Under The Knife 8/11/23

The Future Is Burning

Longtime reader Paul S had a great comment after Wednesday’s newsletter. I know, never read the comments, but I think this one has value:

On the youth injury prevention topic, I have a 14u player whose been with some of the top travel organizations, so we know some of the top 2026, 2027 and 2028 players and coaches in the country. There's little to no injury prevention focus at this level; nor does anyone seem to care. It's never a topic of coaching for players. Everyone defaults to Pitch Smart count and assumes it's adequate, but very few have an understanding of key concepts such as acute to chronic workload, internal vs external rotation strength balance, the risk of weighted balls at a young age etc. The coaching commuity and medical community seem to never cross paths, so travel baseball is all about velocity and winning. In our organization, a 16 year old Power 5 commit just had TJ this week and another had the surgery last summer. I could name several other high school pitchers and youth pitchers in a similar situation.

USA baseball does a better job of education and thankfully roll over innings which pitch counts get too high during training events. This would never happen in a travel tournament where I've seen a coach take a 13u pitcher 50+ pitches in an inning with no plan to pull him because he "needed to work out of it himself". The same coach put a 14u catcher in to finish a game after catching 6 1/3 innings in the 100+ degree southern heat. A different coach had a 13u player go 160 pitches in 3 days "because he (the pitcher) wanted to tough it out and help the team win." I could go on, but you get the point. If you'd ask any of the coaches about injury prevention products like armcare.com, Flex GripPro or Driveline's Pulse you'd get a blank look.

The bottomline is that I'm not surprised at all about the arm injury epidemic and don't see it changing anytime soon because there's no incentive for coaches to focus on player health.

Paul’s right and so much more needs to be done. MLB has taken over minor league baseball with their “One Baseball” initiative. Now, they need to do the same and help fix the scourge of youth baseball that operates as bandits and destroys arms. Imagine an MLB-sponsored organization that guarantees scouting, collects solid data, and focuses on development and health. It’d be easy, relatively cheap, and they’d win. Sadly, owners don’t seem interested in the least. Discussions I had with two on the topic said variations on “I don’t think we’ll be doing that.”

Contrast that with this really nice article from the Denver Post. More and more teams are doing something like what the Broncos ownership is doing, but it’s nice when it’s proactive rather than triggered by new ownership realizing there’s been really bad results. There’s about 20 teams in baseball that should be reading this article and wondering why they haven’t done the same thing (or better.) There’s still so much low hanging fruit to reducing injuries and baseball must be better, now and for the future.

Let’s get to it:

MICHAEL LORENZEN, SP PHI (no injury)

It’s pretty amazing to me that here in 2023, one of the talking points about Michael Lorenzen’s no hitter was that it was 124 pitches. That used to be called “Wednesday” twenty years ago, when complete games existed. It’s hard to say that Pitcher Abuse Points don’t rank up there with saves, as a stat that had so much influence that it actually changed how the game was played, but probably not in the way that the creators expected.

The 124 pitches is an uninformative number to begin with. No hitters and near-no hitters are uniquely stressful. Pitcher after pitcher I speak with says that the last couple innings are all “bear down” pitches because of the situation. You see velocity go up, less in recent years because so few pitchers get the opportunity and the ones that do have been at near-full velocity the whole time as pitchers do now. There’s no coasting.

Lorenzen was smiling and happy afterwards, but even that - talking into the night on MLB Network and others - is unusual. Instead of heading into the training room and getting started on his recovery routine, it’s gatorade showers and standups. I’m sure the Phillies are happy with their deadline deal, but they also may look at some extra rest to make sure that Lorenzen keeps making good starts.

SHOHEI OHTANI, DH/SP LAA (no injury)

Shohei Ohtani made it through his Wednesday start without a recurrence of the cramps he’s suffered with for a couple weeks. There really wasn’t any seeming issue, no one I spoke with saw anything different in game, so it’s unclear if this was just a passing problem that passed or whether the Angels figured something out and were able to quickly correct it in some way. We may never know.