Major League Baseball Pitchers Experienced Increased Flexor Tendon and Forearm Injuries 2 Years After Pitch Clock Implementation

Q3 Medicine

Arthroscopy Sports Medicine and Rehabilitation Pub Date : 2025-08-01 DOI:10.1016/j.asmr.2025.101171

Troy B. Puga D.O., M.B.A., M.P.H. , McKenna W. Box M.D. , Winston Scambler B.S. , Hans Drawbert M.S., M.D. , John T. Riehl M.D.

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Abstract

Purpose

To evaluate the incidence of pitcher injuries 2 years after implementation of the Major League Baseball (MLB) pitch clock.

Methods

Injury data were collected for the 2021, 2022, 2023, and 2024 MLB seasons using the fangraphs.com injury database. The incidence rate ratio was calculated to compare the injury rate for the 2024 season with that for each of the 2021, 2022, and 2023 seasons. Data were pooled for the pre- and post-pitch clock seasons and were compared in similar fashion to the individual seasons using the incidence rate ratio. The z test for proportions was used to determine significance.

Results

The 2024 MLB season, with 366 overall injuries, showed a decrease in the overall number of injuries compared with the 2021 season, which had 467 overall injuries (P < .001), and the 2022 season, which had 461 overall injuries (P < .001). The 2024 season, with 61 lower-extremity injuries, showed a decrease in the number of lower-extremity injuries compared with the 2021 season, which had 104 lower-extremity injuries (P = .001), and the 2022 season, which had 87 lower-extremity injuries (P = .03). The 2024 season, with 55 torso injuries, showed a decrease in the number of torso injuries compared with the 2022 season, which had 75 torso injuries (P = .04). The 2024 season, which had 62 flexor tendon/forearm injuries, revealed a statistically significant rise in flexor tendon/forearm injuries compared with the 2021 season, with 37 injuries (P = .01); the 2022 season, with 33 injuries (P = .005); and the 2023 season, with 36 injuries (P = .02). There was no statistically significant difference in the number of ulnar collateral ligament operations when the 2024 MLB season (n = 34) was compared with the 2021 season (n = 20), 2022 season (n = 30), and 2023 season (n = 27). When the pre-and post-pitch clock pooled data were compared, there was a significant decrease in overall injuries (P < .001) and lower-extremity injuries (P = .004). This comparison also revealed a significant increase in flexor tendon/forearm injuries (P = .04).

Conclusions

Two years after the implementation of the MLB pitch clock, there was a decrease in the incidence of overall injury rates and lower-extremity injuries. There remained no associated increase in ulnar collateral ligament operations 2 years after implementation. However, the pre- versus post-pitch clock comparison showed a rise in flexor tendon and forearm injuries in the 2024 season.

Level of Evidence

Level III, retrospective cohort study.

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美国职业棒球大联盟投手在使用投球钟2年后，屈肌腱和前臂损伤增加

目的评估美国职业棒球大联盟（MLB）投球钟实施2年后投手受伤的发生率。方法使用fangraphs.com伤病数据库收集2021、2022、2023和2024赛季MLB的伤病数据。发病率比的计算是为了比较2024赛季与2021、2022和2023赛季的伤病率。收集了球场时钟前后赛季的数据，并使用发病率比以类似的方式与单个赛季进行比较。采用比例的z检验来确定显著性。结果美国职业棒球大联盟（MLB） 2024赛季总受伤人数为366人，与2021赛季总受伤人数467人（P < 0.001）和2022赛季总受伤人数461人（P < 0.001）相比，总受伤人数有所减少。与2021赛季的104例下肢受伤（P = 0.001）和2022赛季的87例下肢受伤（P = 0.03）相比，2024赛季的下肢受伤人数为61例，下肢受伤人数有所减少。2024赛季有55人躯干受伤，与2022赛季的75人躯干受伤相比，躯干受伤的数量有所减少（P = 0.04）。2024赛季，有62例屈肌腱/前臂损伤，与2021赛季的37例相比，有统计学意义的屈肌腱/前臂损伤增加（P = 0.01）；2022赛季，33人受伤（P = 0.005）；2023赛季，36人受伤（P = 0.02）。与2021赛季（n = 20）、2022赛季（n = 30）、2023赛季（n = 27）相比，2024赛季（n = 34）尺侧副韧带手术次数无统计学差异。当比较前后的数据时，总体损伤（P < 0.001）和下肢损伤（P = 0.004）显著减少。该比较还显示屈肌腱/前臂损伤显著增加（P = 0.04）。结论美国职业棒球大联盟投球钟实施两年后，整体损伤率和下肢损伤发生率均有所下降。术后2年尺侧副韧带手术未见相关增加。然而，前后对比显示，2024赛季屈肌腱和前臂损伤增加。证据水平：III级，回顾性队列研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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