When It Comes to Injuries MLB Teams Remain Clueless

A League of Fans Special Report

May 2019

Baseball has an injury problem. It’s a big one. And an expensive one.

As but one recent example – albeit an extreme one – the New York Yankees had 13 players on the injured list by the end of April, just one month into the 2019 season!

Major League Baseball (MLB) franchises are filled with data analysis experts (sabermetricians, if you prefer) these days. They study the game’s numbers in an ongoing effort to find an edge — any edge — that will give their teams a performance advantage.

But there is one part of the game that has escaped effective numerical analysis: injuries. It can be persuasively argued that nothing impacts a team’s performance, during any given season, more than injuries on the field.

Yet, nobody has developed an analytical tool, of any type, that can make sense of injuries, more specifically, their causes and prevention. Sure, many preventive measures have been employed through the years – e.g., proprietary exercise and stretching routines — to little or no benefit.

“There are a lot of theories about why it (injury rate) has gone up, and a lot of them make sense, but I am not convinced it’s one thing,” said Stan Conte, senior director of medical services for the Los Angeles Dodgers, and formerly the team’s trainer. “Anyone who thinks they have the one answer is lying or wrong.”

Other than a few blips along the way, MLB injuries have risen on a decade-by-decade basis. In looking at the most recent examination of MLB injury statistics (MLB injury data between 1998 and 2015), one can see that overall injury rates continue to increase.

And it’s a very expensive trend. During the 18 years spanning 1998-2015, the average annual cost of placing players on the disabled list (now called the injury list) was $423,267,634, for a total of $7,618,817,407. So, not only are injuries damaging from a win-loss perspective, they are very expensive from a bottom line financial perspective.

Today’s baseball injury rate is significantly higher than it was during every decade of the last century. This despite significant advances in sports medicine and training methods over that time period.

The obvious question is why? Why are more baseball players missing games today due to injury than in previous eras?

Multiple Theories For the High Number of Injuries in Today’s Game

The modern baseball player has many health and safety advantages relative to ballplayers from previous eras.

Consider that today’s outfielders play with padded walls, not the rock hard walls from the past. Today’s fields are immaculate and extremely safe, which certainly wasn’t always the case in Major League Baseball. As one notable example, Hall-of-Famer Mickey Mantle suffered a terrible injury when he ripped up his knee in a hole caused by a sprinkler head during the 1951 World Series. With the prime condition of today’s fields, that type of injury would be highly unlikely.

Hitters today wear batting helmets and arm pads in the batter’s box in order to lessen the potential of injury from being beaned by the pitcher.

Moreover, the field of sports medicine has advanced greatly relative to bygone eras. Today’s MLB players workout year-round and often have personal trainers, nutritionists, and chefs under their employ. As such, players show up at spring training already in good shape. Up until the mid-to-late 1970’s, baseball players often took offseason jobs to help support their families. As a result, they needed spring training to work themselves back into shape for the long baseball season.

Ask almost anyone in baseball why there are so many injuries in the game today and they’re likely to have a theory. There are almost as many theories as there are people in the game. Nevertheless, here’s a quick overview of the most common theories as to why we have more injuries in baseball today:

1. It’s clear that pitchers get hurt more often than everyday position players. While this has always been the case, it’s even truer in the modern game. Many believe the increased emphasis on velocity is a big reason why. MLB average fastball velocities have gone from 90.9 in 2008 to 93.3 in 2017. High velocity pitchers are more likely to go on the injured list, or so the theory goes. “Velocity is a factor,” says Dr. Glenn Fleisig, research director at the American Sports Medicine Institute. “All things being equal, throwing 95 mph is more stressful than throwing 90.”

2. In 2017, 86.7 percent of regular season MLB games had at least one pitcher who had previously undergone Tommy John elbow surgery. 86.7%! That number is hard to get your arms around. So is this one: There were more Tommy John surgeries in 2014 than in the entire decade of the 90’s. While Tommy John surgeries have dropped somewhat in the big leagues the last couple years, they’ve actually increased in the minor leagues. It is believed that a pitcher throwing harder puts more stress on his shoulder and elbow. This is especially the case with relievers who come in throwing hard with max effort on every pitch.

3. In an era of sports specialization, many young baseball players play the game virtually year-round, risking overuse injuries. Travel teams and showcase tournaments put pressure on young players, especially pitchers, to perform at a high level. Young pitchers’ bodies are not ready for this type of stress. By the time young pitchers reach the Major Leagues, they have a lot more “miles on the odometer” than young pitchers in past decades had. This year-round specialization also negatively impacts position players who overuse certain muscles and ligaments and underutilize and underdevelop others.

4. MLB games take longer to play today. With longer games the injury rate goes up. Longer periods between the quick “non-action-to-action” movements common in baseball mean a greater chance for pulled muscle-type injuries. The average length of a game in 2005 was 169.9 minutes vs. 185.1 in 2017. That means players that play 155 games or more are on the field for 40+ hours longer than players in 2005.

5. Today’s players are bigger and stronger. Advanced strength training and nutrition methodologies produce heavily-muscled bodies that are more susceptible to a variety of muscle, tendon and ligament injuries (hamstrings, quads, obliques, etc.) A growing number of people believe that today’s players are too “muscle bound” (i.e., suffering from neuromuscular imbalance) which impairs mechanics, leading to more muscle, joint, bone, tendon and ligament injuries. Basically, their joints can’t handle the torque of their developed muscles. (This factor was more pronounced in the 1990’s due to steroid use. Muscles got too big, too fast and training was too intense for typical baseball bodies.)

6. Amphetamines are banned today in Major League Baseball. In past decades, amphetamines were used by players to mask fatigue and pain and increase reaction time. Without amphetamines to help get them through games, more players sit out games today than in years past – or so the theory goes.

7. Another theory is that we are in an era of overdiagnosis and overtreatment when it comes to baseball injuries. Advanced medical imaging technology (e.g., highly-sophisticated MRI machines) can be both a positive and a negative. MRI machines are helpful in finding abnormalities that couldn’t be identified before with basic x-ray technology. But they can also result in “false positives” and identify insignificant “abnormalities,” leading to unnecessary time spent on the injured list.

8. MLB franchises are more risk-averse these days due to the huge investments they have in players. They don’t want to risk minor injuries turning into major injuries. As such, they play it safe and put players on the injured list more readily than in decades past.

9. Similarly, players are also more risk-averse in the modern game because they don’t want to risk career-threatening injuries that could limit, or eliminate, their future earning potential in the game. As such, they are less inclined to play hurt than the “old-timers” were.

10. Teams are using the injured list (IL) today to rest players, give slumping players time to work through physical or mental issues, or to expand their rosters.

More Research Needed

It’s clear that with all the player games lost to injury in Major League Baseball – and all the dollars spent on injured players — more research is needed in order to fully understand what’s going on and why.

“Injury research, medical research, I think is relatively at its stages of infancy, especially relative to all the things you normally talk about,” says Chris Marinak, Executive Vice President of Strategy, Technology and Innovation for Major League Baseball. “You may have seen quotes from Billy Beane, and others, that say injury research is the next frontier of analytics and baseball, and I think that’s really true.”

Once MLB has a better handle on the causes of baseball injuries, more research will be needed to test injury prevention programs.

“More research is needed to develop and validate appropriately targeted injury prevention programs … There is again a limited amount of literature demonstrating proven injury preventing measures in professional baseball,” concludes a research study led by the Department of Orthopedic Surgery and Sports Medicine at the Mayo Clinic.

A few teams have made a concerted effort to systematically reduce injuries based on research and analytics. One of those is the Washington Nationals.

The Nationals were coming off a 2015 campaign in which they had horrible luck with injuries. They led all of baseball with 2,053 player days lost to injury, according to data compiled by Spotrac.

As a first step, the Nationals brought in Harvey Sharman after the 2015 season. Sharman is a physiotherapist who formerly worked for the Leeds United Football Club. He had become fairly well-known in sporting circles for having success cutting the injury rate for Leeds. Supposedly, Sharman had used an “analytics-driven approach” to injury prevention.

When he was introduced, Washington general manager Mike Rizzo touted Sharman’s analytics approach and said the analytics-driven injury prevention field was “maybe the next Moneyball.”

Sharman implemented a comprehensive new medical program in 2016. The program fully integrated nutrition with strength and conditioning, stretching, ongoing biomechanical testing, etc.

During spring training 2016, the Nationals’ medical team evaluated each player’s mobility. The idea was to get biomechanical baseline measurements. The theory being that as players fatigue their biomechanics show the strain and they are at greater risk for injury. Thus, the baseline measurements provided a means of comparison for ongoing measurements taken during the season. The Nationals hypothesized that if they could identify when a given player was fatiguing they could take proactive steps to lower his risk of injury.

The results of Sharman’s program were promising in 2016. They only had 1,030 player days lost to injury. However, that figure, while a big drop for the Nationals, still wasn’t much better than the middle of the pack in baseball. In 2017, they had 1,132 player days lost to injury. Not bad but certainly not great. In 2018, they had 1,416 player days lost to injury, in the upper third of days lost to injury relative to other MLB teams.

It’s clear the Nationals have yet to solve the injury issue, despite their “analytics-approach” to injury prevention.

“If we can further shed light on risk factors for baseball players who have a higher chance of injury, this could mean less injuries, less time and dollars lost to injuries, a more competitive product on the field and higher earning potential for players,” said USC Assistant Professor of Clinical Physical Therapy Jonathan Sum.

As of today, the most common strategy when it comes to injury prevention in baseball is hope. And hope isn’t a very effective strategy.

“What’s happening in baseball, basically, is that we’re hoping we get lucky (with injuries),” Conte says. “And that, to me is a bad way to go.”

Injury research should probably be Priority One. Major League Baseball owners spent $745,769,319 on injured list players in 2018 alone. Effectively researching and analyzing injuries in baseball is the next frontier, beyond OBP, OPS, WAR, wRC+ and other performance-based, on-the-field analytics.

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The best teams don’t always win championships. Champions are the teams that combine good talent with good strategy and good health. MLB organizations, thanks to analytics have arguably never had a better handle on good talent and good strategy. However, when it comes to good health, more specifically, the cause and prevention of injuries, they are still struggling mightily.

Just ask the New York Yankees.

Brooklyn Dodgers general manager Branch Rickey once said baseball is a game of inches.

That probably still holds true. But in 2019, baseball has really become more a game of injuries.

— Ken Reed, Sports Policy Director, League of Fans