Mark Fidrych, Sandy Koufax, Fernando Valenzuela, Frank Tanana, Tommy John, David Clyde, Andy Messersmith, and countless others who suffered serious and/or career-ending arm injuries (btw, Drysdale among them – his career was over by age 32).

      Fourth, and something NO ONE talks about — pitchers didn’t have “pitching lessons” provided to them during their childhood until very recently. I have to believe that the preponderance of former pro pitchers giving pitching lessons and teaching mechanics to kids — despite not having a formal background in physiology, anatomy, and body movement — has to play into the equation. I think human beings may be better off “figuring out” efficient mechanics than they are getting bad advice from people who don’t really know what they’re doing.

      And there are other factors, but you’ll have to wait for me to write the book. 🙂

      Reply
    • argonbunnies September 20, 2016 at 9:50 am
      I think there’s also an arms race (pun intended) for velocity. Throughout baseball history, it’s been advantageous for a pitcher to throw harder than average. But as training and supplements advance and the talent pool grows, “average” gets higher and higher.

      92 mph is what batters are used to today, so if you want to give them something less comfortable, you hunt 96.

      Perhaps more importantly, if you want to impress scouts and get a big signing bonus, and if you want management to invest in you because they can point to radar gun readings as evidence of your potential… then you’re probably looking for ANY way to throw 96 mph, even if the way you find isn’t healthy.

      Tom Seaver and Warren Spahn didn’t grow up with those incentives. They weren’t used to the constant feedback of knowing how hard they threw every outing, or every pitch. So they may have just stuck with whatever velocity their bodies could naturally handle, instead of trying to push that.

      Reply
    • argonbunnies September 20, 2016 at 9:55 am
      I also think that the modern hitting approach of patience and power has been murder on pitchers. In the 1980s, your bad hitters were good for tons and tons of first-pitch ground outs. Today’s bad hitters strike out on pitch number five, and you can’t afford to just groove one to them. For the pitcher, that’s more concentration, and more pitches, over and over and over.

      Heck, watch the Expos’ ABs in David Cone’s perfect game from 1999. The lack of “working the count” is barely recognizable compared to today’s game. We may never see its like again.

      Reply
  5. lurker September 28, 2016 at 12:19 pm
    what happened to this site?
    Reply
    • Andy September 30, 2016 at 2:13 pm
      I don’t begrudge Joe for having a life. But I do enjoy his posts and want them back if possible. Very interested to hear the Tim Tebow / Wally Backman conspiracy theory alluded to in the comments above. And I think the comment about the Leathersich situation is worthy of being expanded into a full post. Would be nice if this blog could be bequeathed to similarly minded and similarly knowledgeable Mets fans . . . I like Amazin Avenue, but they do have their ideology and I used to like reading MT as a counterpoint.
      Reply

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