MLB Study: Pitch Clock Causing Increase In Tommy John Surgeries

MLB Study: Pitch Clock Causing Increase In Tommy John Surgeries

Sports Talk Philly has gathered data to determine whether the introduction of the pitch clock has contributed to a rise in Tommy John surgeries among MLB players.


Key Highlights:

  • At the current rate, Tommy John surgeries are projected to rise by 71% in 2024
  • UCL tears have doubled in MLB since the beginning of the pitch clock
  • Velocity increase and shorter rest between pitches is contributing to a rise in injuries

Note: all data as of May 14, 2024


The MLB pitch clock has added a new element to baseball and has changed the game.

Many fans enjoy the pitch clock, which speeds up the game with less downtime.

It was agreed upon in September 2022 and implemented in the MLB at the start of the 2023 MLB season.

To create a faster pace of play, a 30-second timer between batters was implemented in 2023.

Between pitches, a 15-second timer is put in place with the bases empty and a 20-second timer with runners on base.

Reviewing The MLB Rule Changes For 2024

From MLB.com, the rule change stipulates the following:

  • The pitcher must begin his motion to deliver the pitch before the expiration of the pitch timer. Pitchers who violate the timer are charged with an automatic ball. Batters who violate the timer are charged with an automatic strike.
  • Batters must be in the box and alert to the pitcher by the 8-second mark or else be charged with an automatic strike.
  • With runners on base, the timer resets if the pitcher attempts a pickoff or steps off the rubber.
  • Pitchers are limited to two disengagements (pickoff attempts or step-offs) per plate appearance. However, this limit is reset if a runner or runners advance during the plate appearance.
  • If a third pickoff attempt is made, the runner automatically advances one base if the pickoff attempt is not successful.
  • Mound visits, injury timeouts, and offensive team timeouts do not count as disengagement.
  • If a team has used up all five of its allotted mound visits prior to the ninth inning, that team will receive an additional mound visit in the ninth inning. This effectively serves as an additional disengagement.
  • Umpires may provide extra time if warranted by special circumstances. (So if, as an example, a catcher were to be thrown out on the bases to end the previous half-inning and needed additional time to put on his catching gear, the umpire could allow it.)

In 2024, one change was made to move the pitch clock from 20 seconds to 18 seconds when runners are on base.

Though this may have seemed like a minor change in Winter Meetings, injuries to pitchers have become a major concern in 2024.

Since then, several top pitchers have suffered significant elbow and arm injuries. Atlanta Braves star pitcher Spencer Strider was ruled out for the year after just two starts in 2024. He was forced to have Tommy John surgery to repair his UCL in his throwing elbow.

Of course, this is the same procedure that Shohei Ohtani had at the end of the last season, which is preventing him from pitching in 2024.

Eury Perez and Shane Bieber also needed Tommy John surgery at the beginning of April. Bieber made two starts this season while Perez did not take the mound at all.

The list doesn’t stop there either.

Despite not being scheduled for Tommy John, Gerrit Cole has yet to take the mound for the Yankees this season due to right elbow inflammation.

MLB Pitchers Require Tommy John Surgery More Than Ever

Elbow injuries have also been a major concern in the minor leagues, but the rise in Tommy John surgeries among MLB pitchers has caught the attention of front offices around the league.

Since the start of 2023, 91 MLB players have undergone Tommy John surgery.

Eleven pitchers between 2023 and 2024 have needed their UCL to be repaired, including big names like Spencer Strider and Shohei Ohtani.

Below, we take a look at whether the pitch clock can be attributed to the injuries of some of baseball’s best pitchers.

MLB MLB % Change
Projected 2024 53* 71.0%*
2023 31 10.7%
2022 28 -20.0%
2021 35 20.7%
2020 29 52.6%
2019 19 -32.1%
2018 28 40.0%
2017 20 5.3%
2016 19 -26.9%
2015 26 -16.1%
2014 31 55.0%
2013 20 -44.4%
2012 36 111.8%
2011 17 0.0%
2010 17 -19.0%
2009 21 40.0%
2008 15 -31.8%
2007 22 10.0%
2006 20 17.6%
2005 17

*projected total

Is The MLB Pitch Clock Causing Injuries To Pitchers?

Going back to the start of the pitch clock in 2023, 102 pitchers between the major and minor league have needed the dreaded Tommy John surgery.

Some big names from last year include Jacob deGrom, Shane McLanahan, Sandy Alcantara, and Felix Bautista needed Tommy John surgery last year and have not seen the field in 2024.

In 2022, before the pitch clock was implemented, 88 pitchers between the majors and minors needed Tommy John surgery.

Of the 88 pitchers, only 28 (31.8%) were in the majors.

In 2023, the first season the pitch clock was implemented, 64 pitchers between the majors and minors needed Tommy John surgery.

Of the 64 pitchers, 31 (48.4%) were in the majors.

Finally, with the shortened pitch clock in 2024, 24 pitchers between the majors and minors have needed Tommy John surgery.

13 of those pitchers (54.2%) were in the majors.

As you can see, the percentage of MLB pitchers who have needed Tommy John surgery has sky-rocketed over the past two seasons.

On top of that, 2024 is projected to have a significant number of pitchers that will need Tommy John surgery.

A projection of 53 pitchers in 2024 means that almost two times the number of pitchers will need Tommy John surgery in 2024 compared to 2023.

UCL Tears Have Doubled In MLB Since The Pitch Clock

UCL Tears (All Levels) UCL Tears (MLB)
2024 3 3
2023 8 5
2022 4 1
2021 8 5
2020 4 3
2019 2 1
2018 5 2
2017 6 0
2016 2 2

What has doubled from 2022 to 2023 is the number of UCL tears.

Not only has the pitch clock contributed to players needing Tommy John surgery, but it has also caused an uptick in UCL tears, especially among MLB pitchers.

In 2022, a total of just four pitchers needed their UCL to be repaired compared to eight pitchers in 2023.

Of the four pitchers in 2022, only one was in the majors. Meanwhile, five of the eight pitchers with UCL tears in 2023 were in the big leagues.

In 2024, all three of the pitchers with UCL tears were in the majors, indicating the potential start of a dangerous trend.

Is Velocity A Bigger Cause For Injuries?

In addition to the pitch clock, increasing velocity has compounded the MLB’s newest problem.

Pitchers are throwing the ball harder than ever before with less downtime between pitches.

With pitchers throwing the ball as hard as they possibly can, they are throwing their arms out and the issue has affected some of the game’s top hurlers.

The MLB players union is blaming the pitch clock but the league is blaming velocity.

In reality, it is a mix of both.

Together, increasing velocity and the shorter pitch clock are both contributing to significant injuries to some of the best pitchers in baseball.

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