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Millions, Medicals, and Maybes: The Maddening Art of Assessing Player Health

By Zack Scott | March 10, 2025 at 11:58pm CDT

Zack Scott, former Mets Acting GM and four-time champion with the Red Sox, empowers sports operations and individuals to win through Four Rings Sports Solutions. He specializes in data-driven strategies and leadership development. His Sports Ops Launchpad helps aspiring sports ops pros break into the industry. Connect with him on LinkedIn here.  Zack will be contributing periodically to MLB Trade Rumors. 

As Florida’s Grapefruit League approaches its halfway point, Yankees and Mets fans are already venting their fury. Prized offseason pitching acquisitions Sean Manaea and Frankie Montas are injured before even throwing a regular-season pitch for the Mets. Yankees ace Gerrit Cole is also hurt and facing the prospect of possibly missing the entire season.

Having given Montas and Manaea a combined $109MM, the Mets faithful want to know how the team doctors green-lit those deals. Likewise, Yankees supporters question what Cole’s physical exams missed after the Bombers convinced him not to opt out and walk away from the $144MM left on his deal.

As a former baseball executive, I’ve fielded those same frustrated queries. Forecasting player injury risk involves far more art than science, often leaving teams and fans dissatisfied. I hear these complaints frequently since I live in the NY metro area and contribute to SNY’s weeknight show, Baseball Night in New York.

There’s rarely a satisfying answer because the assessment process is highly imperfect. Every veteran pitcher has wear and tear if you look hard enough. Acute injuries occur after the fact. Let’s examine how it typically works, its key flaws, and some ways it could be improved.

The Current (Flawed) Process
When a free agent agrees to terms, the deal is almost always contingent on a physical. The team’s medical staff examines the player, including clinical evaluations, strength and flexibility tests, and MRI imaging of joints like shoulders and elbows for pitchers.

Experts from across the organization weigh in with opinions that a head athletic trainer or performance director synthesizes into an overall risk rating for the GM. For trades, it’s a similar review of medical records, but there’s no in-person exam.

There are several issues with this approach:

• Doctors and trainers interpret MRI findings differently
• Individual expert biases color the assessments
• Lack of standardized, objective metrics
• Siloed information without enough collaboration
• Over-reliance on a single organizational voice
• Underutilization of advanced data analytics

In this high-stakes environment, a process reliant on human judgment is open to significant error.

A System Ripe for Abuse
Valid, complete information is critical for proper risk assessments. However, in this ultra-competitive industry, teams are motivated to gain edges wherever possible, sometimes unethically.

When I was with the Red Sox in 2016, we traded top pitching prospect Anderson Espinoza to the Padres for Drew Pomeranz. Our medical staff reviewed the records San Diego shared and signed off on the deal.

After Pomeranz reported, we discovered he was managing multiple health issues that were not disclosed to us. ESPN reported that the Padres instructed their athletic trainers to maintain two sets of files—one for internal use and a sanitized one for trade purposes. While MLB never divulged details, they investigated and concluded there was wrongdoing. GM A.J. Preller was suspended for 30 days (Take that, wrist!).

The incident eroded trust so much that any subsequent transactions with the Padres were thought to need additional vetting by a third party. It exemplified the system’s vulnerability to exploitation and dependence on clubs exchanging information in good faith.

From Biased Experts to Big Mistakes
Even when injury records are complete, human bias and error can still lead teams astray. As the Mets’ Acting GM before the 2021 season, I explored signing veteran starter Rich Hill. Our medical team reviewed his records and strongly recommended against the move, given his age and injury history. While I had reservations about the assessment, I ultimately decided to heed their advice and pass on Hill.

In retrospect, that was a mistake. Hill signed with the Rays for a reasonable $2.5MM and gave them nearly 100 solid innings. When we traded for him that July, I learned Rich was understandably frustrated that our medical assessment was pessimistic months earlier.

I called Rich to clarify the situation and take responsibility for the decision. While our assessor likely took a conservative approach, as the GM, I had to own the final call. This experience reinforced how these assessments can vary based on the individuals and organizational histories involved. Years prior, former Mets performance staff members took bullets, rightly or wrongly, for player injuries, influencing the current staff to take a more risk-averse approach.

Moving forward, I pushed our group to focus more on objective data and collaborate across silos to mitigate individual biases. We had to balance risks with potential rewards and understand that perfect prediction is impossible. Judgment calls wouldn’t always work out, but we needed to approach them with discipline, openness, and the bigger picture in mind.

That same month, we selected Vanderbilt pitcher Kumar Rocker 10th overall in the draft. After the pick, we did a deep dive into his medicals, which included multiple expert opinions. Despite Rocker’s talent, we ultimately decided not to offer him a contract due to the high perceived risk. A year later, the Rangers drafted Rocker third overall and signed him for $5.2MM. Two teams evaluating similar information came to opposite conclusions. Rocker is now a top-50 prospect, excelling in the minors. Our assessment was clearly wrong, and it cost us at least a valuable trade chip and potentially a frontline starter. That’s how impactful these judgments can be.

Finding a Better Way Forward
To reduce costly human bias and error, MLB and individual clubs must evolve to a more data-driven, objective methodology. Some suggested improvements:

MLB should:

• Standardize protocols for medicals, physicals, and imaging
• Mandate sharing of training and biomechanical data
• Use validated tools to assess psychological factors

Teams should:

• Leverage AI and machine learning to analyze images (e.g., MRI) and predict injury risk
• Develop personalized biomechanical and kinetic player models
• Improve collaboration between medical, performance, and analytics staff
• Have subjective evaluators predict outcomes (e.g., innings pitched) and assign confidence scores

By taking these steps and focusing on hard data while still valuing expert insights, teams can optimize the art and science of this process. It won’t be perfect but will be significantly better than current practices.

Progressive teams are already moving in this direction, and others are sure to follow as they recognize the competitive advantages it brings. Smarter, more precise health forecasting is the future of player acquisitions. Hopefully, fans will soon have more confidence in the medical evaluations that drive roster decisions.

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131 Comments

  1. iffster

    3 months ago

    Ridiculous

    3
    Reply
    • Van Lingle Mungo

      3 months ago

      Why? Makes perfect sense to me.

      13
      Reply
      • Fever Pitch Guy

        3 months ago

        Van – Agreed!

        This was a great article by Zack, and it’s encouraging to hear changes are coming that will hopefully prevent at least some of these instances where players are hiding injuries prior to signing huge contracts.

        In the meantime, MLB should immediately implement in-person exams and MRI’s when a player is acquired via trade.

        And medicals should be available to all MLB teams PRIOR to the draft for all potential first round draft picks.

        29
        Reply
    • nukeg

      3 months ago

      The article is an interesting read from a GM perspective. The real problem is *why* these injuries are occurring so frequently. No other word to use than “overuse”.

      I played in college (90s) and the offseason was basketball games and frequent cage work. But very little throwing.

      Now my son is playing baseball in high school and these kids are playing year round. Pitchers have maybe 1 month off (at most). Look no further than overworked players and their overworked arms.

      16
      Reply
      • Fred2023

        3 months ago

        “No other word to use than ‘overuse.'” Interesting. I think it’s the “Can I throw 105” mentality much more than “overuse.” In the olden days, every single pitch from 5 years old to 45 years old wasn’t an attempt to break the sound barrier. Now a days, it is. You also have the fact that the entire kid culture has turned away from physical effort such as playing outside with one’s friends to watching mindless twaddle on a computer screen or TV or handheld timewaster. “Forearm strain” is a byproduct of such button pushing too. Johnny Sain — the other half of “Spahn and Sain and pray for rain” — said when he was a pitching coach that his pitchers learned to pitch by pitching. They had outrageous IP numbers but were for the most part very successful. Perhaps the answer is to teach “pitching” – changing speeds, etc. — instead of “use.”

        2
        Reply
    • 17dizzy

      3 months ago

      Pitchers and players from back in the days of Bob Gibson, Don Drysdale, Warren Spahn. Juan Marichial and even Nolan Ryan —- those individuals, on the first day of Spring training, showed up in shape well enough —- on their first start —- they could throw 9 innings if they needed to do so.

      Spahn and Marichial both pitched 16 innings in the same regular season game!! The Giants and Juan Marichial were the winners!!!
      (Google it!!).

      Now —- a pitcher is “considered a Starter” if he can throw 5 Innings in a regular season game!!! (Bob Gibson and Warren Spahn would call them a pansy!!)

      All those players had long Careers!!! Check out Stan Musial, Willie Mays, Hank Aaron, and even Players from the 80’ and 90’s.
      When they hit Camp —- they were ready —- both Physically and Mentally tough!!!

      Now —- In the Days of the Multi-Million Dollar players —-
      Once a Player signs their “big contract” and have their lifetime “millions”!!! ——-

      Those players could care less if they begin the season in top physical shape or not!!!

      The reason???
      Because they are going to get their lifetime money and be set for the rest of their life whether they play Baseball or Not!!!

      Spring Training 2025 is a Prime example of that!!!!

      In 2025, There has been more career threatening injuries ——- muscle strains, muscle pulls, ligaments strains and tears, hip, knee, elbow and shoulder damage than I’ve seen or heard of in my 74 years!!!!!

      Why —- If a Major League Manager told their superstar players and their friends that they were going to do challistentics (sp) — then jog a mile to build up their legs and breathing ——- the fist week of Spring Training before they played a game ——
      The millionaire’s would file a lawsuit against the manager and the club!

      Weights and weight Machines are nice. But —
      It takes a lot more than just them to keep their bodies in the tip top shape they need to be in —- year around.

      6
      Reply
      • believeitornot

        3 months ago

        It is couldn’t care less. Could care less means that someone cares.

        8
        Reply
      • Sid Bream Speed Demon

        3 months ago

        Easy to list the stars but back then when your arm would be injured and you’d go from 90 to 78 there weren’t surgeries that could fix that, you were just done.

        2
        Reply
        • Fever Pitch Guy

          3 months ago

          Sid – They weren’t done, quite often they became a successful finesse pitcher.

          As one example read up on Frank Tanana.

          vintagedetroit.com/tanana-lost-his-fastball-but-fo…

          1
          Reply
      • Travis M. Nelson

        3 months ago

        Pitchers didn’t have to throw max-effort basically all the time tog et batters out in those days. Take a look at a typical lineup back in the mid 60s, for example. You mentioned Bob Gibson. Take a look at the 1965 Cardinals, a perfectly mediocre, 80-81 team. Gibson won 20 games while pitching 299 innings at age 29, right in his prime.

        But their lineup had *one* guy who hit more than 20 homers, and only three guys with an above average OPS. Last year 77 different players hit at least 20 HR in MLB. Yes, batting averages are down, but the consequences of a mistake are a lot more severe. Pitchers don’t feel they can let up or they’ll get knocked around, and usually they’re right.

        4
        Reply
      • JoeBrady

        3 months ago

        a pitcher is “considered a Starter” if he can throw 5 Innings
        ==========================
        That’s by design. Bob f’in Gibson had the same issues as today’s starters.

        Gibson 2024 SPs
        1st PA .578 .696
        2nd PA .605 ..727
        3rd PA .653 .761

        Gibson’s decline to the 3PA is slightly more pronounced (.075) than today’s starters (.065). The difference is that baseball recognizes the value that RPs provide. The average RP today is much better than an SP facing a batter for the 3rd time.

        3
        Reply
        • whyhayzee

          3 months ago

          The Gibson stat needs context. In the early innings, games tend to be close, pitchers need to keep the game close. If you’re pitching with a lead a bit later in the game, it’s a different situation. The Gibsons and Seavers pitched plenty of shutouts. They could get you out that third time if they needed to do it. But with a good lead, they’re not going to worry as much about a couple extra hits.

          I agree on the average relief pitcher being better but those guys get about 60 effective innings per year. You don’t want to use them up if you don’t have to do it. Of course, same goes with starters. So you need lots of “junk” innings from young unestablished relievers and retreads. Save your blue chippers for the close games.

          1
          Reply
    • Major League Baseball Fan

      3 months ago

      iffster making a giant contribution to the comments. Thank you so much.

      I mute all passive aggressive dopes in the comments. Congratulations.

      1
      Reply
    • seth3120

      3 months ago

      Coles injury should be considered business as usual. Anybody you sign who throws 95+(much less 100+) you should figure a 12-18 month stint without them. There are some players who are legit pansies and won’t play through anything but most players play through more than we ever hear about I think we should tone down the aggression on player injuries. How much a guy gets paid has no bearing on how he’ll fair injury wise

      Reply
  2. James Midway

    3 months ago

    Makes me more in awe of Nolan Ryan and how he was able to take care of himself even before a lot of the modern treatments and methods.

    15
    Reply
    • BlueSkies_LA

      3 months ago

      Yeah, if you could only bottle and sell luck, imagine the price you could get.

      6
      Reply
      • el_chapo_

        3 months ago

        It’s called weed…

        1
        Reply
      • hiflew

        3 months ago

        I wouldn’t call it luck considering Ryan is only the most extreme example. There were a lot more pitchers like Carlton, Seaver, Blyleven, Jenkins, Perry, Sutton, Koosman, Kaat that were able to pitch far more than modern pitchers with relatively few injuries. Perhaps instead of subscribing to “modern treatments” we should go back to the type of preparation and treatment they did way back when.

        3
        Reply
        • DroppedThirdStrike

          3 months ago

          It was called pitching at 80% for 80% of the time, and modern hitters would feast on those pitches if they tried it now.

          The guys you named are the ones who were good enough to get away with it. Everyone else would have an ERA in the 7s if they tried to get crafty with 88 mph fast balls and a curve/change repertoire.

          What they need are modern ways to develop pitchers so that their arms are built up from youth to handle what they throw now as adults.

          4
          Reply
        • hiflew

          3 months ago

          That is 100% conjecture. There is no way to know how modern hitters would do against a Mike Witt or a Dave Stieb or a Joe Niekro or a Frank Tanana or any other random pitcher from the 70s and 80s that was NOT a HOF pitcher. I believe that the free swinging modern hitter might run into a few fastballs, but they would end up walking to the bench with their head down just as much. Pitchers back then knew far about control than they do now.

          1
          Reply
        • BlueSkies_LA

          3 months ago

          I’m feeling like maybe you didn’t read the article very carefully. It’s all about the highly unpredictable nature of sports injuries.

          1
          Reply
        • JoeBrady

          3 months ago

          DroppedThirdStrike
          It was called pitching at 80% for 80% of the time,
          =======================
          There is no way to prove it, but I’d bet that you’re right. Gibson had a K-BB% of 11.1%. In 2024, there were 126 pitchers with 100 IPs. Only 25 had a % of 11.1 or worse. I’d eyeball their average ERA as about 4.50.

          It’s a different game, so maybe you can get away with nothing but location. But certainly today, you have to be ble to strike guys out.

          1
          Reply
    • fightcitymayor

      3 months ago

      It was less about Nolan Ryan taking care of himself, and more that he possessed a singular assortment of biomechanics that let him pitch very hard for a very long time without ruining his frame. Back in his heyday they did a biomechanic study of him and came away basically saying he was a unicorn.

      15
      Reply
      • DroppedThirdStrike

        3 months ago

        I remember that. Dude said he never even had a sore arm.

        1
        Reply
      • MartialArtisan

        3 months ago

        Yeah they’ve done studies on Ozzy Osbourne to see how he survived all those years of dru…er, being married to Sharon.

        2
        Reply
  3. Oddvark

    3 months ago

    It sounds like if all of the recommendations are followed and a team decides not to sign someone based on this new-and-improved confidence score and that player goes on to have a healthy, productive season, that will prove that the new system is terrible.

    At least that’s what the dumb Rich Hill/Kumar Rocker examples suggest.

    Reply
    • Sid Bream Speed Demon

      3 months ago

      Terrible? Hyperbole much? You would have to look at the time frame that matches the contract years you were negotiating for a comparison to do you any good. So if you are negotiating a three year deal (Hill likely was not) or a five year deal like Atlanta had with Jeff Hoffman until they didn’t like his physical, so he ended up signing elsewhere on a 3 year deal at less AAV. If the shoulder was the concern, and after 5 years he was fine, then they made a mistake.

      The Hill and Rocker examples weren’t dumb, a lot of people like to get real examples from people involved. Why such a sourpuss?

      7
      Reply
      • Oddvark

        3 months ago

        The Hill and Rocker examples are dumb because they aren’t evidence of anything but are presented as proof of a broken system. OMG, the team’s medical evaluators thought 40-year-old Rich Hill was a high risk of injury/underperformance but he actually pitched 100 solid innings the next season. That doesn’t mean the assessment was some big mistake. There will always be a range of future outcomes and the fact that Hill happened to have a decent season is virtually meaningless as far as determining whether the system is broken.

        The same is true for Kumar Rocker, especially since he is comparing his performance a year later and when a smaller contract amount was at issue.

        I’m also generally not a fan of results-oriented analysis. You should consider whether a decision was poorly reasoned at the time it was made, not based on whether the results happened to fall on one side or the other of a range of possible outcomes.

        And if you want to make an argument that the system is broken based on past evaluations, give me some statistics that demonstrate it, not just anecdotal evidence that is proof of nothing. Or tell me something that was incorrect about the assessments of Rich Hill or Kumar Rocker at the time they were made, or at least something that was wrong with the processes followed to make those assessments, not just that if you knew the players were going to perform the way they did you might have made different decisions.

        All that being said, of course improvements can and should be made to medical evaluations. The article just seems to demonstrate poor reasoning.

        2
        Reply
        • Sid Bream Speed Demon

          3 months ago

          He gave two personal accounts of things that ACTUALLY happened. It wasn’t anecdotal. He went to great pains to mention that all teams do things differently.

          Not being a fan of results-oriented analysis is probably something you shouldn’t tell anyone. It’s kind of dumb.

          It just seems like you are needlessly contrarian on the subject, and it doesn’t make any sense.

          2
          Reply
        • Travis M. Nelson

          3 months ago

          Listing two things that happened to you can still mean they’re anecdotes. They’re instructive examples, I think, but they’re not a full set of data.

          I appreciated that he offered them, and that he took responsibility for them, though I think in both cases they were defensible positions.

          Rich Hill, coming into 2021, had not made 30 starts or pitched over 135 innings in a season since 2007(!) Even if he looked completely healthy, there was every reason to be skeptical that he could suddenly be productive for a full season at age 41. Sometimes people surprise you. It happens!

          Rocker had some issues in his medical exam, and to date has pitched a total of 75 innings in three seasons . He had shoulder surgery in 2022 and Tommy John surgery in 2023. They were right! That example should be *vindication* of the Mets’ concerns, not an example of how wrong they were!

          3
          Reply
        • Oddvark

          3 months ago

          I’m proud to do my best to evaluate the quality of decisions based on the information available at the time the decisions were made and to not use 20/20 hindsight as the primary evaluation. Doing otherwise is a fool’s errand in my opinion. But you do you.

          And the more I think about his anecdotes– and yes, they are andecdotes; anecdotes are things that actually happened (and your trying to contrast anecdotes in the way you did suggests that you don’t know what “anecdote”/”anecdotal evidence” means) — I’m more convinced that they don’t support his main argument about flaws in the process of medical evaluations. They are fine examples of how teams may deal with risk tolerance differently — under his leadership the Mets apparently had less risk tolerance than the Rays with respect to Rich Hill and arguably the Rangers exhibited more risk tolerance with respect to Kumar Rocker (though the circumstances had changed so it’s not even clean evidence of that).

          But nothing about those examples points to anything flawed with the process of medical evaluations, unless his argument is that everyone should come to the same conclusions about an unknowable future and how they should deal with that uncertainty, and if they don’t something must be wrong. That’s not to say that the process shouldn’t be criticized, just that his examples didn’t really strengthen his case. They were more noise than signal.

          His example about the Pomerance/AJ Preller situation was a good one, as it actually described a flaw in the system.

          I do apologize for explaining the reasoning behind my criticism of one portion of the article. I guess I shouldn’t be contrarian (even if I have defensible reasons).

          And thanks for explaining to me that anecdotes are different than things that actually happened and that my view about results-oriented analysis is dumb. I’m sure your contrariness to my viewpoints was not needless.

          2
          Reply
        • Fred2023

          3 months ago

          Spot on.

          Reply
    • deweybelongsinthehall

      3 months ago

      Probably out of respect or privacy laws, the article doesn’t mention the times the reviewing saved the team millions. I still can’t believe Preller got just thirty days. He should have gotten at least a year if not a permanent ban.

      10
      Reply
      • Sid Bream Speed Demon

        3 months ago

        Agree on privacy and agree on Preller. Intentionally keeping two sets of files should have been a lifetime ban with the opportunity to appeal years later like Coppy from the Braves. His ban was lifted but no one is foolish enough to hire him. He didn’t do anything that hurt anyone unlike Preller

        5
        Reply
    • BlueSkies_LA

      3 months ago

      Not at all. Just as in baseball as a whole, the science of prediction can only become more accurate. It can never be perfect, because you are dealing with probability not certainty.

      Reply
    • Major League Baseball Fan

      3 months ago

      You lost me at “It sounds…”

      Reply
    • JackStrawb

      3 months ago

      @Oddvark Eh, this wasn’t an attempt to get published in The Lancet, it was a general assessment of the field using a couple of useful examples, an opinion piece that might nudge a more scientific approach or a more scientific reply.

      2
      Reply
  4. mlb fan

    3 months ago

    Sports Teams should always consult with the renowned, leading “doctors” in the MLB Trade Rumors comments section before all major medical decisions. They always employ the benefit of hindsight.

    14
    Reply
  5. PoisonedPens

    3 months ago

    Interesting read. One question that I would ask from this article is if there’s a correlation between medically “progressive” evaluations, as Zack termed it, and on-field success or at least success in minimizing games lost to injury?
    +

    2
    Reply
  6. Dmdmd

    3 months ago

    It is fascinating to hear insider details of these transactions that we read about–I enjoy getting Mr. Scott’s insights and hearing about his experiences in the industry.
    Quick question: what specifically is being referred to when he says MLB should use validated tools to assess psychological factors? Would this be assessing for mental illness? How would such an evaluation be implemented (every player to be evaluated at the start of each season, etc)?

    6
    Reply
    • dirtbagks

      3 months ago

      I am also highly intrigued by the psychological factors used in evaluation and would like to read more on this process.

      2
      Reply
      • JackStrawb

        3 months ago

        Teams already do this informally through scouting assessments of ‘grit,’ and willingness to learn.

        Some teams employ sports psychologists to work with players (though they’re often called something else) and to deliver quiet assessments to the front office, particularly wrt potential draftees and trade and FA targets.

        1
        Reply
    • LGMETS 2

      3 months ago

      Kumar Rocker had surgery after the Mets did not sign him later in September. Scott failed to mention that.

      9
      Reply
      • PoisonedPens

        3 months ago

        Yes, I thought so…wasn’t it elbow chip removal or something like that?

        Reply
    • JackStrawb

      3 months ago

      @Dmdmd I immediately had a picture of a team psychologist conducting a Minnesota Multiphasic Inventory of John Kruk.

      God save us from prospective employers having the ‘right’ to compel something like the MMPI.

      1
      Reply
  7. jammin464_

    3 months ago

    It’s ridiculous that someone like Cole could be given $36 million to do nothing but rehab; I believe with most employers, after a few weeks of inability to work pay is reduced or eliminated. Why shouldn’t they just pay them the league minimum salary or some fraction of their regular salary (whichever is higher). I realize it’s not necessarily the player’s fault he’s hurt, but it’s not the club’s either. NO ONE is gonna starve on the pro-rated league minimum salary ($760,000). Hate to see any club hamstrung financially OR competitively by one injury. BEFORE ANYBODY SAYS SO, YES, I REALIZE THE PLAYER’S UNION WOULD NEVER AGREE TO THIS. Just wanted wanted to throw this idea out there and see the responses.

    5
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    • DerekBellsMoistMoustache

      3 months ago

      Lmao

      2
      Reply
      • deweybelongsinthehall

        3 months ago

        Derek, why? The player also still gets service time. The MLBPA would never agree but it should stop the clock to free agency if the team wants to extend the contract by paying the last year of the contract’s deal for an extra season when the player misses 50% plus of a year.

        2
        Reply
        • DerekBellsMoistMoustache

          3 months ago

          Because you guys keep shooting your argument in the foot. Both of you have stated the union wouldn’t agree. This is a useless thought experiment. Teams are pushing these players to the limit, why would they sacrifice the protections that they have been fighting for since the days of the reserve clause?

          9
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        • jammin464_

          3 months ago

          True, but this site and comments column is actually “a useless thought experiment” as well.

          Reply
        • Steinbrenner2728

          3 months ago

          Thanks for contributing to that ‘useless thought experiment’ with your own useless thought experiment then, jammin.

          Reply
    • Sid Bream Speed Demon

      3 months ago

      You’re not going to get the answers you are looking for because the full contract is guaranteed. I am sure there is language in them for injuries. That isn’t something that your standard non-baseball employees have, a guaranteed contract.

      3
      Reply
    • Fever Pitch Guy

      3 months ago

      jam – Have you ever been on Worker’s Comp? It usually covers at least 67% of the person’s salary.

      Expecting a player with a $35M salary to accept just $760K prorated if he’s injured on the job? No offense, but that’s absurd.

      10
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      • jammin464_

        3 months ago

        I get your point….but it’s MORE absurd to pay hundreds of thousands of dollars for NADA. Besides, the pro-rated $760 is pretty good money for MOST people.

        1
        Reply
        • PoisonedPens

          3 months ago

          “Most people” are not Gerrit Cole or Mike Trout or Ronald Acuna Jr. Also, the average MLB career is 2.7 years.. So “most people” including 99.,9% of players who ever played MLB, don’t make $36M/season.

          Tell it to John Means, who was one of the best pitchers in the AL on a pre-arb salary and has not been the same, nor had the same earning power, since his injury.

          Guys get hurt, it’s part of the factor in signing them. If you had some way for a player to be “guaranteed not to get hurt ever in the life of the contract” there would probably be a substantial bonus attached to that, so that player, instead of making $36M, would probably be offered $52M.

          2
          Reply
    • LordBanana

      3 months ago

      Yeah I’m sure players are going to play REALLY hard knowing they lose 95% of their income the moment they get hurt on the job.

      4
      Reply
    • LordBanana

      3 months ago

      Every owner in the league has enough money to live on the league minimum for over 100 years. If that’s enough money, why don’t they just spend more on the team to make up for the injuries?

      Every owner in the league could add $30 million to their payroll and “not starve”, why is $760,000 enough for the players we pay to watch but not the owners?

      4
      Reply
    • Noah G

      3 months ago

      Because he got injured doing his job.

      1
      Reply
      • jammin464_

        3 months ago

        Fair argument….but what about the times they get hurt when they’re NOT working?

        1
        Reply
    • 82rickey130

      3 months ago

      also would be interested in the the insurance issues…..do teams have insurance on high salaried players in case of injury? If so how does that work? Is there a deductible like w/ other insurances? Does the insurance pay the whole salary or a percentage?

      2
      Reply
      • dclivejazz

        3 months ago

        Teams can get insurance but it is so expensive they often or usually don’t. I don’t know the particulars of how it works when they do, but have heard the policies are individually written on a case by case basis with insurerers like Lloyds of London which insure unique situations, such as high end art, etc.

        1
        Reply
    • Pete'sView

      3 months ago

      jammin464 —

      I think the more realistic approach to the problem you broach is to allow the following season’s contract to be downsized based on empirical performance. (I think this should be mitigate contract status regardless if it’s caused by injury or simple bad production.

      Of course, the Players Union will howl at this suggestion and never allow it to be codified, but there are clearly ways to do this and to base a season salary on the previous year’s performance.

      3
      Reply
      • 82rickey130

        3 months ago

        should be a very interesting off season after the ’26 season with contract negotiations due then…….wonder if vegas will give odds that the season will start late or not at all? I would take that bet !!

        Reply
  8. BlueSkies_LA

    3 months ago

    Interesting reading, but it seems this analysis can be summarized by saying that players fall into two categories: those who have been injured, and those who will be, and predicting when is beyond medical science. As a fan I don’t feel any need to be reassured about this medical evaluation process. I figure the teams are mostly doing what they can to assess risk. They are the ones spending the money, after all.

    7
    Reply
    • Sid Bream Speed Demon

      3 months ago

      Probably the healthiest outlook I have seen on this subject. I am like you, if my teams flags the medical, which happened with Jeff Hoffman and also a few years ago with a first round pick Carter Stewart (I think thats his name) then I assume it was for a good reason. I also assume when they don’t that it’s also for a good reason. Not my money, even though I am sure someone is going to refute that by pointing out ticket costs or baseball TV package costs. I look at those costs the exact same way as going to a movie or having a streaming service, they are for my entertainment. They aren’t an investment.

      4
      Reply
  9. el_chapo_

    3 months ago

    Great article, but if I see the phrase “leverage AI and machine learning “ one more time I’m gonna puke. It’s the most overused quote in vogue today. *insert company name* leverages AI and machine learning to *insert whatever* ITS ENOUGH !!

    7
    Reply
    • LGMETS 2

      3 months ago

      Scott forgot to mention that Kumar rocker underwent surgery on his arm.

      Reply
  10. Zenslinger

    3 months ago

    Thanks to Zack for sharing an inside. Look at the process in such clear terms. One thing I am curious about is how a GM functions when there is the extra layer of a President of Baseball Operations. Is there any finality to a GM’s decision in this case, or are they completely beholden to the PBO?

    1
    Reply
    • JackStrawb

      3 months ago

      Easy to say, but in fact that depends on how their purviews are written out at the time of employment, plus a PBOPs might decide to expand his sphere of responsibility, but a GM is far less likely to be able to do that in most FOs.

      Nearly every PBOPs has final authority, though he’s likely to yield final authority on secondary decisions such as ST NRIs, and the like.

      1
      Reply
  11. dopt

    3 months ago

    What so different today than 50 years ago. Is it plain old throwing volume? Are today’s players not tough enough ? Too many steroids ?
    Today’s analytics make some sense but there are exceptions. Nothing is perfect I guess

    What if you have a good prospect who has dodged bro g on injured list but has structural issues. But goes out and gets out and doesn’t miss time. Sign him or send him to independent leagues ?

    Reply
  12. Captainmike1

    3 months ago

    The most frustrating part are the stupid ignorant health related posts by clueless fans who think they are doctors

    Reply
    • paddyo furnichuh

      3 months ago

      You seem agitated, maybe you would like your PRN now?
      /s

      1
      Reply
      • Captainmike1

        3 months ago

        Agitated? You bet I am agitated

        I estimate 5.3856263 out of 10 on the agitation scale !!!

        I lost 17 minutes of sleep last night over this article !

        Reply
        • Major League Baseball Fan

          3 months ago

          Hey Cap, don’t be frustrated. Be grateful for the entertainment and grateful for the fact that you are not a wannabe doctor in the comments.

          Reply
  13. 3 finger split

    3 months ago

    I like the idea of biomechanics for a pitcher to spot potential flaws in their delivery but the fact of the matter is that throwing a baseball is not a natural function and there are only so many bullets in the gun. You could have a perfect delivery and it still just takes one wrong pitch (grip, mechanics, velocity etc) to blow out your elbow or shoulder. I find it strange that 99% of arm injuries are elbow/TJS as opposed to some years ago when it was almost always Rotator Cuff /Labrum surgery.

    2
    Reply
    • MartialArtisan

      3 months ago

      Pretty soon medical evaluations won’t matter at all. There will be robot umps. Pitchers with cybernetic arms and smart balls, that they will still scratch. AI will take the place of GM’s and managers. Hitters will bat virtually from the dugout. Ghost runners will be actual ghosts (boo ya) and all of this will be to make owners Trillions in place of billions and players will no longer have to worry about injuries because they will be subject to term limits. And this will all happen long before the Dodgers stop paying Ohtani.

      Reply
      • DroppedThirdStrike

        3 months ago

        All that’s happening in 9 years?!

        Reply
      • Major League Baseball Fan

        3 months ago

        And Robot commenters.

        1
        Reply
  14. Mikenmn

    3 months ago

    Interesting article. Personally, I’d like to see a three day “exam” period after mid-season trades where medical exams could take place. Some teams are a little less forthright in their “selling” of players at the deadline. Gamesmanship should stop at injuries.

    Reply
  15. LGMETS 2

    3 months ago

    After the Mets did not sign him, Kumar Rocker underwent surgery in September. Zack Scott failed to mention that.

    1
    Reply
    • bruno202

      3 months ago

      My thought as well.
      Kumar Rocker has thrown 110 innings in the 3 years since he left Vandy. As well as the surgery you mentioned, he had Tommy John surgery in May 2023.
      He performed great in 30 innings in AA and AAA last year.
      Then had 3 MLB starts last year and was not particularly good.
      And he’s had two 1 inning outings this spring and was rocked both times.
      Was it a mistake to not tender him a contract?

      3
      Reply
      • Major League Baseball Fan

        3 months ago

        Rocker was rocked! Excellent post.

        Reply
      • JackStrawb

        3 months ago

        @bruno202 Your criticism is based on 13-2/3 innings.

        Meanwhile the Rangers will have him for 6 years.

        Is there a team in the majors that wouldn’t take Rocker for $5m?

        1
        Reply
  16. kellin

    3 months ago

    Ater the mets did not sign Kumar….

    But honestly, this is yet another really interesting article that brings me back to MLBTR. As a baseball nerd (not super nerd), I find this kind of Wizard of Oz reveal to be thoroughly fascinating. Its nice to actually hear thoughts of what goes on with front offices and decisions for signing players.

    6
    Reply
  17. YankeesBleacherCreature

    3 months ago

    Thanks, Zack! Quite an interesting and look forward to more of your contributions here at MLBTR!

    4
    Reply
  18. Troy Percival's iPad

    3 months ago

    That was a lot of reading I didn’t do to come to the conclusion that Gerritt Cole being allowed to un-opt-out was Brian Cashman’s worst mistake to the tune of 4/$144 and Triston Casas can’t be expected to be healthy until he actually does so for multiple seasons so they might as well trade him straight up for Dylan Cease or *insert Mariners Starter here*

    Reply
  19. Blah blah blah

    3 months ago

    why would anyone ever make a deal with AJ Preller again, given what he did? How did he earn trust back?

    3
    Reply
    • Major League Baseball Fan

      3 months ago

      As a Mets fan, I hear this! When is the last time the Mets acquired any player from Preller/San Diego?

      Reply
    • JackStrawb

      3 months ago

      Interesting, that Preller got 30 days, whereas Eppler got a year in baseball jail.

      3
      Reply
  20. Joe It All

    3 months ago

    I could be wrong but I honestly think the reason you see more players injured today instead of years ago has to do with the amount of money teams have invested in them. Years ago teams would let players play through small nagging injuries but now if anything looks wrong, even if it’s minor, players are being held back from playing for fear of something small turning into something major.

    Reply
    • Fever Pitch Guy

      3 months ago

      Joe – It’s not minor injuries we are talking about here.

      It’s the major injuries, the TJS and the Stantons Elbows and the Casas Ribs.

      Without question I do agree these are contributing factors:

      1) Excessive weightlifting
      2) Excessive pampering of pitchers
      3) Excessive max velocity
      4) Excessive spin rate

      5
      Reply
      • This one belongs to the Reds

        3 months ago

        Fever – exactly. Even in my day, late 80s/early 90s, pitchers never threw max velocity every pitch. In fact, pitchers were taught to vary their fastball and other pitches to throw off timing.

        2
        Reply
        • Fever Pitch Guy

          3 months ago

          Reds – That is a fantastic point, the change in velocity screws up the hitter’s timing.

          Heck I’m old enough to remember Wakefield relieving Pedro …. imagine going from a Pedro fastball to a Wakefield knuckler …. then imagine a similar change in speed happening within the same AB!

          3
          Reply
      • FoulTipper

        3 months ago

        Fast twitch muscles can only stay fast twitch up to a certain point.. Using weighted baseballs might lead to injury even using heavier weights could also cause it.

        Reply
  21. Moff_Nick

    3 months ago

    Funny that its 9 years later and this guy still has an axe to grind against preller. Worth noting that the guy the padres got back in that deal was also damaged goods and needed TJ soon after, but nobody talks about that part.

    2
    Reply
    • foppert3

      3 months ago

      No surprise. Deliberate deception like that is a dog act.

      Reply
    • Padre Rob

      3 months ago

      As memory serves, Espinoza would wind up having TWO TJ surgeries.
      One almost right after the Red Sox complaint was filed.
      The irony, Pomeranz had an All-Star year that season and had a really, really good season the following year.
      I’m thinking the author of this ‘article’ isn’t revealing the same level of maleficence with the Red Sox FO (of which, he admits, was a part of).

      Reply
  22. iffster

    3 months ago

    Whatever happened to PLAYING the game? This is why today’s game turns me off. Why be a serious fan when this kind of stuff dominates baseball talk. Somebody hurt? Next man up. Play the damn game and keep these people who are more concerned with off the field junk ($$$)…away from me. Give me the box scores and let the sofa jockeys worry about the other stuff. (Yes I am an old -ucker)

    Reply
    • zippytms

      3 months ago

      You have the right to skip past articles like this if you don’t find the topic interesting. This page has much more to do with “off the field junk” than anything else, so maybe find another place to browse.

      6
      Reply
    • momTurphy

      3 months ago

      It was a couple of “old -uckers” who taught me the data approach. That’s what baseball is supposed to be. Plenty of time between each pitch to discuss each and every facet of the game (and life) to its most minuscule details. If you don’t like one conversation go join another.

      2
      Reply
  23. The Raven

    3 months ago

    I would like to see a baseball world where salary for injured players does not count against the tax threshold. Injuries happen in this era, but because some teams have set financial limits, getting a second chance to buy a replacement player can help them.

    1
    Reply
    • Major League Baseball Fan

      3 months ago

      The Dodgers have enough advantages.
      Hard stop on this idea.

      Reply
  24. foppert3

    3 months ago

    As I understand it, the NFL partnered with GE in developing CTE diagnostic software for their MRI data. MLB might have to throw them some cash to work on an elbow system.

    1
    Reply
    • JackStrawb

      3 months ago

      @foppert3 It would be remarkable if the smarter MLB front offices didn’t already have the latest AI software to assist with imaging diagnoses, given the money at stake—or at the least that their radiologists of choice didn’t have access to such software as a precondition of employment with teams..

      1
      Reply
  25. HalosHeavenJJ

    3 months ago

    Very cool look behind the curtain at a process we don’t generally hear a lot about.

    There’s also a lot of unknown data out there, particularly with draft signees. A kid might have only started a dozen games for his high school team, but how many innings in travel ball, all stars, etc? And how long were they?

    3
    Reply
  26. Troy Percival's iPad

    3 months ago

    Look at it from another perspective.

    Remember Ed Figueroa threw about 1,100 innings in a 4 year span and was out of baseball like 2 years later? With a grand total IP of like 1,300?

    Guys “didn’t get hurt” back then because “they got hurt so bad that they retired and you never again heard anything about them.”

    A contributing factor to the increase in injuries is the fact that medical technology is so advanced that guys can come back from a blown knee/shoulder/elbow. Even if they’re back at only 60%, that is phenomenal compared to 50 or even 20 years ago.

    Reply
  27. Grady Sizeless

    3 months ago

    Pitchers pitch at the limit of human capability, with high-tech assessments to bring them as close as possible to the line beyond which the body breaks down. It’s inevitable that pitchers all too often cross the line, driven by the insane competitiveness all these guys feel or desperation to keep a career going, or to finally reach the pot of gold. Fans remember the tiny handful of pitchers who had long careers, not the hordes whose careers were cut short.

    2
    Reply
    • JackStrawb

      3 months ago

      @Grady Sizeless Exactly. The user car lots of America in the 1930s to the 1980s were littered with the arms and dreams of terrific sandlot and college pitchers whose elbows and shoulders and ligaments had been shredded by the absurd dream of a rotation with 4 starters going 270 innings each.

      I always point to some of the great teams in history who had NOTHING like the fantasy rotations of 4 x 40 with 20 CG each. Take the 1939 Yankees: one starter with 200+ innings, none with as many as 30 starts–not a one.

      Or the 1954 Yankees: Maxed out at 28 starts and 210 innings. Second highest GS was Eddie Lopat with 23. 1975 Reds? Two starters with 32 starts each and 210 and 208 innings, no one else with more than 190 ip or more than 26 starts. The ’76 Reds were very similar to the ’75 incarnation.

      1
      Reply
  28. momTurphy

    3 months ago

    The insights in these articles are incredible. Love reading them. But nothing like an article filled with common sense, expert analysis, and facts to bring out the folks who want to watch guys throw a million innings of 60mph fastballs.

    2
    Reply
    • JackStrawb

      3 months ago

      @momTurphy And without doing any research or thinking at all whine about the good old days when teams could destroy without let or remit the arms of young pitchers then just shrug and move on to the next guy when the first blew up.

      Continuing from my comment upthread,

      St. Louis Cardinals:

      —1946 WS winners, 2 starters w/ more than 19 starts.

      —1934 WS winners, 2 starters w/ more than 26 starts

      —1931 WS winners, more like the conventional malwisdom wrt old-time starters, but still only one starter with more than 28 starts, and only one starter with more than 212 innings.

      The past is rarely what we think it is.

      2
      Reply
      • momTurphy

        3 months ago

        One of my favorite quotes is “nostalgia isn’t what it used to be.”

        1
        Reply
        • JackStrawb

          3 months ago

          That’s a great one.

          1
          Reply
  29. Smuckles

    3 months ago

    Some genius is gonna have AI review Shane McClanahan’s elbow MRI and recommend giving him a $700m contract

    Reply
    • Major League Baseball Fan

      3 months ago

      After Tyler Glasnow trades his left elbow for McClanahan’s right elbow. Efficiency!

      Reply
  30. IronBallsMcGinty

    3 months ago

    I think a lot of the young pitchers are over throwing trying to make a big impression. Not only to get to the bigs but stay there which is very demanding. Unfortunately, more often than not, turns out to be a career altering decision.

    1
    Reply
    • JackStrawb

      3 months ago

      It’s more that—most things being equal—a lot of young pitchers know that if they don’t put the maximum velocity, torque, and spin on most of their pitches, teams (from youth leagues on) will go with pitchers who will go all out.

      Young pitchers also know that the first TJ surgery is practically a rite of passage.

      1
      Reply
  31. FoulTipper

    3 months ago

    Who discovered this Sweeper and Gyro slider? This thing has to be taught many different ways. I know the guy who started it and he even has cool cues that only he talks about. I got this information from a ML pitcher who throws it. It’s secretive and has been since he said 2018.

    1
    Reply
  32. FoulTipper

    3 months ago

    I hear about all these different ways throwing the sweeper, it’s obvious that’s an issue. It’s like when you were a kid throwing a curve ball, the kid who just spun it sideways always got injured and was shot by high school.. There’s multiple issues causing injuries like weighted baseballs but you cant throw a ball the way I hear on these videos I see all the time.

    Reply
  33. FoulTipper

    3 months ago

    Mostly the scouts had radar guns in the 1970’s and 80’s. A 10 year old kid then was learning how to pitch and wasn’t blowing his elbow out trying to impress someone.

    Reply
  34. FoulTipper

    3 months ago

    The cutter and split finger are the two most vulnerable on the arm any serious pitcher knows that. Fastball and circle change are the 2 that aren’t going to get you injured.
    From all the videos I watch the Sweeper is the taught wrong the most. If you paid attention to who started it he has the perfect cues and just assisted Brent Strom all 2024 season. That’s part of the problem MLB needed to come out and say there’s a traditional slider thrown like this and there’s a sweeper, Gyro thrown like this. That’s the problem. They should be fired and hopefully soon will.

    1
    Reply
  35. FoulTipper

    3 months ago

    Rest never hurt a pitcher. You throw 150-180 pitches don’t touch a ball for 4 days and day 5 you do it again. That was normal since the beginning of baseball. In the off season take a few months off and start throwing a month before spring training. Too many people that never pitched calling the shots. Imagine an analyst saying no sliders today go with the changeup and the pitcher that day wasn’t feeling the changeup. Baseball is a mess.

    1
    Reply
  36. MBAFranko32

    3 months ago

    Amazing article. Instead of denaturalizing the game with silly rules, Manfred and the MLB should worry about fixing the game itself.
    This is proof that the game needs fixing ASAP ….for the love of the game.

    1
    Reply
  37. frisbees

    3 months ago

    Too many doctors know little about pitching.
    Too many inexperienced coaches know little about proper pitching form.
    Too many analysts know little about competitive sports.
    Too many GMs hire unqualified personnel.
    Too many owners can’t get the right answers.

    1
    Reply
  38. Old York

    3 months ago

    MLB teams are significantly underutilizing the financial markets’ risk modeling techniques in player health assessments. Wall Street firms analyze risk using stochastic modeling, Monte Carlo simulations, and predictive analytics, yet MLB still relies heavily on subjective medical opinions and inconsistent data-sharing.

    Right now, teams with better predictive risk models could exploit the gap by buying low on undervalued, “high-risk” pitchers before their stock rebounds. If MLB embraced true quantitative risk analysis, they could eliminate costly medical misreads (like passing on Kumar Rocker or misjudging Montas/Manaea).

    The next competitive edge will come from treating players like hedge funds treat assets, not just as baseball talents.

    1
    Reply
  39. 66TheNumberOfTheBest

    3 months ago

    Great article.

    Reply
  40. The Saber-toothed Superfife

    3 months ago

    Cole.
    How could they NOT know?

    Even I knew.

    Reply
    • JackStrawb

      3 months ago

      I knew when they let him ‘forget’ his opt-out and brought him back for 4/144m.

      ZIPS at fangraphs had Nestor Cortes’ projected to pitch slightly better than Cole, with an ERA around 3.45 in 153 innings pitched for Cortes.

      This is all on Cashman. Even before the TJS news he signed the slightly worse pitcher using 2025 projections, while dealing the slightly better pitcher for a closer when closers couldn’t all find deals this offseason.

      Cole + Williams

      OR

      Cortes + $36m a year for four years.

      To choose the former is an obvious blunder, even before the TJS news.

      1
      Reply
  41. The Saber-toothed Superfife

    3 months ago

    What would you do for a Klondike bar?

    Most people would throw their arms off – for just the minimum salary…. or no?

    Guys arms are being overworked simply because they are competing for MILLIONS OF DOLLARS.

    Is that hard to figure out?

    I am quite surprised owners haven’t used it as an excuse – to lower salaries. “We are doing it to protect themselves from themselves”!

    1
    Reply
    • JackStrawb

      3 months ago

      At the same time, look at hitters. When you have guys the size of Brett Baty taking reps at 2B and when MLB is incentivized to juice the ball as much as they can get away with (2019 comes to mind), anything less than going all out is going to end with pitchers getting smoked, sitting on ERA’s around 8.00.

      The only way to compensate is to soften the ball or move the fences out another 30 feet, but what are the chances MLB will consciously cut down on home runs and make crafty pitching and 7-inning starts the norm?

      1
      Reply
  42. FoulTipper

    3 months ago

    I assisted a ML pitching coach in the national league all of 2024. I have a list of pitches that are weaker and easier to hit than others and a list of pitches that are easier on the arm to tougher on the arm based on common sense and injuries. Ex. a Fastball is easier on the arm than a cutter.

    Reply
  43. iffster

    3 months ago

    Baseball = throw, catch, hit, run. Try it.

    Reply

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