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MLB Injury Report: The Perfect Storm

Nic Civale is a Doctor of Physical Therapy and former NCAA Division I Baseball player. He combines his knowledge of anatomy and physiology with that of baseball mechanics to provide injury analysis. Utilize The MLB Injury Report to start your planning for 2021 drafts and keeper decisions.

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MLB Injury Report: The Perfect Storm

The year is 2021, the second Covid-19 year, the year of the Ox, and the year of the injury in MLB. Fantasy baseball lineups and rosters have been decimated with IL stints, day-to-day designations, and last-minute lineup changes. At this point, many fantasy teams are treading water with their lineups and managers have had to resort more to free agency and waivers than ever before. We know Trout, Acuna, Tatis, deGrom, Bellinger, and Betts have all missed multiple games for injury. We know about the Zac Gallen roller coaster managers are riding. Today, we will look a bit into the why. Why are we seeing so many injuries this year? Has there been a trend leading to this? Will it change in any way? Injuries are mostly unpredictable, but at the very least we can adjust our expectations to account for them.

Why Have Injuries Taken a Hold of MLB?

Since 2015, there have been drastic changes in MLB. The ball, the home run rates, the strikeouts, the “unwritten rules,” and the injuries. When we boil down the changes that have taken place in the league, we generally see that the game is played faster. Faster pitching, faster swings, more emphasis on home runs and strikeouts. It kind of feels like a video game. Just like the NBA and NFL have become similar to video game play with 3-pointers taking over and 50 QB passes a game becoming the norm.

So what does this have to do with injuries? Can we make a connection? Not a direct one, to make a long explanation short. There are no baseball stats that perfectly align to injury rates. But there are certain elements of the style of play and circumstances caused by the Covid-19 pandemic that are interesting. They lead this Physical Therapist to think there is a correlation of some sort between this age of velocity and the influx of injuries.

The Game is Changing

According to Statcast, there hasn’t actually been a monumental shift in average fastball velocity by year. In fact, from 2015 to 2021, fastball speed (including 4-seam, 2-seam, cutter, and sinker) velocity has only risen from 92.4 to 92.8 -this number actually went from 92.7 to 92.8 in the time it took me to write this article. However, there is an interesting caveat. A great April article by Devan Fink of FanGraphs entitled, Fastball Velocities Are Already Up, describes that the 92.7 average fastball in April of 2021 is notably fast for the particular month. The previous high for average fastball speed in April was 92.4 back in 2019. To see pitchers throwing this hard this early in the season is not likely a surprise to you. It’s become apparent that 95 mph isn’t must-see TV anymore. Bullpen arms often reach 98 mph regularly. Now, it would be too rudimentary to say that increased velocity equals increased injuries, but there’s no doubt that hard data like this piques suspicions. Let’s look into a few other suspects.

The 2020 Effect

Last year, training staffs were not as readily available to players as previous years. This comes as a surprise to no one. But we have to consider that while these athletes are masters of their craft, their craft is not rehab or physical therapy. Without the monitoring and assistance of team trainers, therapists, and doctors from February to July last year, players were required to essentially treat themselves.

Some players coming off of surgery were able to arrange for therapists to work with them fairly regularly, but the players who were “healthy” were often almost on their own. Last year we saw a spike in injuries falling under the category of “sprains,” “tightness,” or “soreness” that lead to IL stints than ever before. From 2017-2019 (since the 10-day IL was made available to teams), there were 126, 118, and 129 such injuries, respectively, per Derek Rhoads and 2020 gave us 79 of these injuries in 60 games, pacing out for 213! That’s over a 65% increase. As we allow 2021 injury stats to compile, will we see a rate even higher than this? It certainly seems that way.

The next question I asked myself was, for those who stayed relatively healthy through 2020, will they experience any delayed repercussions in 2021? Was the limited prep and “pre-hab” for the 2020 season something that players will pay for later on even if they squeaked by last year?

The answer seems to be yes for many athletes in baseball, as some of the game’s biggest stars have gone down with strains, tightness, and sprains this season. Looking at the top of the draft boards, we instantly think of Mike Trout’s calf, Christian Yelich’s back, Mookie Betts’ back to some degree, Jacob deGrom’s side/lat, and Zac Gallen’s elbow. Players have also experienced a rash of hamstring injuries, including but not limited to, Ketel Marte, Carlos Carrasco, Brendan Rodgers, Michael Conforto, and Tommy LaStella. At this moment, there are currently 19 players with hamstring-related IL or day-to-day designations related to hamstring injuries per There are 10 such designations for forearm injuries, and 59 classified under the broader term, “elbow.”

The Future of the Game

The third, and more systemic problem I’ve encountered is how athletes are going about acquiring velocity gains and exit velocity gains. Let me say right off the bat, there are many programs and systems that are 100% data-driven and excellently run. Driveline Baseball seems to be at the forefront of mechanics and body construction. There are many programs that make it apparent they are concerned with training an athlete to use every part of their body correctly and efficiently. Not only this but programs are individualized to a particular body type or arm angle/swing angle.

That being said, not every little league, high school, or college coach is a driveline instructor. I witnessed a little league practice a few months back as I was at the batting cages with some of my men’s league teammates. These 12-year-olds had weighted baseballs and the coach had a radar gun. They were rearing back, crow-hopping, and firing the balls into the net, trying to get the highest velocities their little bodies could muster. This was instantly upsetting, and the rest of the practice was very similar. Limited warm-up, weighted balls, no instruction on body mechanics. Just a number on a radar gun and, “Good!” or no comment.

Kids were straining with all the wrong elements of their body in order to try and impress the coach by reaching their max velocities. They’d get congratulated if they did, even if they were obliterating any notion of safe throwing mechanics. This is a huge problem in our sport. And when people have access to small clips of what MLB pitchers and hitters are doing, they’re going to try and replicate it. They see Bauer ripping a weighted ball 114mph into a net, and they’re going to go home and try to replicate it. They see Stanton hitting the ball 116mph off the bat, and they’re going to swing out of their shoes and pull whatever muscle they need to to try and accomplish that. This is a problem that will take a shift in the entire approach of the game to solve. There’s no way to monitor how all baseball players are trained. Not every young athlete has access to an instructor with the right knowledge and training. There will always be an advantage to those who have that access or to those who can afford it. But this infatuation with velocity is opening the door for many coaches and players to seek it in dangerous ways.

What to Expect

The normalization of injury rates will likely take years, not months, and I can’t imagine we will see injuries decreasing in rate for at least a few seasons. The future of the sport currently projects to be laden with platoons, load management, and maybe 6-man rotations. In terms of what that means to fantasy managers, it will make things a bit more challenging. But the true benefit would be to see more players remain healthy, for more of the season.

The three factors that I believe caused an increase in soft tissue injury rates have come together to create the perfect storm for 2021. The shortened 2020 season and related isolation of players from their physical therapists and trainers, the demand for increased velocity in all aspects of the game, and the inconsistencies of biomechanics and training all account for the increased rate of injury.

The good news is, this season does not appear to be in major jeopardy of being shortened. By 2022, we would imagine baseball players of all levels will be a bit more prepared for the upcoming season. And I’d also suspect that training and education on body mechanics will continue to improve and become more readily available to all levels of athlete. I don’t, however, see the demand for velocity going anywhere. Whatever is analytically proven to get outs will likely continue to remain the emphasis. It is up to players and coaches and especially physical therapists and trainers to come up with more sound, regulated, and responsible ways to improve athletes’ performance at a broader scale.

I imagine we are going to see record number IL stints this year that compete with last year’s crazy pace. Teams will utilize the 10-day Il regularly. Being cautious pays off when the minimum number of IL days is that low. The Dodgers have shown us that that can be an advantage to teams who utilize it correctly. Depth will decide the winners this year, and top-heavy teams have a long hill to climb, but this 2021 season should be as exciting as ever. Let’s remember to enjoy every minute of it.

Don’t forget to check out Corbin Young’s great recent work here, on FantraxHQ!

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