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Pitching Injuries and How To Prevent Them: A Q&A With Will Carroll

on 04/14/2005


The Brewers have been plagued by injuries to their young pitchers for more than a decade. Prospect after hard-throwing prospect has signed on the dotted line, eager to fulfill their big league dreams and anxious to one day climb the bump at County Stadium or Miller Park, but precious few have survived their apprenticeship in the organization's minor leagues. For that, the Brewers have paid a heavy toll. Without the financial resources to acquire top-notch free agent hurlers, the team's failure to safely and successfully develop young pitchers has contributed in no small way to their ongoing 12-year losing streak.

But things are beginning to change. Or at least that's what Doug Melvin, Gord Ash, Reid Nichols, and the rest of Milwaukee's braintrust are hoping for.

And it's not just hope -- they're doing something about it.

Over the past few seasons, the organization has undertaken a comprehensive review of its player development system with an eye toward improving the health of its pitchers. From the Arizona League to Triple-A to the big leagues, the Brewers are attempting to rectify the ills of the past while implementing an innovative, common-sense approach to pitching injury prevention from the top of the organization to the bottom.

But will it work? Will serious pitching injuries -- or the majority of them, at least -- become a thing of the past?

To help find the answer, consulted Will Carroll, a pioneer in the field of baseball injury analysis and reporting. A writer at Baseball Prospectus (where he pens the popular column "Under The Knife") as well as The Juice, a weblog he co-authors with Scott Long, Carroll is the author of a forthcoming book about steroids in baseball entitled The Juice: The Real Story of Baseball's Drug Problems as well as Saving The Pitcher, "a revolutionary analysis of pitching injuries and how to prevent them." The host of Baseball Prospectus Radio, he is quickly becoming a fan of the team from the Beer City. The Brewers have implemented a "piggyback," eight-man rotation at Single-A West Virginia this season that pairs two starting pitchers with one another and limits their pitch counts in consecutive outings to 80 and 40 pitches, respectively. A similar system was developed in the mid-1990s by Grady Fuson while he was with the Athletics and has since been implemented by the Rangers (thanks to Fuson) and Reds (thanks to Dan O'Brien, who worked with Fuson in Texas). According to the Washington Post 1, those three teams were the only ones in Major League Baseball to use the system in any form as of May 2004. Have other organizations begun to implement similar programs?

Will Carroll: Actually, the system is more a product of research by Bob Cluck, now the pitching coach with the Tigers, than anyone else. There have been a number of teams have considered what I call the "tandem system" but only those you mention have committed to it. I believe it's a very effective system with proven results. The hardest part is getting the pitchers themselves to buy in while also strengthening their arms. Pitchers focus on wins, not things like efficiency and really have to be taught to understand why this system works and how it won't retard their progress. I think the Brewers understand this. I'd like to see the system at High-A and even at the start of the season in Double-A as well. Someday -- maybe in the next revision of Saving The Pitcher -- I'll write up the best way to develop pitchers. I'll be wrong of course, but it will make for a conversation starter.

Proponents of the system cite several benefits in both injury prevention and pitching effectiveness. Fuson, for example, argues that "the 18- to 22-year-old arm is not prepared to pitch the way people traditionally think. Their arms are not fully grown and mature. They're not prepared to take the torque that major league guys can. This system eases them into it." 2 Do you agree? In your opinion, will the implementation of this system result in a reduction in pitching injuries?

I completely agree and believe that this will system reduce injuries. Nate Silver's research on the injury nexus, Mike Marshall's work with biological age, and Glenn Fleisig's work on biomechanics all point to the same thing. It's difficult to put it all on age -- it's maturity, not age. Worse, the more stresses that are put on arms at a young age, the more damage there is. We're seeing younger and younger pitchers needing overuse treatments like Tommy John surgery. At some point, we have to do something to stop that. In the interim, we have to protect them where we can and the minor leagues is one.

Of course, there's also the idea that college pitchers are safer bets. That's true, but we're also seeing some insane pitch counts. Part of the value of college pitchers is predictability and the fact that they survived the experience while pitching on someone else's dime. From a purely developmental perspective, I'm not sure that's best. If I could predict with anything resembling certainty which pitchers would develop, I'd draft high school pitchers.

Another benefit of of the program, its advocates argue, is that it helps develop pitchers who are aggressive in the zone and comfortable "pitching to contact." Reds' Director of Player Development Tim Naehring contends, for instance, that "coming out of college, with aluminum bats, these guys are used to pitching away from contact. We're trying to teach these young pitchers at an early age to pitch to contact, which means trying to command the fastball and get the hitter out early in the count. When you only have 75 pitches, you better be pretty effective with the way you use your pitches if you want to stick around until the fifth and sixth innings." 3 Is this something that you foresee the Brewers emphasizing? How important do you feel it is for young pitchers to learn how to effectively manage their pitch counts?

It all gets back to efficiency. If you have X pitches to throw, it makes you think about "wasting one." There will be times that you do, that the pitch accomplishes something. Doing it on 0-2 has never made any sense to me. I'm not sure any team teaches the theory of pitching well. In my opinion, it comes back to command. I'd rather have a team of soft tossing guys who can hit spots than a fastballer who relies on blowing someone away.

The "pitching to contact" idea to me might lead to problems. You have to have a good defense and seems to have a groundball bias. It's antithetical to some stathead orthodoxy, but I think pitchers occasionally need to say "I need a groundball" and pitch to that. At other times, they better be pitching for strikeouts.

Another interesting experiment being implemented in the Brewers' farm system this season is an inversion of typical pitching roles wherein relief pitchers start the game and are later relieved by starters. In an interview with, Doug Melvin explained that successful big league starters (like Curt Schilling) go deep into games and don't rely on middle or long relievers to bridge the gap to the closer. On the other hand, "there's a lot of minor league pitchers who never see the ninth inning because of pitch counts," he said, arguing that working in the late innings will help develop a pitcher's mental toughness. 4 Are you familiar with any other organizations that have attempted a similar role-inversion? Is this program a good complement to the "piggyback" system mentioned earlier, insofar as it allows pitchers to work later into games without elevating their pitch counts? How important do you feel it is for young pitchers to work in the late innings?

I love this idea in some ways, hate it in others. I think Melvin's exactly right that some pitchers won't reach it and that this might have some real tactical advantages, but I'm not sure that we really know how the ninth inning is any more valuable than the fifth or first. Pitching is pitching, an out is an out, and if you need some artificial construct to get you on the ball, I worry. I'll tip my cap to Melvin and his staff for thinking outside the box and wait to see how it works out.

The Brewers have suffered through injury after injury to their young pitching prospects over the past decade. From Tyrone Hill to Jeff D'Amico to Kyle Peterson and from J.M. Gold to Nick Neugebauer to Mike Jones, Milwaukee has been disturbingly unable to develop healthy young hurlers. To what do you attribute the club's inability to protect the arms of its pitchers? Is the organization's tendency to draft pitchers with high injury risks (like Peterson and Gold) at the root of the problem? Or does the team's player development system deserve more of the blame?

It's partly the selection and partly a lack of commitment to preventing injuries. That's changed, albeit at a high cost. It doesn't make Neugebauer feel any better that Mark Rogers might survive because he didn't, but at least the Brewers are learning. They have a proactive medical staff with Roger Caplinger and Bill Raasch. They've invested in great medical facilities. They do high speed video on all their pitchers. They're considering injury prevention at every step, from draft to Triple-A. They're willing to look in any direction -- even mine -- to try to improve something they acknowledge as a weakness. That's a great sign.

In your book Saving The Pitcher, you argue that "there's no reason a pitcher should ever be injured." 5 Traditional baseball thinking holds that serious arm injuries are just part of the game. Brewers Assistant GM Gord Ash, for example, commented that "any time you have significant injuries, you can't be happy about it. But it's not just an affliction of the Milwaukee Brewers. Injuries are part of the game." 6 Given that the origins of many pitching injuries can be traced to a player's time in little league, high school, or college, to what degree can Major League organizations prevent pitching injuries? Are they more preventable than Ash and others believe?

Forgive a little hyperbole on my part. We know what causes injuries and theoretically we can prevent them all. Of course, we'll never be able to do that in the real world. There are always going to be freak incidents, a pitcher that breaks down well below the level we'd predict, and the fact that we can't control all elements of the game. We need legislation to protect young pitchers -- coaches can't do it because they need to win. We need more organizations willing to protect arms like the A's, Indians, Blue Jays, and Brewers are doing. Injuries are part of the game; I like to believe we can make them a lot smaller part of the game.

Kansas City-based writer Bradford Doolittle argues that "injury management is just another area where small-market clubs can develop a competitive advantage against the rich teams, much in the same way statistical analysis can help them to build a lineup or a bullpen." 7 Do you agree with Doolittle? What are some of the most important things that organizations like the Brewers can do to prevent pitching injuries at the minor league level? At the Major League level?

Absolutely! I think just the commitment to the process is the biggest thing. There's a major league team that's made an organizational decision NOT to prevent injuries. The GM said he's going to "ride his horses" and then send them to Jim Andrews. That's going to back fire, even if I can understand the thinking on some level. When we see Tampa and Milwaukee at the top of the charts for "medhead stats" that's a nice sign. Injury prevention and management is very cheap, has a great rate of return, and doesn't require significant changes to the organization. Things like assessment of risk, managing risk, and understanding risk are the most important parts.

One of the biggest debates in discussions about baseball's Amateur Draft is the comparative desirability of selecting players from high schools or colleges. The Brewers have tended to focus on prep players, and prep pitchers in particular, although they have struck a balance between the two schools of thought. If you were running a Major League organization, would you advise your scouting department to concentrate more on high school or college pitchers? In your opinion, which demographic is more likely to suffer an arm injury?

Younger pitchers suffer more injuries, but heal quicker. I'd look for pitchers with reasonable workloads, a good work ethic, and healthy results. I'd look high and low, not eliminating anyone until I'd given them a chance. Tall, short, fat, skinny, high school, college -- to me, it doesn't matter. I want pitchers. Mark Rogers is a great example -- he hasn't pitched much because of his location (Maine) yet really has a great arm, good work ethic, and Tony Blengino really took the time to understand what he could do. Great use of scouting.

A related issue with regard to amateur scouting is the divide between pitchers from northern climates and those from the South, who often play year-round and accumulate much more experience during their prep careers. The Brewers drafted two high school pitchers last June with their first two picks: Mark Rogers from Maine and Yo Gallardo from Texas. Placing yourself in the same position as before (at the helm of a big league organization), would you recommend concentrating on more experienced pitchers from warm climates or less experienced (but less overworked) pitchers from the North? Is there a tangible difference between the injury risks presented by prep hurlers with significantly different high school workloads?

I'd point to my answer above. I wouldn't eliminate anyone. I know a good bit about Rogers, not so much about Gallardo (Though you've gotta love a guy named "Yo"!). When you can look at a pitcher holistically, you have a much better chance of accurately assessing his performance potential and his risk potential.

One of the organization's most promising young hurlers, Mike Jones, has suffered through a number of serious injuries during his tenure as a Brewer. You described his latest, a SLAP lesion of the labrum in his pitching shoulder, as "baseball's most fearsome injury" 8 and one from which "only a small percentage of players ... are able to successfully return. 9 Does Jones have a chance to be one of those in that small percentage?

I hope so. Jones has some great stuff. We're learning more about labrum injuries and even seeing some returns (and odd side effects of those returns.) I think Jones has a great chance because of the organization, just how good he was (at 80% of his former self, he could still have value), and because Jim Rooney and his minor league staff really understand what's going on. It's going to be difficult and I can't give any sort of percentage of his chance of return, but I will say Jones has hope. Just a couple years ago, he'd need to be thinking about a new career.

A sincere "thank you" to Will Carroll for sharing his time and expertise with the community!


  1. Dustin Gouker, "System Counted On To Protect Pitchers," The Washington Post, 05-20-2004.
  2. Ibid.
  3. Tony Jackson, "Minor-league starters will be on pitch counts," The Cincinnati Post, 01-15-2004.
  4. Doug Melvin, "GM Doug Melvin on the Brewers," Interview with, 03-08-2005.
  5. Will Carroll, "Preface," Saving The Pitcher, 2004, p. 8.
  6. Tom Haudricourt, "Sore season continues in minors," Milwaukee Journal-Sentinel, 07-16-2004.
  7. Bradford Doolittle, "Hurt pitchers haven't cost KC much money," The Kansas City Star, 04-01-2004.
  8. Will Carroll, "Labrum, It Nearly Killed Him,", 05-20-2004.
  9. Supra Note 5, p. 53.

Bill Batterman is a writer for You can get in touch with him via email at


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