Sports
What's fueling the rise in arm injuries across MLB? A dangerous 'cocktail' of causes
Matt Blake texted Cleveland Guardians pitcher Shane Bieber a conciliatory message over the weekend. As a member of the Cleveland player-development system in the 2010s, Blake aided Bieber’s rise from college walk-on to unanimous American League Cy Young Award winner in 2020. For a time, Bieber represented the modern model for the manufacturing of a big-league ace, a player who added strength to his frame, velocity to his fastball and spin to his offspeed pitches as he ascended the ranks.
By the time Blake sent his text, though, Bieber had become part of a growing, more troubling demographic: talented young pitchers who will spend this season as spectators. Two days after the Miami Marlins announced 20-year-old phenom Eury Pérez would undergo Tommy John surgery, the Guardians disclosed Bieber, 28, would need the same procedure. A recent examination of 25-year-old Atlanta Braves starter Spencer Strider revealed damage to his elbow’s ulnar collateral ligament, which could result in his second Tommy John surgery. In New York, where Blake is now the Yankees pitching coach, the team has lost its ace, Gerrit Cole, until June with elbow inflammation and one of its top relievers, Jonathan Loaisiga, to year-ending elbow surgery.
“As a pitching coach trying to get through nine innings worth of pitching every night over 162 games,” Blake said, “I’m pretty worried.”
Pitching has always been hazardous for its practitioners. There is reason to believe it is only getting more challenging to keep them healthy. The opening days of the 2024 season have demonstrated the inherent fragility of the position. A recent story by The Ringer cited research from former MLB trainer Stan Conte that tallied 263 UCL surgeries in 2023, a steady uptick from 111 procedures performed in 2011. Of the 166 players who began the season on the injured list, as the New York Post reported, 132 were pitchers. If these trends continue, 2024 will be another banner year for arm injuries — and cause for alarm around the game.
The subject prompted sniping between Major League Baseball and the MLBPA on Saturday, as the two sides argued through press releases about the effect of the pitch clock, which was introduced in 2023 and shortened for 2024. MLBPA chief Tony Clark painted the league’s insistence on cutting time off the clock before the 2024 season against the wishes of players as “an unprecedented threat to our game.” MLB countered by citing unpublished analysis from Johns Hopkins University that found no link between the introduction of the clock and the surge of injuries.
The clock, however, was just one area of concern among players, coaches and managers surveyed by The Athletic this weekend. Those conversations presented a tapestry of additional reasons for the injury problem, including the industry’s relentless push for optimization, the encouragement of players to chase maximum velocity and spin, and the usage of training methods that encourage year-round, full-throttle workouts. To some, the explanations are interwoven and intractable. Untangling the knot may require years of research and re-evaluation.
“To protect these guys’ arms is paramount,” Dodgers manager Dave Roberts said. “And clearly we haven’t nailed it.”
This season began with baseball’s most heralded pitchers on the shelf. Los Angeles Dodgers starter Clayton Kershaw underwent shoulder surgery last October. Texas Rangers pitcher Max Scherzer is recovering from back surgery, while his teammate Jacob deGrom is rehabbing from a second Tommy John surgery. Houston Astros ace Justin Verlander experienced shoulder soreness in spring training. All those pitchers are 35 and older, the sort of age where the body no longer cooperates with the rigors of the big-league schedule.
Not long ago, Eury Pérez and Sandy Alcántara were on their way to becoming twin aces for the Marlins. Now both will spend 2024 rehabbing from surgery. (Megan Briggs / Getty Images)
For MLB, the more pressing concern is the fleet of arms breaking down soon after reaching prominence. Miami Marlins starter Sandy Alcántara, the unanimous winner of the 2022 National League Cy Young Award, underwent elbow reconstruction last season. So did Tampa Bay Rays pitcher Shane McClanahan, a little more than a year after starting the All-Star Game. Milwaukee Brewers pitcher Brandon Woodruff will miss this season because of shoulder surgery. Same story for Kansas City Royals pitcher Kyle Wright, a 21-game winner for Atlanta in 2022.
“Our sport deserves our best pitchers to be on the mound,” Detroit Tigers manager A.J. Hinch said. “Regardless of the era you’re in, the starting pitcher matchup is the first thing you look at every day. You want the big boys out there. You want the guys that are elite, and more and more are getting hurt.”
To research the problem, MLB commissioned a study last October, which has sprawled to include conversations with 100 people around the game, including medical officials. When the study is completed, the league intends to create a task force and provide recommendations to clubs about how to keep pitchers healthy.
The sport has grappled with the problem since its inception. In another era, pitchers were believed to get hurt by overuse. Teams altered how they used pitchers in hopes of preserving them. Gone are the days of the exhausted starter, pushed to the brink at 125 pitches or more, trying to finish the seventh or eighth inning. The new archetype asks the pitcher not to ease into outings but explode at the outset. Go as hard as you can for as long as you can, is the new mantra. An influx of data about the shape and movement of pitches offered teams granular ways to make pitchers better. The data did not, however, offer an answer for how to keep them healthier.
“I’ve heard through my years managing that we ask less out of starting pitchers because we don’t leave them in the game long enough and they don’t throw 100 pitches as much anymore,” Hinch said. “Yet we ask them for max velo, max shape, max everything, and virtually train year-round.”
Hinch pointed to Tarik Skubal, a 27-year-old Tigers lefty who underwent Tommy John surgery in college and flexor tendon surgery in 2022. Skubal trained this past winter so that when he arrived at spring training, he touched 99 mph in his first session of live batting practice. “Go to Tarik Skubal and tell him, ‘Hey, ease it off and throw 92 mph,’ and see how that works out for you,” Hinch said. “No. Because we’re asking our athletes to compete at the highest level.”
To some retired players, the quest for elevated velocity and spin has put pitchers at risk. Dan Haren, a 13-year veteran who now works as a pitching strategist for the Arizona Diamondbacks, posted on X about his Instagram feed providing footage of “guys throwing weighted balls at max effort against a wall, with a crow hop, with his bros cheering him on.” Added Roberts, “The body is designed, in my opinion, to only take so much force and velocity before it gives way.”
Shane Bieber hadn’t allowed a run over two outings this season when it was announced he would undergo elbow surgery. (Jason Miller / Getty Images)
Some, like Chicago Cubs manager Craig Counsell, suggested pitchers will always try to throw harder. “I don’t think the pursuit of velocity is ever going to end,” Counsell said. “Because it’s something that makes pitchers better. I don’t think we should demonize the pursuit of velocity.”
Yet the industry has championed this trend by shortening the outings of starting pitchers and encouraging them to maximize their output. Not only do pitchers throw their fastballs as hard as possible, they throw offspeed pitches with utmost force, in hopes of generating unique movement and missing bats. “The types of deliveries that create the outlier shapes are probably more stressful in some ways,” Blake said. “I think the maximization of force to create the shapes probably doesn’t help. When you’re chasing 20 inches of break or 20 inches of ride or the high velo, I think there is some level of physical cost.”
Despite protestations from MLB officials, players will continue to complain about the clock. The innovation trimmed 24 minutes off the average game last season. The timer in 2023 granted pitchers 15 seconds to act with the bases empty and 20 with runners aboard. MLB’s 11-man competition committee voted to shave two seconds off the 20-second clock for 2024 despite objections from the players.
Los Angeles Angels pitcher Tyler Anderson suggested pitchers might place more stress on their arm rather than their legs because of the clock. But he doubted any study could show a correlation between decreased time between pitches and increased injuries. The act of pitching was already unhealthy enough. “Rob Manfred knows it’s really hard to prove, would be my guess,” Anderson said.
The union sees the clock as a bogeyman. The commissioner’s office sees their complaint as a straw man. For coaches like Blake, who must navigate the season as injuries continue, the clock is only part of the problem, along with the perilous chase of velocity and spin.
“I don’t think any of them are the most responsible,” Blake said. “But the cocktail of them all is hard to get by.”
The Athletic’s Fabian Ardaya, Sam Blum, Patrick Mooney, Cody Stavenhagen contributed reporting.
GO DEEPER
Rosenthal: Pitching injury crisis has no easy fix, but baseball’s leaders better get to work on one
(Top photo of Strider: Justin K. Aller / Getty Images)
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The highly anticipated 30th WNBA season tipped off Friday with three games, including the expansion Toronto Tempo’s first-ever contest.
The action continued Saturday with a full slate, including Caitlin Clark’s return after an injury-riddled sophomore season.
Clark and the Indiana Fever hosted the Dallas Wings on Saturday afternoon in a matchup featuring the four most recent No. 1 overall picks. The Wings outlasted the Fever 107-104, but the game was defined by Azzi Fudd’s — the most recent top pick — underwhelming debut.
Dallas Wings guards Azzi Fudd and Paige Bueckers react during the first half of the Fever’s season opener at Gainbridge Fieldhouse in Indianapolis on May 9, 2026. (Grace Smith/IndyStar / USA TODAY NETWORK via Imagn Images)
Fudd played 18 minutes off the bench, scoring three points — the lowest ever by a No. 1 overall pick in a WNBA debut.
Wings coach Jose Fernandez addressed Fudd’s performance after the game, encouraging the rookie to, “Keep doing what she’s doing, it’s her first year in the league. We got five really talented backcourt players.”
EX-WNBA STAR CRITICAL OF SKY ROOKIE HAILEY VAN LITH, BELIEVES POPULARITY PLAYED ROLE IN DRAFT SELECTION
In addition to Fudd, Dallas’ backcourt features last year’s top draft pick Paige Bueckers, last season’s No. 12 overall pick Aziaha James, four-time All-Star Arike Ogunbowale and starting guard Odyssey Sims.
Until Saturday, Kelsey Plum held the record for the lowest-scoring debut by a No. 1 pick. Selected first overall by the then-San Antonio Stars in 2017, she scored just four points in her debut. The Stars relocated to Las Vegas in 2018 and was subsequently rebranded as the Aces.
Dallas Wings guard Azzi Fudd warms up before the game against the Indiana Fever at Gainbridge Fieldhouse in Indianapolis, Indiana, on May 9, 2026. (Michael Hickey/Getty Images)
Despite the slow start to her first season in the league, Plum ended the year with All-Rookie team honors. In the years since, she’s been named to four All-Star teams and won two championships with the Aces.
The Wings’ decision to take Fudd with the No. 1 overall pick drew controversy, raising questions about whether Bueckers’ personal relationship with her influenced the selection. Late last month, Bueckers said last month it did not.
Azzi Fudd poses with WNBA Commissioner Cathy Engelbert after being selected first overall by the Dallas Wings during the 2026 WNBA Draft at The Shed in New York City on April 13, 2026. (Angelina Katsanis/Getty Images)
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“Azzi Fudd was the No. 1 draft pick because she earned it, and it had nothing to do with me and everything to do with who she is as a human being, who she is as a basketball player,” Bueckers said, according to ESPN.
Neither Bueckers nor Fudd has publicly updated their relationship status since the April draft.
“Quite frankly, I believe me and Azzi’s personal relationship is nobody’s business but our own,” Bueckers also said in April. “And what we choose to share is completely up to us.”
Next up, the Wings play their home opener on Tuesday when they host the Atlanta Dream.
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The Lakers are one playoff defeat from their season being over and from the conversation turning to LeBron James’ future.
They are in a hole no team has climbed out of in the history of the NBA, the Lakers’ 131-108 loss to the Oklahoma City Thunder in Game 3 putting L.A. down 3-0 in the best-of-seven Western Conference semifinal series.
James and his teammates gave a gallant effort Saturday night at Crypto.com Arena, but the defending champion proved to be more than the Lakers could handle.
James finished his night with 19 points on seven-for-19 shooting, eight assists and six rebounds. Rui Hachimura had 21 points and Austin Reaves finished with 17 points and nine assists.
Even so, the Lakers have now lost all three games by double digits.
And the Lakers are fully aware that no NBA team has successfully come back from a 3-0 deficit in the playoffs, with those teams holding a 161-0 record. Only four teams have forced a Game 7 after trailing 3-0, all of which ultimately lost the series, including the Boston Celtics in 2023.
Lakers forward LeBron James shows frustration as Thunder center Chet Holmgren slam dunks during Game 3 on Saturday night.
(Robert Gauthier / Los Angeles Times)
Game 4 is Monday night, when the Lakers will try to stave off elimination and a night that will determine how the conversations go with James if they lose.
James has been frequently asked this season about retirement, but he has not given any indication of what the future holds for him.
He’s 41 years old and playing in an NBA-record 23rd season.
James is in the final year of his contract that pays him $52 million, making him a free agent this offseason. He can retire, join another team or perhaps return to the Lakers next season.
That will be the conversation if the Lakers can’t win Game 4.
They will see the same Thunder team that had seven players score in double figures, led by Ajay Mitchell’s 24 points and 10 assists and Shai Gilgeous-Alexander’s 23 points and nine assists.
The Lakers went down 13 in the third quarter and had to play catchup the rest of the way. They never did, going down by 112-94 with 6 minutes and 12 seconds left, forcing Lakers coach JJ Redick to call a timeout.
The deficit just kept growing, topping out at 27 points in the fourth.
They were outscored 33-20 in the third quarter. The Lakers didn’t take care of the basketball in the third, turning it over six times, and they didn’t play good defense, allowing the Thunder to shoot 59.1% from the field and 55.6 percent from three-point range,
The Lakers did not give an inch to the Thunder in the first half, even when they fell behind by 10 points.
They just kept grinding until they led 59-57 at halftime.
Hachimura had 16 points in the first half, continuing his hot three-point shooting by making all four of his threes. Luke Kennard came off the bench to give the Lakers 13 points, shooting five for six from the field and three for four from three-point range.
The Lakers kept the pressure defense on Gilgeous-Alexander. Though he had 14 points in the first half, he shot only four for 14 from the field and one for five from three-point range.
The Lakers shot 55% from three-point range in the first half, which went a long way in helping them.
The Lakers lost the first two games by identical margins of 18 points and each loss was magnified because Gilgeous-Alexander was kept under wraps for the most part by L.A.’s defense.
When Gilgeous-Alexander picked up his fourth foul with 10:34 left in the third quarter of Game 2 and went to the bench, the Thunder turned a five-point lead into a 13-point advantage at the end of the quarter.
So, when he wasn’t on the court, the Lakers failed to take advantage.
“Well, you know, again, I’ll repeat what I said after the game: we’ve got to be better in the non-Shai minutes,” Lakers coach JJ Redick said.
Role players like Mitchell and Jared McCain hurt the Lakers in the second game. Chet Holmgren also was hard to deal with.
“Mitchell and McCain have hurt us in those non-Shai minutes, and then Chet [Holmgren] has hurt us the whole game,” Redick said. “I think you’ve got to be willing to live with something. Shai playing one-on-one, thus far in the series, we haven’t been willing to live with, so you’re going to be in rotation. That can lead to smalls on bigs at the hole, and the offensive rebounding from Chet has really hurt us.”
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In 2025, Alex Palou kicked off the Month of May with a Sonsio Grand Prix win at the Indianapolis Motor Speedway road course.
Based on the odds, it’s likely that Palou will find himself in Winner’s Circle again this Saturday when INDYCAR goes back to IMS on May 9 (4:30 p.m. ET, FOX).
Considering Palou has already captured the checkered flag three times this season, are there any other drivers whose odds are worth a wager?
Here are the latest lines at DraftKings Sportsbook as of May 9.
This page may contain affiliate links to legal sports betting partners. If you sign up or place a wager, FOX Sports may be compensated. Read more about Sports Betting on FOX Sports.
Sonsio Grand Prix 2026
Àlex Palou: 5/18 (bet $10 to win $12.78 total)
Kyle Kirkwood: 5/1 (bet $10 to win $60 total)
Pato O’Ward: 12/1 (bet $10 to win $130 total)
David Malukas: 14/1 (bet $10 to win $150 total)
Josef Newgarden: 16/1 (bet $10 to win $170 total)
Scott McLaughlin: 20/1 (bet $10 to win $210 total)
Christian Lundgaard: 30/1 (bet $10 to win $310 total)
Scott Dixon: 40/1 (bet $10 to win $410 total)
Will Power: 60/1 (bet $10 to win $610 total)
Felix Rosenqvist: 80/1 (bet $10 to win $810 total)
Alexander Rossi: 100/1 (bet $10 to win $1,010 total)
Marcus Ericsson: 100/1 (bet $10 to win $1,010 total)
Marcus Armstrong: 100/1 (bet $10 to win $1,010 total)
Christian Rasmussen: 150/1 (bet $10 to win $1,510 total)
Graham Rahal: 150/1 (bet $10 to win $1,510 total)
Louis Foster: 300/1 (bet $10 to win $3,010 total)
Dennis Hauger: 500/1 (bet $10 to win $5,010 total)
Romain Grosjean: 500/1 (bet $10 to win $5,010 total)
Santino Ferrucci: 500/1 (bet $10 to win $5,010 total)
Rinus Veekay: 500/1 (bet $10 to win $5,010 total)
Kyffin Simpson: 500/1 (bet $10 to win $5,010 total)
Caio Collet: 1000/1 (bet $10 to win $10,010 total)
Sting Ray Robb: 1000/1 (bet $10 to win $10,010 total)
Nolan Siegel: 1000/1 (bet $10 to win $10,010 total)
Mick Schumacher: 1000/1 (bet $10 to win $10,010 total)
Here’s what to know about the oddsboard:
Heavy Favorite: It doesn’t look like Alex Palou’s dominance will be slowing down anytime soon. As noted above, he’s already won three of the five races since the INDYCAR season started in March. With 186 laps led, Palou sits first in the standings and has the shortest odds to win the title again. Last season, he started from the pole and led 29 laps before winning the race.
Long Shot to Watch: While his odds of 150/1 to win at IMS are much longer than Palou’s, Graham Rahal is one to watch. At this race in 2025, he started second and led 49 laps before finishing sixth. He finished second at this course in 2015, 2020 and 2023. He’s currently 10th in the INDYCAR standings, with one top five and three top 10s.
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