Why Are All of the Baseball Players Hurt?


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It’s a rough year to be a fantasy baseball manager. Ok, maybe fantasy baseball shouldn’t be the primary concern when scanning the MLB injured list but it hits closer to home.


You could build multiple championship teams with the players on the injured list this season. The MLB hasn’t seen injury rates as it has the first six weeks of the 2021 season.


Compared to 2019 — the last full season — injured list placements have climbed by 15 percent. More disturbing, soft tissue injuries — mainly hamstring and oblique strains — are up 97 percent.


Why are players breaking down more this year? What changed?


The negative influence of a shortened season

The loss of fans in stadiums and reduction from 162 to 60 games last year cost the MLB north of $3 billion dollars. The financial hit keeps coming.


While stadiums are expanding capacity and we are back to a full slate of 162 games, the mounting injuries are costing teams. These hits are a result of the shortened season.


As a physical therapist, injury prevention is a primary focus of mine. While we don’t have a perfect formula for preventing injuries, we know it is multifactorial and highly dependent on the overall demand placed on the body.


For professional athletes, their sport is a year-round job. Every day fits into a training plan. Rest is intentionally scheduled. Meals and workout programs are designed to maximize physical performance. Training schedules account for the rigors of a sport.

To reduce the chance of injury, players


Injury prevention is about volume, but traditionally too much volume is the issue. The shortened season decreased volume, so shouldn’t fewer injuries occur in 2021?


Games prep the body

Practice can never simulate a game. The intensity differs.


Research shows soft tissue (e.g. oblique strains) injury rates are highest at the beginning of a season. The body is adapting to the rigors of a game. Unfortunately, the adaptation is on a steeper curve than most years.


Players build training plans year-round. More so, each year builds off of the previous one, especially for pitchers as they gradually build up a tolerance to more innings. The shortened season threw a wrench in these structured, year-long training programs for players. Preseason, season, and offseason training schedules were adjusted.


In 2020, teams were isolated to hotels for travel. Pitchers were conducting bullpen sessions in their hotel rooms by throwing into a mattress against the wall.


A professional athlete's body is finely tuned. The shortened season altered their preparation. The offseason COVID-19 restrictions remained, making it difficult to return to normalcy. Professional athletes are still adjusting and trying to figure how best to train and prepare their bodies.


Off the field impacts

Virtual workouts are not the same as in-person. The Broncos have learned that lesson through two season-ending injuries within a couple of weeks of players electing off-site workouts.


While players can replicate the logistics of a workout anywhere — gym equipment, routines, pre and post-workout nutrition — the environment differs.


COVID-19 restrictions influence team interaction. Restrictions are not removed until 85% of the team is fully vaccinated. Research shows psychosocial factors can influence injury rates and performance.


The baseball season is rigorous, both in volume and frequency of playing. The St. Louis Cardinals just completed a stretch of 17 games in 17 days. Players are away from their families and in hotels for weeks at a time. If they don’t have their teammates to fall back on, the stress and rigors of the season worsen.


Injury prevention research is clear that physical characteristics alone only account for a small portion of injury risk factors. Fatigue and mental status influence how we play and recovery.


Caveats to the data

There are many caveats to the increased rates of injury:

  1. The rate of increase in April injuries from the 2019 season to this year is similar to the rate of increase from 2018 to 2019.

  2. The minimum time on the Injured List (formerly known as the Disabled List) was 15 days prior to 2017. Teams are more likely to place a player on the 10-day IL, allowing them to call up a replacement player. If a player would be out a week, they were more likely to sit on the bench when the IL placement was 15 days.

  3. As we learn more about injuries and rehabilitation, teams are taking a more cautious approach. We see the same thing in the NBA. Players are provided more rest days to improve performance and reduce injury risk by way of fatigue reduction. The increase in MLB roster size from 25 to 26 — implemented in 2020 — provides greater flexibility for teams to adjust lineups.

  4. Pitchers throw harder year after year. According to baseballsavant.com, the average velocity of a four-seam fastball in 2008 was 91.9 mph. In 2021, the average is 93.6 mph, which would set the record. The Fastball is the most dangerous pitch as it creates the most strain at the elbow and shoulder (the danger of the curveball is a myth). Unfortunately, from an injury prevention perspective, it is the most important pitch. The fastball sets up all secondary pitches.

Do these caveats mean the 2021 data can be written off as expected and part of a new trend? I don’t think so.


These factors certainly play a role, but they compounded the issue of a shortened season. Trainers, coaches, and players will take note as this is unlikely to be the last shortened season.


I am not talking about another global pandemic, rather, I am worried about a potential strike. The current relationship between the MLB Players Association and Owners rivals that of the two sides of the aisle in the US Congress. It’s deteriorating, too.


If a strike does happen, expect another spike in injuries when baseball resumes.


Will this be a season-long problem?

Most likely.


We saw a spike in early-season and per-game NFL injuries in 2020. Like baseball, the soft-tissue injury risk spiked. The injuries remained throughout the season with the highest rates in weeks 7, 11, 14, and 15 (17-week season).


Basketball did not suffer the same fate as they had a minimal disturbance in-game volume. The bubble was the primary interference. The NBA claims rates are down this year.

There is a domino effect to injuries as well. One of the greatest predictors of an injury is a previous injury.


Bear in mind, not all injuries result in placement on the injured list. Some smaller tweaks and pains are likely to become issues later in the season. Players that spent time on the injured list have a good chance of returning. It will be challenging for the league to fully recover from a rough first month.


This case study shows how sensitive our bodies can be to change. It also shows how important physical preparation is for athletic events. I expect trainers and coaches to make changes in their programing after reviewing the results from this season.


It’s unfortunate so many players are getting hurt, but oftentimes experience is the best teacher.