SABR Analytics: MLB, Teams View Injury Prevention As Next Frontier

PHOENIX—The third annual SABR Analytics Conference gathered many of the top minds in the analytic community to share insights and discuss research findings. Conference organizers loaded Day One with panel discussions, which lasted 45 minutes and were followed by a 15-minute question-and-answer session. Batting leadoff was "Medical Analysis and Injury Prevention,” the most interesting panel from a player-development perspective.

Sharing their thoughts on how baseball can curb its increasing injury rate while learning from its mistakes were Dodgers vice president of medical services Stan Conte, American Sports Medicine Institute research director Dr. Glenn Fleisig and Major League Baseball vice president for league economics and strategy Chris Marinak.

Teams view injury research—particularly pitcher injuries such as those requiring Tommy John surgery—as the next frontier in analytics, but Marinak admits the process is in the infant stages. He should know because MLB is writing the book on the topic, so to speak.

"We're building a foundational database to determine re-injury rates and recovery times," he said, "because the best way to treat an injury is to prevent it in the first place."

Joakim Soria had his Tommy John surgeries several years apart. (Photo by Mike Janes).

Joakim Soria had his Tommy John surgeries several years apart. (Photo by Mike Janes).

MLB has gotten involved in building a centralized database because, according to Conte, injuries in the game have been on the rise since 2007, with the last three seasons seeing the most injuries ever. Part of this, the panel agreed, was due to the fact that more injuries are being diagnosed by team doctors today. Players also are more willing to have those injuries treated than they had been in the past.

The discussion point most rich for player-development and scouting purposes centered on an expanded role for Pitch f/x technology, which records the velocity and movement of every pitch thrown in the major leagues. Conte conceded that while Pitch f/x cannot diagnose biomechanical issues, the technology could still be crucial at the minor league level to monitor changes in a pitcher's velocity, which could presage important mechanical adjustments or warn of danger ahead.

"Having success as a pitcher is all about repeating your delivery," Conte said, "and Pitch f/x can tip teams off to an injury."

Having access to universal Pitch f/x data also could help inform teams when making trades. “Velocity to me is one of the more telling pieces of information,” Conte said. “If you’re seeing a pitcher who dropped two miles per hour last year, do you really want to give him $10 million?”

The panel discussion understandably dwelled on the theme of pitcher injuries. Not only are injuries to pitchers more prevalent, but they’re also much more narrow in scope. More than 50 percent of pitcher injuries, it will come as no surprise to the reader, affect either the elbow or shoulder. (The most common injury type in the major leagues overall? The hamstring.)

Fleisig said that no pattern has been detected linking injuries to the professional pitcher with innings totals or pitch counts. Conte said the notion of the pitch count of 100 per start took hold after the publication of Craig Wright's 1990 book "The Diamond Appraised," but that the number is not rooted in hard science. For his part, Conte believes conditioning plays a larger role, in that minor league starters are never asked to throw more than 80-100 pitches, so their bodies are unprepared to take that next step in the majors.

He also shared an interesting point about how the Dodgers have come to view the idea of stressful innings.

"Pitchers tell me that it's not 30-pitch innings that are stressful," Conte said. "It's the runners-on-first-and-third-with-no-outs or bases-loaded situations that are truly stressful. That's why we've started looking at leverage index for pitchers as a indicator of stress, because we've seen a correlation between high stress and runs allowed."

The panel also talked about the history of Tommy John surgery rates and the number of full recoveries. Typically, about 18-20 major league pitchers will have the procedure each season, Conte said, though that rate doubled in 2012 for reasons that are not clear.

Despite its safe reputation, TJ surgery carries more risk than is commonly acknowledged. About 74 percent of major league pitchers return to their pre-surgery levels of effectiveness, and that’s after a grueling rehab period lasting between 12-18 months. The good news is that now the medical science community has enough data to examine the procedure’s overall effectiveness.

"For the first five years with the new elbow ligament, the body accepts it," Fleisig said, "but after that time the body is not 100 percent happy with the ligament."

Conte had studied seven TJ surgery revisions—pitchers who had the procedure twice—but could draw no firm conclusions, save that the recovery for a second TJ surgery is longer, about 16-18 months.

Conte listed as examples Rangers reliever Joakim Soria, who went about eight or nine years between surgeries, and Diamondbacks righthander Daniel Hudson, who had a second procedure almost immediately after recovering from his first, though in that case Conte believes a failure in surgery or rehab is to blame.