Pitchers Are Creatures of Habit. A Season of Chaos Is Testing Them.

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Of all the elements that make baseball distinctive, nothing compares to pitching. In what other team sport does the most influential player spend most of the schedule resting? Training for the treacherous job of throwing overhand repeatedly, at high speeds, requires careful calibration and strict routines.

And then there is 2020, when quarantined pitchers are firing baseballs into hotel-room mattresses to stay loose.

“I lined up the mattress, I set up chairs to act as hitters, and I would throw for about a half-hour every day, just trying to simulate something, just trying to make sure I was putting some velocity into it so the arm stayed in shape,” said Miami Marlins pitcher Brandon Kintzler, whose teammate, Elieser Hernandez, had the same idea. “Hernandez’s room was next to me, and I know he was doing the same thing, because I could hear the ball bouncing everywhere.”

Kintzler and his teammates were effectively trapped in their hotel rooms for a week after an outbreak of positive tests for the coronavirus tore through the Marlins’ roster after their first series last month, in Philadelphia. The St. Louis Cardinals, too, hunkered down in their Milwaukee hotel for five days after their own outbreak on July 30. Jack Flaherty threw baseballs into his mattress, Adam Wainwright into his pillows.

Beyond the health risks of the virus itself, the pandemic scrambled the preparation of baseball’s most finely tuned creatures. When Major League Baseball shut down in mid-March, the sport was four weeks into its six-week spring training. Three and a half months of inactivity followed, then teams held three-week summer training camps for a 60-game season that started on July 23.

Somewhat predictably, the early season has been marked by a rash of arm injuries. No type of pitcher has been spared, from rookies like A.J. Puk to the 40-year-old Rich Hill, middle relievers like Tommy Kahnle to closers like Ken Giles. High-profile casualties include Cy Young Award winners (Justin Verlander, Corey Kluber), World Series most valuable players (Cole Hamels, Stephen Strasburg) and Shohei Ohtani, the celebrated two-way player for the Los Angeles Angels.

“Pitchers are a unique breed, and they rely very heavily on getting into the flow, where everything seems to slow down and it just goes exactly right,” said Dr. Anthony Romeo, a former team physician for the Chicago White Sox.

“I think that’s something many pitchers are experiencing this year, that the only normal part of their life is on the pitching mound, and everything else is completely disrupted — how they interact with their teammates, how they travel, how they interact with their families. All of that is a tremendous distraction, and I think it’s really hard for many of these pitchers to get into the flow the same way they’re used to.”

The healthy pitchers have been largely effective, even with the designated hitter now used in both leagues. Through Thursday, M.L.B. pitchers had a 1.262 WHIP (walks plus hits per inning pitched), better than the season-ending WHIP for every season since 1972. The collective earned run average, 4.17 — while in line with 2018, when it was 4.15 — is much lower than last season’s 4.51.

Yet the pileup of injured pitchers is concerning. According to Baseball Prospectus data compiled by The Ringer, there were 30 pitcher arm injuries requiring an injured-list stint through the first 10 days of this season. The previous high for any season in the last decade was 12.

Pitching injuries are common at the start of every season, but Dr. Chris Ahmad, the Yankees’ team physician, predicted on his blog in May that inactivity during the pandemic “may greatly compound and exaggerate the risk factors” associated with the usual rash of early-season Tommy John surgeries. (Kahnle, a Yankees reliever, had the procedure on Tuesday.)

For pitchers, the physical gains they made during the familiar spring training buildup were all but erased by the long layoff.

“It’s not like all of a sudden you bank what you did in spring training 1.0 and you pick up where you left off in spring training 2.0,” said Dr. Keith Meister, the Texas Rangers’ team physician. “It was a pretty diverse off-season for different people in terms of ability to work out or throw. The last level of getting ready for games was those competitive innings, and we definitely didn’t have a lot of those into the lead-up of this season, and that was a concern.

“But you have to be very careful about overanalyzing a very small snapshot. When we look at injuries, we look at them over a three- to five-year cycle.”

To mitigate the risk for this year, most teams have been extremely conservative with pitchers’ workloads, continuing a long trend. Through Thursday, 23 of the 30 major league teams were averaging fewer than five innings per start, taking advantage of the extra depth this season offered by expanded, 30-man rosters to begin the season.

Rosters have since been pared to 28; initially, baseball had planned to reduce the roster size again later this month, to 26, but decided last week to hold off on further cutbacks. The league has taken other measures to reduce the strain on pitchers, holding seven-inning games during doubleheaders and a putting a runner on second base in extra innings to resolve games faster.

But there was no way to fully account for the stress of pitching in real games — even without fans in the stands — after just three weeks of camp. Dr. Meister said the first month of this season would essentially be an extension of spring training, with pitchers continuing to build to top form.

“But sometimes it’s not necessarily just the buildup, it’s the spike in effort,” he added. “Guys will tell you all the time: Once the uniform color changes on the other side of the field, and you’re not throwing live batting practice and intrasquads, all of a sudden everything jumps up.”

The Rangers encouraged pitchers to back off a bit during the layoff, Dr. Meister said, but to try to stay active with regular throwing sessions. Wes Johnson, the Minnesota Twins’ pitching coach, said he wanted his starters to stay in a “holding pattern” by working four-inning simulated games throughout the break, with relievers throwing two bullpen sessions — one long, one short — per week.

“But muscle capacity goes up the more you take on, and that’s really hard to replicate when you are throwing sim games at an indoor facility or in a wide-open park,” Johnson said. “So I think that’s some of the challenge. We had some guys built up, but you just can’t replicate adrenaline and having a real hitter in the box.”

While pitchers navigate this strange season, the bigger questions may come next year. If baseball gets back to its usual six-month grind, what happens to prospects who missed a full year of games because the minor league season was canceled? Can veterans safely resume their usual workloads after a big drop this year? What about young pitchers, or those coming off injuries, who had hoped to reach certain innings thresholds this season?

The mystery of the pitching arm — that fickle, fragile, fantastic apparatus that makes baseball so beguiling — is about to get more complicated, and even the experts wonder what comes next.

“We’re trying to get a hold of how to manage that — and to be completely honest with you, we don’t know yet,” Johnson said. “I don’t think anybody knows. There’s not a manual for this one.”

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