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Major League Baseball’s Injury Epidemic

by Sox On 35th Contributors

Outside of “Sticky Stuff,” one of the main topics of discussion among baseball fans this past season was injuries. As is with the entire league, the White Sox had a large number of injuries, unfortunately affecting the core. With these injuries, the game missed out on some of its biggest stars, like Mike Trout being out a majority of the season.

While injuries have always been a part of the game, it was more pronounced in 2021. I am focusing on comparing 2021 to injury rates of past seasons, as well as possible reasons behind these injuries and the economic cost.

The Effect of the COVID-19 Season

Before I get into how or why they are occurring, I want to bring up injuries from the 2020 season as well. Taking out COVID-19 IL stints, the injury rate per 1000 exposures was almost twice the amount of 2019 [1]. This shows that 2021, the first full season since 2019, was not the first one to have a ton of injuries. The type of injuries that were happening were interesting as well. In 2020, there was almost double the amount of upper extremity, or shoulder, upper arm, elbow, forearm, and hand injuries [1]. This statistic is huge because it tells us that pitchers had a ton of arm injuries, which is bad for their careers and the teams they play for. Tommy John surgeries leave players out for 12+ months, making them miss full seasons of their careers and costing them earnings. In fact, elbow and forearm injuries more than doubled from 0.74 to 1.55 per 1000 [1].

As for the current season, I believe it is an after-effect of 2020. While players had a quick increase in workload from shutdown to Summer Camp to the regular season, it was also a substantially less workload than previous seasons. Then the workload went back up to a full 162 games after playing 102 less last season. An easy way to understand this is when a pitcher is drafted. In their first full season, the athlete is usually limited in innings pitched. The reason is that they have only pitched maybe 50 innings in high school or 80-100 in their college season. When they go to the full MiLB season, they play a significantly higher amount of games. Coaches will let them throw maybe 20-30 more innings the next season after being drafted before letting them loose for 150+ in their following seasons.

Why is this Happening?

The reason behind injuries is of course, multi-factorial. This also is not complete, since if we knew everything about injuries there would not be any. Some of the main factors are overuse or fatigue, improper ramp-up period, and “freak” accidents. The first 2 reasons are the main ones we see. Especially for pitchers, throwing too much in a time period, as well as not having enough time to prepare the body for the demands of a baseball season is how shoulder and elbow injuries happen. Those types of injuries are typically wear and tear, in which the muscle, tendon, or ligament sustains micro-tears over time and finally ruptures. Fatigue is a huge factor, especially when it comes to pitchers’ elbows. The muscles in the forearm can protect the ligament on the inside of a pitcher’s elbow by absorbing the force and stabilizing the joint against forces that cause stress on the ligament. This is why when we see news of flexor muscle strains, fans get worried as it is seen as a precursor to Tommy John surgery. The last reason I mentioned includes injuries like Eloy Jimenez‘s Pec tear when jumping for a ball at the wall, or general collisions with other players in the field.

Improper Ramp-Up Period

When the 2020 season started back up in July, the players only had about 3 weeks of Summer Camp to prepare for the 2020 season. While this is about as much as normal spring training, the players were coming out of quarantine in which they had little to no access to the team weight room facilities or baseball facilities. From March until July 1st, there was little they could do to keep their bodies prepared to play.

Economic Cost

The cost of these injuries goes both ways, for the players and teams. For the entire league, 835 players were put on the IL, including for COVID-19 protocols. While the players still earn their contracts while on the Injured List, the teams pay for no production. The total player salary cost for IL stints in 2021 was over $833M [2]. The owners are not the only ones losing out on lost production, however. Many players have incentives in their contracts. These incentives can be based on games played or placing in certain positions for awards like MVP, Cy Young, Silver Slugger, etc. So while players may be earning their contract while injured, they miss out on millions more in other areas. This could also factor into players that are arbitration-eligible. Without production, players in arbitration are subject to lost income in the following years that they may have played well enough for a larger salary.

What this meant for the White Sox in 2021

The White Sox had 23 total players on the IL in 2021, 22 if you take away Dylan Cease‘s 3-day COVID stint [3]. As we know, the team’s core, such as Luis Robert, Eloy Jimenez, and Yasmani Grandal, was heavily affected by injuries. This left the team without 3 of its best players. In total, White Sox players missed a combined over 1,200 days and cost the team almost $18M for those missed days [3]. What I want to do is pick a couple of players and give my thoughts on the specifics of what I think caused their injuries, as well as address the hamstrings.

Pullin’ Hammies

The first thing you notice when looking at the team’s injuries is the number of hamstring strains. The White Sox had 8 total hamstring injuries with a few spanning much longer than the minimum 10 days. The hamstring muscles are the primary group that flexes the leg. It is a powerful group of muscles but can be injured quite frequently. The hamstrings are highly activated in sprinting, throwing, and hitting, which are all high-speed movements. If the muscles are not strong enough to handle the load, or it is stretched or contracted too fast, it can become strained.

Luis Robert

This one was one of the higher-profile injuries. Robert tore his hip flexor muscle while sprinting to 1st base. When the leg is swinging back during a sprint, the hip flexors become stretched. The simplest reason I have for this is that his hip flexors were not strong enough to handle the stretch during the sprint. The only other reason is that he may not have had built up sprinting enough. Although, that is not likely in my opinion since it happened in late May. He had Spring Training and the entire month of April in which he was sprinting enough to build up his body’s capacity.

Yasmani Grandal

Grandal missed almost 2 months after surgery for a tear of one of the tendons in his knee. Yaz suffered from some knee issues early in the year and it never seemed to go away. It finally culminated in a tear mid-at-bat. I would file this under fatigue, as he played on it throughout the first half o the season with some rest days mixed in. Being a catcher, his knees already take a beating so adding onto it by playing through that pain mostly contributed to this injury.


With this article, you have learned a bit about how injuries can occur. It also shows how many things can factor into an injury, and how it can build up over time.

With all these injuries, I wanted fans, in general, to appreciate how many factors play into it as well as the overall cost to players and teams alike.


  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7970198/
  2. https://www.spotrac.com/mlb/disabled-list/cumulative-player/
  3. https://www.spotrac.com/mlb/disabled-list/cumulative-player/chicago-white-sox/

Featured Photo: NBC Sports Broadcast

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Aaron Sapoznik

There is another cost that was not mentioned in regards to injuries, that of replacing injured players with trades that cost the White Sox prospects and young MLB talent. An example was Nick Madrigal who wasn’t even mentioned in an article that featured key injured White Sox players. The team not only lost their starting 2B for the remainder of 2021 but the front office also felt compelled to deal him along with young reliever Codi Heuer to obtain ‘luxury’ closer Craig Kimbrel for at most 1-1/2 seasons and more likely as a 2-3 month rental. Actually replacing Madrigal at 2B with another deadline trade cost them another prospect, LHP Konnor Pilkington to the rival Indians for yet another potential rental in Cesar Hernandez.

The cost of this young talent will likely only pay off with a 2021 World Series championship, all at the potential expense of multiple years of their assumed core starting 2B, a possible future closer and perhaps an eventual back of the rotation southpaw pitcher. Nobody will be pulling harder for a 2021 White Sox championship than yours truly but if they fall short in that quest the front office will not hear the end of it from me and many other skeptical diehard fans.

Kyle Wood

Thanks for reading and leaving some feedback! I didn’t think of it that way, so I appreciate another perspective. However, I don’t necessarily think if Madrigal was healthy that he would not have gotten traded. They still needed bullpen help and Madrigal was the most expendable player that could get them what they needed. In the end I believe Kimbrel + Cesar are more valuable than Madrigal + Pilkington in the short term, which they are trying to win a world series. I think of it in similar terms to the Cubs trading Gleyber Torres for 3 months of Chapman. Torres has been a very good to great hitter, but the Cubs likely wouldn’t have gotten to the WS without Chapman. I also think Kimbrel will still be around next year. He struggled at first with the Cubs too, I don’t think his struggles after coming from the North Side are too concerning. He gave up 9 ERs in August compared to 4 in September.

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