MLB Should Look to the Art of Pitching to Solve Its Injury Crisis

Greg Maddux built a 5,000-inning Hall of Fame career on command, location and movement—and he never injured his arm. It’s time baseball experts started listening to him.

RVR Photos-USA TODAY Sports

Having given you the data and the biomechanical analysis of how the single greatest cause of the injury epidemic to pitchers is increased velocity, I sought an expert opinion to confirm or contradict the evidence. I wanted art, not just science.

And not just any expert. The best. The man with the most wins of any living person, who pitched more than 5,000 innings over 23 years without a single arm injury and who went on the injured list just once—for 10 games in 2002 with a sore back. You want to know why pitchers are breaking down? Ask Greg Maddux, the winner of 355 games and four Cy Young Awards, who until this year has spent years working with amateur and professional young pitchers.

“Being around a lot of young college guys and high school guys, it’s all about the velo,” Maddux says. “You know, it’s all about how hard can I throw it? What can I do to throw it and get my spin rates up and all that? And that’s kind of what most of the pitches are.

“I think when we were growing up, we were learning how to pitch. We were learning how to locate our fastball and change speeds. We threw hard enough to have success. We weren’t trying to force extra velocity. We were trying to force extra command and location and movement and game planning and all those things.”

Maddux was speaking to me and Joe Maddon for our podcast, The Book of Joe, from Las Colinas Country Club in Irving, Texas, where he is playing in the PGA Tour Champions event this week with 39 other sports and entertainment celebrities. He took this year off from working with Texas Rangers pitchers in spring training as he became a first-time grandfather. He has seen first-hand how pitching has changed.

Know this about Maddux, besides his numbers: he was one of the smartest baseball players I have ever covered. He was playing 3D chess while everyone else was playing checkers.

He used to call his next pitch (fastball or off-speed) by the way he caught the return throw from the catcher—positioning his body to catch it in front of his chest or off to the side.

He would sit next to the Braves’ hitting coach during games he wasn’t pitching to better understand how hitters thought.

He used to move inches on the rubber—right or left—to move the ball inches in or out.

When I once asked him what he loved most about baseball, he said it was designing a series of pitches to retire a batter and executing them exactly as imagined, like a scientist proving a theorem.

He would throw more warmup pitches from the stretch than from the windup (the opposite of just about every pitcher) and when I asked him why, he replied brilliantly, “When do you have to execute your biggest pitches?”

I loved his explanation about how to pitch out of trouble: “I don’t think about throwing harder; I think about locating better.”

When I asked him to explain the simple beauty of his arm swing, he put it this way: “I make an upside-down L when I take the ball out and an upright L when I take it up.” He knew, without knowing the exact science, that the arm should be raised in a 90-degree angle or less when that front foot lands. That’s how you pitch 23 years without an arm injury.

So, you listen to Greg Maddux when it comes to pitching.

“Execution wins,” he says. “I know velocity is nice and big sliders are nice, but, you know, execution still wins. Even in today’s game, the pitcher that’s going out there and executing the most quality pitches is the one that’s going to win.

“I always told the guys, ‘Look, it’s not a speed contest. It’s a pitching contest. If that was the case, Nolan Ryan would have went 500–0.’ Nobody threw harder than him. So, you have to be able to execute pitches and get your breaking ball down and locate some fastballs.”

Folks, it’s not that complicated what is happening to pitchers. This is not about three weeks of ballgames with a reduced pitch clock that the players association wants you to know it proudly voted against, reminiscent of those “Don’t Blame Me; I Voted for McGovern” bumper stickers. It’s not about one year of the pitch clock. Sure, don’t dismiss the clock as a potential factor; keep studying injury rates under it. But last year—one year of data—showed virtually no change.

This is about a 10-year trend that has been right in front of our faces—of pitchers throwing harder and harder (fastballs and breaking pitches) and at younger and younger ages. We have become a society of specialists, not devotees of liberal arts and humanities, and baseball is no different. Throwing factories with state-of-the-art cameras, tracking devices and weighted balls are popping up everywhere, with 12-year-olds flocking there to train like grown men.

It’s working. Velocity is going up. Mechanics are being improved. The supporting muscles are being strengthened. (Shoulder injuries have become rarer.) But there is nothing the wizards of velocity can do about the ulnar collateral ligament, that important but fragile band of tissues in the elbow that keep popping like guitar strings around the game.

The more velocity increases, the more torque impacts the elbow. Since I told you 18 of the 21 hardest throwing starters of the past five years have broken down, Bobby Miller of the Los Angeles Dodgers joined the injured list. That’s a breakdown rate of 90% for extreme velocity throwers. When I ran the same measurement on starters with average velocity over the past five years (93.8 mph) the breakdown rate was only 60%.

deGrom has struggled to stay on the field for large parts of his career. / Charles LeClaire-USA TODAY Sports

“It’s easy to say they’re overthrowing or they’re trying to throw it too hard,” Maddux says. “But you watch somebody like Jacob deGrom and you watch him throw and it’s an easy 98 [mph] coming out of his hand. He’s not overthrowing, but it’s still 98. So, you know, that’s a tough question. I think that’s best left up to the medical guys and all that.”

deGrom happens to be the perfect example of what “the medical guys” have been saying. Easily hitting 100 mph and snapping off 95-mph sliders, deGrom throws too hard for his UCL to handle. He has very good mechanics. He is never overworked. (He has thrown more than 118 pitches in a game once in his career). His body is shredded. He is a terrific athlete.

And he cannot stay healthy.

Maddux points to secondary injury factors besides the chasing of velocity:

Year-round pitching for youngsters replacing multi-sport participation.

“That’s a lot of throws from the time you’re 15 to 22,” he says. “There’s only so many throws in your arm. It doesn’t seem like they take the time off that much.”

Over-specialized training.

Maddux ran sprints, power-shagged in the outfield, took batting practice, took infield once a week, rode a bike and went on 40-minute walks. “I guess it’s to the point it’s way too lopsided and not really incorporating things like that that we did in the past that I think are really more vital than is realized,” he says.

Lack of emphasis on winning in the minors.

Maddux threw 17 complete games in the minors. “There’s kind of a fine line between developing and also teaching the guys how to win,” he says. “I think you have to teach winning as you’re developing.

“That’s the one thing that I didn’t see in the minor leagues. I've been to a few games even in Vegas the last couple of years. The AAA team of the A’s is out there and you don’t see players doing things to win. It’s more like, ‘Well, I got 70 pitches and I need to throw 22% off-speed.’ And, ‘You know, I need to throw 5% fastballs up.’ It seems like it’s not, ‘Let’s read the hitter or the situation and execute a pitch off of that.’ It just seems too prescriptive.

“I would love to see the minor league coaches develop their players in how to win baseball games instead of just how to stay healthy and throw the number of pitches they’re supposed to throw.”

Lack of concern and know-how about pitching through a lineup three or four times.

“You never really paced yourself, but you had to do something a little different the third and fourth time through the lineup,” Maddux says. “Hopefully you pitched inside enough. In a perfect world, when it’s late in a game, you realize you’re a little tired, so you have to rely on your command more than your velocity. And at the same time, your changeup’s usually probably going to be better than your breaking ball.

“So, that was something I understood. So, the first two times through the lineup, if I could stay away from throwing too many fastballs away, I wanted to show the guys in and I wanted to show them a breaking ball because I knew later on in the game that I was going to have more success throwing fastballs away and changeups. So, I didn't want to abuse that the first couple times through the lineup.”

Nobody talks like that anymore. Maddux faced at least 260 hitters a third time in a game in 11 seasons. Nobody has done that once since 2019.

Pitchers have never thrown so few pitches and so few innings and with more rest than they do now—and never have they broken down more often. Generation Driveline and the cookie-cutter conservatism of front offices have been wildly successful in cranking out extreme velocity throwers but a failure in producing lasting stars.

Take two snapshots: one in 1995, when Maddux was 29 years old, of the active pitchers in their 20s with the most wins, and the same group in 2024:

Welcome to the Lost Generation when it comes to Hall of Fame-bound starting pitchers. Bieber is the “workhorse” of this 20-something generation? His 62 wins would have ranked 18th in 1995. He averaged 10 wins and 140 innings over six years before—you guessed it—blowing out his elbow this year.

Baseball has more than 100 experts studying this injury epidemic among pitchers. It is costing MLB billions of dollars and the drawing power of premier starting pitchers. Wins may mean nothing in an analytic world, but they matter at the box office.

I am not optimistic that the environment will change. Velocity drives the amateur market. Specialization drives our commerce. Faith in medicine increases. Tommy John surgery has lost its taboo. The dollars are such that one contract is a bigger carrot than a long career. Like rock climbers, hang gliders and stunt people, pitchers now sign up for what they do fully aware of the inherent risk. Throw harder and assume you are a blowout waiting to happen. It’s still the favored path, including by MLB teams, over trying to change speeds and locate better.

Argue all you want about pitch clocks, sliders, mechanics, slick baseballs, spin rates, grip strength and whatever other variables you wish. Of course they matter. But there is one leading cause. Pitchers have reached the physical limit of what the UCL can endure—and not for a pitch here and there, but red-lining the tachometer on every pitch because the game demands swing-and-miss over weak contact. If the environment doesn’t allow another pitcher like Maddux, maybe we should at least listen to him.