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Advanced Analytic and Pitch-Tracking Risk Factors for Capsulolabral Injuries in Major League Baseball Pitchers.

Michael A Mastroianni1, Morgan R Dillon2, Kyle K Obana1

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Orthopaedic Journal of Sports Medicine
|April 20, 2026
PubMed
Summary
This summary is machine-generated.

Elite MLB pitchers with superior performance metrics like Stuff+ and a more medial release point face a higher risk of shoulder instability requiring surgery. This highlights a trade-off between high performance and injury likelihood in modern baseball.

Keywords:
Statcastbaseballbiomechanicslabrumpitching mechanicsshoulder

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Area of Science:

  • Sports Medicine
  • Biomechanics
  • Baseball Analytics

Background:

  • Shoulder instability is a common cause of disability among pitchers.
  • Advanced pitch-tracking technology enables large-scale analysis of mechanical factors in MLB injuries.

Purpose of the Study:

  • To identify pre-injury advanced analytic and pitch-tracking metrics associated with surgically treated shoulder instability in MLB pitchers.
  • To test the hypothesis that pitchers requiring surgery exhibit distinct pre-injury performance profiles compared to matched controls.

Main Methods:

  • A case-control study matched 35 MLB pitchers who underwent primary capsulolabral repair (2017-2024) with 70 uninjured controls.
  • Pre-injury advanced analytics and pitch-tracking metrics (e.g., FanGraphs wins above replacement, Stuff+, fastball velocity, release point) were compiled.
  • Statistical analysis included unpaired t tests and binary logistic regression to identify risk factors.

Main Results:

  • Pitchers undergoing surgery showed superior pre-injury performance metrics (fWAR, xFIP, xERA, Stuff+, WHIP) and pitch characteristics (velocity, spin rate).
  • A more medial release point was also observed in the surgical group compared to controls.
  • Stuff+ and a medial release point were identified as independent risk factors for surgery; Stuff+ showed a stronger association than velocity or spin rate alone.

Conclusions:

  • Modern advanced analytics and pitch-tracking metrics reveal potential risk factors for shoulder instability in MLB pitchers.
  • Pitchers requiring surgery exhibited higher performance metrics, increased velocity, higher spin rates, and a more medialized release point.
  • Superior performance, particularly high Stuff+, is linked to an increased risk of shoulder instability requiring surgical intervention, suggesting a performance-injury trade-off.