Why Pitching Injuries Happen and How to Avoid Them | Keith Meister, M D 

“What’s the value of 0.8 whip if it lasts two weeks” Bingo. Meister is spot on

1 of the best interviews we've done on this show. VERY IMPORTANT for all pitchers to watch this

Great interview, lot of moving pieces but think the pre-tacked baseballs are an important first step.

Freaking awesome guest guys...A+++. Dr. Meister not only has the expertise to add insight into this serious topic but he also has the balls to be brutally honest.

Most important interview I have seen in recent times.

Keith Meister, M.D. is spot on. It's the things that these pitchers are throwing today that is the key difference to 10 years ago. I've really watched Dustin May of the Dodgers for some time. I was able to review film of him in High School, and up through the minors to the big leagues. A great talent, but you could see changes he made along the way to be that major league stud. Everyone would remark how nasty his stuff is in the show. He's now on his second surgery. I hope he pulls the nasty back a little so he can have a good career and life. I've told young pitchers to look at pitchers of the past such as Greg Maddux, Don Sutton, and Tommy John. They lived on the ball changing speeds, and great control.

I've been saying the MLB needs more pitchers like Greg Maddux.

That makes Trevor Bauer, with his wacky kinetic exercises and drills , a genius. Yes , he is off the kilt, but boy does he ever analyses his craft.

This is a fascinating interview. Baseball has a huge problem

Kratz, Chapman's elite mechanics are also important. His utilization of his bottom half increases speed and alleviates pressure on his arm. Guys like Carlos Rodon are strictly upper body. He doesn't use his legs, which is a big reason why he has back and shoulder problems. Sandy Alcantra is another pitcher who has poor mechanics, and you can see precursors for Tommy John if you know what to look for. I also disagree with the notion that velocity is a problem. You can have guys throwing harder than they are currently throwing and still be completely healthy. There is a large list of pitchers and hitters who have developed inefficient ways to throw and hit balls far, not just pitchers. Through improper mechanics, they overexert themselves and cause unnecessary pressure to ligaments and muscles. From my perspective, either the teams are extremely ignorant and don't comprehend this aspect of the game, or they comprehend it and don't care because they get to keep the price down of pitchers as cheap and expendable . I do not see this lack of understanding of such a basic thing as technique in other sports.

I just completed my 29th year as a Head High School Baseball Coach and have never had a single elbow or shoulder surgery. I appreciate your input as I try to grow my knowledge. RGHS BASEBALL O. GRIEGO

The most insightful baseball pitching discussion I have ever seen. Why does no one remember the Braves trio who pitched together for nearly a decade under pitching coach Mazzone? They were never max effort pitchers.

The reality being, muscle fibers hypertrophy and strengthen at a rate exceeding that of tendons and ligaments. So as athletes train to enhance strength and power, but the tendons and ligaments do not strengthen proportionately, this leads to overload forces applied to these tissues at near max efforts. We can observe a pitcher and predict their future injures, based upon biomechanical loads and the efficiency of their kinesiology. Pitches who develop their lower extremities, have a strong core and use such efficiently, sparing loads on the upper extremities. Baseball teams in general have employed a philosophy where management has realized the exorbitant cost of pitching in free agency and they collectively made business decisions that have impacted player development and care. Management has decided that because acquiring starting pitching in free agency is so expensive, and resigning even your own player when they enter free agency can be cost prohibitive, better to ride then hard while you have them under control, because who cares what happens to them once they leave to sign with another team. This has resulted in a trickle-down phenomenon, wherein training, coaching staff, and analytics staff instruct plays to push themselves and their bodies to throw certain pitches at certain pitch frequencies, which induces tremendous overload forces on the ligaments and tendons, with insufficient recovery time between pitches and performances. The team figures get what you can out of them, who cares what happens later. It has become the assembly-line mentality of pitching. Just have a readily available supply of young fresh arms, capable of throwing 100 mph waiting in the minors, to replace the pitchers you lose to injuries or free agency, and don't worry about actually coaching and teaching them the art of pitching. Just have them throw as hard as they can, with max spin rates for as long as they can, then once they are injured, bring up the next guy. It has been known for 50+ years that youth should not throw curves and breaking balls for good reason. Similar principals apply to adults. Combine that with that fact that training, nutrition, and lets face it Performance enhancing drugs, now permits pitchers to routinely exceed velocities that were once the l=thing of legends, exceedingly rare and attained by a very select few, introduces overlord forces to the shoulder and elbow that predispose to injuries.

Dr. Meister repaired my throwing shoulder and bicep tendon in 2008when I injured it in college baseball. I have not had any issues since. His rehab team is fantastic and sport specific.

Great video. Very fascinating. Would love more with Keith Meister.

This is the best baseball story I've heard this year. BOOKMARKED!

I pitcher timeout is a great idea. Just like the batter they get one. Also let pitchers use something for grip

Good stuff and hits deep, considering some point today or this week he's probably doing Strider's surgery

This channel is KILLING IT right now

You only need 2 pitches if you throw hard, just look at Nolan Ryan, fastball and curveball, both were thrown with over the top delivery from the greatest power pitcher of all time that also was an Iron horse one time even throwing 200+ pitches in one game. The increase in UCL injuries definitely have something to do with arm angles and how hard the pitchers are throwing and trying to spin it.

Great question from AJ. I was wondering what Doc's take is on at least allowing some form of 'stick'em' for pitchers...rosen or a range of products/substances that could be allowed across the board?

Thank you for this video. My son is a sophomore in high school and we have been dealing with inner elbow pain for the last 3 years. Physical therapy pictures and nothing. Great information

Finally.....you don't need analytics to know spin rate and velocity are the problem. Not pitch count or clock.

This Dr. Needs to be lecturing to all 150 MLB & MiLB teams.

Great interview and information. I think pitchers are headed in the direction that RB's in the NFL are currently at. Go hard 3-5 years and on to the next guy. Just running them through a meat grinder so to speak.

Great interview

As a pitcher in high school I found it to be common sense knowledge that virtually any non fastball (maybe a standard 3 finger change up too) will cause more pain and result in injury. The curveball particularly is the most vicious pitch on the elbow and shoulder.

Pivetta has a sweeper now and look when happened to him today. He’s having elbow recovery issues and is on the 15-Day IL

1. Analytics have made the performance translate into numbers and digits. Then every pitcher tries to achieve spin rate numbers and they simply cannot. They try to throw hard all the time and they can’t. They try to be like the stars and they’re not. People need to understand that not everyone can be a star folks. Some guys can throw 100 all their careers but they’re built for it or whatever the case may be. That’s why they get paid big $ Stay in your lane. Be the best you can be at a level where you’re actually playing in the field. Chasing the dragon and the numbers and spin rates. 2. I’m not sure how much this applies or calling out any players but it’s been noted quite clearly that some coming off steroids or PEDs or whatever you call it can subject themselves to injuries because they’re trying to perform like before with no drugs. 3. Throwing MAX velo all the time. There’s no need for it. Get to the playoffs. Get on the big stage. When you face the stars in postseason then bring out the guns. You don’t need to be hurling 99 mph all game long on a Tuesday night at Tropicana when you’ve got the 5-0 lead. It’s like guys aren’t playing the game anymore by looking with their eyes on the conditions. Why do I need to throw this 100 right now? To keep stats elevated and get paid. DUMB. STUPID.

I would love to hear what the reason for the increase in position players needing TJ surgery. Surely they can't blame the pitch clock on that can they? And talking about having the pendulum swing back in the other direction, maybe players need to put the baseball down in the off-season, lay off the designer pitchers and work on the beer belly. Worked pretty good for Boomer Wells

I think those super fast pitches should be reserved for the best of hitters and for when you’re in a traffic jam. The human arm is not meant to exude this much force, whatever it is I hope health and safety for these pitchers who bring us valuable entertainment.

Very informative and it seems that the MLB really should take action.

Dr Mike Marshall in 1975 figured out pitching injuries. His videos are all on RU-vid explaining the cause of all pitching injuries. It’s just no one cared to listen.

MLB needs to see this!

Wish we had more pitchers like Jamie Moyer in the game.

have we studied the Pitchers with 5 plus years MLB service with no elbow injuries. What type of pitches thrown, weighted ball training, sleep, hydration, weights- All the whole thing??? What is a common in those non injured pitchers. This is such a hot topic... No quick fix, need to start at youth level. Are they on the mound too soon? Would machine pitch be a better altenative until balls drop? Too little throwing? Too much throwing? No answer here just want solutions. I had my oldest with MLB service time that got hurt and out of the game. he saw Dr. Meister multiple times. I now have a 15 year old lefty that was born to throw hard and does, I am worried about him. I take precaution, no year around pitching, train hard and prep great....... I can do all the right things and still get him hurt.

I've been around long enough to remember when the slider was losing popularity because it was said that it would blow your arm up. I'm not sure when it changed, if it was Steve Carlton's and Ron Guidry's success or what. Nolan Ryan never had arm trouble and basically went fastball and 12-6 curveball. He was also fanatical about working on his legs. He'd throw 100++ pitches in 7 or 8 innings then ride an exercise bike for another hour after the game. Are pitchers still working on their lower bodies as much?

Are managers getting it wrong about pitch count? Paul Skenes recently had a no hitter going and was pulled after 6 innings. He was dominating (14 strikeouts I think) but as soon as he reached the magic number of 100 pitches thrown his manager pulled him in spite of his no hitter. My belief is its not the number of pitches thrown you should be looking for but rather the number of stressful pitches thrown. In this case he hadn't been in any stressful situations, he was cruising right along. Am I wrong or right about this?

The problem the MLB has is that we all know velocity and spin equals outs. There is no putting that cat back in the bag.

Randy Johnson had horizontal movement on his sweeping slider. He was tall but not bulky. How did he do it without injury?

Throwers, not pitchers. And they're building and used like an F1 car. Tear the engine down after 100 miles. Not like a reliable truck to run thebsand dunes for 100k+ miles.

Need to go back to teaching the art of pitching!!

Biomechanics are the key, I have two bulging discs, my symptoms are improving everyday, the first thing told me my PT avoid the things are hurting you, that apply to the pitchers.

All that body extreme forces are stopping the arm drastically. The muscle are crying in pain!🚨🚑 No arm, no pitcher!

I think it’s lack of Cardio. This is a problem for all positions. Position players can pull something running to first cause they pump iron but don’t keep the body loose because they think static stretching gonna work. Running also helps pitchers heal in between days. Wish I knew this sooner but I remember hearing about James Shields habits. he threw gas and had a healthy career because he was running after every start. Once I started doing that I noticed it was way easier to heal in between starts. No im not a ML and don’t throw anywhere near 100 but it was a significant difference in how long soreness lasted…

this problem can't be understated and it's going to get worse

Random ques - but I've been wondering - can someone pitch without a UCL? Like, maybe it tears completely but they just don't get surgery, what would happen? I play soccer. I ruptured my ACL and never got surgery, but I still play alot of soccer. I just am more mindful and go about the game differently. And of course did some rehab.

Goose Gossage threw VERY hard. He told me his most impressive achievement in his 20+ years in MLB is that he never had an injury.

The issue is training they need to get back to teaching pitching properly the way they used to. None of the analytics number crunchers are going to reinvent the wheel all they're doing is injuries these players.

thumbnail title is real

How pervasive are pitching injuries in Japan or Korea? They throw disgusting breaking stuff, but don't they use balls that come out of the box with some kind of tack on them? That might be the simplest quick fix for this problem.

I think they should increase the roster size and allow teams to increase bullpen sizes and limit pitches.

The MLB for years has tried to De-emphasize starting pitching. Whether it is the Openers. Pitch Counts. 5 inning starts. Bullpen games. Pitch clocks. Checking their hands for substances. Why??? $$$$$$$$. MLB doesn't want to pay starters big money. Blake Snell and Montgomery found out this off-season. When you tell your starters go out and throw Max velocity for as long as they can that is not pitching. That is throwing.

They'll have to bring back the ball tack.

Give the pitchers a timeout in at-bats that last longer than 6 pitches. But keep the pitch clock. The injuries are clearly linked to spin and velo, not the pitch clock.

Keeping legs strong.

Tbh I’m not worried, these pitchers will stop getting huge contracts and the smart duravble pitchers who don’t push it will become more valuable. Yeah this gen might have to be a sacrificial gen but it will be a great experiment to tell the future pitchers where the max is and they can find a good medium. Sucks but they know they will get hurt and they still choose to do it cause they’ll get the bag, so not really the same as runners twisting ankles of the bags

The Commissioner should call in some of the great older pitchers for a roundtable on this while they are still living. The ones who pitched a ton of innings and never needed elbow surgery. Would include Randy Johnson, Jim Palmer, Bert Blyleven, Jack Morris, Greg Maddux, Steve Carlton, and Roger Clemens to name a few. By the way, they weren't on innings limits and pitch count limits. Seems those limits have made things worse as well.

The way you throw a cutting pitch is with proper arm slot but the big thing is the lower half. Your pitch plane and how you open your hips. Note thet some of the really special pitchers that lasted had beefy lower halves. The guys that are tall and skinny tend to tear things because they have no bottom half. Pitching velocity and movement is heavily controlled by your liwer half but it seems like everyone is teaching to open your hips and torque the heck out of the shoulder and elbow like a slingshot. And then you wonder why you have injuries? 🙄

We need more players and more rest time in the big league

Man, it seems that these pitchers would really benefit from using a sticky substance to help them with their grip 🤔

How bout changing the ball to the ones they have in Japan how many Japanese pitchers are getting TJ surgery

Baseball is good for his business it seems

U know what it is, they teach how to throw hard and fancy and not how to actually PITCH!!!! Look at ever great great pitcher ever. They were smart, they knew HOW to get hitters out not just blow thing by them, I miss that.

The best way to avoid an injury is to never play

I cant believe that mlb and players dont understand how to avoid injuries and why theyre on the rise. Is for one thing and very simple. They do not train for withstanding more throws they inly train for increasing velocity. Tell me which pitcher in the offseason goes all the way to 100-150 pitch bullpens? Nobody absolutely nobody. The only way to be prepared to throw 100 throws in the game is that in the offseason you slowly progress all the way to 100-150 throws. You might call me crazy to encourage offseason bullpens of 100-150 throws but its even crazier to think that 30 pitch bullpens will prepare you to throw 100 in the game. That is foolish nonsense. The arm doesnt know how many throws is doing it only knows stress. If youve only throwing 30 pitch bullpens and the increase it all of the sudden to 100 youre increasing more than double of what your body can handle. Now if you slowly progress in the offseason to 150 throws your body and arm are going to get use to that stress. But pitchers from today dont give their body the opportunity to get use to the stress. Sometimes you only need logic and common sense to solve a problem. Its ironic that sometimes common sense is the less common sense the human uses.

Couldn’t break Chapman’s arm with a 4lb Plyo

If you throw a lot you gotta find 3-4 months off a year

Great interview. Two critical points missed. One touched on, but not explained. We are taking players with the internal infrastructure to throw high 80s and teaching/training them to throw high 90s. Like putting 80 story building on 40 story infrastructure. Unsustainable. Point two. The market will correct this...moneyball 2....teams will start to figure out that spending 30 million plus per year on high velo guys is not cost effective as the likelihood they will break down increases. Teams will start looking for and demanding and paying more guys like Jose Quntana, who doesn't blow people away but starts 30 plus games every year.

It sounds like they're not learning how to pitch. They're just throwers today. A pitcher like Greg Maddux wouldn't even be drafted today.

Easy fix. Switch to underhanded pitching, lol.

Do we place any blame on youth coaches or gurus who encourage poor mechanics and/or overusage?

Bottom line, learn to PITCH and not throw. Greinke never threw harder than 92 from his age 31 onward. Prior 2 or 3 seasons he sat at 94 most of the time. They can do it too but it takes time and effort and the short term easy way is to yank the arm for that precious 99.

Weighted balls?

Travel youth baseball is putting those who pitch into far too many games. 125 games a year can be good for hitters and fielders but bad for young pitchers. That is the hazard that causes injuries to many young pitchers and continues until the elbow gives out.

Very interesting. How did Greg Maddux remain healthy when nobody could make X's out of the plate with balls running in then away like him?

This won’t be much different than the steroid era… the gain.. getting the contract will always outweigh the chance of just being around as a major leaguer…

Too much weight training. Muscles get too strong for the tendons and ligaments. As the great former world record shotputter, Brian Oldfield, said: “It’s like putting a Cadillac engine in a Volkswagen.”

Hitters can use stickum to grip the bat. Pitchers should be allowed the same advantage.

AJ caught a guy who seldom hit 90 and had a long injury free career -- Mark Buehrle.

Doc is wrong about horizontal movement only achieved through pronation or supination. It is being taught that way by analytics people who have no experience, but it is wrong you can get horizontal movement without torquing the foreman. It's probably one of the reasons that pitchers are getting hurt, they're been taught by people with no onfield experience and they're been taught stuff that's getting them hurt because it's wrong.

"Will the owners use this information to pay the players less?" I love the comedy on this show. I'm dying. Yeah, tell injured pitcher, Shohei Ohtani that he could have gotten so much more.

Wait he started off saying push for more velo was issue, then went on tanget about percentage off speed pitches. I call bs. Nobody knows including Meister.

Let pitchers learn and practice the art and craft of _'PITCHING'_ for God's sake and *cease* indulging this perverted obsession with 'throwing'

If pitchers pitch to contact and do not focus on K's, the game will be A LOT more interesting! Many games have are filled with K's or HR's and nothing else VERY BORING!. Pitching to contact will reduce the stress on an arm and allow pitchers to stay in the game longer.

Pitching should be about DECEPTION, not power. Change speed, location, and arm slot. Not throw 100 mph hour curveballs. And yes, movement begins with the hips.

If you SLAP tear it doesn’t matter, you’re most likely done…speaking from experience

Bullshit. Sticky stuff was unfair advantage. It was used to create super soin not to get a grip. Pedro and other pitchers had no problem with grip without sticky stuff. Get a clue