How Do You Keep a Pitcher Healthy?

The biggest news in Yankeeland last week was Mariano Rivera’s knee injury. He tore his A.C.L. and his meniscus doing the most mundane of things—shagging fly balls during batting practice. The greatest closer of all time is done for the season, and, given his age (he’s forty-two), maybe forever, despite his stated desire to stage a comeback. As much as it stings, though, the Yankees are prepared to move on, though they’ll never be able to fully replace him.

The injury that will hurt the team more in the long run is Michael Pineda’s, whose 2012 season ended before he ever threw a pitch. What the Yankees had initially described as shoulder tendinitis in his throwing arm turned out ot be much more serious. The twenty-three-year-old starter underwent arthroscopic surgery last week to repair an anterior labral tear—in other words, his shoulder is damaged, and he won’t see action in a game again until 2013.

Unlike Rivera, Pineda is still very young—an injury like this at his age is by no means a career-jeopardizing thing. But to see this prized arm go down so early in his Yankee career is an alarming development, especially given the team’s recent track record of failing to develop young pitchers. (The Yankees could always look for pitchers among their position players, as the Orioles and Red Sox had to do on Sunday during their seventeen-inning marathon.)

Pitching prospects are notoriously fragile. For every Justin Verlander, the Detroit Tiger who won last year’s American League Cy Young and M.V.P. awards after five years without missing any significant time due to injury, there’s a Kerry Wood, whose flashes of dominance have been interrupted by more than a dozen trips to the disabled list. For every Greg Maddux, a future Hall of Famer who pitched well into his forties without so much as a hiccup, there’s a Mark Prior, a top prospect with one memorable season who’s been chronically injured since.

Why does this happen? Glenn Fleisig, a research director at the American Sports Medicine Institute (A.S.M.I.), has studied pitching extensively. He says injuries in young pitchers stem from a combination of excessive workload, ineffective conditioning, and poor throwing mechanics.

In Pineda’s case, we know that he entered 2012 with major red flags. His workload last season, his rookie year, was a hundred and seventy innings. That was a career high for him, nearly forty innings more than he’d pitched in any year before, so he was putting unprecedented mileage on his arm. He didn’t help matters by showing up to spring training this year twenty pounds heavier than he was at the start of 2011. And then there’s his delivery.

The seemingly simple act of throwing a ball from the pitcher’s mound to home plate is complex and physically demanding. One need only look at the particularly violent delivery of a player like Tim Lincecum, of the San Francisco Giants, to see that the forces put on the body can be extreme. His unorthodox mechanics—his body appears to wind up tightly, and then suddenly, uncoil—are part of why he is nicknamed “The Freak.” Those mechanics have helped him to several extraordinary seasons and two Cy Young awards, but now he’s lost a notable amount of velocity, and has been struggling this season.

Any flaws in a pitcher’s motion can cause injuries. Depending on which expert you ask, though, there are a variety of answers as to what actually constitutes a flaw. One prolific thinker on the subject is Chris O’Leary, the pioneer of the “inverted W” (otherwise known as an “M”) theory. Imagine watching a pitcher’s delivery in profile, from first or third base. Now trace a line from the hand in which the pitcher’s holding the ball up to his elbow, to his shoulder, then his other shoulder, his other elbow, and finally the glove hand. If the line you’ve drawn looks like an inverted “W” (O’Leary uses Mark Prior’s delivery as an example on his Web site), O’Leary believes, the player is at a significantly higher risk for shoulder and elbow problems.

O’Leary’s exact explanation for why the “inverted W” causes injuries is complex, but, in brief, he believes that it creates a timing problem. The formation causes the throwing arm to lag behind the rest of the pitcher’s body; getting it to catch up therefore requires that much more speed and force. Imagine cracking a whip—only the whip is your elbow and shoulder, and it’s being ferociously cracked a hundred times a game, thirty games a year.

Pineda’s motion doesn’t include the “inverted W.” But in O’Leary’s analysis of the pitcher’s mechanics, he noticed a similar timing problem. As he winds up, Pineda brings his throwing arm far behind him, something O’Leary calls “showing the ball to center field”—it looks as if he might as well be presenting the baseball to Yankee center fielder Curtis Granderson. Many pitching coaches teach this. But as with the “inverted W,” because Pineda puts his arm that far back, it requires immense force to get it to catch up to his body as it moves towards home plate. That means cracking that same whip, putting intense pressure on his elbow and shoulder with every pitch.

Injuries are nothing new for Pineda—he missed most of 2009, when he was a minor leaguer, with elbow trouble. It’s not possible, yet, to say definitively whether that injury, or this one, was a result of his mechanics. His shoulder problem could instead be the product of last season’s intense workload, or the fact that he was twenty pounds too heavy in spring training, or, more likely, some combination of all these things.

“We have no idea how to keep young pitchers healthy,” Will Carroll, a sportswriter and expert on all things injuries, said in an e-mail. “Like nearly all major league pitchers, we have no idea what forces pitchers like Pineda are putting on their arms with every pitch. The Yankees, like twenty-seven other teams, don’t do biomechanical studies. It’s sad.”

Baseball has long been resistant to the notion of rigorous, scientific analysis of pitching deliveries. If you read Michael Lewis’s “Moneyball”—or saw the movie based on it—you know that when it comes to scrutinizing a player’s style, many in the game prefer to rely on gut intuition. And biomechanical analysis is by no means perfect. The two teams that use it seriously, the Boston Red Sox and the Milwaukee Brewers, don’t have sterling records when it comes to keeping pitchers healthy. (A biomechanics skeptic could argue, rightly, that Boston’s pitching staff might have suffered fewer injuries last year if the organization spent less time on mechanics and more on keeping its pitchers from drinking beer and eating fried chicken in the clubhouse during games.) And there’s considerable risk involved in tinkering with a pitcher’s delivery. By the time a player reaches the major leagues, he has spent years repeating the same mechanics over and over. That level of muscle memory is hard to beat, and if you try to change it, the pitcher might never be the same. So, rather than go for wholesale changes when it comes to pitching mechanics, many err on the side of tweaking existing habits rather than introducing new ones.

But there is evidence in favor of biomechanical analysis. The Yankees have one example in their starting rotation—staff ace C.C. Sabathia, whose remarkable talent has not come at the expense of his durability. With the exception of 2006, he has started more than thirty games every year since 2001. (His slightly shortened 2006 season, when he still logged twenty-eight starts, had nothing to do with arm trouble—he had an abdominal strain.) He went to A.S.M.I. early in his career, when he was with the Cleveland Indians, for biomechanical analysis, and he’s been one of the game’s most dominant pitchers since.

What, exactly, Sabathia changed after his A.S.M.I. visit is unclear. Fleisig remembers his visit well, but can’t discuss what happened, due to client confidentiality. What he did say, in an e-mail, is that Sabathia was “friendly, receptive, and smart.” He also added that the Indians, at the time, had an effective infrastructure for utilizing A.S.M.I. results. (Their director of player development back then, John Farrell, would later take this biomechanics-friendly approach to the Red Sox, where he was pitching coach for five years. He’s now the manager of the Toronto Blue Jays.) Just watching Sabathia’s delivery today, it seems smoother and less violent than Pineda’s. O’Leary looks at Sabathia pitch in Yankee pinstripes and sees several mechanically sound characteristics. He doesn’t exhibit the “inverted W.” He doesn’t present the ball to center field. He isn’t rearing back like Pineda. There’s none of the arm lag, no need for him to adopt that lethal throwing motion.

Every pitcher is unique. Pineda shouldn’t copy Sabathia’s delivery. But now that he’s suffered two arm injuries in his short career, the latest of which will obliterate his first season with the Yankees, he probably needs to change something. The team can limit his workload. They can ask him to show up next year in better shape. And they can give him the tools he needs to make sure he’s not destroying his arm with every pitch he throws.

Photograph by Nick Laham/Getty Images.