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 New England Patriots defended home turf in the Wild Card Round, dominating the Los Angeles Chargers in a 16-3 victory to move on in the NFL Playoffs.
New England, winning its first playoff game since their 2018 Super Bowl-winning campaign, will await the victor of the No. 4 Houston Texans and No. 5 Pittsburgh Steelers Wild Card game on Monday night to see who they face in the Divisional Round next week.
This game saw its first touchdown in the fourth quarter, but that was because of how suffocating both defenses were in this contest. But it was clear the Patriots had every answer for Justin Herbert and the Chargers’ offense.
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Drake Maye of the New England Patriots celebrates after a touchdown in the third quarter against the Miami Dolphins at Gillette Stadium on January 04, 2026 in Foxborough, Massachusetts. (Winslow Townson/Getty Images)
Mike Vrabel’s squad shouldn’t have given up only three points, especially after Drake Maye was picked off on the Patriots’ second drive at his own 10-yard line. However, the Patriots’ defense was relentless all night, and the Chargers couldn’t adjust.
They stopped the Chargers on four plays to turn them over on downs, and ultimately got on the board first thanks to a 93-yard drive that resulted in a field goal.
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Los Angeles was knocking at the door again with a third-and-2 from New England’s three-yard line, but Kimani Vidal was stuffed. Cameron Dicker added a field goal to tie the game, and only another Patriots field goal was added to the score before halftime, a 6-3 lead for New England.
While the Chargers couldn’t get anything going on offense, their defense kept them in this game, at least for the first three quarters. Maye was strip-sacked by Odafe Oweh while in Chargers territory to keep it a three-point game in the third quarter.
But after another failed drive, a third Patriots field goal split the uprights to make it 9-3.
Stefon Diggs of the New England Patriots talks to teammates in a huddle prior to an AFC wild card playoff football game against the Los Angeles Chargers at Gillette Stadium on Jan. 11, 2026 in Foxborough, Massachusetts. (Kathryn Riley/Getty Images)
The dagger for the Patriots came after yet another Chargers punt, when Maye placed his pass perfectly for tight end Hunter Henry, the ex-Chargers star, for a 28-yard touchdown. The first six-pointer for either team seemingly ended all hopes for Los Angeles.
On the ensuing drive, Herbert was crushed by K’Lavon Chaisson, resulting in a fumble recovered by Christian Elliss, as the Gillette Stadium crowd went ballistic.
The Chargers tried to get some playoff heroics going, as they dinked and dunked their way down the field into Patriots territory. But on fourth-and-9 from New England’s 34-yard line, Milton Williams ended all hope when he delivered the Patriots’ sixth sack on Herbert to turn them over on downs again.
In the box score, Maye went 17-of-29 through the air for 268 yards, with running back Rhamondre Stevenson being his top receiver with 75 yards on three catches. Kayshon Boutte also added 66 yards on four grabs, while Henry finished with 64 yards.
Drake Maye of the New England Patriots looks to pass prior to an NFL wild card playoff game against the Los Angeles Chargers at Gillette Stadium on Jan. 11, 2026 in Foxborough, Massachusetts. (Michael Owens/Getty Images)
And Maye was also the Patriots’ leading rusher with 67 yards on the ground on nine carries, as he continuously picked his spots to gash the Chargers’ defense.
For Los Angeles, Herbert’s playoff woes continue, as he’s now 0-3 after this performance. He had just 159 yards passing and 57 yards rushing.
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FOXBOROUGH, Mass. — The MVP chants for the second-year quarterback of the New England Patriots rang throughout Gillette Stadium on Sunday night.
The Chargers, meanwhile, were haunted by their own echoes.
Another playoff game. Another one-and-done exit.
The gutty season of quarterback Justin Herbert again ended with a whimper, a 16-3 loss on a night when the Chargers defense provided ample opportunities.
“We have to do better than three points,” Herbert said. “As an offense, that’s not good enough. The quarterback play wasn’t good enough, and we let the defense down today.”
Chargers quarterback Justin Herbert is sacked by New England Patriots linebacker Anfernee Jennings in the fourth quarter Sunday.
(Robert Gauthier / Los Angeles Times)
Three years ago was the nuclear meltdown at Jacksonville, when the Chargers blew a 27-0 lead to lose, 31-30.
Last year, the first under coach Jim Harbaugh, Herbert was picked off four times at Houston after making it through the regular season with just three interceptions.
Now, the Chargers have all offseason to ponder the fiasco at Foxborough, when they generated one field goal, 207 yards and converted one of 10 third downs.
The cover-your-eyes postseason scorecard under Harbaugh: Two games, 15 points on three field goals, one touchdown and a failed conversion.
Asked after the New England loss if the impending offseason changes could include changing out offensive coordinator Greg Roman, Harbaugh was notably noncommittal.
“Right now I don’t have the answers,” Harbaugh said. “We’re going to look at that.”
The juxtaposition between the Chargers and Patriots is stark. The Chargers are precisely where they were a year ago, groping for answers about how to win a postseason game.
The Patriots won just four games last season but bumped that to 14 this year — one of three teams in NFL history to improve by at least 10 games in 12 months — and now advance to play host to Monday night’s winner between Houston and Pittsburgh.
As good as Herbert was all season — particularly playing behind a patchwork offensive line and with a broken left hand — he seemed lost in space Sunday, unable to connect with his receivers or establish anything close to an offensive rhythm.
Former Chargers tight end Hunter Henry catches a touchdown pass in the fourth quarter for the Patriots. It was the game’s only touchdown.
(Robert Gauthier / Los Angeles Times)
He threw for 120 yards and oversaw an offense whose possessions ended thusly: punt, turnover on downs, field goal, punt, end of half, punt, punt, punt, fumble, turnover on downs.
It’s not as if the Patriots were much better. The Chargers largely shut them down on offense, but New England was able to cobble together three field goals and a touchdown by tight end Hunter Henry, who, in a tormenting twist, began his career with the Chargers.
But Patriots quarterback Drake Maye was more calm and in command than Herbert despite two fumbles (one lost) and an interception on a pass that was batted at the line of scrimmage.
“Credit to Drake Maye,” Chargers safety Derwin James Jr. said. “Every time we got to him, he got back up. Every time his team needed a play today, he used his legs.”
In fact, the quarterbacks were the leading rushers, with Maye running for 66 yards and Herbert 57. The Patriots got 53 more from Rhamondre Stevenson, whereas the Chargers couldn’t mount anything of a true running game.
When teams win, they spend the offseason trying to keep their rosters together. When they lose, it’s back to the drawing board. The Chargers are in the latter category.
In a locker room so quiet you could hear a dream drop, linebacker Daiyan Henley said Harbaugh thanked his players after the game.
Chargers quarterback Justin Herbert is slow to get up after being sacked in the fourth quarter against the Patriots on Sunday.
(Robert Gauthier / Los Angeles Times)
“There was a lot of confidence going into this game,” Henley said. “I think the feeling and vibe you’re getting in this locker room right now is that it’s over and that this team is going to change. Everybody is aware that our defense is going to surely change.
“When you have a core group of guys like this, everybody holds a lot of pride in what we do. So to know that we lost and the season is over and this locker room is going to change — and upstairs may change — it hurts more.”
Henley said Harbaugh thanked his players after the game, especially for the way they fought all season despite the various hurdles in their path.
“It sucks because this is how the season ends, so when you talk about processing a loss like this, the process lasts longer,” Henley said.
“You go out on a loss, I’ll be thinking about it until I can go out and get my next win.”
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The Green Bay Packers’ playoff exit on Saturday immediately put added focus on what the organization will do with head coach Matt LaFleur.
The NFL coaching cycle has been the wildest in recent memory, with veteran coaches like John Harbaugh and Pete Carroll being shown the door. Packers fans seemingly put LaFleur on the hot seat following their crushing defeat to the Chicago Bears.
Green Bay Packers head coach Matt LaFleur reacts during the wild-card playoff game against the Bears Saturday, Jan. 10, 2026, in Chicago. (AP Photo/Erin Hooley)
ESPN’s Adam Schefter said Sunday that the Packers will have a major decision to make.
“The Green Bay Packers and their new president, Ed Policy, have a significant decision to make here in the coming days – and that is whether to extend Matt LaFleur’s contract. He’s currently got one year remaining, or to move on from him,” Schefter said. “If they moved on from him, he would automatically go near the top of coaches available and shakeup this current head-coaching cycle yet again.”
Schefter added that Harbaugh could be one of the names that would interest the Packers’ organization.
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Green Bay Packers head coach Matt LaFleur talks after the playoff game, Saturday, Jan. 10, 2026, in Chicago. (AP Photo/Erin Hooley)
“Notice how we said this belongs to the Packers’ president, Ed Policy. Well, the Packers’ former president from the back in the day was a man by the name of Bob Harlan,” Schefter explained. “Bob Harlan’s son, Brian Harlan, represents John Harbaugh. John Harbaugh is a Midwestern guy, who has a home in the Upper Peninsula, and a lot of people around the league have been wondering if the Packers decide to go in a different direction, if all of a sudden the Green Bay Packers might fall to the top of John Harbaugh’s list as the top available choice for him.
“This has been a wild, crazy coaching cycle, and we may be just scratching the surface.”
Green Bay Packers’ Matthew Golden celebrates his touchdown against the Bears Saturday, Jan. 10, 2026, in Chicago. (AP Photo/Erin Hooley)
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Green Bay finished 9-7-1 this season. LaFleur is 76-40-1 as the Packers’ head coach with a 3-6 record in the playoffs.
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