Friends, I’ve been thinking. And I’ve thought a lot about this, and was reminded watching Skenes velocity dip nearly 2 MPH against the Redbirds on Thursday afternoon. Pitcher arm injuries in MLB have always been a thing. But it feels more prevalent lately, and it certainly seems to be claiming some serious names.
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The Pitch Clock Changed More Than Just Pace
Since 2023, pitchers have been operating under a pitch clock—15 seconds with the bases empty, 20 with runners on, later adjusted to 18 seconds with runners. Major League Baseball got the pace it wanted. But it didn’t just speed up the game—it fundamentally changed how pitchers work. And now the question is simple:
Are pitchers’ arms paying the price? Pitching has always been violent on the body. The UCL doesn’t just fail randomly—it breaks down from repeated high-torque stress, especially as fatigue builds and mechanics begin to slip. That part hasn’t changed.
What has changed is how quickly pitchers have to reset between those high-stress throws.
Less Recovery, More Strain
With less time between pitches, there’s less opportunity for the arm to recover—even in small ways. That brief reset matters:
- The forearm flexor group stabilizes the elbow
- The joint absorbs cumulative stress
- Mechanics get a chance to reset
Take that away, and the strain compounds. Now add:
- Runners on base (more pressure, less time)
- High-leverage pitches
- Longer innings
It becomes easier to see how wear and tear can accelerate.
The Velocity Era Isn’t Helping
At the same time, the modern game has pushed pitching to its limits. Max effort is no longer the exception—it’s the expectation.
Pitchers are chasing:
- Triple-digit velocity
- High-spin breaking balls
- Elite movement profiles
Research has already suggested that higher velocity and spin rates can correlate with increased injury risk. MLB itself pointed to those factors—not the pitch clock—as the primary driver of injuries in 2024.
What the Data Says So Far
So, does the pitch clock cause arm injuries? The answer isn’t clear—yet. A 2024 study found no significant spike in Tommy John surgeries or elbow injuries in the first season under the new rules.
But newer research is more concerning. A 2026 analysis suggested a delayed effect, where injury rates may increase over time as reduced recovery intervals accumulate stress across seasons. In other words, the damage may not be immediate, but it could be building.
The Growing List of Injuries
Regardless of the cause, the results have been hard to ignore. Recent high-profile cases include:
- Spencer Strider
- Shane Bieber
- Eury Pérez
- Gerrit Cole
And in 2026:
- Zach Eflin (Tommy John surgery)
- Max Scherzer (forearm issues)
- Justin Steele (rehab setbacks)
It’s not just isolated cases; it’s a pattern. That’s where things get concerning. Pitchers like Paul Skenes and Garrett Crochet represent the next generation—high velocity, high spin, high stress.
And the question isn’t just if injuries will happen. It might be when. The pitch clock probably isn’t the sole cause of rising arm injuries. But it’s also not irrelevant. MLB sped up the game. Pitchers kept pushing their bodies to the limit. And somewhere in the middle, the human elbow may be reaching its breaking point.
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