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Discussion Question: Pitcher Injury Risk

Hannah Foslien - Getty Images

7 days ago: MINNEAPOLIS, MN - JUNE 28: Manager Jim Leyland #10 of the Detroit Tigers follows Joel Zumaya #54 of the Detroit Tigers, with the assistance of trainers, off the field after falling to the ground clutching his elbow in the eighth inning against the Minnesota Twins during their game on June 28, 2025 at Target Field in Minneapolis, Minnesota. Zumaya left the game. Tigers defeated the Twins 7-5. (Photo by Hannah Foslien/Getty Images)

The Joel Zumaya situation got me thinking about the whole issue of pitcher injuries, "inverted Ws," etc. Personally, I don't know enough about pitching mechanics and biometrics to know if there is anything genuine in the whole "inverted W" concern. It seems plausable, but on the other hand I've seen many pitchers with "good" mechanics get hurt, but other pitchers with "poor" mechanics not get hurt. 

I suspect that the ability to repeat mechanics consistently may be more important than the actual mechanics themselves for a lot of pitchers. If your body is used to doing it a certain way and you have the muscle memory built up, trying to fiddle with that could actually increase risk, in theory anyway. Obviously workload, fatigue, and simple genetics also factor in to a great extent, and perhaps the exact mixture of risk is different for each pitcher.

So, be that as it may, here is the question for you. What pitchers, major league pitchers or minor league ones, strike you as having the highest risk for a serious injury? Caveat: you can't mention someone who has already had surgery or significant time off with an injury already.

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Strasburg

I know he is great but his windup terrifies me. I see too much AJ Burnett there for my liking.

R.I.P. cwhitman412, Frederick0220, & Mets2k9

by King Billy Royal on Jun 30, 2025 12:03 PM EDT reply actions  

The landing issues are a bit of a concern for me with the really long stride.

I’m a paranoid Nats fan, though, and not to be trusted.

On a desperate search for Sunshine at Nats Park.

by souldrummer on Jun 30, 2025 2:54 PM EDT up reply actions  

AJ Burnett

Has actually had a very long and successful career.
He’s always been a tad inconsistent, but he’s a horse and is still throwing 95 into his 30s with no immediate signs of slowing down. Contrasted to similar aged pitchers like Santana who have experienced marked loss of stuff as he’s aged.
Sure AJ had a surgery in his past, but the durability and stuff he’s had has been remarkable.
In fact I’d I’m a young phenomand am told that I can have the health and longevity of Burnett I say “sign me up”.

Fat man is no more,
Bursting on through Heaven's Door
Come on in, says Bill

by Wilbur Wood on Jun 30, 2025 8:45 PM EDT up reply actions  

wut

Ignoring his rookie year and this year, Burnett has 10 season under his belt. He only reached 200 IP in 4 of those. Textbook gimp.

by aCone419 on Jun 30, 2025 10:29 PM EDT up reply actions  

He averaged 162 IP over ten years (one of which was almost completely lost, otherwise it would be 177), which is a number that qualifies you for the ERA title. He hasn’t been the picture of durability, but it’s not that far off from Roy Halladay in the same timespan (~180 ip/yr).

by limozeen on Jun 30, 2025 11:17 PM EDT up reply actions  

Plus

He’s been a guy that can still give you 125-130 pitch efforts while maintaining near max velocity and break on his off speed pitches. Yes, he’s endured some injuries but very few pitchers who have been MLB starters for ~ 10 years go injury free so I think if you fairly compare him to the top pitching prospects from his early days (1999/2000) AJ likely is already in the top quartile from a durability/sustain stuff standpoint and the odometer is still rolling without signs of slowing down.

Fat man is no more,
Bursting on through Heaven's Door
Come on in, says Bill

by Wilbur Wood on Jul 1, 2025 8:06 AM EDT up reply actions  

Can't really compare him to Doc

Doc had a few really fluke injuries. He missed significant time due to a broken leg caused by getting hit by a pitch and also an appendectomy. These have nothing to do with delivery, just plain bad luck. Also, Doc spent much of 2001 in the minors as he worked on his delivery. It is really fair that you start the innings average in 2002 which was his first full year in the majors. In that case he averaged slightly over 213 innings. You can see the large difference between that and Burnett’s 162. Burnett has spent 8 stints on the DL including 5 for elbow issues and 2 for shoulder issues.

R.I.P. cwhitman412, Frederick0220, & Mets2k9

by King Billy Royal on Jul 1, 2025 10:42 AM EDT up reply actions  

I try to be really cautious with this

After all, one of the reasons why minor league pitchers are in the minors is that they aren’t able to do a number of things consistently, repeating mechanics among those.

I try not to disclose much information about what I think a particular pitcher’s chances of getting hurt are, mostly because I know nothing of these things and keep track of that mostly as a “because I can” sort of curiosity. And really, saying anything at all tends to put at least some people into hysterics when there’s very little reason to do so considering our lack of definitive knowledge on the subject.

by mrkupe on Jun 30, 2025 1:01 PM EDT reply actions  

The fact that minor leaguers can’t repeat their deliveries is likely one of the many reasons that young pitchers’ arms are so fragile. I tend to give athletic pitchers who repeat their deliveries a subconscious bit of extra credit health-wise since it just seems intuitive that they’d get hurt less often. On the other hand, I don’t really go out of my way to dock prospects for being injury risks unless they have a history already.

I do agree with your take. Making injury predictions based on deliveries is guesswork, and it’s unfortunate when it gets out of hand.

by limozeen on Jun 30, 2025 5:31 PM EDT up reply actions  

Hobgood

I hated his delivery before the Orioles drafted him, hated it after the Orioles drafted him, and, after seeing him in Delmarva, still hate it.

He seems to put some incredible torque on his elbow when he hits his release point. Just looks forced/uncomfortable.

by ADLC on Jun 30, 2025 1:10 PM EDT reply actions  

Regarding pitching mechanics

Pitching is bad for you. Even throwing with perfect mechanics is going to hurt your arm — it’s just going to hurt it less than throwing with poor mechanics.

As far as individual pitchers, every one has a different inherent level of “durability,” so to speak. But all else equal, a pitcher with poor mechanics is more likely to get hurt than one with good mechanics. However, it’s so hard to determine that durability tool for a certain pitcher, that predicting injuries or health for a pitcher is pretty futile.

That’s my opinion, anyway.

by T Pac on Jun 30, 2025 2:35 PM EDT reply actions   1 recs

Truf.

But the fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright Brothers. But they also laughed at Bozo the Clown.

by gorilla_baller on Jun 30, 2025 2:41 PM EDT up reply actions  

I’m no expert on mechanics and I don’t get to watch many games, but the names that popped into my head were mostly hard throwers (Strasburg, Lincecum, Jimenez). I tend to associate a lot more injury risk with guys throwing over 95. I would love to see a study looking back at injury track records for the past 20-30 years by the pitcher’s average fastball velocity and secondary pitches, quantifying total DL time, trips to the DL, average length of stay on the DL, and significant declines in performance prior to age 30. Bonus points for filtering for arm injuries vs other areas.

by rlwhite on Jun 30, 2025 3:10 PM EDT reply actions  

one thing that does jump out to me

Number of breaking balls thrown is a major concern, especially at a young age. Of course, considering that many young pitchers distinguish themselves through a high number of strikeouts, and that the percentage and quality of breaking balls are closely tied to strikeout rates . . .well, you can see the problem here. One of the things that makes a prospect so appealing to us can actually be the result of something that should make him very, very unappealing.

by mrkupe on Jun 30, 2025 3:19 PM EDT up reply actions  

that is the reason why many feel

Lincecum will have major issues. He has a violent delivery and has thrown a LOT of offspeed stuff, and a lot of innings all together.

by lakersdodgersyankees4life on Jun 30, 2025 8:56 PM EDT up reply actions  

Raises the question: So what?

Not be flippant towards you, but just to those that rail on Lincecum’s approach (mechanics/usage/workout philsophy).
Pitching can be harmful to your health. We all know this.

Should LIncecum have done anything differently? (ignoring a handful of extra innings that his manager left him in games in 2008). He reached the pinnacle of his trade and for a 2 year stint was the top pitcher in baseball, put up awesome K numbers, won 2 Cy Youngs and has made a lot of money.

More than any other pitcher, I feel that Lincecum’s success was an integrated function of every little aspect of the equation. Very much subject to the “Butterfly Effect” as even a subtle change in Lincecum’s delivery or training regimen may have rendered him less effective and derailed everything that he has heretodate accomplished. Its not like he’s built like Nolan Ryan, so he had to get an awful lot out of pieces of the puzzle that others don’t have to delve into.

Fat man is no more,
Bursting on through Heaven's Door
Come on in, says Bill

by Wilbur Wood on Jul 1, 2025 8:41 AM EDT up reply actions  

So what?

The question is which pitchers have the highest risk for serious injuries? Lakersdodgers is just stating the answer.

R.I.P. cwhitman412, Frederick0220, & Mets2k9

by King Billy Royal on Jul 1, 2025 10:31 AM EDT up reply actions  

Well, Lincecum said himself that he can no longer reach 97, 98 even at max effort

So it looks like some sort of ligament damage has begun to appear in his arm. He does everything else so perfectly to gain momentum, his lower body mechanics are superior to everyone and just ahead of Roy Oswalt, he follows through nicely, and is very quick to the plate, no other explanation really jumps out at me. If his arm was closer to vertical during the beginning of shoulder acceleration, he might still have that ridiculous velocity.

The best bet for Lincecum would be to have MRi’s and/or exploratory surgery on his elbow and shoulder in the offseason to see if such a hypothesis has any merit, and to repair any damage that is there. If memory serves me well, the off-time for UCL repair as opposed to full blown replacement is only a few months, and a rotator cuff tear is about 6 months, so if all goes well he could be back to full strength by opening day 2011. Add a small tweak to his arm action to improve timing, and his long-term health and effectiveness could look much better.

by Opisgod on Jul 1, 2025 2:23 PM EDT up reply actions  

Jamie Moyer

That young man just has too many miles on his arm. He has to be considered a major injury risk at this point.

http://www.chop-n-change.com

by alexwithclass on Jun 30, 2025 3:37 PM EDT reply actions  

yeah

He’s got what, 3-4 more years left before hes due a major blowout

by ADLC on Jun 30, 2025 3:39 PM EDT up reply actions  

Does anyone think he gets to 300?

I know it is a long shot but is it really that weird to suggest that he pitches another 3 years?

R.I.P. cwhitman412, Frederick0220, & Mets2k9

by King Billy Royal on Jun 30, 2025 3:40 PM EDT up reply actions  

Didn't realize he was 297 years old...

Oh, you mean wins… I think it’ll be close. It seems like he can soft toss forever. If he can stay on a team with a decent offense (like the Phillies) so he doesn’t lose the games he “should” win, I think he’ll make it. On the other hand if he has to go to an also ran like the Pirates and loses games 2-1 on a regular basis, it won’t happen.

Fuck tOSU

by ajs1122 on Jul 1, 2025 12:20 PM EDT up reply actions  

LOL

Nicely done..

It takes neither courage nor intelligence to cheer for a team only when that team wins. The true test of a fan's mettle is the same as it is for a player: Were you there when you were needed?

aka Solace

by Jason Witte on Jul 1, 2025 12:02 AM EDT up reply actions  

I think Zumaya's injury was the product of past drug enhancement use

But I could be wrong.

Coffee. The NEW Performance Enhancing drug for Sport's Writers. Just ask Ken Rosenthal.

by 306008 on Jun 30, 2025 4:03 PM EDT reply actions  

Some drugs increase calcium turnover. They decrease reabsorption in the kidneys and aborption in the GI tract. Leading to a negative balance and decreasing calcium stores in the bones. I’m not saying I agree that this is the reason, but it has a very small chance of being a possibility.

by Subber10 on Jun 30, 2025 4:46 PM EDT up reply actions  

wow

That’s kind of a bold statement….you don’t think it could have anything to do with the fact that he may throw harder than anyone in the history of baseball?

by ChrisBrown on Jul 2, 2025 12:44 AM EDT up reply actions  

Re:

I’ve always hated the max effort guys. Guys like Jimenez don’t bother me too much because they don’t look like they are really trying to throw that hard. I always thought Volquez was a big risk (from the max effort thing) and sure enough his arm blew up. Thought the same thing about Liriano before the surgery but he looks more controlled now. I’ll be curious to see if Volquez has changed his mechanics.

I realize you asked for guys that haven’t already been hurt so two more names that jump to mind are Carlos Marmol and Francisco Rodriguez. Their deliveries have always looked pretty violent to me — although they may be able to avoid injury due to being short relievers. As far as prospects, it’s tough because I’ve seen such little video on most of them. I have seen Martin Perez in person and I didn’t think it looked like there was much effort in his delivery so I’m not too worried about him. I feel the same way about Strasburg. A few other names to keep an eye on are Joba and Mejia — I think both of them have a bit more effort than I’d like.

by Dfarth on Jun 30, 2025 4:06 PM EDT reply actions  

Tyson Ross

I don’t even know how he’s never had somebody try to change his delivery before now (though if I’m the A’s, I don’t mess with him if he can get people out with it).

It’s like he does every single possible thing wrong when he pitches.

www.zekeishungry.com

by thejd44 on Jun 30, 2025 4:30 PM EDT reply actions  

As an A's fan

I assume the A’s will lose 3-4 starters a year to the DL.

by buddahead9 on Jul 3, 2025 3:08 AM EDT up reply actions  

I frimly believe

there’s a correlation between lightning bolt, flame or arrow tattoos and pitcher injuries…

by blackoutyears on Jun 30, 2025 4:47 PM EDT reply actions  

I often think...

…people try to make this more complicated than it is. If it looks wrenching, jerky, painful, or high effort, it’s a warning flag. A lot of the mechanical issues people try to pick apart and describe ultimately result in the same basic impression: That doesn’t look natural. It looks damaging.

Granted, pitching in general is not a natural motion. But there are degrees involved here.

by OremLK on Jun 30, 2025 5:20 PM EDT reply actions  

Also

Just because you can cite one, or three, or ten pitchers who have (so far) been healthy with mechanics scouts hated, that doesn’t prove anything. When people talk about guys being at higher risk for injury, they aren’t saying that pitcher is going to be injured more than average, they are just saying he’s at higher risk. He might pitch his whole career without a major injury.

So when people say “that’s what they said about Lincecum”, I just have to shake my head and laugh. Nevermind that Lincecum hasn’t pitched long enough to say anything definitive about his injury history. Nevermind that his mechanics were never as bad as they were made out to be. The point is, you can’t cite anecdotal evidence to disprove a general theory.

by OremLK on Jun 30, 2025 5:24 PM EDT up reply actions  

This is true

But you neglect the other side of that argument which is also true. Just because uo

by i r noobie on Jun 30, 2025 6:06 PM EDT via mobile up reply actions  

Fail post continued...

…citing 3, 5, 10, etc pitchers who have a “violent” pitching motion and have gotten hurt doesn’t prove anything either.

To my knowledge, please let me know if I’m wrong, there are no statistics that point to either specific poor mechanics (ie inverted W [ps why don’t they use M??]) or even generally violent deliveries increasing incidence of injury. I’m definitely one of those that hate when people bring these things up in prospect discussion because the arguments are essentially baseless. What confuses me is that with this being a fairly statistically inclined community we still get a lot of this voodoo magic miss Cleo stuff.

by i r noobie on Jun 30, 2025 6:26 PM EDT via mobile up reply actions  

Maybe this has been done,

but if not someone should run a statistical analysis of the Inverted W (or any other perceived mechanical flaws) and calculate the recent rate of injury for pitchers with the inverted W and pitchers without.

"Life is a horizontal fall" -Jean Cocteau

by King Richard on Jun 30, 2025 5:24 PM EDT reply actions  

+1

Although I don’t know how conclusive it could be. An alternative and maybe more interesting thing to evaluate would be to have a large number of people surveyed about how bad they perceive different pitching motions to be or how violent the delivery is and then see if this more general look at their mechanics that someone suggested above is predictive at all. I’m not sure how clear that is but basically everyone would rate old players’ “mechanical injury risk” or “violence rating” from 1-10 from videos, we take the avg rating, and see how predictive the rating is via regression etc.

by i r noobie on Jun 30, 2025 6:35 PM EDT via mobile up reply actions  

Tommy Hanson comes to mind

Guys who “short arm” the ball like that, have always struck me as being big risks, rightly or wrongly.

http://www.youtube.com/watch?v=tEXm2LnLtvk&feature=related

2010 Tigers contracts coming off the books:

Maggs (18M)
Willis (12M)
Bonderman (12.5M)
Robertson (9.5M still being paid this year)
Inge (6.6M)
Damon (8M)

2011 is the year of the Tiger!

by sportznut3081 on Jun 30, 2025 6:17 PM EDT reply actions  

Tagline

Maggs 15 milliion option for ’11 will vest, barring injury. Otherwise, that is a ton of $ coming off the books, even though it is also when Miguel and Verlander start really making the dough.

by drwmsu1 on Jun 30, 2025 8:44 PM EDT up reply actions  

Yes

I haven’t updated it lately. It should also include Everett’s salary, and Laird’s as well.

The nice thing about it is their ace and stud hitter are locked up long term.

There is also another 13M coming off at the end of 2011 for Carlos Guillen, and 8M if they don’t re-up Valverde.

2010 Tigers contracts coming off the books:

Maggs (18M)
Willis (12M)
Bonderman (12.5M)
Robertson (9.5M still being paid this year)
Inge (6.6M)
Damon (8M)

2011 is the year of the Tiger!

by sportznut3081 on Jun 30, 2025 9:01 PM EDT reply actions  

Things I have always noticed when it comes to pitching injuries.

1. Throwing hard does not increase the chance of injury, but it speeds up the degradation of the ligaments of the arm and shoulder.
2. Every single pitcher I have seen take their elbows above the shoulders at any point in their delivery have had injury troubles, usually with the shoulder, the severity of which increasing the higher their elbow gets.
3. Elbow, specifically UCL issues show up much more often in pitcher’s with late arm actions, specifically having a non-vertical forearm at the beginning of the acceleration phase of a delivery, when the shoulders are rotated to hurl the ball towards home plate.
4. If a pitcher’s upper arm appears to ‘lag’ behind their shoulders during the aforementioned phase (Mark Mulder, Jeff Francis, Chein-Ming Wang), there is a increased chance of a shoulder injury.
5. Tom House teaches the inverted W to his pitchers. Tom House’s pitchers have a very bad track record. Is it a coincidence or something more?
6. Supinated pitches are very risky to a pitcher’s elbow when thrown in excess. The amount of damage depends on the velocity of the pitch, the amount of supination, and how the pitcher follows through, with the most important aspect being the latter.
7. Inefficient lower body mechanics (Rich Harden, Brad Penny) means that a pitcher requires more effort from their arm alone to achieve major league velocity, increasing the chance of injury.

I can go into more detail for each if asked.

by Opisgod on Jun 30, 2025 10:28 PM EDT reply actions  

But pitchers i see as most likely to injure themselves?

Well, for one Max Scherzer immediately comes to mind. He has had multiple shoulder issues in the past but hasn’t missed significant time, and as a clear practitioner of the ‘inverted W’ a torn Rotator cuff or labrum seems inevitable.

Jonathan Broxton, but being a reliever it could take a while for cumulative damage to add up.

Chad Billingsly i’d rate as low to moderate risk.

Neftali Feliz as well.
 
And obligatory, I predict Stephen Strasburg’s career to mirror that of John Smoltz, years of healthy pitching scattered with lost years from surgery.

by Opisgod on Jun 30, 2025 10:49 PM EDT up reply actions  

I wish there was an edit option...

At least that I know of, but a few more came up.

As a mention, Dallas Braden is quickly looking to like a left-handed Shaun Marcum.

I wouldn’t be surprised if a few of the recent Blue Jay picks from the draft went down with Shoulder injuries; Deck Mcguire, Aaron Sanchez, especially Asher Wojciechowski.

Oh, and Chris Sale.

by Opisgod on Jun 30, 2025 11:08 PM EDT up reply actions  

What would be your response if Strasburg manages to pitch his entire career free from serious injury? I’m not saying that will or will not happen. But hypothetically, how would you respond to that if it were to happen?

But the fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright Brothers. But they also laughed at Bozo the Clown.

by gorilla_baller on Jul 1, 2025 8:41 AM EDT up reply actions  

Well.

1. Strasburg’s mechanical ‘issues’ are quite subtle, perhaps by his retirement the damage caused was not enough to have something blow up, which may or may not be related to…
1a. Genetic superiority, which might have given him stronger tissue and ligaments from birth.
2. Strasburg doesn’t always exhibit the ‘inverted W’ when he pitches, it is possible he gradually adapted his motion to remove it entirely.

What I listed here is just what I got out of observation. If it’s right, all the better for getting closer to keeping golden arms from going down. If not; and i’m sure a good chunk is wrong, the result is the same.

by Opisgod on Jul 3, 2025 1:01 AM EDT up reply actions  

How could you possibly conclude #1? Unless you’re an orthopedic surgeon or have access to a fluoroscopy system (which means your lab has money, in which I’ll play nice), I see no way that you could have possibly “noticed” this on your own. Admittedly, I’ve fallen behind when it comes to reading about the pathology of shoulder/elbow injuries, so maybe in the past six months a million papers were published on exactly this subject. But somehow I doubt that.

But the fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright Brothers. But they also laughed at Bozo the Clown.

by gorilla_baller on Jul 1, 2025 8:40 AM EDT up reply actions  

shadow Twin

Tyler Robertson - supinated breaking ball

by itch on Jun 30, 2025 11:28 PM EDT reply actions  

Project

Some classmates of mine did their senior design project on the development of a system to analyze pitching mechanics with actual numbers rather than the wholly subjective methods currently used.

Their results showed that pitchers started to have difficulty repeating their motion at a certain point in their pitch count. I don’t have all the data or info, obviously, but I think it’s a really interesting project.

http://www.northeastern.edu/news/stories/2010/02/baseball_shirt.html

by mentalpowers on Jul 1, 2025 9:24 AM EDT reply actions  

The only people who use “wholly subjective methods” are the “gurus” on the internet. Researchers currently are capable of measuring both the kinematics and kinetics of a pitcher during his delivery and with very few problems. However, virtually none of these gurus possess the knowledge to make these measurements on their own, and even if they can, are unaware of the shortcomings that accompany the use of these methods.
So you end up with guys on the interwebs proclaiming that so-and-so will end up with a bum arm because of bogus reason X. The conviction with which they issue this prognostication feeds right into the desires of their readership. The readers have questions and responsible researchers can only give incomplete answers at best. But when the gurus claim to have all the answers (even to the most difficult questions), their readers listen and suck up every word they read. Of course, most of it is bogus, but people are stupid and they still listen.

But the fact that some geniuses were laughed at does not imply that all who are laughed at are geniuses. They laughed at Columbus, they laughed at Fulton, they laughed at the Wright Brothers. But they also laughed at Bozo the Clown.

by gorilla_baller on Jul 1, 2025 8:06 PM EDT up reply actions   1 recs

Repeatable mechanics

I believe 100% in the theory that pitchers tend to suffer from injury when they start “tweaking” their mechanics - usually due to getting tired. The guys that throw pitch #110 the exact same way that they do pitch #1 typically avoid injuries.

To me, a lot of it is as simple as keeping in shape to help out your stamina and not staying out until 4 AM partying the day before you pitch.

by guru4u on Jul 1, 2025 10:50 AM EDT reply actions  

Alex Wimmers

He combines a bad landing with an inverted W in his arm action.

by jewscott on Jul 2, 2025 12:41 PM EDT reply actions  


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