Is there a way to mitigate pitching injuries? The Rays (and Dodgers) may shed some light

10 hours ago

Tommy John surgery was never supposed to go this far.
It was once a cross-your-fingers-and-pray fix for a career-ending injury. Now, MLB teams cycle through as many as 40-plus pitchers a year, knowing that surgery is a phone call away.
Just ask John himself, a left-hander who never threw all that hard, only reaching the mid-80s on his sinking fastball. The soft-throwing lefty was having his best year as a Dodgers starting pitcher in 1974.
He didn't have the strikeout acumen of teammate Andy Messersmith, or the ace makeup of future Hall of Famer Don Sutton. But what John did have was consistency. John consistently pitched late into games, and sent opposing hitters back to the dugout without reaching first base.
'The game of baseball is 27 outs,' said John, now 82. 'It wasn't about throwing hard. It's, how do I get you out?'
He was the first to go under the knife. The first to lead pitchers through a dangerous cycle of throwing as hard as possible, knowing the safeguard is surgery.
'I threw one pitch and boom, the ligament exploded,' John said.
John's arm injury left a sensation akin to what an amputee feels after losing a limb. In 1978, he told Sports Illustrated, 'It felt as if I had left my arm someplace else.' He didn't feel pain. He felt loss. His left arm was his career. It was the direct cause for his toeing the Dodger Stadium mound in the first place. Then, John went on to pitch another 15 years in MLB.
It's the same loss that Hall of Fame Dodgers left-hander Sandy Koufax felt when he retired at age 30 after numerous arm injuries, which could have likely been fixed if current elbow and shoulder surgeries had existed in 1966.
It's the same loss that Texas Rangers team physician Keith Meister sees walking daily into his office.
Today, Meister can view MRI scans of elbow tears and can tell pitchers where and how they hold the baseball. The tear patterns are emblematic of the pitches being thrown in the first place. The solution — Tommy John surgery, a once-revolutionary elbow operation — replaces a torn or partially damaged ulnar collateral ligament in the elbow with a tendon from somewhere else in the body. The operation is no quick fix. It requires a 13- to 14-month recovery period, although Meister said some pitchers may require just 12 months — and some up to 18.
Meister, who is currently tallying data and researching the issue, wants to be part of the change. Midway through an October phone interview, he bluntly stopped in his tracks and asked a question.
'What is the average length of a major-league career for a major-league pitcher?' he said.
Meister explained that the average career for an MLB pitcher is just 2.6 years. Along with numerous other interviewees, he compared the epidemic to another sport's longevity problem: the National Football League running back.
'People say to me, 'Well, that sounds like a running back in football,'' Meister said. 'Think about potentially the money that gets saved with not having to even get to arbitration, as long as organizations feel like they can just recycle and, you know, next man up, right?'
Financial ramifications play close to home between pitchers and running backs as well. Lower durability and impact have led to decreasing running-back salaries. If pitchers continue to have shorter careers, as Meister puts it, MLB franchises might be happy to cycle through minimum-salary pitchers instead of shelling out large salaries for players who remain on the injured list rather than in the bullpen.
The Dodgers and the Tampa Bay Rays have shuffled through pitchers at league extremes over the last five years. In the modern era — since 1901 — only the Rays and Dodgers have used more than 38 pitchers in a season three times each. Tampa used 40-plus pitchers each year from 2021 to 2023.
Last year, the Dodgers used 40 pitchers. Only the Miami Marlins tasked more with 45.
The Dodgers have already used 35 pitchers this season, second-most in baseball. The Rays tallied just 30 in 2024 and have dispatched just 23 on the mound so far this season. What gives?
Meister says the Rays may have changed their pitcher philosophy. Early proponents of sweepers and other high-movement pitches, the Rays now rank near the bottom of the league (29th with just 284 thrown) in sweeper usage entering Saturday's action, according to Baseball Savant. Two years ago, the Rays threw the seventh most.
Tampa is rising to the top of MLB in two-seam fastball usage, Meister said, a pitch he says creates potentially much less stress on the elbow. Their starting pitchers are second in baseball in the number of innings, and they've used just six starting pitchers all season.
'It's equated to endurance for their pitchers, because you know why? They're healthy, they're able to pitch, they're able to post and they're able to go deeper into games,' Meister said. 'Maybe teams will see this and they'll be like, 'Wait a minute, look what these guys won with. Look how they won. We don't need to do all this crap anymore.''
The Dodgers, on the other hand, rank ninth in sweeper usage (1,280 thrown through Friday) and have used 16 starting pitchers (14 in traditional starting roles). Meanwhile, their starting pitchers have compiled the fewest innings in MLB. Rob Hill, the Dodgers' director of pitching, began his career at Driveline Baseball. The Dodgers hired him in 2020. Since then, the franchise has churned out top pitching prospect after top pitching prospect, many of whom throw devastating sweepers and change-ups.
As of Saturday, the Dodgers have 10 pitchers on the injured list, six of whom underwent an elbow or shoulder operation — and since 2021, the team leads MLB in injury list stints for pitchers.
'There are only probably two teams in baseball that can just sit there and say, 'Well, if I get 15 to 20 starts out of my starting pitchers, it doesn't matter, because I'll replace them with somebody else I can buy,'' Meister said. 'That's the Yankees and the Dodgers.'
He continued: 'Everybody else, they've got to figure out, wait a minute, this isn't working, and we need to preserve our commodity, our pitchers.'
Outside of organizational strategy changes, like the Rays have made, Meister has expressed rule changes to MLB. He's suggested rethinking how the foul ball works or toying with the pitch clock to give a slightly longer break to pitchers. He said pitchers don't get a break on the field the same way hitters do in the batter's box.
'Part of the problem here is that a hitter has an ability to step out of the box and take a timeout,' Meister said. 'He has to go cover a foul ball and run over to first base and run back to the mound. He should have an opportunity take a break and take a blow.'
Meister hopes to discuss reintroducing 'tack' — a banned sticky substance that helps a pitcher's grip on the ball — to the rulebook, something that pitchers such as Max Scherzer and Tyler Glasnow have called a factor in injuries. Meister has fellow leading experts on his side too.
'Myself and Dr. [Neal] ElAttrache are very good friends, and we talk at length about this,' said Meister.
Meister explained that the lack of stickiness on the baseball causes pitchers to squeeze the ball as hard as possible. The 'death grip on the ball,' Meister said, causes the muscles on the inner side of the elbow to contract in the arm and then extend when the ball is released. The extension of the inner elbow muscles is called an eccentric load, which can create injury patterns.
The harder the grip, the more violent the eccentric load becomes when a sweeper pitch, for example, is thrown, he said.
'Just let guys use a little bit of pine tar on their fingertips,' Meister said, adding that the pitchers already have to adjust to an inconsistent baseball, one that changes from season to season. 'Not, put it on the baseball, not glob the baseball with it, but put a little pine tar on their fingertips and give them a little better adherence to the baseball.'
According to the New Yorker, MLB is exploring heavier or larger baseballs to slow pitchers' arm movements, potentially reducing strain on the UCL during maximum-effort pitches.
Meister, however, said there does not seem to be a sense of urgency to fix the game, with a years-long process to make any fixes.
In short, Meister is ready to try anything.
For a man who has made a career off baseball players nervously sitting in his office waiting room, awaiting news that could alter their careers forever, Meister wants MLB to help him stop players from ever scheduling that first appointment.
'To me, it's not about the surgery any more as much as it is, what can we do to prevent, and what can we do to alter, the approach that the game now takes?' Meister said.
'It's very, very dangerous.'