I'm "guessing" just as much as you are.

And lots of people with medical degrees talk about how unnatural and harmful the overhand pitching motion is.

A Look at Pitcher Injuries

by Nate Silver and Will Carroll

Pitching is an unnatural act that invites injury. The stress it places on the bones of the shoulder, arm, and back is immense. The strain it places on the 36 muscles that attach to the humerus, clavicle, and scapula is remarkable. It is widely accepted by sports medicine practitioners that every pitch causes at least some amount of damage to the system.

///

Even for a successful, established pitcher, the risk of catastrophic injury is meaningfully high throughout his career, almost certainly at least 10 percent in any given season. However, the risk does appear to be to some degree dependent on a pitcher's age. For the very young pitchers in our study--ages 21 and 22--the risk of injury is significantly higher, in excess of 20 percent. Injury rate then drops dramatically as a pitcher matures physically, reaching its lowest point at roughly age 24, while rising gradually throughout the remainder of his career. (Although pitchers aged 37 and up appear in the chart to be as vulnerable to injury as very young ones, that is also the age at which pitchers will begin to retire voluntarily. The uptick in injury risk at the tail end of a pitcher's career is probably not as substantial as what is implied here).

///

As an athlete matures, his bones calcify and harden, his growth plates close, and his ligaments reach full strength. Since no athlete matures on the same schedule as another, it is important to note that chronological age does not always directly correlate to physical age. However, as Dr. Jobe and others have noted, a pitcher is generally most vulnerable at a young age, before the bones and muscles of his upper body have fully developed.

///

Finally, a pitcher with poor mechanics, fatigued or not, is at increased risk of injury. Although the lack of readily available data makes it difficult to discuss biomechanical efficiency with the same precision that we do pitch counts, there is no doubt that the makeup of a pitcher's delivery can separate those pitchers that can withstand high levels of use from those that cannot.

http://www.baseballprospectus.com/artic ... cleid=1658

2 things jump out:

1.

For the very young pitchers in our study--ages 21 and 22--the risk of injury is significantly higher, in excess of 20 percent. Injury rate then drops dramatically as a pitcher matures physically, reaching its lowest point at roughly age 24, while rising gradually throughout the remainder of his career.

Yet, by making his cutoff 25, Verducci includes ages 23 and 24, which the BP study has found are the ages at which injury risk is the lowest.

2.

Finally, a pitcher with poor mechanics, fatigued or not, is at increased risk of injury. Although the lack of readily available data makes it difficult to discuss biomechanical efficiency with the same precision that we do pitch counts, there is no doubt that the makeup of a pitcher's delivery can separate those pitchers that can withstand high levels of use from those that cannot.

I would also argue that those with lack of proper conditioning are more prone to injury, too. And proper conditioning includes sufficient reps of the activity in question.

In any case, Verducci's article appeared last November. He listed pitchers in 2006 who met his criteria for possible problems. How did they do in 2007?

Cole Hamels: excellent year, better than last year
Justin Verlander: better than last year
Anibal Sanchez: shoulder injury
Jered Weaver: great 2006, regressed to mean in 2007
Sean Marshall: mediocre 2006, improved to mean in 2007
Scott Olsen: good 2006, bad 2007
Jeremy Bonderman: a little worse than expected in 2007
Adam Loewen: out with elbow injury
Anthony Reyes: equally mediocre both years
Scott Mathieson: injured in 2006
Boof Bonser: got a little worse in 2007
Chien-Ming Wang: exactly as good in 2007 as 2006
Rich Hill: improved a bit in 2007

Three injuries (two if you don't count Mathieson), maybe one collapse among the non-injured pitchers, and a few improvers. Make of that what you will.

Link

The point is, it's one thing for you or I to guess. But Verducci is guessing on a national stage. Those who are researching (as opposed to guessing) are finding that Verducci is supporting his argument through anecdotes, rather than evidence. It's now become an urban myth and, worse yet I fear, a self-fulfilling prophecy. Without real research and evidence to back up his claims (especially in the face of evidence to the contrary, such as the THT article I cited earlier), it's just rubbish -- and arguably counterproductive and dangerous rubbish.

I dont think they are saying injury risk is lowest at 24 (relative to any other age), but that the level of increased risk on a young arm tends to be at its lowest at 24 (ie, the further away the pitcher gets from 20), but the risk is still there.

I've never advocated that the 30 innings limit should be strictly adhered to, I've argued two main things since this thread was started;

1. Fatigue is the biggest issue. Lots of studies have shown that fatigue begins to set in and then become more prevalent somewhere between 95 and 110 pitches. Pitching while fatigued leads to bad habits and altered mechanics, which increase the risk of injury.

2. There's no need to tack on extra innings/pitches in games where it isn't necessary. There was no reason for Hamels to throw an extra 12 or 15 pitches with a 4 run lead in the 8th inning. Things like that are foolish, in my opinion.

No one really knows exactly what the threshold is, and its clearly different for different guys. But you're tempting fate by abusing really young pitchers. I have no problem with guys gradually starting to throw more pitches. Brett Myers is different than Carlos Carrasco in terms of what he should be expected to do. Myers is older, he's got experience logging 200+ inning seasons, so he should be treated differently. But even in the case of Myers, what is the inherent value of having him throw 120 pitches in a 4 or 5 run game?

FTN wrote:I dont think they are saying injury risk is lowest at 24 (relative to any other age), but that the level of increased risk on a young arm tends to be at its lowest at 24 (ie, the further away the pitcher gets from 20), but the risk is still there.

Maybe I'm misreading it, but the way I read it is that from ages 21 onward, age 24 is the age of lowest risk. If the risk drops to its lowest at age 24 among pitchers ages 21-24 "while rising gradually throughout the remainder of his career," it would seem to me that 24 is the year of lowest injury risk relative to any other age from 21 through the end of a career.

Im pretty sure they are talking about risk in terms of when its more elevated, which is before the age of 25. The article talks about the growth of most muscles and tendons being done by age 25. Pitchers after 25 all have a risk of getting hurt, but players 24 and under are at a higher risk, and the younger the more risky.

I don't think the risk of injury is lower at 24 than it is at 30. That doesn't make intuitive sense. The more wear and tear, the more likely a breakdown will occur, though it doesn't always happen.

I find the following facts ridiculously obvious and probably something that both of you would agree on:

1) Pitching causes a lot of injuries, much more than hitters.
2) A lot of researchers have found that you need to be careful and have come up with better methods to evaluate injuries than before.
3) Verducci is not the one to make the best case, since he doesn't really have remotely reasonable research methods.
4) Even though pitching a lot of innings at a young age is risky, it would have been idiotic to shut down Cole Hamels in advance of Game 5 of the World Series last year. That represents an obvious example of when it's worth the risk.
5) It was pointlessly risky to have Tim Lincecum throw 138 pitches in a meaningless September game last year, given the lack of knowledge we have about what causes injuries. That represents an obvious example of when it's not worth the risk.

There really doesn't seem to be much diagreement here. Obviously, we can all only guess at this. Verducci doesn't really know what he's doing. For one thing, he should use pitches thrown, or at least batters faced, rather than innings as the measure effectively deeming those pitchers who get better at getting outs to be injuring themselves in the practice. Also, Verducci creates a ridiculous sample when he selects pitchers who threw 30 more innings in year X than in year X-1. To have thrown fewer innings in the previous year, you're more likely to have been injured in the past. Being injured in the past is correlated with being injured in the future. He's creating a correlation, declaring it causal, when there is a flagrantly obvious third omitted variable that is correlated with both. Of course, that's not to say that reaching a conclusion for the wrong reasons makes the conclusions wrong.

It's a pitcher to pitcher thing. Using the Verducci Effect to look at Cole Hamels is useless. They have an actual MRI and Ultrasound conducted last week to look at. They have another one from a few months ago, and a whole slew of data to evaluate him based on. Using the Verducci Effect is to use a questionable study to evaluate something they have real person-specific medical data on.

i would like to inject another thought into this discussion:
in addition to the factors mentioned already, the prognosis for a particular pitcher will have something to do with his willingness to report soreness and with the willingness of the organization to react constructively to such a report.

in the past, we heard all too many stories of phillies players being too macho to report pain, and phillies management encouraging silence and failing to run full medical checks when something was reported. in that climate, any hint of an injury to a phillies pitcher was certain doom. to get to the point of complaining, they almost certainly had been hurting for a while, and they almost certainly would be asked to pitch in pain a few more times before being sent for an mri. the most recent victims of that i can recall were wolf and padilla... and maybe hamels in that spring training where he got hurt overthrowing.

but that incident may have served as a wake up call for hamels and the phils. since then, he seems to be reporting every significant ache, and the phils seem to be reacting with due diligence to each report.

the pitcher injury statistics that informed the conclusions of bp and verducci may be strongly influenced by the results of guys who have been willing to pitch through pain, with the encouragement of management. if hamels and the phils have become unusually proactive in dealing with soreness issues, maybe they really don't fit the model.

then again, history is littered with examples of pitchers who supposedly didn't fit the model but still ended up hurt.

MattS wrote:I find the following facts ridiculously obvious and probably something that both of you would agree on:

1) Pitching causes a lot of injuries, much more than hitters.
2) A lot of researchers have found that you need to be careful and have come up with better methods to evaluate injuries than before.
3) Verducci is not the one to make the best case, since he doesn't really have remotely reasonable research methods.
4) Even though pitching a lot of innings at a young age is risky, it would have been idiotic to shut down Cole Hamels in advance of Game 5 of the World Series last year. That represents an obvious example of when it's worth the risk.
5) It was pointlessly risky to have Tim Lincecum throw 138 pitches in a meaningless September game last year, given the lack of knowledge we have about what causes injuries. That represents an obvious example of when it's not worth the risk.

There really doesn't seem to be much diagreement here. Obviously, we can all only guess at this. Verducci doesn't really know what he's doing. For one thing, he should use pitches thrown, or at least batters faced, rather than innings as the measure effectively deeming those pitchers who get better at getting outs to be injuring themselves in the practice. Also, Verducci creates a ridiculous sample when he selects pitchers who threw 30 more innings in year X than in year X-1. To have thrown fewer innings in the previous year, you're more likely to have been injured in the past. Being injured in the past is correlated with being injured in the future. He's creating a correlation, declaring it causal, when there is a flagrantly obvious third omitted variable that is correlated with both. Of course, that's not to say that reaching a conclusion for the wrong reasons makes the conclusions wrong.

It's a pitcher to pitcher thing. Using the Verduci Effect to look at Cole Hamels is useless. They have an actual MRI and Ultrasound conducted last week to look at. They have another one from a few months ago, and a whole slew of data to evaluate him based on. Using the Verducci Effect is to use a questionable study to evaluate something they have real person-specific medical data on.

Yes. These are a lot of the points I've been trying to make here but you do so much better than I. The whole Verducci thing is not a study. It really is a list of good young pitchers and pitchers who had a good year last season. In some (many?) cases it's also a list of pitchers who were hurt two years ago and then weren't hurt so their number of innings went up.

Verducci doesn't compare his list to anything. He makes a blanket statement that the guys on his list do worse the year after they make the 30 inning jump. And some do, some don't and some get hurt.

And here's the thing about that. The guys who HAVE done a comparison, have found that the rule of 30 doesn't really exist. In fact, the rule of 30 guys tend to end up doing better than the group of other pitchers. I was going to look at all big league pitchers younger than 25 in a year and compare them to the rule of 30 guys and see what was what. But it will take some time and I haven't really had that lately. But one thing I have noticed is there really isn't a lot of starting pitchers in the big leagues younger than 25. And of the ones there are, many of them suck, get hurt or just disappear the next year. And they aren't breaking no rule of 30.

According to Verduci himself, the Red Sox were very careful to not have Clay Buchholz break the rule of 30 in 2007. And he proceeded to suck in 2008.

The fact of the matter is, the Verducci effect is really nothing. It's true that you have to be careful about not abusing young pitchers. Abuse as a very young amateur is a big factor in pitchers getting hurt (Kyle Drabek anyone?). number of pitches in an inning is probably very important. I'd guess if you did an actual study on things like that, you might get some valuable information.

I think claiming "rule of 30" for any pitcher who is on the list and who gets hurt or sucks this year is kinda silly. There are a myriad of reasons why an arm gets abused or why a pitcher gets hurt or sucks. And to pin it all on some rule a sportswriter pulled out of his hat just doesn't make the greatest sense to me. I'd really like to see some serious studies done on this issue. Then we might get some place.

phorever wrote:i would like to inject another thought into this discussion:
in addition to the factors mentioned already, the prognosis for a particular pitcher will have something to do with his willingness to report soreness and with the willingness of the organization to react constructively to such a report.

in the past, we heard all too many stories of phillies players being too macho to report pain, and phillies management encouraging silence and failing to run full medical checks when something was reported. in that climate, any hint of an injury to a phillies pitcher was certain doom. to get to the point of complaining, they almost certainly had been hurting for a while, and they almost certainly would be asked to pitch in pain a few more times before being sent for an mri. the most recent victims of that i can recall were wolf and padilla... and maybe hamels in that spring training where he got hurt overthrowing.

but that incident may have served as a wake up call for hamels and the phils. since then, he seems to be reporting every significant ache, and the phils seem to be reacting with due diligence to each report.

the pitcher injury statistics that informed the conclusions of bp and verducci may be strongly influenced by the results of guys who have been willing to pitch through pain, with the encouragement of management. if hamels and the phils have become unusually proactive in dealing with soreness issues, maybe they really don't fit the model.

then again, history is littered with examples of pitchers who supposedly didn't fit the model but still ended up hurt.

Again, very fine point. All pitchers have arm soreness. Anyone who has ever pitched anywhere knows that. But when is the thing you feel just soreness and when is it an injury. Pitchers are world class athletes and are very good at what they do. They don't really want to get the reputation of being a crybaby. So when do they report pain? It varies according to the individual. Good point!

swishnicholson wrote:The Tampa Bay Rays believe, sort of (I don't see this online. It's from Gerry Fraley in the USA Today Sports Weekly:

Last Season's success has not changed Tampa Bay's philosophy on player development. That means that Price could go from World Series reliever to Class AAA starter in April.

Tampa Bay believes that to give young pitchers as much protection from injury as possible their workload should be increased by only about 25 innings a season.

It's a hard-and-fast rule that the Rays are unlikely to overlook with as valuable a pitcher as Price, the top pick in the 2007 draft.

Including the postseason, Price worked 129 1/3 innings last year, his first professional season. Having a starting pitcher with a limit of about 155 innings in the majors all season would tie a manager's hands.

The Rays could limit Price's appearances in the minors and bring him to the majors during the season with significant innings still in him.

"To have him start a season in the majors would be a significant jump," Maddon says. "I'm not saying we won't do that. But if we do, he's one guy we'd really monitor as he builds up the innings.

"Jumping a guy from 130 to 200 innings, that's not something we relish doing."

Which to me sounds like a hard-and-fast rule which they would never break unless they wanted to.

Price fits the mold of a rule of 30 candidate. A potential "young ace." It's really hard to limit these young, very good pitchers to the rule of 30 parameters if your team in in a close race, as the Rays most likely will be. Look at Hamels last season. Would it have made any sense to shut him down after he crossed the line in September?

It will be interesting to see what the Rays do with Price this season. They can save him an inning here or an inning there perhaps. But it's gonna be interesting to see how they go about limiting him to 154 1/3 innings -- if that's what they decide to do.

FTN wrote:Im pretty sure they are talking about risk in terms of when its more elevated, which is before the age of 25. The article talks about the growth of most muscles and tendons being done by age 25. Pitchers after 25 all have a risk of getting hurt, but players 24 and under are at a higher risk, and the younger the more risky.

I just don't see how what they wrote can be read that way. Here's what they say:

For the very young pitchers in our study--ages 21 and 22--the risk of injury is significantly higher, in excess of 20 percent. Injury rate then drops dramatically as a pitcher matures physically, reaching its lowest point at roughly age 24, while rising gradually throughout the remainder of his career.

So they say that, after age 22, the injury rate "drops dramatically" and at age 24 it reaches "its lowest point," and then rises throughout the remainder of a pitcher's career. The plain reading is that the risk of pitcher injury is lowest at age 24. Based on what their research revealed, it would seem that pitchers have to be watched more and more closely after 24. That's intuitive when you think of the accumulated wear and tear on a pitcher's arm specifically and his body generally and that his muscles and tendons become less flexible with age, cartilage deteriorates, joints become arthritic, etc.

EDIT:

Here's their attrition chart, btw:

The so-called injury nexus does appear to be a real phenomenon, but it occurs before the age of 23, a younger age than some previous studies have suggested.

From an mlbtr interview with D'Backs GM Josh Byrnes:

MLBTR: How do you decide how many innings you'll allow a guy like Max Scherzer to throw, since he's never topped 109 in a season? If he's healthy and the team is in a pennant race would you be comfortable taking him to 200 innings?

Byrnes: Including the Arizona Fall League and instructional league, Scherzer threw around 140 innings last year. We will try to moderate his innings throughout the season and shoot for a range closer to 170 innings.

Will Carroll referred to a "new study" regarding this issue in his Phillies Health Report in today's BR. An actual study would be good to see. That's what we really need here.

Most will never develop the bulldog toughness that once defined a great starting pitcher, a Ryan, Seaver, Gibson, Koufax, Carlton, Marichal

Kinda strange to bring up Koufax considering his career was shortened due to injury most likely stemming from overuse.

And Citizen Ryan, who one season threw 5,684 pitches in 333 innings pitched, is doing something about it. By the way, the season was 1974, when Ryan was 22-16 for the Angels, leading the American League with 202 walks and 367 strikeouts. He averaged 135 pitches for 41 starts. That insane workload ravaged his arm so severely his career only lasted 19 more seasons. Ryan was still throwing in the 90s when he finally retired at age 46.

Well, you've convinced me. If the biggest freak of a pitcher in the history of the game can handle the workload, then by golly, anyone can. Why don't more players hit 60 HR in a season? Babe Ruth did it.

And he was a fat slob.

Here's another article supporting Ryan:

http://seamheads.com/blog/2009/05/27/co ... nt-add-up/

I think we'll see a lot of these type articles as the Rangers continue their process. It will be interesting to see what happens.

Will Carroll wrote that he agrees with most of what is in the above article:

I mostly agree with these sentiments, but the problem is the development, not the pitch count in isolation; a count can't exist in isolation and have meaning. ..

smitty wrote:Here's another article supporting Ryan:

http://seamheads.com/blog/2009/05/27/co ... nt-add-up/

I think we'll see a lot of these type articles as the Rangers continue their process. It will be interesting to see what happens.

Will Carroll wrote that he agrees with most of what is in the above article:

I mostly agree with these sentiments, but the problem is the development, not the pitch count in isolation; a count can't exist in isolation and have meaning. ..

I dunno, I would just like to read one of these articles that doesn't say something like this:

Why are pitchers the only athletes who are going backward? How does it make sense that inferior athletes with inferior training and inferior medical care could do 30-40-50 years ago what modern day pitchers cannot do? How could guys like Steve Carlton, Nolan Ryan, Cy Young and so on down the line toss 300+ innings - effective, dominant innings - often throwing God-knows-how-many pitches while pitchers today are lucky to make 200 innings and rarely make it past the 6th or 7th inning because they’re “around 100 pitches?”

I like whenever people whine about pitch counts, their examples are always these insanely dominating Hall of Fame pitchers. Carlton, Ryan, and CY YOUNG? Wow, yeah, I wonder why everyone doesn't pitch like them.

Since the examples are always world class pitchers, I was kind of curious what the true difference between starters now and in the past. According to baseball-reference, the Innings Pitched per Game Started in 2008 in the NL was 5.8
In 1955, it was 6.3

So, starters then were getting an average of 1.5 outs more per start.

Even if you look at second dead ball era numbers like 1968, it's not as extreme as it's made out to be. The average starter went 6.8 innings, so they still only went about 1 inning longer than they do now. And given how many more CGs were thrown then, that means the remaining starters were awful and only pitching a couple innings.

this argument is really dumb, to be honest.

the single biggest issue is pitching while fatigued.

if you take pitchers who have been on a program since college and say "well, toughen up, you're going to start throwing 125 pitches per game", you're going to see injuries. if you develop a strengthening program where these guys learn to build up endurance over the course of a season, and multiple seasons, and they aren't feeling excessive fatigue at 110 pitches, then where is the issue?

guys who aren't conditioned to throw 130 pitches every time out shouldn't just start throwing 130 pitches per game. if thats what nolan ryan thinks, hes an idiot, and so are people who support that line of thinking. but thats probably not his line of reasoning