MLB grappling with unprecedented spike in injuries: 'We've never seen an increase like these two months'

Jack Flaherty and Fernando Tatis Jr. very well could have – maybe still will – win the National League Cy Young and MVP awards, respectively.

Yet in a span of less than 24 hours, the St. Louis Cardinals ace and San Diego Padres shortstop suffered oblique injuries, the latest stars succumbing to what can only be described as an unstoppable epidemic in Major League Baseball.

Flaherty tore his oblique muscle during a Monday start at Dodger Stadium; his absence will be measured in months, not weeks. Tatis, 23, was removed with oblique tightness one night later and the cautious maneuver left manager Jayce Tingler “optimistic we caught it before things got bad.”

Tatis has already made two trips to the injured list, due to a shoulder injury, but looks to have dodged a bullet in joining dozens of others to suffer a soft tissue injury – pulls, strains or tears of the hamstring, oblique quadriceps or groin – ravaging MLB one year after a pandemic-shortened season.

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Through May, there were 104 soft tissue injuries that resulted in stints on the IL, a 160% increase over the 48 after two months in 2019, according to Stan Conte, the former trainer for the Dodgers and Giants who now operates Conte Sport Performance Therapy in Arizona and consults for multiple MLB franchises and the league office.

Hamstrings are going haywire – already the most common injury in baseball, they are up 193% since 2019, with 47 IL stints compared to 16 through May 2021.

Adductors are in disarray – there have been 16 groin-related IL trips, compared to two in 2019’s first two months.

And oblique strains and tears are up 83% - from 12 after two months of 2019 to 22 in 2021.

Tatis, who may avoid the IL, and Flaherty are the stars of a group waylaid by the set of core muscles that are so pivotal to a ballplayer’s rotation, be it a batter’s swing or a pitcher’s delivery. Key pieces of other clubs - like Cleveland’s Franmil Reyes, the Yankees’ Luke Voit, Arizona’s Christian Walker and Kansas City shortstop Adalberto Mondesi – have or will be sidelined longer than a month with oblique injuries.

With four-time AL MVP Mike Trout (calf) out until August and two-time NL Cy Young winner Jacob deGrom serving an IL stint due to side and back discomfort, it feels like a star a day is succumbing to injury.

Conte assures you your feelings are valid.

“What you’re feeling is what we’re seeing,” he says. “The increase is real. Whether it will smooth out after these two months? We’ve never seen an increase like we’ve seen these past two months.

“The why is a little bit tougher.”

Why the flood of injuries?

There’s an obvious culprit: A 2020 season that saw players ramp up during spring training in February or March, then return home for four months as the COVID-19 pandemic interceded, followed by an abbreviated “summer camp” in July and then a 60-game season.

The winter months, presumably, should have provided “some sort of reset” for ballplayers, says Conte, though the 12-month rhythms many have lived for more than a decade – physically, mentally, emotionally - were undeniably disrupted.

“Clearly, elite athletes know how to condition themselves, but this was unprecedented,” says James Gladstone, head of sports medicine at New York’s Mount Sinai Health System. “The whole last year really threw people off; in part, injuries may be a result of that.

“Obviously you assume that most, if not all professionals are using the offseason to recuperate, rejuvenate and rebuild. We’re talking about the physical here. The psyche of pretty much everyone in the world was affected by this COVID pandemic. It’s hard to directly correlate the two sometimes, but I think there’s some kind of connection.

“I wouldn’t be surprised that the whole environment plays a role in it.”

The injury flood is particularly curious given how teams regard players as assets, have deeper benches of strength and training coordinators and better technology to monitor it all. Professional sports are now a 12-month endeavor, with athletes investing in their own bodies to maintain peak performance and, in the case of baseball, report for spring training finely tuned.

Gladstone does not believe overtraining is to blame.

“Certainly, if you’re fatigued, you’re prone to injury,” he says. “But with all the testing and the way they’re looked at and monitored, I think that part can now be controlled a lot better. What may play a role is sometimes muscle conditioning.

“If one muscle (say, a quadriceps) is overdeveloped and another (the hamstring, for instance) isn’t as developed, you’re more prone to injury. Mismatches in terms of the muscles that work together or against each other certainly plays a role.”

Load management

Conte was the San Francisco Giants’ head athletic trainer from 1993-2006 and served in similar capacities with the Dodgers from 2006-2015. His finger remains on the pulse of high-impact training in the analytics age, and wonders – while clarifying he has no answer – if players are taking too many repetitions in the batting cages and bullpen mounds, which now double as pitch-design and swing-plane laboratories.

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Injuries are rising at a time load management and frequent days off for core players are front of mind for every franchise.

“They have a hard time defining what workload is,” says Conte. “A hitting coach told me that one thing he saw was the number of swings players take before the game – swinging so much to try to get their swings down, you wonder if they fatigue due to workload prior to game action.

“When people look at workload, they may disregard practice. Are bullpen sessions max-effort pitches or sub-maximal pitches? We’re pretty good about getting the epidemiology down. There’s lots of great research out there. But the why always eludes.”

It’s not for lack of trying. Teams are constantly tinkering with player routines at spring training, giving players multiple days off in succession or holding stars out of games altogether well into mid-March.

While the oblique remains ever-vexing, Conte says the industry has reliable data on the whos and whats of the injury: Hitters suffer 55% of oblique injuries, while 45% are pitchers or due to throwing. More than three-quarters occur on a player’s lead side – the left side of a right-handed hitter or pitcher as they rotate into their pitch or swing.

But how to prevent it? That’s an answer that can’t come soon enough for teams like the Cardinals.

“It’s going to be awhile for it to heal,” Cardinals manager Mike Shildt said in announcing Flaherty’s diagnosis. “Wish I had a crystal ball for that. It’s a real strain, tear, significant enough that Jack is going to miss some time.”

Flaherty was off to an 8-1 start with a 2.90 ERA and 1.03 WHIP; hard for the Cardinals to imagine they’d do much differently in hindsight.

If they’re looking for a culprit, Conte has an idea, albeit decidedly unscientific.

“2020,” he says, “is great to blame everything on.”