Gary Armida's Blog
Velocity and Injury Risk: A look into if throwing harder means more injuries 
Posted on August 17, 2012 at 06:44 AM.
The 2012 season will long be remembered for the exploits on the mound. The no-hitters, the perfect games, and the dominant performances have all made headlines throughout the season. For all of that achievement, a black cloud continues to hang over Baseball with each and every pitch. That black cloud continues to hang over the sport, even over its brightest young star.
Stephen Strasburg, the phenom, the next great one is having an incredible season. Sadly, it looks as if he won’t be able to finish. Unfortunately, Strasburg isn’t the first potentially dominant pitcher to walk off the mound and lose more than a season because of injury and the resulting surgery. That surgery fixed him, but now he is being restricted in his use during his first full season back. He’s not the first nor will he be the last. That black cloud has cost the Baseball industry close to a billion dollars over the past three seasons.
Yet, as the cost of paying for injured pitchers continues to rise, many clubs are slow towards finding a solution. Some clubs have looked towards the science of biomechanics for the answers. The Orioles, Brewers, and a couple of others are using the science. Most teams, however, are simply reactionary. They try to limit pitchers in the hopes of avoiding injuries. Obviously, that isn’t working.
While solutions are tough to come by, the causes of pitching injuries are relatively known. Injuries occur because of poor conditioning, overuse, and poor mechanics. With the exception of overuse, one would figure that poor conditioning and poor mechanics would not be an issue at the Major League level. In some cases, they are issues, but there has to be another reason for the epidemic level of pitching injuries. Perhaps it was the very reason that many shouted when Stephen Strasburg walked off the mound in pain two years ago.
Maybe, the human body wasn’t made to throw close to 100 MPH on a consistent basis. Maybe, Stephen Strasburg and all who walked that same painful walk off of a baseball diamond have one thing in common. Maybe, they all throw too hard for their own good.
Dr. Glenn Fleisig of the American Sports Medicine Institute has spent most of his professional life researching and studying the causes of pitching related injuries. His work alongside the famed Dr. James Andrews has led to the credibility of biomechanics as well as the continued research into the areas of preventative measures such as long toss, pitch counts for youth pitchers, and the use of biomechanical analysis for measuring a pitcher’s mechanics.
Dr. Fleisig states, “Directly, velocity does not relate to higher rates of injury. Higher rates of injury is a product of the torque and force put on an arm, how often a pitcher throws, and how much rest and recovery he gets after pitching.”
But, there is an indirect relationship between velocity and injuries. “How much torque is placed on an elbow or shoulder often leads to velocity. Indirectly, velocity can relate to injury,” states Dr. Fleisig.
With this explanation, excess torque (force) on an arm can lead to injuries. Pitchers who throw harder do have a chance of putting too much torque on their arm. But, one can’t directly link that torque to injury. Dr. Fleisig explains, “Pitchers who throw with high velocity do have higher chances of injury because added torque and because they pitch more often. That goes for both professionals and little leaguers. Extra care needs to be taken for the child who throws harder. He pitches more.”
That indirect relationship is in the process of being validated with more study. In one study conducted by Dr. Brandon Bushnell (published in the July 2010 American Journal of Sports Medicine), a link was found between velocity and injury. The study followed 23 professional pitchers over a three year period. Of the 23 pitchers, nine were injured, some enough to warrant surgery. The mean pitch velocity for that cohort was 89 MPH. The 14 healthy pitchers had a mean velocity of 85. The three pitchers who threw the hardest all required surgery.
The study is a good first step in proving that increased velocity does increase injury risk. But, the study isn’t truly conclusive for two reasons. First, it only follows 23 pitchers over a three year period. It is difficult to accept the results based on just 23 pitchers. Additionally, none of the pitchers were put through a biomechanical analysis before the study began.
Until further study is conducted, there are two distinct possibilities that can be linked to velocity. The first is controllable. Pitchers who throw with higher velocity tend to be overused, especially at the amateur level. It makes sense as the higher velocity pitchers give teams a better chance to win. That overuse leads to fatigue. That fatigue is what causes a pitcher’s mechanics to breakdown, leading to injury.
But, the other, more direct relationship is the toll on the body. Higher velocity pitchers tend to put more torque on their elbows and shoulders. Because of that force, a pitcher who throws 95 MPH is more of an injury risk compared to a pitcher throwing 88 MPH.
“The faster you throw, the more critical it is to have better mechanics. If a pitcher who throws a 95 MPH fastball is throwing less properly, you would amplify torque and force. A pitcher throwing in the 85 MPH range can still amplify torque, but not as much as a harder thrower,” explains Dr. Fleisig.
Perhaps, instead of a direct link between velocity and injury, a relationship can be established. Higher velocity puts a pitcher more at risk for injury because it places a premium on a pitcher being more exact than a pitcher who throws with less velocity. With increased velocity, each phase of the delivery must be exact. Inherently, added velocity puts extra torque on the arm, but a pitcher with proper mechanics can pitch without injury.
“Take two pitchers who throw 95 MPH. How much torque they had put on their elbow may be different for each. If one has good mechanics, he might have achieved optimal performance. 95 MPH with poor mechanics puts even more torque on the arm,” says Dr. Fleisig.
Poor mechanics are the great predictor of injuries as well as ineffectiveness. Dr. Fleisig explains, “Good mechanics are a good kinetic change, a proper sequence, a proper transfer of injury. A Pitcher with poor mechanics generally has less velocity. If the pitcher does have great velocity, he puts inordinate torque on shoulder and elbow.”
The importance of proper mechanics cannot be overstated. Proper mechanics keep pitchers healthy. They also allow a pitcher to throw at his optimum level. The danger is when a pitcher who throws hard has poor mechanics. That added, dangerous torque is what causes injuries.
Certainly, one would think that the industry would react. But, only one team has their own biomechanics lab. Only a few utilize the science of ASMI and their analysis process. Those few teams that are ahead will be ahead. The precision required in an elite pitcher’s delivery is so fine that Dr. Fleisig states that only a biomechanical analysis can spot potential flaws that lead to injury.
“It is close to impossible to watch with eyes or from different angle. The human eye can’t see the subtle timing differences. Even using standard video won’t let you see the timing. From one particular angle, you aren’t getting 3D; you are judging from perspective. With elite level pitchers, you need better technology.”
With the increased risk of injuries for harder throwers, perhaps it would make sense to draft pitchers who don’t throw quite as hard. A staff full of pitchers throwing in the 88-90 MPH range would prove healthier. They all take the ball every fifth day, rarely miss starts, and allow an organization the “luxury” of not having to pitch the seventh and eighth starters. Those starters tend to ruin a season. From a health standpoint, this makes perfect sense.
“From health point of view, sure teams should stockpile (pitchers who don’t throw in the upper 90′s),” states Dr. Fleisig, “But, they’d lose.”
If a team gets lucky, it could draft a Greg Maddux or a Tom Glavine, two pitchers who didn’t throw particularly hard and never missed a start until very late in their great careers. Mike Mussina is another pitcher who didn’t throw extraordinarily hard and compiled a borderline Hall of Fame career while staying remarkably healthy. But, those three are the exceptions. Elite level pitchers all throw with above average velocity. Teams will not win without those types of pitchers.
Sure, there will be the occasional starter who can pitch at the elite level without elite level stuff, but a team needs a Felix Hernandez, Justin Verlander, and Clayton Kershaw to lead a staff. While velocity isn’t everything, it does cover up quite a bit. Velocity makes up for imperfection; it takes the pressure off of defenses. It can neuter hitters.
With that information, organizations should weigh the benefits of higher velocity pitchers. “Higher velocity pitchers are a good thing, but they have more maintenance needs. Other issues become more critical such as the mechanics, physical conditioning, and the amount of rest and recovery. But, a team can’t win without them,” asserts Dr. Fleisig.
Teams do need high velocity pitchers to compete. Those higher velocity pitchers do have more maintenance needs in order to keep them healthy. The increased velocity does lead to increased torque on the body. If the delivery is not precise, that added torque becomes dangerous. One has to question an industry that hasn’t embraced a science that will give them the needed tools to get that precision. Stephen Strasburg has already lost a season due to injury. Now, it looks like he will lose the final month of a season and the playoffs because of that injury. He is just another victim of a guesswork system that continues to produce injured pitchers at an alarming rate.
Does velocity equal injury? Perhaps it does, but it can be prevented. Hopefully, someone decides that prevention is a good idea. Until then, professionals such as Dr. Fleisig and Dr. Andrews will continue their research, continue to educate, and, unfortunately, continue to operate.
Gary Armida
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Joe Page was said to be a monster K pitcher for the Yankees in the 40s and yet his K's per 9IP would be lousy for today. Maybe those guys threw more often and not always at max effort and it worked. I'm not sure.