{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T16:52:08Z","timestamp":1790873528192,"version":"4.1.0"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T00:00:00Z","timestamp":1747785600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2025,5,19]],"date-time":"2025-05-19T00:00:00Z","timestamp":1747612800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["arthroscopysportsmedicineandrehabilitation.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To evaluate the incidence of pitcher injuries 2 years after implementation of the Major League Baseball (MLB) pitch clock.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Injury data were collected for the 2021, 2022, 2023, and 2024 MLB seasons using the\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/fangraphs.com\">fangraphs.com<\/jats:ext-link>\n                      injury database. The incidence rate ratio was calculated to compare the injury rate for the 2024 season with that for each of the 2021, 2022, and 2023 seasons. Data were pooled for the pre\u2010 and post\u2010pitch clock seasons and were compared in similar fashion to the individual seasons using the incidence rate ratio. The\n                      <jats:italic>z<\/jats:italic>\n                      test for proportions was used to determine significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The 2024 MLB season, with 366 overall injuries, showed a decrease in the overall number of injuries compared with the 2021 season, which had 467 overall injuries (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001), and the 2022 season, which had 461 overall injuries (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). The 2024 season, with 61 lower\u2010extremity injuries, showed a decrease in the number of lower\u2010extremity injuries compared with the 2021 season, which had 104 lower\u2010extremity injuries (\n                      <jats:italic>P<\/jats:italic>\n                      = .001), and the 2022 season, which had 87 lower\u2010extremity injuries (\n                      <jats:italic>P<\/jats:italic>\n                      = .03). The 2024 season, with 55 torso injuries, showed a decrease in the number of torso injuries compared with the 2022 season, which had 75 torso injuries (\n                      <jats:italic>P<\/jats:italic>\n                      = .04). The 2024 season, which had 62 flexor tendon\/forearm injuries, revealed a statistically significant rise in flexor tendon\/forearm injuries compared with the 2021 season, with 37 injuries (\n                      <jats:italic>P<\/jats:italic>\n                      = .01); the 2022 season, with 33 injuries (\n                      <jats:italic>P<\/jats:italic>\n                      = .005); and the 2023 season, with 36 injuries (\n                      <jats:italic>P<\/jats:italic>\n                      = .02). There was no statistically significant difference in the number of ulnar collateral ligament operations when the 2024 MLB season (n = 34) was compared with the 2021 season (n = 20), 2022 season (n = 30), and 2023 season (n = 27). When the pre\u2010and post\u2010pitch clock pooled data were compared, there was a significant decrease in overall injuries (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and lower\u2010extremity injuries (\n                      <jats:italic>P<\/jats:italic>\n                      = .004). This comparison also revealed a significant increase in flexor tendon\/forearm injuries (\n                      <jats:italic>P<\/jats:italic>\n                      = .04).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Two years after the implementation of the MLB pitch clock, there was a decrease in the incidence of overall injury rates and lower\u2010extremity injuries. There remained no associated increase in ulnar collateral ligament operations 2 years after implementation. However, the pre\u2010 versus post\u2010pitch clock comparison showed a rise in flexor tendon and forearm injuries in the 2024 season.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level III, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2025.101171","type":"journal-article","created":{"date-parts":[[2025,5,21]],"date-time":"2025-05-21T11:31:18Z","timestamp":1747827078000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":7,"title":["Major League Baseball Pitchers Experienced Increased Flexor Tendon and Forearm Injuries 2 Years After Pitch Clock Implementation"],"prefix":"10.1002","volume":"7","author":[{"given":"Troy B.","family":"Puga","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery Medical City Denton Denton Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"McKenna W.","family":"Box","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Medical City Denton Denton Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winston","family":"Scambler","sequence":"additional","affiliation":[{"name":"College of Medicine Texas Christian University Fort Worth Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hans","family":"Drawbert","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Medical City Denton Denton Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John T.","family":"Riehl","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Medical City Denton Denton Texas U.S.A."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,5,21]]},"reference":[{"key":"e_1_2_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465241262339"},{"key":"e_1_2_2_3_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967120988736"},{"key":"e_1_2_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671221111169"},{"key":"e_1_2_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465221093995"},{"key":"e_1_2_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2015.08.040"},{"key":"e_1_2_2_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967117745021"},{"key":"e_1_2_2_8_2","doi-asserted-by":"publisher","DOI":"10.26603\/001c.39614"},{"key":"e_1_2_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/23259671211027551"},{"key":"e_1_2_2_10_2","unstructured":"JaffeJ. 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Published by Elsevier Inc. on behalf of the Arthroscopy Association of North America.","name":"copyright","label":"Copyright"}],"article-number":"101171"}}