Did we miss anything? Is there something you believe is the cause of the rise in TJ surgeries lately?

some great analysis here! Really appreciated the insights into off season work, there really is no “off season” for MLB pitchers.

Thanks like always for these in depth injury videos. Injuriries are worst part of competitive sports. Im using an article about bicep tendonitis that you contributed to a while back to rehab it this time (and hopefully the last!). I think this kind of content can have a super valuable longtail since its not like injuries are going anywhere soon sadly.

frequency is a big part of the answer ie over load to tendon capacity , the other is Not having significant conditioning /weight training to elbow AND a work load to great , nolan ryan ( 1 of THE historic best on earth least injuries)stresses in pitchers bible you Have to do light workout for tendons, shoulder , area along with legs ALL ON and OFF season keeping it strong ~Period .

good vid i like the ways to reduce the risk of injuries you mentioned, also it was weird to see how strange players get treated in the minors

In my mind the top contributors are. Velocity, Intensity+Freq(High Intense multiple times per week), Lack of volume training. Personally I found that throwing 25 pitches at a high intensity required almost the same recovery time as 100+ pitches at the same intesity (For the smaller muscles and tendons). I would much prefer to do 100 pitch bullpens once a week as it built capacity better and allowed you to learn how to throw while your body fatigued naturally during the session. It also allowed more time to work on pitches as you werent limited to 5 or so of each pitch type. But that style doesn't fit in with the modern strength training like schedules. I would argue if teams started to reduced freq (@intensity) instead of volume that arms would hold up much much better. Pitch counts aren't helping anyone (within reason of course not going full Japanese 400+) volume being limited over a whole year is good as in more rest time between sessions not so much limiting pitches per session/outing.

Great insight and info in this presentation. 👍 As far as rule changes, what if the MLB rules committee proposed these 3 rule modifications: --Limit pitching changes per 9 inning game to encourage the pursuit of endurance from starters, with the by-product being a lower avg stress intensity per pitch. Sure, it probably means we need to get used to starters having higher ERA's, but wouldn't this also encourage more pitches in that 80-90% of full tilt range, while they picked their spots to ramp up intensity? (Maybe there'd be certain exceptions within the rule, like if a pitcher exceeds 40 pitches in an inn.) --Open the strike zone back UP to the armpits. I'd be curious to know how much the strike zone has shrunken over the last 60 yrs. Would expanding the strike zone place slightly more attention to using location, pitch sequence, & finesse to continually change the eye level and balance of the batter, rather than relying so much on pure velocity or spin rates? --Add two seconds to the pitch clock for any pitcher who has completed 4 innings. Two additional seconds are then added to the pitch clock for each additional inning completed thereafter. When a pitching change occurs, the pitch clock goes back down to the original baseline.

as i blow my elbow out my elbow 2 weeks ago lol

Great content thanks'

personally weak supporting muscles were the reason i had elbow pain, strengthening them in the offseason i have no pain now

Waiting for this ❤❤❤

Tommy John starts at the youth level. My son plays on a 12u Majors teams. Last weekend he played an against a team that threw 119 pitches. The kid had above average velocity and ball movement. I don’t know the kids throwing routine, it might be great but 119 pitches seems excessive and unhealthy. I think the road to pressure parents to have their son throw faster and have more movement. I’m guilty of it. I see little Johnny throw 70 miles an hour and I want my son to throw that hard. For example in a previous local tournament each team had at least one pitcher that threw in the 70s, again these are 12-year-olds. Thank you for all this information. I have a learned a lot from you guys and will continue to watch all of your content. Much appreciated.

Perfect time perfect video

Good to note that Spencer Strider had a bone fragment in his elbow that produced over time, not a UCL tear

In the layback part of the throw you almost feel a stretch nagging pain on the out side of the elbow what could this be?

Would shifting to a 7 man starting rotation, maybe increasing the roster size per team to 28 man for the entire season help reduce fatigue? Issue would be, teams wont wanna add to payroll for 1-2 more elite starting pitchers plus relievers. but we all know that the answer is to reduce the amount of work or increase the rest period

What advice would you give youth players looking to play in HS and or college? What exercises would you have then focus on to build a stronger arm to be less prone to arm injuries?

This may be a dumb question and maybe no one knows for sure but why is it that guys that are 6'3"-6'6" throw 100-104mph repeatedly with ease I've seen guys 6'0" throw 100-101 but the guys that are tall as hell are usually the ones that throw heat seeking missiles is it a strength things or is it a arm leverage thing because they have longer arms I honestly thought if randy Johnson could've got into one of these programs when he was younger he could've thrown 102-104 but idk just sorta my question/theory (I know not all tall people can throw hard)

Good morning Ben, an exciting discussion form Tread (As usual). I am 48-Year-Old Engineer who pitched in Collage in the Dominican Republic and I have a couple of observations to make, albeit it’s all conventional wisdom do please bear in mind it’s only the observations of this old washed-up pitcher: • The Idea that you shouldn’t teach follow through might need to be revisited. The durable pitchers from the Past (Seaver, Ryan, Clemens, Randy Johnson, Maddux ect) they all buried their shoulder. I see some dramatic recoiling in today’s boys (Strder, Skenes to name a few) that doesn’t look right to me. DeGrom does a good Job a keeping his arm quet, but I admit it’s not a cure all recipe. It’s just an idea. For example here is a link of me throwing a bullpen session: kzfaq.info-jtbEbX45CM • In Page 69 on Nolan Ryan’s Pitchers Bible (A Classic for the Kids of my Generation) he states that he ramped up his strength training from October till January) with no pitching till February. I know that you addressed this earlier in the video. But the Point I wanna make, me living in the Dominican Republic, is that I see these young guns coming from the USA and in the off season they are still pumping gas……..THEY DON’T EVER REST.. • Endurance Training has disappeared from the Training Schemes these days……….AND TRUST ME I HATED IT (INCREDIBLY BORING), but the reality is that fatigue plays a role in injuries, there is no getting around that. I believe there needs to be a more balanced approach between Strength and Endurance. Hopefully I’ve been able to provide something to the situation and help a little bit. Again, It’s just the opinion of an ol timer. Best Regards

could tommy john surgeries be improved where the ucl is replaced by artificial piece of tendon which the strength is much stronger than human tendons? In that case TJs will just be a rite of passage to a bulletproof arm.

It's a very niche sport, but I think the only comparable sport in terms of torque on the elbow is pro arm wrestling. I was wondering if you've considered adapting any of their flexor and biceps training methods to support pitchers' musculature, since those muscles end up supporting 2/3 or more of the overall torque on the elbow. Obviously you can't crank muscular development to 11 so that it inhibits mobility like they do in arm wrestling, but I think there is a lot to plumb there that pitchers aren't doing. A lot of the guys in arm wrestling have rigged machines in weird ways, or even welded their own, in ways specifically to train biceps, flexor and hand muscles and at monstrously high volumes. Since building capacity specifically in those muscle groups is huge for preventing elbow injury, and really is one of the more controllable factors of it, I think it could be worth looking into. Fair warning though, once you start down the Devon Larratt training video rabbit hole there's no going back.

43:35 - Is there really going to be a notable impact on player fatigue from conducting grip tests between innings? (Next paper... Does grip testing between innings significantly contribute to player fatigue?)

10:49 so the saying that “gripping the baseball tight causes injury” is not helpful? because flexor muscles are the one you use to contract your fingers to grip the ball.

they need to shorten the season. its crazy anyone's arm can make it from preseason league in february to playoffs in october throwing 95+ the whole time.

Yay... first comment!

strider specifically added a nasty curveball and bam 2nd ucl

Building up high intensity on flat ground and then all of the sudden going that same high intensity off the mound can throw your mechanics out of whack and put excess stress on the arm

You can grow muscles, you can’t grow ligaments and tendons

I still find it kinda comical that this is a mystery to some people. The only guys out there blasting the ball as hard as they can 40-100 times a game are the same ones blowing their elbows and/or shoulders out. I mean...maybe the human body is simply not made to do that for long periods of time...lol

In my honest opinion, I just do not think us as humans where meant to throw an object at speeds greater than 90mph consistently, let alone multiple times in a single day. With such great forces acting upon the entirety of the arm for 50 - 100+ pitches in which a player is performing/pitching at 100% it does not surprise me how relevant arm injuries are. I tore my labrum at 14 and it was simply due to overpitching. One can do all they can to remediate and do preventative measures to protect themselves. However, it is inevitable to NOT have to go through at least 1 arm surgery in an MLB career. I think the amount of people who can consistently throw a baseball 90+ mph with MLB level of precision for a prolonged amount of time is few and far in between and the MLB truly proves that. It's no wonder why we have such a rotation of new and upcoming arms that just get pumped and dumped. I think a possible way to remediate this would be to stop emphasizing pure velocity. Especially at the low level. Who cares if some high schooler can nail a 90mph fastball consistently. Can they throw offspeed pitches well, can they establish a zone, can they set up batter for certain pitches. Or are they simply throwing a ball to throw a ball because they can throw said ball "hard." At a low level, this is what kills arms. Coaches who have no high level, or even low level experience capitolize and take advantage of these players and ruin them. From top to bottom player development across the board is whack and its hard to see any clear solution. At the rate the average fastball is rising, how long does it take for this speed to simply flatline, or get to the point where hitters can't even hit and everyone becomes a 3 outcome hitter. Walk, Home Run, orStrike out. Right now, I don't think there will be a shortage of players who throw 90+. However, I do think there will be a massive shortage of "star" power pitchers. With that, I do also see a massive decrease in overall production over a career for many pitchers. In a nutshell, pitchers will have career of 3 - 5 years before diminishing to the next guy up who tops them in average velo. It will be a while before we see starting pitchers who last 5+ years in the MLB. let alone 10+. We will see many Tim Linecum's yet fail to see a few Randy Johnsons or Rogers Clemens in between then.

Most of these guys been throwing curveballs since they were 12 years old; that’s why right there

I think it’s concerning how MLB reps are calling these training facilities ostensibly seeking information, with the subtext of the conversation being, “WTF are you guys doing to our athletes?” Ultimately there needs to be a complete paradigm shift in how we’re developing our pitchers. One element to explore is motor preferences and even genetic testing of athletes to determine what amount of stress their UCL can actually handle. No more “velo days” for little Jimmy Numbnuts who is a bird-boned 5’8 and 100 pounds soaking wet. Sorry, no more videos of him yeeting the ball at max effort to post on instagram. If his body can’t physiologically and genetically handle anything over 89mph, it makes no sense to try and hit 95. No more velo day net-yeet. No more weighted balls. No more driveline bs. Throw it in the trash and go back to old school conditioning and flexibility routines that are maintained year round. No more “ramping” on or off for the season. Muscles can adapt quickly and work that way but not connective tissue.

The answer is extremely simple: the human body isn’t built to throw a baseball over and over at 100mph