Year After Effect: Five pitchers at injury risk

Only five pitchers make up the 2016 class of The Year After Effect, Tom Verducci's annual look at pitchers who could be at risk of injury after making large innings jumps the previous season, but they include some big names.

Lance McCullers of the Astros is the embodiment of state-of-the-art pitching. He reached the big leagues last year at a precocious age (21), throws ferociously hard (up to 98 mph, with a cruising speed of 95), whipsaws one of the game’s nastiest curveballs (batters hit .148 against it in 2015) and flaunts a freakish changeup with elite run and velocity (90 mph, and sometimes as hard as 95). McCullers makes hitters look foolish: In 22 starts last season, he averaged 9.24 strikeouts per nine innings. Only one American League pitcher that young with that many starts ever punched out hitters at a better rate: Frank Tanana, with 9.4 for the Angels in 1975.

This strikeout prodigy was the No. 4 starter on a wild-card team that won 86 games. Now you understand why just getting on base has never been so hard for AL hitters since the DH was introduced in 1973. Velocity, spin and control have evolved to become an all-time difficult combination.

Weaponry is not the only reason McCullers is state of the art. There is also this marker: The Astros, while in first place, shut him down for two weeks last August when he was perfectly healthy. Why? Two industry-wide words that didn’t exist a generation ago: innings limit.

McCullers had never thrown more than 104 2/3 innings in a pro season, so Houston kept him off a game mound for a fortnight to lessen the increase of his workload as a proactive way of keeping him healthy. He threw three minor-league innings over a 20-day period.

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“Knowing he’d be looking at a big jump up in innings, we were looking for an opportunity to give him a break,” said Astros general manager Jeff Luhnow, who added that his organization does not use firm limits for its pitchers. “I think the most important thing to remember is that there is no silver bullet. Every pitcher is unique. We don’t have any specific rule of thumb. Really what we want is constant discussion and dialog between the player, the trainers, the coaches, the doctors, the medical professionals and the front office. That’s our only rule. The only outcome I can’t tolerate is not having constant communication about it. This is a science, but it’s an inexact science. We think we have a lot of information and we look at everything, but in a lot of ways you’re still playing a guessing game.”

Inspired by how Oakland handled young aces Tim Hudson, Mark Mulder and Barry Zito in the early 2000s, I have tracked for well more than a decade how teams increase the workload on their young starters. Teams have grown more conservative over this time: Shutdowns of healthy pitchers and pre-determined caps on innings have become commonplace, lest their young arms be endangered by something I call The Year After Effect, in which too many innings piled on too quickly could increase the risk of regression or injury.

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What’s too many? Luhnow is correct in saying that every pitcher is unique. Many pitchers simply get hurt for reasons that have nothing to do with their workload, and some defy the odds and never get hurt, even with large workloads. But to track workloads, you do need qualifiers. I look at major league pitchers in their age-25 season or younger who increased their previous high in innings by more than 30%. It doesn’t mean these pitchers will definitely get hurt; it means they packed on innings at an especially high rate and bear watching this year.

So let’s get right to it. For the second year in a row, I found only five pitchers who added enough innings to qualify as an outlier. All of them pitched for contenders, including four postseason teams. Mr. State of the Art is on top of the list with the largest increase in innings as measured by percentage. (The increase by innings pitched is over the pitcher's previous career high. All innings are counted, including winter ball):

Pitcher	Age	Innings	Increase by IP	Increase by %
Lance McCullers, Astros	21	164	+59 1/3	+56.7%
Noah Syndergaard, Mets	22	198 2/3	+65 2/3	+49.4%
Luis Severino, Yankees	21	161 2/3	+48 2/3	+43.1%
Carlos Martinez, Cardinals	23	179 2/3	+52 2/3	+41.5%
Tyler Duffey, Twins	24	196	+46 2/3	+31.3%

I’ll get to each of these pitchers in more detail shortly, but first let’s examine what happened to the five pitchers I red-flagged before last season, in order of their respective innings increase, and how the year after turned out for them:

Jesse Hahn, Oakland (58.4%): Shut down in July with elbow discomfort and a right forearm strain, five years removed from Tommy John surgery.

Rubby De La Rosa, Arizona (46.5%): Made 32 starts; his 4.67 ERA (up from 4.43) was the second worst of any NL qualifier.

Daniel Norris, Toronto/Detroit (44.5%): Threw 150 2/3 combined innings in the minors and majors and missed four weeks with an oblique injury.

Yordano Ventura, Kansas City (38.9%): ERA rose from 3.20 to 4.08.

Marcus Stroman, Toronto (34.8%): Blew out his knee in spring training; missed five months.

And now for the class of 2016.

Lance McCullers

How could Houston give McCullers an August sabbatical and still allow him to take on the biggest workload increase? As Luhnow said, the Astros don’t have fixed limits, and the feedback they received on McCullers during the season was favorable. They saw a young pitcher who maintained his velocity and who was given extra rest in 13 of his 22 starts. (The idea of “extra rest,” however, as I’ve written before, needs updating. Four days of rest are no longer the norm; pitchers make a majority of starts now on five or more days of rest.)

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At the end of a long season, Houston handed McCullers the ball in ALDS Game 4 against Kansas City for what turned out to be his final outing of the season. He allowed one run and struck out seven batters, just 10 days after turning 22. Only two AL pitchers that young ever had more strikeouts in a postseason game: Bret Saberhagen of the Royals in the 1985 World Series and Chief Bender of the Philadelphia A's in the 1905 World Series. Not bad for a kid who wasn’t even in big-league camp in spring training.

“Our plan going into the season was that we knew he would start at Double A and likely move to Triple A with a chance to pitch in the big leagues,” Luhnow said. “We wanted to let him pitch and monitor it.”

Luhnow recently was reported to have said that the Astros will place an innings limit on McCullers this year, but as he told me, “I think those comments were misinterpreted. We are not placing a limit. We are going to try to manage his workload so that he stays healthy through the season and is available in the playoffs.”

How conservative have teams grown when it comes to pushing their young pitchers? Compare Floyd Youmans, who was taken by the Mets with the 33rd pick of the 1982 draft, with McCullers, the 41st pick 30 years later, in 2012. Both are righthanded power pitchers who stood 6'2", had been born in Tampa, were drafted out of high school and reached the big leagues at age 21 in their fourth professional seasons. Here are their year-by-year innings workloads:

Year	McCullers	Youmans
Year 1	26	39 1/3
Year 2	104 2/3	134 1/3
Year 3	97	125 2/3
Year 4	164	200 1/3

Look at that jump for Youmans in Year 4, which was 1985, the year he reached the majors with Montreal. He followed it up in 1986 by throwing 219 innings, all at the major league level, including 202 strikeouts and an NL-high 118 walks. We don’t have pitch count records from 1986, but just imagine the load on his 22-year-old arm in so-called "good old days” of pitching. Youmans threw at least eight innings in eight of his final 10 starts for an Expos team that was more than 20 games out of first place. Such use today would get a manager fired. Youmans hurt his elbow in 1987, and the year after that, he was in drug rehab. His major league career was finished at age 25.

McCullers has thrown 28% fewer innings in his first four years (391 2/3) than did Youmans 30 years ago (499 2/3). Youmans tossed 10 complete games in the minors in those four seasons. In 50 minor-league starts, McCullers never threw more than 6 1/3 innings, and he only lasted that long once. He threw five innings or less in 45 of those starts. He also made 15 assorted relief appearances and missed three weeks in 2014 with back soreness.

That’s why McCullers is state of the art. The game is training starting pitchers to throw fewer innings less often but with more effort. And, despite half of all starting pitchers winding up on the disabled list each year, the system is working (at least as far as depressing offense) because of the expanding inventory of hard-throwing pitchers.

Noah Syndergaard

With all the attention last year on an innings limit for Mets teammate Matt Harvey, Syndergaard made a riskier jump in workload with a fraction of the fuss. The 23-year-old Syndergaard is four years younger than Harvey and had never before pitched a sixth month in a season, never mind the seventh that he did last year as New York advanced to the World Series. In that seventh month (October), Syndergaard threw 19 high-stress innings, including a 101-pitch start in the NLCS on two days of rest from a 17-pitch relief outing in the NLDS clincher. He also threw far more sliders in September and October.

At 6'6", 240 pounds, Syndergaard is built like an NFL tight end and, like McCullers, he maintained his velocity. (It actually increased a bit in October: Against the Dodgers in the Division Series, he threw his fastest pitch all year, at 101.3 mph.)

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The Mets will treat all of their young starters with extra care this spring and through the first two months of the season. From day one of camp those pitchers—a group that also includes Jacob deGrom and Steven Matz—will be on a slower-than-normal track in terms of when they throw and how much. They rarely will pitch on the fifth day early in the regular season, as New York will drop in a sixth starter when the luxury of an off day does not provide five days of rest between starts. Syndergaard, who said he thrives on a heavy workload, made 32 starts overall last year; just 11 on the fifth day. The bottom line is that the Mets believe Syndergaard is such a physical force—a true outlier when it comes to strength and size—that the usual risk of such an innings jump for such a young pitcher does not apply.

Kathy Kmonicek/AP

Luis Severino

The Yankees knew Severino was so good that they limited his early-season work in the minors so that he could throw big-league innings in the second half. In 19 minor-league starts last year, Severino averaged only 82.9 pitches per start. Then New York promoted him in August for the playoff push, when development takes a back seat to winning games. Against higher competition, the Yankees bumped his pitches per game to 93.3, a 13% increase. His innings totals ramped up simply because he was too good for the team to back off on his usage.

Just how good was Severino at age 21? He posted an ERA+ of 137 in 11 starts. Only one other Yankee that young ever posted a better adjusted ERA with at least 11 starts: Hall of Famer Whitey Ford in 1950 (153 in 12 starts).

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​Severino throws in a similar manner to Kansas City's Yordano Ventura. Both are 6-foot righthanders who often recoil off a stiff landing leg. They don’t have long levers but make good, efficient use of body speed and balance. Severino doesn’t have Ventura’s two-seamer or curveball, but he is blessed with textbook arm deceleration—something you can see in how easily and how far his hand travels behind him after releasing the baseball. It saves wear and tear on the shoulder, as opposed to an abbreviated stop, which is the equivalent of wearing out a car's brakes (the muscles in the back of the shoulder) by jamming them at each stoplight.

Carlos Martinez

No need to wait for the Year After Effect here; this is a classic case of the difficulty of transitioning a reliever to the rotation. Martinez had never thrown more than 127 innings in a pro season and worked mostly out of the bullpen in 2013 and '14. Yet in 2015, the Cardinals dropped him into their rotation and let him go. They tried to protect him by giving him a nine-day rest around the All-Star break and by never letting him throw more than 108 pitches in a game. But still, just as Martinez passed his previous innings high, he began to wear down, even as his velocity rose. He posted a 2.57 ERA through his first 127 1/3 innings but a 4.11 ERA over his last 50 1/3. On Sept. 25, his shoulder cried “uncle:” Martinez came out of his start that day after throwing only six pitches, and St. Louis shut him down for the year.

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The transition story of Martinez holds echoes of the one for Joba Chamberlain, another young righthander with a power slider. Chamberlain transitioned from the Yankees' bullpen to their rotation midway through the 2008 season and soon went on the DL with rotator cuff tendinitis. He went back to the rotation the next year, posted a 4.75 ERA and a 36% innings jump over his previous high, then blew out his elbow in 2011.

Martinez has remained in Jupiter, Fla., this winter to work with the Cardinals’ newly established medical performance staff (another totem of state of the art). He is expected to be ready for spring training.

Tyler Duffey

The Twins remained in the wild-card race until the last weekend of the season, and this 6'3", 220-pound rookie righthander was a key part of that run: Minnesota went 8–2 in Duffey’s 10 starts after his promotion from the minors. The Twins did give him “extra rest” in seven of those 10 starts, but Duffey, who was used as a reliever at Rice University, rolled up 196 innings in 32 overall starts—a significant jump from 149 1/3 innings and 25 starts the previous season.

Minnesota believes Duffey has several factors working in his favor to withstand such a jump. He recently turned 25 years old, has a big body and doesn’t throw a power slider, as do Chamberlain, Martinez, Severino and Syndergaard. Except for the rare changeup, Duffey is a two-pitch pitcher who throws his curveball like nobody else in baseball—40% of the time, the most by any pitcher who made at least 10 starts.

But here’s the bad news: Duffey has several red flags in his delivery, the kind of movement patterns you just don’t see in sustainable starting pitchers. He pulls his pitching hand and elbow behind his back during his stride phase (crossing the acromial line, the imaginary line between the tops of the shoulders); he shows the ball to centerfield as he loads it, which causes timing issues; he loads with the arm at more than a 90-degree bend (forearm flyout); and he throws with a slight crossfire action over his front leg.

Duffey showed last year that he can pitch like that and still be effective. His 134 ERA+ was the third best among first-year pitchers in franchise history with at least 10 starts, behind only Scott Erickson in 1990 (145) and Mickey Haefner in '43 (140). But when you combine his unorthodox mechanics with his jump in innings, the Twins should keep a close eye on him this year.