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Steven Matz’s shoulder injury is a reminder that no one knows how to prevent arm injuries

We’ve come so far, and yet we still know so little.

Arizona Diamondbacks v New York Mets Photo by Rich Schultz/Getty Images

Steven Matz pitched a great game against the Padres a couple of weeks ago, taking a no-hitter into the eighth inning before giving up a one-out single to Alexei Ramirez. Terry Collins took the base hit as his cue to lift Matz from the game—an apparently sensible-enough decision, given that Matz’s pitch count was at 104 and he was only five days removed from a start in which he threw a career-high 120 pitches.

After the game, Collins, invoking the long, dark teatime of Johan Santana’s high-pitch-count no-hitter, expanded on his thinking: “I’m not going to sacrifice this kid’s next year for one more inning...especially when you know he’s getting tired and that’s when injuries are going to occur, once you start to get fatigued.”

Matz, for his part, seemed to at least partially attribute his strong performance to the very fact that he had thrown more in his previous game. After the 120-pitch game, Matz reportedly approached Collins and said, “I needed that.” Then, after his one-hit, 104-pitch game against the Padres five days later, Matz said, “I think it’s good when you get deep into games because you get a little tired have to have better command of your pitches...I think it helps you a lot.”

Matz missed his next start in San Francisco with shoulder discomfort. An MRI revealed rotator cuff irritation, and the Mets placed him on the disabled list, from which he’s expected to return on Thursday.

One could be forgiven for feeling exasperated by all this. Despite all good intentions and the seemingly reasonable practices of stretching Matz out a bit and then handling him conservatively, his shoulder flared up and has keep him off the mound at a time when the Mets desperately need their players in top form.

What happened here? There’s the bone spur in Matz’s elbow: Could that have affected his delivery somehow and caused the shoulder problem? Was 120 pitches too much? Did Matz sleep on his arm funny or high-five a teammate too hard?

This is just the thing: No one actually knows what caused the problem. Plenty of smart and otherwise rational people will point to the bone spur—or to the 120-pitch outing, or to Matz’s injury history, or to their Armchair Doctor YouTube Certificate in Kinesiology—and position themselves as experts on the likely causes of this latest injury. Some of these prognosticators may actually be right.

And yet, here, now, in the second decade of the 21st century, when we have CRISPR and cloned animals and ears being grown on lab rats, no one knows for certain how Matz’s injury could have been prevented, let alone the countless devastating arm injuries that have assailed pitchers over the years. All we know for sure is that, as a group, pitchers get hurt an awful lot, except for the ones who don’t.

Luck and chance will always loom large in baseball. One could do a reading of the game through the lens of chance: freak injuries, games won and lost on a bad hop, dominant teams pruned off in the early rounds of the playoffs, etc. In this consideration, things like batting and fielding practice could be viewed as attempts to assert control over outcomes that would otherwise be unduly influenced by luck.

One hopes that baseball will eventually find a way to wrest injury prevention in pitchers from that realm—or, more accurately, from the realm of ignorance, where good health is chalked up to good luck, and the true causes of injuries are obscured by speculation and glossed over with good intentions.