Are pitchers’ severe elbow sprains rarer in Japan than in MLB? If so, what is the principle issue, how might context lead to different outcomes on different sides of the Pacific, and what do these say about the future of these injuries in Japan, especially for those pitchers here who throw really hard?

Could it be that Japan is doing something right that MLB might learn from? These questions were posed recently by my podcast partner, John E. Gibson (@JBWPodcast).

One of the advantages of being independent of MLB is that Japan does things differently for different reasons. Thirty years ago, Japan was different in that complete games were still expected from every regular starting pitcher, and it was not uncommon to see a really good pitcher in a high run context throw 140 to 150 pitches three times over a 15-day span until his career was essentially over at the age of 30.

Japan is no longer an outlier in that department, but it is an outlier with a fairly fossilized six days between starts, with the starting pitcher showing up to practice the following day to make sure everything is intact, and then taking the next day off.

Travis Sawchik recently published a superb article in The Score, titled, “Velo vs. Injury: Is there a better way for pitchers?“

Sawchick found minimum velocities in MLB are rising faster than maximum velocities, suggesting more maximum-effort pitches. He also stated that 37 percent of the pitchers on active MLB rosters have had Tommy John surgery.

I actually do have the material on hand in the form of html files needed to learn whether a similar phenomenon is happening in Japan, but need to write some code to capture it, so I’ll pass on that for a moment and simply make some obvious points.

1. Severe elbow sprains that call for surgery are indeed rarer in Japan. I checked every active pitcher the first week of this season to see if he had a published record of surgery to repair an elbow ligament sprain.
2. Dr. James Andrews, who has just retired from a career that included repairing elbow sprains, said recently that the current epidemic in America is not limited to professional pitchers, and that most of the surgeries performed, either Tommy John or his cousin “the brace,” are on high school and college pitchers.
3. Dr. Kozo Furushima, who has performed a huge number of Tommy John surgeries in Japan, said surgeries on Japanese college pitchers are also increasing rapidly.

Japan’s TJ frequency

I went through the active pitchers for the first week of this season, and counted 143 pitchers who were whose pro careers essentially started in Japan – this includes SoftBank’s Livan Moinelo, since his pro experience in Cuba was extremely limited before playing in NPB and his teammate, Carter Stewart Jr., who turned pro here.