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MLB is trying to find answers to the pitching injury crisis. It’s going to take a while

In the 1990s, when the Atlanta Braves ruled the National League East, each of the club’s three future Hall of Fame starting pitchers filled a particular archetype. Greg Maddux toyed with hitters as if they were marionettes. Tom Glavine lived on the black. John Smoltz was the power pitcher, the right-hander with explosive stuff, the guy who missed bats. Smoltz, 56, wonders sometimes how his career would have unfolded if he was born 30 years later.

“If I pitched in this generation, I’d be two years [and] gone,” Smoltz said. “You wouldn’t even know my name. Because I could throw 100 mph. My shoulder would have fallen off. My body couldn’t have taken it.”

Smoltz speaks with authority gleaned from 21 seasons in the majors and another decade behind the microphone as a broadcaster. He has watched the incentives for starting pitchers change as part of the industry’s push for optimization. He harbors concerns about pitchers chasing exaggerated velocity and movement with each throw and undertaking offseason regimens that prioritize maximum effort. He worries about a youth system that exposes young players to overuse. He believes the sport is facing a crisis.

Smoltz has not hidden his alarm about the subject. He has vocalized his concern on Fox and MLB Network. He vocalized his concern in a lengthy conversation with The Athletic this week. And he vocalized his concern to MLB officials as part of the league’s ongoing study to determine the causes of the rising injury rate for pitchers.

Smoltz is one of more than 100 former players, doctors, athletic trainers, biomechanics experts and pitching coaches to be interviewed by MLB officials. The survey has included youth coaches, college officials and operators of independent training facilities. MLB ordered the study last October, months before an onslaught of arm injuries hijacked the opening weeks of the 2024 season as Miami Marlins starter Eury Pérez, Cleveland Guardians starter Shane Bieber and Braves starter Spencer Strider all suffered major elbow injuries. The list of aces on the shelf already included New York Yankees pitcher Gerrit Cole, Los Angeles Dodgers two-way star Shohei Ohtani and Texas Rangers starter Jacob deGrom.

“Everybody in baseball wants to see the best players on the field,” said Morgan Sword, MLB’s executive vice president for baseball operations. “And this issue is tremendously important to us. Given its complexity, we thought that the best place to start was gathering the very best thinking in baseball, from the big leagues down to the amateur game, in attempts to create a common set of facts from which to find solutions.”

That effort does not yet include active big-league players. MLB officials have approached the MLBPA about participating in a joint study, which would allow access to the union’s electronic database of medical records, according to interviews with MLB and MLBPA officials who requested anonymity in order to speak candidly about the situation. The union has not yet agreed to participate, in part because the initial findings presented by the league lacked sufficient mention of the pitch clock, which some players consider a significant factor in the recent injuries. The two sides are expected to continue discussing a joint study in the coming days.

The union and the league traded dueling statements this past weekend about MLB’s willingness to examine the clock’s effect on players. After MLBPA chief Tony Clark derided the recently shortened clock as “an unprecedented threat to our game,” MLB pointed to unpublished analysis from Johns Hopkins University that found no correlation between the clock and an upswing in injuries.

Several high-profile players batted aside the suggestion that the clock has not played a role. “Any time you do any endurance-type sport, where your heart rate is elevated, shortening the recovery is going to have some repercussions,” Baltimore Orioles starter Corbin Burnes said. Ohtani will not pitch this season after undergoing his second Tommy John surgery last fall. “I’m sure there’s some added pressure just to the body in having to maintain a workload in less amount of time,” Ohtani said on Monday through interpreter Will Ireton. Cole will be sidelined until at least June with elbow inflammation. He expressed frustration with the league’s dismissal of the issue. “To be able to say you implement something in one year and it has no effect is shortsighted,” Cole said.

“I don’t really care what MLB’s study shows, if players think (the pitch clock) affects them,” said Chicago Cubs starter Jameson Taillon, who has undergone two elbow reconstructions. “I don’t personally think it really affects me. But if players think it’s affecting them, how are you going to argue that?”

The Johns Hopkins research, which is still under peer review, is separate from the arm-injury study, MLB officials said. The latter study was coordinated by John D’Angelo, MLB’s vice president for amateur and medical baseball operations. The league hopes to form a task committee to make recommendations to teams at the conclusion of the study, which is not imminent.

Part of the problem, according to interviews with players, coaches and executives, is the sheer number of causes contributing to the injuries. Yankees pitching coach Matt Blake noted that preteen and adolescent pitchers are taught to prioritize velocity. In a lengthy thread on X, Oakland A’s pitcher Alex Wood described how his peers have traded offseason rest for intense, year-round workouts. “Guys are pushing the envelope like never before,” Wood wrote. Rangers team physician Keith Meister pointed to the proliferation of “designer pitches,” the deluge of off-speed pitches guided by data to increase movement.

“We can almost look at an MRI and the type of tear and say, ‘Oh, this guy is throwing this type of pitch,’” Meister said in an appearance on “Foul Territory.” Added Meister, “There’s no question velocity and speed are two very significant additive risk factors.”

John Smoltz was a fireballer in the 1990s. That would have likely resulted in a shortened career today. (Jim McIsaac / Getty Images)

Meister has also participated in MLB’s study. Smoltz agreed with the doctor’s assessment. He pointed to the inherent risk required for pitchers. Smoltz believes that risk has been amplified by an industry valuing maximum velocity and movement. “[Pitching] is the most unnatural thing you can do in any sport,” Smoltz said. “And when it’s something unnatural that becomes supernatural — and we ask guys to be supernatural every time — I mean, come on.”

When Smoltz watches the modern game, he feels envy for the ability of the players. “The stuff that they have is so jaw-dropping,” he said. Yet he believes the process that has created that ability comes with a cost. The bills will keep arriving until the sport alters its priorities, he said.

“The guys are bigger, they’re stronger, they’re better,” Smoltz said. “They have more technology at their fingertips. They have all the answers to the test. They’ve got more things at their disposal — but yet can’t stay healthy. That is mind-boggling, to me.”

The Athletic‘s Stephen J. Nesbitt contributed to this report.

(Top photo of Cole: Al Bello / Getty Images)

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