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Pitcher Reports to Pain and Suffering

St. Louis flamethrower Alex Reyes, the no. 1 pitching prospect in baseball, just became the latest victim of the sport’s spring training Tommy John trend

(Getty Images)
(Getty Images)

On Monday, St. Louis Cardinals pitchers and catchers reported to spring training. On the same day, Baseball Prospectus published its annual “Top 101 Prospects” list, where one of those Cardinals pitchers, 22-year-old right-hander Alex Reyes, ranked first.

Despite a second career marijuana suspension that delayed the start of his minor league season, Reyes made the majors last August and threw 46 innings split between the bullpen and the rotation, recording a 1.57 ERA. As with any non-full-time reliever running a mid-1.00s ERA — Clayton Kershaw excepted — we can caveat that number until it looks less exceptional, citing an unsustainable strand rate or an abnormally low home-run-per-fly-ball figure. But imperfections aside, the big picture was pretty impressive: Reyes debuted in the big leagues before he turned 22 and struck out more than a hitter per inning while facing well-above-average batters. He threw hard and surrendered soft hits. Among pitchers who threw at least 100 four-seamers as a starter, his 96.7 mph average velocity in that role ranked eighth; among relievers who threw at least 100 four-seamers, his 98.1 mph average velocity in that role ranked 10th. And among pitchers who allowed at least 100 batted balls tracked by Statcast during the regular season, Reyes allowed the lowest batted-ball speed, 84.9 mph.

There was a lot left to work on: the erratic delivery that yielded too many walks; the lack of a pitch that could get ground balls. But because Reyes’s four-seamer, changeup, and curve all had the potential to be close to the best in their class, watching him work out the kinks was bound to be one of the season’s best MLB.TV entertainments. His development was also crucial to the Cardinals, whom FanGraphs projects to be on the cusp of a wild-card berth, and for whom Reyes was tentatively slotted in as the fifth starter.

Instead, the young pitcher — who already had a 2013 elbow strain (with accompanying platelet-rich plasma treatment) and a 2015 shoulder flare-up in his history — is adding a more serious entry to his medical record. Last week, Reyes experienced elbow discomfort while throwing, which he told the team about before his scheduled physical. Instead of joining the rest of the staff on the field for the spring’s first official workout, the righty spent part of his Tuesday sliding into and out of an MRI tube. After reviewing the results, he and the Cardinals confirmed Wednesday morning that Reyes will require Tommy John surgery to repair a complete tear of his right elbow’s ulnar collateral ligament, which will sideline him until 2018 and leave Michael Wacha (a surgically repaired pitcher himself) as the leading contender to bring up the rotation’s rear.

As Baseball Prospectus wrote in its book blurb about Reyes, “putting a pitcher at the top of your national list is the kind of risk-lover’s high a prospect writer could normally only get from splitting tens against a six.” For now, that risk seems to have backfired, as Reyes will follow in the surgical footsteps of the only other two pitchers to be ranked first by BP, eventual Tommy John victims Matt Moore and Stephen Strasburg.

Reyes’s early-onset elbow woes make him the Cardinal in the coal mine. Two years ago I used injury data collected by athletic trainer Corey Dawkins (formerly of Baseball Prospectus and now of Baseball Injury Consultants) to determine whether elbow injuries that culminate in Tommy John surgery are more likely to occur — or at least to come to light — at certain times of the year. Last time, I looked at Tommy John surgeries performed on MLB pitchers from 2005 to 2014; this time, I’ve added 2015 and 2016, enlarging the sample to 12 years and 243 surgeries.

The graph below shows the percentage of TJ-precipitating injuries that cumulatively occurred in each calendar month over that span. With the exception of rare cases where players went on the disabled list and had surgery almost simultaneously, this doesn’t mark the months when the surgeries took place; this marks the months when the pitchers first missed time with the injuries that kept them out of action until they recovered from their Tommy John surgeries. A future refresh of this graph would record Reyes as a February loss, no matter when he goes under the knife.

The graph reveals that spring training and the start of the regular season are minefields for serious elbow injuries. March alone accounts for close to 30 percent of all injuries that lead to UCL replacements and is also a bad time for pitcher injuries that lead to other surgical procedures. I noted in 2015 that the tendency toward preseason UCL tears seemed to be intensifying, with 36 percent of 2012 to 2014 TJ surgeries tracing their origins to March. That trend has continued in the past two years, which saw 35 percent of TJ operations originate in March. No wonder, then, that when we read about hard-throwing Noah Syndergaard’s strength gains, we fret about his already overtaxed arm and hope he’s intact in April.

There are two primary reasons for spring training’s disproportionate toll. The first is that the ramp-up from a winter of relatively light activity to pitching to MLB batters (even in exhibition games) subjects the body to unusual stress. Even if a player is diligent about his offseason training, it’s difficult to re-create those conditions in a low-stakes trip to the gym. Teams can try to reduce risk by tinkering with workout plans and relying on light early workloads to ease pitchers into spring training, but there’s probably no way to eliminate the casualties during the transition from winter to spring. As Chris Geary, chief of sports medicine at the Tufts University School of Medicine, told me in 2015, “I don’t think you’re ever going to completely reach a point where you say, ‘All right, the number of injuries in March is the same as the number of injuries in June.’”

The second source of March’s inflated total is unpublicized (and often undisclosed) injuries from the previous year. Although these TJ-inducing-injury numbers exclude players who go on the DL in March or April because they’re still trying to return from a previous injury that made them miss time, not every injury is widely known or acknowledged. If a player feels a twinge in his elbow toward the end of a season or over the winter, he may keep quiet, banking on rest to restore him to health. But if the pain is still present in spring training, he can’t pretend that it’s going to go away on its own. “That happens all the time,” Stan Conte, then the Dodgers’ vice president of medical services, told me in 2015. “We get calls a lot of times in January saying, ‘Jeez, this thing just isn’t better.’ And we say, ‘Uh, what thing?’ ‘Oh, the thing that bothered me in September that I didn’t tell you about. I just figured it would get better over the offseason.’”

The timing of Reyes’s injury appears to be a product of use, not concealment: Although he had suffered a partial tear in the past and had pitched through flexor pain, an arm exam in January “found no evidence of additional damage,” according to Post-Dispatch Cardinals beat writer Derrick Goold. When Reyes undergoes the procedure, which could happen as soon as Thursday, he’ll join a long line of exciting and prominent pitchers whose seasons have been spoiled by serious elbow injuries before they began, including Carter Capps in 2016 (an unusually light TJ year); Yu Darvish and Zack Wheeler in 2015; Kris Medlen, Jarrod Parker, and Patrick Corbin in 2014; Daniel Hudson and Dylan Bundy in 2013; Joakim Soria and Ryan Madson in 2012; and, particularly poignant for Cardinals fans, Adam Wainwright in 2011. (Not that they needed him.) History suggests that Reyes is just the first to fall in baseball’s annual spring reaping.

The start of spring training doesn’t bring back baseball, which won’t begin in earnest for another six weeks. It’s a reassuring ritual, the week when the local news runs B-roll of players touching their toes under sunny skies to mark the moment when we know we’ve made it through the thick of the winter without succumbing to boredom or falling through the roof of our barn. It’s also the point at which our offseason hopes run into reality. Sometimes, anticipation is sweeter than the season itself; for Reyes, reporting became the worst kind of anticlimax.

Thanks to Corey Dawkins for research assistance.