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

Background: Shoulder instability is a significant cause of disability in pitchers. The advent of advanced pitch-tracking technology now provides an opportunity to investigate the mechanical factors associated with these injuries on a large scale in Major League Baseball (MLB). Purpose/Hypothesis: The purpose of this study was to identify preinjury advanced analytic and pitch-tracking metrics associated with surgically treated shoulder instability in MLB. It was hypothesized that pitchers requiring surgery would demonstrate distinct preinjury profiles in advanced performance analytics and Statcast data compared with matched controls. Study Design: Case-control study; Level of evidence, 3. Methods: tests to compare groups and binary logistic regression to identify risk factors. Results: < 05 for all significant factors). Conclusion: Several modern advanced analytic and pitch-tracking metrics were looked at as potential risk factors for shoulder instability in MLB pitchers for the first time. Pitchers who underwent capsulolabral surgery were more likely to throw harder with higher spin rates and a more medialized release point than matched controls. Overall, MLB pitchers who were more effective and had superior Stuff+ were at the highest risk for shoulder instability requiring surgical intervention. These findings point to a potential trade-off in modern pitching; the pursuit of elite performance is linked to a greater likelihood of injury.