The Cubs Are the Face of an Alarming New Injury Trend in MLB

[Matthew Trueblood]

Over the weekend, Craig Counsell revealed that one of the Cubs' most important young pitchers will miss considerable time, as the injury with which he's dealing is more severe than first believed. It's also, while rare, part of a trend that should concern baseball fans everywhere.

Image courtesy of © Katie Stratman-USA TODAY Sports

It'll be a while before we get a chance to see Ben Brown continue his exciting rookie season. Shelved last week with what was dubbed a left neck strain, Brown has now been diagnosed with a stress reaction in that area. In essence, a stress reaction is the larval stage of a stress fracture. The Cubs' medical and training staff will have to work closely with Brown to give time for his neck to rest and recover, but there will also need to be a change in the way or the amount that he throws, or he's going to suffer stress fractures in that area, which would cost him the rest of this season.

To understand why this is so ominous (especially as we take a look at the broader team and league context for it), we should start by getting some things clear about stress fractures. Here's an important passage from the abstract of a detailed paper on these injuries, housed at the National Institute of Health's National Library of Medicine:

Quote

Stress injuries are often seen in running and jumping athletes and are associated with increased volume or intensity of training workload. Most commonly, they occur in the lower extremities. Upper extremity stress injuries are much less common, but when they do occur, they typically occur in the ulna.

That's 'ulna' as in 'ulnar collateral ligament,' which is why baseball fans have been familiar with the concept of a stress reaction in the elbow for a long time. It's usually an early signal of failure of the UCL, which necessitates Tommy John surgery. The bone doesn't quite break, but it starts to show its inability to bear the force being exerted upon it. As the above says, runners and jumpers see these more often, because that repetitive force is totally unavoidable when your chosen sport involves those fights against friction and gravity.

Note, too, the mention of "increased volume or intensity" of workload. That's certainly been the case for Brown this year, as he was thrust into a large and demanding role for the Cubs. Still, for the strain of that increase to show up in the neck instead of the elbow is highly unusual.

Or, we might need to say, it was highly unusual.

Baseball Prospectus has one of the most valuable and powerful tools on the entire baseball internet: a suite of injury database tools that allows us to break down the frequency and severity of various types of injuries, to various body parts, within seasons and across them. Using those tools, I can tell you this: In 2016 and 2017, there was one pitcher each season who missed time due to a stress fracture or stress reaction in their back, shoulder, ribcage, or neck--specifically, in the spine or the scapula, as opposed to the humerus or the ulna (the bones of the arm itself). There wasn't another such player until 2021, and then, again, only one.

Injuries by Body Part Through N Days of Season, 2019-24, MLB

In 2022, there were six pitchers placed on the injured list with such maladies. In 2023, there were three. Already, in 2024, there have been five of them--and two are Cubs. Brown is the latest, but early in the season, Julian Merryweather also hit the injured list with stress fractures in his ribs. Merryweather last pitched on Apr. 5, and just got back onto a bullpen mound late last week, as he tries to work his way back to readiness.

That Brown and Merryweather belong to a burgeoning class of hurlers losing time to these types of injuries suggests that there's more afoot than a sudden change in workload. That certainly doesn't help--last year, Brewers closer Devin Williams pitched through persistent back pain late in the season, as he bore a heavy workload for the hard-charging Crew, and he was diagnosed with stress fractures in his upper back during spring training. It can't be the whole explanation, though, because most pitchers (including Brown) are being handled very carefully, league-wide, but injuries like these are on the rise.

Maybe it's something mechanical. Let's take a quick look at a fastball Brown threw way back in his MLB debut, on Mar. 30.

There's something in here, but it might not be what you think. From this very straight-on rear camera angle, we can see how Brown jerks his head to the side to accommodate his arm path as he delivers. That's somewhat common. Pitchers call it "head whack," and if it were fatal to the bones of the neck, Max Scherzer wouldn't be two decades into his professional career. It looks like the kind of movement that would eventually be bad for your neck, and it might even be bad for your neck, but it's not the main reason Brown has come up with this issue. If it were, perhaps the issue would be unique to him.

Watch the clip again, though, and keep in mind that this camera is situated quite high and very far behind Brown. That makes it hard to tell how far the tall, lanky Brown extends down the mound. As I've discussed before, though, he does have superb extension, and that's despite a high three-quarters slot that typically doesn't correlate with that trait. Subtly, the big hurler takes a long stride, he gets some extra momentum and release distance from staying in hyperextension (that backward lean or bend of the back that precedes the forward snap of the torso) and then launching at the last moment into flexion (a forward bend at the waist, where any good pitcher should end up as they finish a delivery).

Williams does this, too. So does Merryweather. Every pitcher in the big leagues goes from some degree of hyperextension of the spine when their foot lands to some degree of flexion at release, but these three are good examples of guys doing it at a high, near-extreme level. Not coincidentally, perhaps, Williams has some of the best release extension (it's confusing, I know, to term that so similarly to hyperextension, which is a different idea here, but that's what the stat has come to be called) in MLB.

Throwing hard, with such great extension and that suddenness of transition in spine position, makes for a violent delivery. Whereas Scherzer (the platonic ideal of the head-whacking hurler) has a low slot, both Brown and Merryweather have high three-quarter slots that compel them to push the force they're applying to the ball through the top of their torso, rather than releasing it like a whip through their arms.

To survive in MLB, you have to throw hard. To throw hard, you have to find a lot of force somewhere and channel it through the ball at the moment of release. Pitchers are desperate, these days, for ways to create that force with more of their body than just their arm, because that's how they might hope to avoid elbow surgery.

In that quest, though, more and more of them are simply finding that the force required to throw that hard is exceeding what other structures in their bodies can bear. Here's another important tidbit on stress fractures in the back, from the website of the Hospital for Special Surgery.

"These stress fractures in the back are most often seen in adolescent athletes such as gymnasts, where there is a great deal of extension and landing with an arched back."

Now, to be clear, the injuries described on that page are not exactly what Brown and Merryweather are dealing with. They are quite similar to Williams's injury, which has cost him the whole season so far and figures to keep him out until at least the All-Star break, but they're distinct from those the two Cubs relievers are battling. That doesn't mean they're unrelated, or that the above isn't vital information.

Landing with an arched back in the course of a highly forceful movement is dangerous. It's also an awesome way to throw hard, without having to maximize arm speed and maximally imperil the UCL. Pitchers have been trying more and more ways to streamline their mechanics, increase their functional strength, and recruit new muscles and body parts to create great velocity. Some of them are successfully avoiding snapping their ligaments like rubber bands, but instead, they're wracking themselves--pushing central parts of their own skeletons right to their failure points. They're doing some gymnastic movements, at anywhere from 180 to 250 pounds.

This, to me, is the latest argument for a serious, global push to disincentivize velocity, somehow. Without some change that allows pitchers to quit the rat race, there will continue to be great facilities like Driveline Baseball and Tread Athletics and the Texas Baseball Ranch, all teaching pitchers multiple means of generating huge linear and rotational force with their bodies, all helping them make millions--and all steering them toward new and unexpected frontiers of injury that disrupt seasons and careers; affect their lives after those careers end; make it increasingly difficult to evluate and build a roster, for front offices and public analysts; and alienate fans who can't count on seeing familiar faces on the rubber the way they once could.

If pitching is becoming backbreaking work, in a literal sense, someone ought to step in and demand that a major change be made. Otherwise, in a decade, we won't be talking about a handful of pitchers with injuries like these. We'll be reading spreadsheets full of them, like we are now with elbow surgery patients.

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[CubinNY]

I'm not trying to bag on someone's physical appearance, but Brown seems to have an unusually long neck or at least it appears that way. 

[cl smooth]

archie manning's nickname for peyton growing up was "longneck."

[Matthew Trueblood]

1 hour ago, cl smooth said:

archie manning's nickname for peyton growing up was "longneck."

That must have been before the top half of his head grew in. I mean it's an impressive neck, but it has so much to stabilize, it just looks necessary.

[Matthew Trueblood]

1 hour ago, CubinNY said:

I'm not trying to bag on someone's physical appearance, but Brown seems to have an unusually long neck or at least it appears that way. 

Yeah, it does. Statcast, hit us with some neck-length leaderboards.

[PackLandVA]

On 6/17/2024 at 8:36 AM, CubinNY said:

I'm not trying to bag on someone's physical appearance, but Brown seems to have an unusually long neck or at least it appears that way. 

He’s got nothin’ on Merton Hanks.