Why Are So Many Pitchers Getting Hurt? Orioles Ace Corbin Burnes Has Thoughts

His theory? The pitch clock. Here's what Burnes wants MLB to change:

If he could, it sounds as if Orioles ace Corbin Burnes wouldn’t mind smashing a baseball bat into the pitch clock on the brick wall behind home plate at Camden Yards. At the very least, he’d like to pause the timer for a few extra moments before it begins ticking, so pitchers’ arms can rest a touch longer.

To him, it’s this clock—which makes for quicker games and a better viewing experience on TV and in-person—that is in part responsible for what is an ongoing, potentially worsening epidemic of pitchers injuring their arms.

The latest instance occurred Friday night in front of a sold-out crowd against the Phillies at Camden Yards, when Kyle Bradish—the O’s No. 2 starting pitcher behind Burnes—strained the ulnar collateral ligament (UCL) in his right elbow for the second time this year. He’s on the injured list now undergoing further tests.

“I’ve been a big believer that the pitch clock has something to do with a lot of the injuries,” Burnes told us in the Orioles clubhouse a few hours earlier on Friday—you could say by coincidence, but not at the rate it seems pro pitchers are hurting their arms these days. We’re not even at the midseason All-Star break yet, and already nearly 30 percent of more than 600 MLB pitchers have spent time on the injured list this year because of a throwing arm injury.

As he spoke, Burnes didn’t need to look far for evidence of his hypothesis. Former All-Star John Means was walking through the O’s locker room with a bionic elbow brace on his left arm, just days removed from having his second Tommy John surgery in about two years. The procedure replaces the UCL—the main stabilizer of the elbow during overhead throwing—with another tendon to re-connect the upper arm bone to one of the forearm bones.

At a pregame media session on Friday, the first three questions posed to manager Brandon Hyde by reporters were about injured pitchers Dean Kremer (triceps muscle strain), Danny Coulombe (elbow inflammation), and Tyler Wells (UCL). Hyde answered each query briefly. “We’ll let you know when we have an update on all those guys,” Hyde said.

Then, a few hours later, the O’s took a gut-punch when Bradish—who hit a career-high 98.6 miles per hour in the first inning—was added to a long list of walking-wounded pitchers on the O’s, and in MLB.

“Starting pitching, relieving, pitching in general is a high explosive movement,” Burnes said, comparing it to a sprinter in track and field. “We’ve been told you’re going to make a two- or three-second sprint in our pitching, and then you have to do it again in 15 seconds. The recovery is not there.

“[MLB’s] argument is, don’t throw as hard so you can recover faster. But in a day where if you don’t throw hard and you give up runs, you lose your job, you’re going to go out and perform at max effort—or as close to it as as you can. You have to try to bounce back, and guys aren’t bouncing back, they’re getting hurt.”

While the 29-year-old Burnes, a 2021 Cy Young Award winner acquired by the O’s in a headline trade this offseason, is not the first to argue the pitch clock is leading to arm injuries—for the simple idea that less recovery time between throws means more cumulative strain on an already unnaturally overworked arm—he speaks from a unique position of first-hand experience. He is one of the most effective pitchers in professional baseball—as he most recently displayed during a six-inning gem in an 8-3 win over Philadelphia on Sunday—and one of baseball’s most durable throwers.

Burnes’ 655 innings tossed since the start of the 2021 season is the second-most in baseball during that span, and he has the most strikeouts and lowest earned run average of anyone, even in the ballpark of his amount of innings. That makes him arguably the most valuable pitcher in all of MLB, and it’s why he’ll command top dollar on the free agent market this offseason (unless the O’s sign him to a new contract beforehand.)

Burnes is the only full-time Orioles starting pitcher this year who hasn’t missed playing time because of injury. (Grayson Rodriguez had a stint in the IL last month with shoulder inflammation. Cole Irvin has been healthy, too, though he has spent time in the bullpen.)

“There are a lot of pitching injuries right now. It’s no secret,” Orioles general manager Mike Elias said a few weeks ago in a media session announcing Means’ and Wells’ impending elbow surgeries to repair their UCLs. “It’s unfortunately a big part of being a pitcher right now.”

Some, like Major League Baseball officials, say the rash of injuries is part of a multi-decade trend of pitchers throwing harder and straining their arms with more speed and spin on the ball. A pitcher who could touch nearly 100 miles per hour with a fastball was once a novelty. Now, it’s relatively common. And repeated stress accumulates, from Little League to the bigs, particularly on the UCL, which can strain or partially or completely tear. The latter requires surgery.

This is why more coaches at all levels have become conscious of things like pitch or innings counts. At the same time, though, the pursuit of blistering fast pitches (and technology and coaching that can help develop them) has seen kids, prospects, and pros push the capabilities of their bodies.

“It’s really an overuse injury,” says Dr. Matthew Best, an orthopedic surgeon and director of sports medicine research at Johns Hopkins, who frequently performs surgeries on the UCL. “People that are pitching more, they’re pitching faster, and if they’re pitching year-round, they’re just stressing the UCL more. That’s one reason for the higher rate of injuries, especially in youth athletes.

“It’s definitely been increasing over the past 10 to 20 years,” Best continues. “The repetitive kind of stress to the ligament is what leads to the ligament wearing down over time. There are ways to reduce the risk. One is keeping the muscles around the elbow strong, reducing the frequency of pitching, and ensuring that there are good pitching mechanics. It’s a multifactorial injury.”

Elias, in charge of the Orioles roster and the organization from top to bottom, acknowledged being “paranoid” when it comes to thinking about pitching injuries right now. He said he welcomed an ongoing discussion about the source, but also said he wasn’t sure the problems were exclusive to MLB.

“It’s concerning,” he said. “If I were to try to explain it, it would be more like a perfect storm. You go out and do amateur scouting [and see] this is happening in college and high school, basically at the same level, or the same rate to some degree. I don’t know that it’s anything we’re doing in pro ball, or not doing.”

In an story this year, officials said “the rate of professional pitchers undergoing Tommy John surgery has been on a steady climb for years, a trend that began long before the implementation of the pitch timer.”

There may be something to that. Burnes throws hard, mainly a 95-mile-per-hour cutter that is his primary pitch, and a rare faster sinker, though not a fastball. Nearly half of his pitches are off-speed curveballs, sliders, or changeups. So he’s not the hottest of flamethrowers out there. He also believes his body type—6-foot-3, 245 pounds—is a factor in his durability (knock on wood) compared to other, sinewy pitchers.

“I’m a bigger guy,” he says, “so I think I have a little bit more of an advantage to staying healthy compared to some of the leaner guys in the league.” Part of his attention to staying healthy is tracking his sleep quality. He’s worn a Whoop tracker around his wrist at night long enough to know that even when he’s feeling worn down, more hard work with conditioning, not less, helps his body recover better—and rest easier.

Recovery for pitchers has always been needed. Sure, there are stories of old-timers throwing a seemingly unlimited number of innings a century or two ago. But you can find black-and-white photos of hurlers wearing ice packs on their elbows and shoulders, too.

Today, many pitchers throw harder than ever and often from a younger age, as specializing in a sport has become more popular among kids. Yet the Major League Players labor union thinks there’s something more to the arm injury story at the big-league level. Which brings us back to Burnes’ theory—the pitch clock.

To speed up the pace of games and boost attendance and viewership, a 15-second timer with no runners on base and a 20-second clock with runners on, was implemented with great success from a fan perspective a year ago, trimming 24 minutes off games on average to the fastest pace in 40 years. In December, MLB made more changes, saying the length of games ticked up as the season went on and pitchers were throwing with several seconds left on the clock, so the league decided to shorten the timer with runners on to 18 seconds.

This year, pitching injuries became a ballpark storyline from the jump. Shortly after Opening Day, the issue came to the fore amid a string of popular pitchers going down with elbow injuries. Bradish experienced problems in the preseason and tried a lower-risk platelet-rich plasma injection in his elbow just to pitch. The MLBPA sounded the alarm that its “concerns about the health impacts of reduced recovery time have only intensified.”

As part of its response refuting those concerns, MLB referred to an “independent analysis” by Johns Hopkins University “that found no evidence to support that the introduction of the pitch clock has increased injuries.”

About that, though: This report and any associated data are still unpublished, and its specific findings are unclear. Best, the director of sports medicine research at Johns Hopkins, told us on Monday that neither he nor his colleagues in orthopedic surgery were part of the study, and that it came from the School of Public Health.

“We did not see that research, and we can’t confirm it,” said Best, who is also a physician for Johns Hopkins’ athletics teams. “In addition, it’s not been published yet, so it’s not past the peer review stage, meaning other surgeons have to read it and make sure it’s valid. I’m not refuting it. It just needs to be reviewed. You really need to see more data on the injuries to tease out how much the pitch clock is associated with it or not.”

Still, count Burnes among those who believe the clock has something to do with pro pitchers’ ligaments and arms fraying in what feels an increasingly inevitable way.

“Unless you’ve been in the sport and know what pitching does to your body, and the recovery involved, you don’t know what shortening the pitch clock does to you. MLB will tell you it’s the same, [injuries are] on pace as previous years, but if you ask them what on pace is for previous years, the line’s doing this,” Burnes said, angling his left hand skyward. “They’re expecting more guys to get hurt, so why don’t we do something to try to level that off or send it in [a lower] direction? That’s where the logic is for me.”

His potential solutions?

First, add time to the clock. He says pitchers are only throwing quicker in the allotted time because they don’t want to become predictable—and throw with one second left on every pitch—which allows baserunners to potentially time the pitch and steal bases easier. A longer clock would allow for more recovery.

Second, Burnes suggested MLB raise the cap of the maximum 13 pitchers permitted on the active 26-player regular season roster, which could help teams give pitchers more rest—either by allowing for six-man starting rotations or more bullpen depth, which he says is needed. And that’s saying something, considering Burnes is the most durable pitcher in the game.

“We play the game. We have a pretty good idea of what’s going on,” Burnes said. “They’re just hesitant and reluctant to listen to what we have to say.”