NORTH PORT, Fla. – Spencer Strider, like any data-driven student of baseball, is not offering concrete explanations for the rash of Tommy John elbow reconstruction surgeries in the game.

The Atlanta Braves ace simply wants Major League Baseball to put the brakes on what he and other pitchers believe might exacerbate what he calls the game’s “injury epidemic.”

Strider, who underwent Tommy John surgery himself as a Clemson sophomore in 2019, believes MLB should not further reduce the time on the pitch clock after just one season of use.

By almost any metric, MLB’s pitch clock and other rules changes were a rousing success in 2023, shaving nearly 25 minutes off average nine-inning game time, which fell to 2 hours, 40 minutes. In the off-season, MLB’s competition committee approved reducing the time on the clock from 20 to 18 seconds with runners on base; it remains 15 seconds with the bases empty.

Yet the pitch clock’s implementation coincided with one of the worst seasons for severe pitching injuries in modern history, continuing a trend line that’s seen a rise in Tommy John surgeries concurrent with the rise in average fastball velocity.

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The orthopedic community continues trying to separate signal from noise in diagnosing blown-out arms, be it from increased velocity, overuse, poor mechanics, overzealous youth coaches and other factors. Strider, who struck out a major league-high 281 batters in 2023 largely on the strength of a 98-mph fastball, believes one year of pitch-clock data does not make adjusting it further downward worthwhile amid a flurry of rules changes in recent seasons.

“There’s an injury epidemic in the game regardless of velocity,” Strider told USA TODAY Sports. “If anything, the league is making rule changes despite an injury epidemic that could very well be encouraging injuries, such as the pitch clock, limiting the number of pitchers on roster, how many pitching changes you can make, how many mound visits you can have – all those things are making pitching harder and potentially, I think, making health more difficult to manage.

“With injury rates where they are, I don’t know how we can blindly decrease the clock after the worst injury season in baseball, arguably, without having a conversation about injuries. The league talks about creating more action on the field.

“Well, when the best players in the league are hurt, how much interest is there in the game?”

In 2023, 30 major league pitchers succumbed to Tommy John surgery or similar elbow reconstructions or revisions, including All-Stars Shohei Ohtani, Sandy Alcantara, Shane McClanahan, Liam Hendriks and Jacob deGrom. That pushed the percentage of major league pitchers who’ve undergone Tommy John surgery to 35.3%, a 29% increase since 2016, according to independent injury analyst Jon Roegele.

Glenn Fleisig, head of biomechanics research at American Sports Medicine Institute, was part of a working group studying the pitch clock for MLB and also sits on MLB’s research and medical group, a consortium of physicians, biomechanics experts and trainers. He said the pitch timer settings weren’t simply pulled out of the sky; they were studied for nearly a decade in minor league ball, which first workshopped full-season pitch timers in 2015 at Class AA and AAA and across the minor leagues in 2022.

While acknowledging that major league competition is “a different animal," Fleisig, who is preparing a final report on 2023 pitching injuries, says the pitch clock had no discernible effect on an injury rate that was annually increasing before its implementation.

“We’ve reviewed data from last year and the number of injuries to major league pitchers is in line with the trend from the last decade,” says Fleisig, a Ph.D. in biomedical engineering from the University of Alabama and a disciple of the recently retired orthopedist James Andrews.

“Last year, with the pitch timer, did not seem to bump the injury rate up or down.”

While the average nine-inning game time now fits neatly within a three-hour broadcast window, MLB had reason to trim the on-base clock by two seconds. MLB data indicates time of game increased by seven minutes between April and September, and that the average pitch with runners on base was delivered with 7.3 seconds on the clock.

Just 1.1% of pitches were thrown with two or fewer seconds remaining on the 20-second clock; a two-second reduction with runners on base shouldn’t markedly affect most deliveries.

Yet while injured list placements were slightly down in 2023, days spent on the IL for all players were up, and veteran pitchers such as Max Scherzer have voiced concern about increased severity of injury.

MLB Players Association executive director Tony Clark echoed Strider’s concerns and says the issue could have undergone further study before the competition committee – comprised of six owners, four players and one umpire – approved the clock change.

“That’s a conversation that should have warranted a much longer dialogue than what we had,” Clark says. “We voiced those concerns, players voiced those concerns, and yet, the push through of the change to the pitch clock still happened.

“We just had the biggest adjustment this league has ever seen in regard to length of game and how the game was affected by including a clock. Rather than give us another year to adjust and adapt to it, why are we adjusting again, and what are the ramifications going to be?”

Pumping the brakes on the clock might have decluttered the landscape, but other factors affecting pitcher health continue pushing toward the forefront. In 2023, average fastball velocity topped 94 mph for the first time, capping a 15-year increase from 90.5 mph in 2008.

While stopping short of full correlation, Fleisig said arm injuries and velocity increases are roughly in lockstep.

“The chase for the velocity certainly seems to be one of the factors,” he says. “The injury rate increase in pitching pretty much mirrors or is the same as the increase in velocity. If you plotted those two (data points) against each other, it’s not proof, but it appears fastball velocity has been increasing at same rate injury rate.

“Pitchers themselves chase velocity as a ticket to move up. Teams chase velocity because faster is better. They’d rather a guy pitch faster and have to replace them than pitch (with less velocity).”

Strider says that teams pay for strikeouts – he’s beginning the second year of a $75 million contract extension – and that’s not likely to change. For better or worse, this is the modern game, with its inherent risks and Faustian bargains for teams and players alike.

He simply wonders if the payoff to rush deliveries will be worth it.

“Everything they wanted was accomplished: There was more action, more balls in play, there were more runs scored, game time was reduced, viewership was increased – but (severe) injuries were way higher,” says Strider of MLB’s pitch clock and shift ban entering 2023. “Everything was achieved by the rules changes. What else are we trying to go for?

“It seems like the benefit at this point is so marginal, it’s not worth the risk of potentially way more players getting hurt. I just don’t think there’s enough conversation or looking at data to justify these decisions.”

Contributing: Bob Nightengale in Phoenix

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