Yet Another Young Star Pitcher May Need Tommy John Surgery

The scourge of pitcher injuries in Major League Baseball appears set to continue.

Rotations across the league have been decimated this year, with injuries affecting teams at the top and bottom of the standings. And in particular, the Miami Marlins, whose pitching staff was expected to be one of baseball's best entering the season. 

Top prospect Eury Perez underwent surgery early in April, ending his season and much of next season. Spencer Strider, arguably the best pitcher in the sport over the past few years went down with an injury a few weeks later. Sure enough, that resulted in Tommy John surgery that will keep him out through mid-2025. 

Gerrit Cole seemingly avoided a more serious elbow procedure, but remains out for several months for the Yankees. 

Now we have another potential case from an exciting young pitcher.

The Marlins announced on Friday afternoon that they were placing star pitcher Jesus Luzardo on the injured list with…you guessed it, elbow issues. On the same day that Wade Miley went down with a Tommy John surgery of his own.

While there's been no indication that the injured list stint for Luzardo will lead to Tommy John, a staggering percentage of the time with pitcher arm injuries, it's an inevitability. What in the world is happening?

Miami - Miami Marlins starting pitcher Jesus Luzardo (44) pitches in the first inning against the Los Angeles Angels at loanDepot Park on April 2. Photo: Jim Rassol-USA TODAY Sports

Tommy John An Epidemic Across MLB

That list doesn't even account for Shohei Ohtani, who's recovering from Tommy John as a pitcher, set to miss the entirety of 2024 for the Dodgers.

So what's the explanation?

Mostly, velocity. 

The average fastball velocity across the sport continues to reach new highs, with 2024 the highest yet. The harder pitchers throw, the more stress placed on their arms, the more injuries that occur.

But it's not just velocity. Teams and players have become smarter about what pitches are most effective, realizing that the old adage of "pitch off the fastball" is outdated and inaccurate. And if a pitcher's most effective offering is a breaking ball, that's the pitch that should be thrown most frequently.

In particular, the slider/sweeper/cutter horizontal breaking pitch has been more and more popular as pitchers use it to create a tunneling effect off their fastball. The rate of slider usage has increased substantially in the past decade, and sliders are...wait for it, much tougher on the elbow than even fastballs are.

Combine the two, higher velocity and more breaking balls, and you get what we've seen so far this year: more injuries and more Tommy Johns.

So how can we fix it? Unfortunately, there aren't a lot of great options. High velocity and more breaking balls get more hitters out, so pitchers will continue down that path, hoping to avoid surgery as long as possible. But the frustrating reality is that most will at some point in their careers be forced into Tommy John as a result of chasing more effectiveness.

All those clips of 102mph fastballs and devastating sliders baseball fans love to see are a ticking time bomb towards injury. Enjoy your favorite pitcher while he lasts.