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If the change in reliever usage hasn’t altered how effective teams are pitching late in games, it has changed how managers handle their tactical choices, and by doing so has affected the way we watch the game.The shift to relievers pitching fewer innings per appearance did nothing to arrest the decline of innings pitched by starting pitchers.After a sharp jump up to the levels of the late 1890s, we see a gradual rise until the late 1980s, where again we see a dramatic increase.Teams are increasingly using more pitchers to fill their roster spots.A manager’s chief strategic weapon is no longer the position player, but the relief pitcher.While specialization came naturally to position players, it had to be created for relievers.Looking at all seasons from 1950 through 2011, each reliever used per game adds an additional 10 minutes to the length of the game.And changes in reliever usage account for over 70 percent of the variance in game length over that time period.What this means is that, from 1950 through the present, we’ve added more than half an hour to the length of a ballgame.If this addition meant more play, it might be worth it.Seeking ephemeral advantages, managers have instead colluded to add 30 minutes of tedium to our national pastime.If history teaches us anything, it’s that nothing lasts forever.Just don’t expect it to happen anytime soon.Could Stephen Strasburg’s Injury Have Been Predicted or Prevented?Strasburg’s talent is historic.He’s a big, physical pitcher who maintains his velocity all night.Over his next nine starts, Strasburg continued to impress, striking out 75 over 54 innings, but shoulder inflammation would cause him to miss 19 days.What could have caused a young, otherwise healthy pitcher to need surgery that would cause him to miss nearly a whole season?Could it have been prevented?Why is it that Strasburg needed an operation only a few months into his major league debut while Felix Hernandez, with 1388.1 innings to his name through his 25th birthday, has never needed any arm or shoulder surgery?Once the information was assembled, however, it became apparent that all games of a given pitch count are not created alike.Relief pitchers are injured and end up on the disabled list more often than starting pitchers.Injuries occur not because a pitcher went beyond 100 pitches, but because he threw too many pitches for his body to handle without harm, whatever his count happened to be.This is one of the core principles of strength, conditioning, and rehabilitation programs, which demand that everything be tailored to the individual.Pitching through fatigue can lead to rotator cuff strains in the shoulder, which diminish the stability of the joint and can lead to labrum damage.In the elbow, fatigue of the flexor pronator muscles can increase the amount of force that is transmitted to the ulnar collateral ligament of Tommy John surgery fame.Power pitchers respond differently than finesse pitchers.Power pitchers with an excellent curveball respond differently than power pitchers who rely on the changeup, and so on.During the windup and stride stages, especially, the risk of injury is low because little forceful activity is taking place.Most of the potential injury risk is concentrated in the middle three stages.The late arm cocking phase starts when the front foot makes contact with the ground and ends when the shoulder reaches maximum external rotation.Arm acceleration follows and lasts until the ball is released.There are two key moments in the pitching motion at which the pitcher faces an elevated risk of injury.As the arm lags further behind the body, the humeral head bangs up against the top back edge of the labrum, leading to internal impingement in the shoulder, which can cause tears in the labrum.Then, when the muscles are already eccentrically contracting to provide stability, the latissimus dorsi, pectoralis muscles, and other components of the rotator cuff concentrically contract to accelerate the arm and transfer energy to the ball.To get some idea of the velocity attained by professional pitchers, swing your arm in a full circle twenty times as fast as you can.If you could do that in one second, you’d approach the angular velocity of over 7,000 degrees per second achieved by professional pitchers during arm acceleration.The next critical moment with an increased risk of injury occurs immediately after ball release, during the arm deceleration phase.The joint loads are highest during this stage, with roughly 90 pounds of posterior shear force and almost 70 pounds of inferior shear force generated in the shoulder with each pitch.That alone might sound doable, but factor in the 1,000 pounds of force pulling the arm away from the body, and it quickly becomes apparent why so many injuries occur at this moment.This distraction force is directly related to ball velocity, so the greater the velocity, the greater the force required to keep the shoulder in place.When Strasburg’s stride leg made contact with the mound, his forearm and elbow were often horizontal to the ground at shoulder level and with his elbow behind his back.According to medical studies, this late external rotation increases the load on his shoulder but decreases the load on the elbow.A pitcher having his elbow behind his back in a hyperangulated position at foot contact also increases the forces on his shoulder.All of the musculature is in jeopardy of tensile failure during this stage, and it seems that the rotator cuff and posterior shoulder musculature are especially at risk.The prime function of the rotator cuff muscles is to keep the glenohumeral head in proper position in the shoulder joint.The rotator cuff is already contracting to resist the distraction force in the shoulder during arm deceleration, so when the extremely large muscles like the latissimus dorsi, trapezius, and pectoralis muscles contract near maximal effort, the rotator cuff is often overloaded and cannot do its job properly, resulting in injury.If the rotator cuff is already fatigued and cannot produce enough force, significant acute injuries can occur.Strasburg’s peculiar mechanics also had implications for his elbow.There were two main factors in his mechanics that likely led to Tommy John surgery.It’s in everyone’s best interest to isolate the point of fatigue and determine when it begins to affect production.Fatigue in musculoskeletal tissue is similar to structural fatigue in buildings.In the human body, fatigue often manifests itself in muscle weakness, slowed movements and reaction times, lack of energy, or a combination of any of the above.Through repeated loading and unloading of forces approaching the maximum tissue tensile strength, fatigue causes damage on a microscopic level without exhibiting any clear outward symptoms, such as cracks or mechanical deformation.Continued cyclic force loading can cause that microscopic damage to progress to visible damage, which in the human body involves partial tears of ligaments, cartilage, or tendons.However, competitive pitchers are hesitant to admit to being fatigued until their discomfort becomes painfully obvious.The maximal torque is the average of three or five measurements taken prior to the start of the official testing sequence.Depending on the research study, protocols define fatigue as 30–60 percent of the peak torque or maximal force production level.There has to be some other way to recognize fatigue without relying on these methods.The hitters would tell me when I’m done, and there is certainly some truth to that.Not all pitchers are fatigued after throwing 100 pitches.Being able to recognize fatigue is of paramount importance in preventing pitching injuries.One major misconception is that fatigue does not set in until we have seen a drop in velocity.What often occurs is that the pitcher actually gains a little velocity as he tries to compensate for the relative weakness or neurological delay caused by fatigue.If this continues, the structures can become compromised.Before the pitcher’s velocity drops, we often see that the movement and control of his pitches suffer.Instead of delivering a pitch on the back of the inside corner, it’s an inch or two into the zone, allowing a hitter to reach it.Instead of diving out of the zone, a breaking ball rolls into the middle of the plate.If this position is delayed until the arm acceleration phase, increased stresses will be placed upon the shoulder and elbow.It has been shown that fatigue decreases the body’s ability to replicate the position of the hand in space.When the arm angle deviates from 90 degrees of abduction consistently, the arm is at a higher risk of injury.The hips also play an important role in the pitching motion and in injury prevention, so by looking at the hips, we can gain some valuable information.When the pitcher starts to fatigue and reaches back in an effort to restore his lost velocity, he increases his maximal shoulder external rotation and also brings the arm farther behind the shoulder.At the same time, he often takes a longer stride, resulting in increased amounts of hip extension on the dominant leg.This relationship of increased hip extension and increased shoulder external rotation has been associated with shoulder injuries in professional pitchers.In addition to hip extension, rotational characteristics of the hips are important.If the pitcher lands in a more open position, increased external rotation of the hips and pelvis occurs.As a result, the upper extremity needs to generate more force instead of leaving the task to the lower extremities and core, which plays a role in injuries.Can We Use Trajectory Analysis to Estimate Fatigue and Tie It to Injuries in Professional Players?Those snapshots are run through algorithms to determine each pitch’s velocity and release point.Another study six years later reported similar findings among college pitchers, despite the majority of pitching mechanics remaining consistent.Still another observed that proprioception suffered in the setting of muscle fatigue.When pitchers lose proprioception, they lose the ability to repeat their delivery.Consequently, the defining characteristics of injuries, precise joint angles, and hand height at the moment of release are likely not contained within the data set.Some analysts have posited that release point changes are indicative of an upcoming injury.While it is true that certain individuals have shown changes in release point prior to suffering injuries, that pattern proves irrelevant when applied to a larger sample.Given our theory, we can form a hypothesis that large variations in the standard deviations of velocity and vertical release point could serve as injury warning signs.To test this hypothesis, we limited our sample to starting pitchers, since the smaller sample sizes associated with relief pitchers would skew the numbers.Unfortunately, there is no significant correlation between any of these factors.Although it’s not yet available to the public, the innovative system used by a Danish company called TrackMan represents one such potential solution.TrackMan has been used in golf for some time, but it has started to make its way into baseball in the last few years.The consensus over the last couple of decades has increasingly shifted toward settling on 100 pitches as the point beyond which further work increases the odds of injury.In 2011, only 12 outings of 133 pitches or more were made by major league starters.Just 20 years earlier, in 1991, there were 168 such outings.Jazayerli’s original pitching abuse points was one of the first systems to examine the effects of pitch counts and quantify stress to a pitcher’s arm on an individual game and cumulative basis.Sa bathia and Carlos Zambrano, but it also has to do with the emergence of a new class of pitchers that began to arrive in the major leagues in 2007 and 2008, including Tim Lincecum, Justin Verlander, Felix Hernandez, and Jon Lester.Since 2007, these six pitchers have been responsible for 7.9 percent of category 4 starts and 9.2 percent of category 5 starts.First and foremost, it largely excludes relief pitchers.Could Strasburg’s Injury Have Been Prevented?The most likely cause for his physical breakdown was that his musculoskeletal system was not able to perfectly balance the forces created and dissipated throughout pitching in the game and over the course of the season.