Quality Over Quantity: The Archetype of a Modern Pitcher Written by Andrew Schmidt | Edited by Anagha Gouru | Designed by Zachary Rentala Baseball, America’s oldest professional sport, has Over long periods of time, repetitive valgus overload drawn thousands of fans for over a century and a may cause a micro-rupture, which, if overuse is half with its leisurely pace that can suddenly be sustained, can lead to a larger rupture and eventual interrupted at any time by one swing of the bat. tear of the ligament. A 2006 study found that injured However, despite its continued popularity, America’s adolescent pitchers, before sustaining an injury, pastime is hardly recognizable as the same sport threw more months per year, games per year, from a century earlier, and few changes have been innings per game, pitches per game, and pitches per more drastic than the increasing number of injuries year compared to the uninjured control group. In suffered by pitchers. Storylines like two-time Cy addition to continuous use, increased pitch velocity is Young award winner Jacob Degrom undergoing an a second factor that has been shown to correlate with elbow procedure every year are all too common in injury risk. A study published in 2016 concluded that the MLB, and it is important to understand the root there was a 2.6-fold reduction in risk of UCL causes of these injuries so the league can make reconstruction surgery for pitchers who’s maximum strides to ensure the safety of their players. pitch velocity was less than 86.9 mph vs those who threw over 95.7. In other words, pitchers who consistently throw at high speeds are at a higher risk of sustaining an elbow injury, a scary factor considering baseball teams highly value hard- throwing pitchers਀㠀 Current Baseball Trends Compound Injury Ris欀਀ Now that key injury factors have been well- documented, why is it that pitchers are sustaining more elbow injuries than ever? The answer lies in the advent of advanced analytics. Before the Figure 1: Elbow and shoulder injuries suffered by pitchers from ਀ 1980s, pitchers were primarily 1998 to 2015 Factors That Contribute To Elbow Injur礀਀ Since 1997, the prevalence of elbow injuries among pitchers in the MLB has been steadily increasing (Figure 1). Many of these injuries require an ulnar collateral ligament (UCL) reconstruction procedure, colloquially known as Tommy John surgery, which can take upwards of 18 months to recover from and is frequently devastating to a pitcher’s career. Studies have shown that the primary factor contributing to injury is overuse. Each time a pitcher throws a Figure baseball, a certain amount of force is sustained by the elbow joint that causes its lateral (inner) structures to 2 : pngimg.com compress, putting the medial (outer) tendons under tension. This bending force about the elbow is called valgus torque, and a key medial ligament, the UCL, plays an essential role in bearing this force. 27